【摘要】 目的 了解低浓度长期二甲苯暴露与职业噪声暴露的联合作用对听力损伤的影响。方法 选择同时接触二甲苯和噪声的495人为混合暴露组，单纯接触噪声的1 032人为噪声暴露组，无噪声和二甲苯暴露史的4 571人为对照组，匹配现场二甲苯浓度和噪声强度结合工龄计算其累计暴露量，比较三组研究对象听力水平，并对结果进行统计学分析。结果 调整潜在的混杂因素后，与未暴露于职业噪声的参与者相比，累计噪声暴露量>85 dB(A)·年的组别听力损失风险显著更高（OR=1.58,95%CI:1.33～1.87），并且在男性中呈现随累计噪声暴露量增加而听力损失风险增加的剂量-效应关系；未观察到听力损失风险随着累计二甲苯暴露量增加而增加；听力损失风险随着累计二甲苯暴露量和累计噪声暴露量增加而增加，累计噪声暴露量>85 dB(A)·年和累计二甲苯暴露量>5 mg/m3·年组别有更高的听力损失风险（OR=2.05,95%CI:1.47～2.86），并且存在显著的剂量-效应关系。结论 二甲苯是听力损失的协同危险因素，且与职业噪声暴露对听力损失有联合作用，应充分考虑复合暴露条件下的噪声作业防护。更多还原

【Abstract】 Objective To understand the effect of combined exposure of xylene and occupational noise on hearing loss.Methods A cross-sectional survey was conducted,including 495 workers exposed to xylene and noise at the same time were selected as the mixed exposure group,1 032 workers exposed to noise alone,and 4 571 workers without noise or xylene exposure history were selected as the control group.The cumulative exposure was calculated by matching the xylene concentration and noise intensity at the scene and combining the length of service. The hearing level of the subjects in the three groups was compared,and the results were statistically analyzed.Results After adjusting for potential confounding factors,the risk of hearing loss in the group with cumulative noise exposure>85 dB(A)·year was significantly higher than that in the group without occupational noise exposure(OR=1.58,95%CI:1.33-1.87),and there was a dose-effect relationship between the cumulative noise exposure and the risk of hearing loss in male workers. It was not observed that the risk of hearing loss increased with the increase of cumulative xylene exposure. The risk of hearing loss increased with the increase of cumulative xylene exposure and cumulative noise exposure. The groups with cumulative noise exposure>85 dB(A)· year and cumulative xylene exposure>5 mg/m3· year have higher risk of hearing loss(OR=2.05,95%CI :1.47-2.86),and there is a significant dose-effect relationship.Conclusion Xylene is a synergistic risk factor for hearing loss,and it has a combined effect with occupational noise exposure on hearing loss. Therefore,the protection of noise exposure should be fully considered.更多还原