勞工聽力損失盛行率調查之先驅計畫聽力檢查及實驗室之標準化

The pilot study on the prevalence survey of the hearing loss among labors--The standardization of hearing examination and laboratory

本研究係為進行現階段國人聽力閾值之常值調查，以為判斷勞工聽力損失參考之前驅計劃。針對勞委會所指定勞工健康檢查醫療院所進行聽力檢查設施調查與聽力檢查之測試。聽力檢查設施調查，由研究者設計調查表，郵寄109家調查醫院自行填寫後寄回。聽力檢查之測試則以同一受測各體前往篩選軟硬體較佳之48家醫院進行聽力測試之標準化工作。所得主要結果：一、聽力檢查設施調查方面1.所使用檢查儀器以一年校正一次為最多，且由儀器商負責校正。2.大部份醫院係使用氣導純音聽力檢查法，測定250，500，IK，2K，4K，8KHz等六個頻率。3.各醫院之檢查人力以配置1人為最多(59.3％)。除醫師外，僅38.7％之檢查人員曾受過訓練。4.大部份(87.9％)為個人檢查室。僅有42.9％之醫院有定期測量室內外噪音。有91.2％之檢查室具有空調裝置。檢查室中有52.7％其面積在1至3坪之間。5.各醫院採行之聽力檢查品管措施，最主要為檢查儀器之定期校正。二、聽力檢查之測試方面1.各醫院聽力測量值一致性之統計結果，有66.18％符合參考值。一致性最高為80.65％最低為27.50％，大部份在60〜70％之間。2.聽力測量值一致性較高的醫院以醫學中心與區域醫院為多。所有調查醫院中有45.8％符合參考值70％以上。

The main purpose of the pilot study was to investigate the hearing threshold among labors in order to determine their hearing loss. The study investigated the hearing examination laboratory equipments and hearing examination process in the 109 hospitals which were appointed by the Council of Labor Affairs to be responsible for the health examination of labors. The hearing examination equipment questionnaire designed by the researcher were mailed to 109 hospitals.The standardization testing of hear-ing examination was done by the same individuals in 48 selected hospitals which had good equipments. The main findings included: 1. The survey of hearing examination equipment: (1) Most hospitals calibrated their examination equipments once a year by instrument manufacturers. (2) Most hospitals adopted air-conducted pure tone hearing examination to test the following six frequencies: 250,500, 1k, 2k, 4k, and 8khz. (3) Most hospitals (59.3%) had one examiner. Only 38.7% of the exam iners (not including physicians) had participated related training. (4) Most laboratories (87.9%) were individual examination laboratories. Only 42.9% of the hospitals periodically examined the noise levels inside and outside their laboratories. In addition, 91.2% of the laboratories had air-condition. The area of most laboratories (52.7%) were between 1 and 3 pings(i.e., l ping is an area of 6 feet square. (5) The main quality control measure done by the hospitals was the periodical calibration of hearing examination equipment. 2. The standardization testing of the hearing: (1) In the aspect of consistence of the hearing examination values, 66.18% of the hospitals matched the reference values. The highest value of consist ence was 80.65%, the lowest was 27.5%; and most ranged between 60% and 70%. (2) The hearing examination values of medical centers and area hospitals had higher level of consistence. Among all the investigated hospitals, 45.8% of the hospitals matched 70% and more of reference values.