环境与职业医学2025，Vol.42Issue(7)：793-799,807,8.DOI:10.11836/JEOM24548
A、C计权峰度调整噪声等效声级在评估职业性听力损失中的作用
Roles of A-and C-weighted kurtosis adjustment for equivalent sound level in evaluating occu-pational hearing loss
摘要
Abstract
[Background]Temporal kurtosis(without frequency weighting,i.e.,Z-weighted kurtosis)can evaluate noise-induced hearing loss(NIHL).However,few studies have considered the function of frequency weighting(A-or C-weighted)kurtosis on NIHL. [Objective]To study the significance of A-and C-weighted kurtosis adjustment for equivalent sound level(L'EX,8h)in evaluating occupational hearing loss. [Methods]A cross-sectional survey was used to select 973 noise-exposed workers in seven industries as the subjects.The noise exposure of all workers was assessed by distributions of A-,C-,and Z-weighted kurtosis(e.g.,KA,KC,and KZ)and respective adjusted equivalent sound level(e.g.,L'EX,8h-KA,L'EX,8h-KC,and L'EX,8h-KZ).The significance of A-and C-weighted kurtosis in evaluating NIHL was evaluated by correlations between three types of L'EX,8h and NIHL,and improvement of noise-induced permanent threshold shift(NIPTS)underestimation predicted by the ISO prediction model(Acoustics-Estimation of noise-induced hearing loss,ISO 1999-2013). [Results]The median KA,KC,and KZ were 68.33,28.22,and 19.82,respectively.The binary logistic regression showed that LEX,8h-KA,LEX,8h-KC,and L'EX,8h-KZ were risk factors for NIHL(OR＞1,P＜0.001).The receiver operating characteristic(ROC)curve showed that when the outcome variable was noise-induced hearing impairment(NIHI),the areas under the curves corresponding to L'EX,8h-KA,L'EX,8h-KC,and L'EX,8h-KZ were 0.625,0.628,and 0.625,respectively.When the outcome variable was high-frequency noise-induced hearing loss(HFNIHL),the areas under the curves corresponding to L'EX,8h-KA,L'EX,8h-KC,and L'EX,8h-KZ were 0.624,0.623,and 0.622,respectively(P＜0.05).The order of underesti-mation improvement values predicted by L'EX,8h for NIPTS1234 was:L'EX,8h-KA(4.68 dB HL)＞L'EX,8h-KC(4.38 dB HL)＞L'EX,8h-KZ(4.28 dB HL)(P＜0.001).The order of underestimation improvement values predicted by L'EX,8h-K for NIPTS346 was:L'EX,8h-KA(7.20 dB HL)＞L'EX,8h-KC(6.83 dB HL)＞L'EX,8h-KZ(6.71 dB HL)(P＜0.001). [Conclusion]The adjustment of A-and C-weighted kurtosis to equivalent sound level LEX,8h can effectively improve the accuracy of the ISO 1999 prediction model in NIPTS prediction,and compared with the C-weighted,the A-weighted kurtosis can improve the result of the ISO 1999 prediction model in terms of underestimating NIPTS.关键词
峰度/频率计权/噪声/等效A声级/噪声性听力损失Key words
kurtosis/frequency weighting/noise/equivalent A-weighted sound pressure level/noise-induced hearing loss分类
医药卫生引用本文复制引用
刘海英,武林杰,李扬,李金哲,辛佳芮,邹华,邱伟,沈彤,张美辨..A、C计权峰度调整噪声等效声级在评估职业性听力损失中的作用[J].环境与职业医学,2025,42(7):793-799,807,8.基金项目
"十四五"国家重点研发项目(2022YFC2503200,2022YFC2503203) （2022YFC2503200,2022YFC2503203）
美国国立卫生研究院(NIH)资助项目(1R01DC015990-01) （NIH）
