台灣男性工作者的年度噪音暴露劑量和聽閾及耳石-前庭功能之相關

Study on hearing thresholds shift and otolith-vestibular function associated with annual noise exposure doses and the in male workers in Taiwan

目標：本研究旨在探究男性工作者年度噪音暴露劑量（ANE）和聽力及前庭功能之相關。方法：我們給予噪音暴露組（NE）51人和對照組（CR）29人，施測純音聽力檢查、頸部和眼部前庭誘發肌電位測驗（VEMPs），並以台灣華語版職業暨休閒娛樂噪音暴露問卷，分別計取得聽力閾值、耳石-前庭功能以及ANE。結果：NE組的平均ANE（85.8 dBA, SD = 5.05）顯著高於CR組（67.9 dBA, SD = 2.93）（p < .001）。聽力方面，ANE和3,000及4,000 Hz純音聽閾有顯著低至中度正相關（r = 0.283-0.385, p < .05），ANE數值越高，此兩個頻率聽閾值則越差。此外，噪音暴露和年齡增長都會加重高頻3,000，4,000，6,000 Hz的聽閾值。兩種前庭肌電位檢查均顯示兩耳間振幅差異比在NE組（cVEMPs: 28.9%; oVEMPs: 26.7%）的異常比例高於CR組（cVEMPs: 17.4%; oVEMPs: 0%），且NE組整體VEMPs異常的風險比是CR組的4.54倍（95% CI [1.33, 15.49]）。結論：年度噪音暴露劑量（ANE）過高的工作者，不僅是噪音型聽力損失高風險族群，其耳石-前庭神經路徑功能檢測異常的比例也較高。建議職場高噪音暴露人員，除監控其聽閾變化，也應關注內耳前庭系統的潛在傷害。

Objectives: This study explores the relationships between personal annual noise exposure doses (ANE), and hearing thresholds, and otolith-vestibular function. Methods: We recruited 51 male workers who had exposed to noise in the past year for the noise-exposed group (NE) and 29 men without noise exposure for the control group (CR). We used pure tone audiometry, cervical and ocular vestibular-evoked myogenic potentials (VEMPs) tests, and“the annual noise exposure questionnaire-Taiwan Mandarin version”to evaluate hearing thresholds, otolith-vestibular neural pathway and the ANE doses, respectively. Results: The mean ANE was higher in the NE group (85.8 dBA, SD = 5.05) than in the CR group (67.9 dBA, SD = 2.93) (p < .001). There were significant low-to-moderate positive correlations between ANE and hearing thresholds at 3,000 and 4,000 Hz, with higher ANE associated with poorer hearing thresholds. We also found that both noise exposure and aging aggravated the high-frequency hearing thresholds (3,000, 4,000, 6,000 Hz). The findings of the interaural amplitude difference ratio showed that percentages of abnormalities for two VEMPs tests were higher in the NE group (cVEMPs: 28.9%; oVEMPs: 26.7%) than in the CR group (cVEMPs: 17.4%; oVEMPs: 0%). Furthermore, the odds ratio of abnormal VEMPs for the NE group was 4.54 (95% CI = 1.33, 15.49) compared to the CR group. Conclusions: The excessively elevated ANE is a strong risk factor for noise-induced hearing loss and abnormal otolith-vestibular function. This research recommends that individuals with high occupational noise exposure should be monitored for their hearing threshold shifts and be aware of the potential damage to the vestibular system.