| ObjectiveTo investigate the hearing loss of noise-exposed workers and its risk factors in automobile manufacturing enterprises.To explore the relationships between hearing loss and blood glucose and the impact factors of hearing loss.To explore the effects of blood glucose,working age and gender in noise-included hearing loss.Methods1628 noise-exposed workers were selected from automobile parts components enterprises in Anhui.The case-control study was applied.The workers whose hearing test results confirmed as hearing loss were selected into the observation group,while whose hearing level confirmed as normal were selected into the control group.The two groups were matched by age.The workers were tested for pure tone hearing and their general information were collected.The variables with statistically significant difference in two groups were taken as independent variables,and the hearing loss was taken as the dependent variable.The risk factors of noise-included hearing loss in noise-exposed workers were analyzed by logistic regression analysis.The relationship between blood glucose and hearing loss in different groups of gender and working age was also explored.Logistic regression model was used to analyze the risk factors of hearing loss.And the additive model was used to evaluate the effect of the interaction between blood glucose and gender on hearing loss.Results1.The relationship between general characteristics and hearing loss.The analysis showed that the difference was statistically significant between general hearing loss group and control group in gender,equivalent sound level,drinking,smoking status(P<0.05);and the difference was statistically significant between high frequency hearing loss group and control group in gender,equivalent sound level,drinking,smoking status(P<0.05),and also between speech frequency hearing loss group and control group in gender,equivalent sound level,marital status,drinking,smoking status(P<0.05).2.The relationship between blood glucoses and hearing loss.The differences were all statistically significant in blood glucose among general hearing loss group,high frequency hearing loss group,speech frequency hearing loss group and control group.The risk of NIHL in men with high blood glucose is 2.152 folds increased compared with that of the normal.And the risk of NIHL among high frequency and speech frequency in men with high blood glucose is 2.292 folds and2.528 folds increased compared with that of the normal,respectively.The difference was not statistically significant in blood glucose between the hearing loss group and the hearing normal group among 0～6 working age group(P=0.099).However,among the working age groups of 6-11 years,11-16 years and over 16 years,the risk of NIHL was 2.234 times,4.111 times and 4 times higher than that in the group of normal blood glucose.The difference was statistically significant in blood glucose between the high frequency hearing loss group and the control group among all the working age groups(P<0.01).Among the working age groups of less than 6 years,6-11 years,11-16 years and over 16 years,the risk of NIHL was 1.801 times,2.105 times,4.259 times and 4.583 times higher than that in the group of normal blood glucose,respectively.The difference was not statistically significant in blood glucose between the hearing loss group and the hearing normal group among over 16 years working age group(P=0.095).Among the working age groups of less than 6 years,6-11 years and 11-16 years,the risk of NIHL was respectively 2.17 times,2.423 times,and 4.143 times higher than that in the group of normal blood glucose.3.The relationship between hemogram index and hearing loss.The analysis showed that the difference was statistically significant beween general hearing loss group and control group in,red blood cell count,,monocyte count,hemoglobin,and blood platelet count(P<0.05);and the difference was statistically significant between high frequency hearing loss group and control group in,red blood cell count,monocyte count,hemoglobin,and blood platelet count(P<0.05),and also between speech frequency hearing loss group and control group in monocyte count,and hemoglobin(P<0.05).4.The multi-factors analysis.The multivariate logistic regression analysis showed that the hyperglycemic,male workers and high noise exposure level had a higher risk of general hearing loss.The monocyte count and the blood platelet count are related to hearing loss.The risk of noise-included hearing loss with the hyperglycemic workers was 1.943 folds increased compared with that of normal blood glucose,and 4.08 folds increased for the men compared with women.The risk of NIHL was 1.036 times higher for each unit increase of equivalent sound level.The high noise exposure level hyperglycemic male workers had a higher risk of high frequency hearing loss.The monocyte count and the blood platelet count are related to high frequency hearing loss.The risk of high frequency hearing loss in the hyperglycemic workers was 1.98 times increased compared with those with normal blood glucose,which was 4.032 times increased in men compared with that in women.And the risk of high frequency hearing loss between the workers with low monocyte count was 0.598 times decreased compared with that in the normal group.The risk of high frequency hearing loss was 1.042 times higher for each unit increase of equivalent sound level.The hyperglycemic,male workers and high noise exposure level had a higher risk of speech frequency hearing loss.The monocyte count and the blood platelet count are related to speech frequency hearing loss.The risk of speech frequency hearing loss among the hyperglycemic workers was 2.562 times increased compared with those with normal blood glucose,while the risk was 3.254 times increased in the hyperglycemic males compared with females.The risk of speech frequency hearing loss was 1.028 times higher for each unit increase of equivalent sound level5.The additive interaction between l blood glucose and gender.The additive interaction between l blood glucose and gender on the general hearing loss,high frequency hearing loss,and speech frequency hearing loss was statistically significant,and the OR value were 8.648,11.313 and 11.020,respectively,and SI value were 2.123,2.518 and 2.208,respectively.Conclusion1.The hyperglycemic,male and high noise exposure level may be the independent risk factors for the workers with high frequency hearing loss and speech frequency hearing loss,while the monocyte count,hemoglobin were related to hearing loss.2.The blood glucose levels are related to working age.With the increase of working age,the workers with hyperglycosemia tend to be a higher risk of hearing loss.3.The male workers with high blood glucose have more risk of hearing loss.There is an additive interaction between male and high blood glucose.4.Considering hyperglycemia may be a risk factor for hearing loss,blood glucose testing is recommended in routine inspection items for noise-exposed workers.Moreover,screening patients with hyperglycosemia,especially among the males,may be the necessary methods for reducing the occurrence of noise-included hearing loss. |
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