铁路机车乘务员听力损失的影响因素分析

发布时间：2018-04-30 05:22

本文选题：机车乘务员 + 噪声　；参考：《中国疾病预防控制中心》2013年硕士论文

【摘要】：背景铁路运输是我国交通运输的重要方式之一,对国民经济、社会发展以及人民生活水平的提高起着重要作用。到2012年底,中国铁路营业里程达9.8万公里,居世界第二位；高铁运营里程达9356公里,居世界第一位。而作为铁路运输中运载工具的铁道机车,是铁路运输中的重要元素。随着近年来经济和科学技术的发展,铁路高速化、轻量化进程不断加速,铁道机车的平稳性和安全性引起了社会的高度重视。随着铁路运行速度的提高,机车产生的噪声问题也尤为严重。噪声对人体的危害很大。噪声对机体的损伤主要表现为听觉系统的损伤,这种损伤具有特异性。噪声不但致聋,而且还可以对机体造成非特异性损伤,如引起头晕、头痛、耳鸣等症状。噪声也会影响铁路机车司乘人员的正常作业,使人反应迟钝、工作效率降低,严重者甚至影响铁路机车的运输安全。由于机车乘务员职业的特殊性,其昼夜不中断工作和轮班工作制的要求,在一班次接触噪声的时间与其他企业噪声作业工人接触时间上有明显不同。因此,对噪声对机车乘务员影响因素进行分析,探讨噪声对机车乘务员的听力损失,对进一步研究有效的车内噪声控制措施具有重要意义。目的了解噪声对机车乘务员听力的影响,探讨机车乘务员噪声性听力损失与噪声接触剂量之间的关系,分析工龄、年龄、文化、吸烟、饮酒等因素对噪声性听力损失的影响,为防控职业性噪声性听力损失提出建议,对进一步研究有效的车内噪声控制措施、保护机车乘务员身体健康、保证运输生产安全提供依据。方法 2012年我们对1027名男性机车乘务员进行体检,并对工人的年龄、文化、职业史、吸烟、饮酒等情况进行了详细的调查。调查问卷由专职的职业病科医师进行详细的询问、检查和登记录入,由专业人员进行双录入核对。本次调查使用电测听测定噪声作业工人听力,声级计测定作业环境噪声强度。采用x2验检、t检验、Logistic回归等方法,分析噪声性听力损失与噪声接触剂量之间的关系,分析工龄、文化、年龄、吸烟、饮酒等因素对噪声性听力损失的影响。结果 1.本次共测定8种车型74辆铁道机车的司机室噪声强度,结果显示：噪声均值为74.3dB(A),标准差为5.3,最小值为65.8dB(A),最大值为88.5dB(A),超标数为15辆,超标率为20.3%。 2.通过对两组工人的纯音测听检查发现,1027名暴露人群的听力损失发生率为22.1%,高于550名对照组人群的听力损失发生率(8.5%),差异有显著性(P0.05)。 3.随着工龄、年龄、累积噪声暴露量(CNE)的增长,机车乘务员观察对象和噪声聋发生率也在逐渐增加,差异具有统计学意义(P0.001)；同时经趋势卡方检验发现随着工龄、年龄、CNE的增长,工人听力损失发生率有逐渐增加的趋势,这种趋势具有统计学意义(P0.001)。 4.分别以听力测定结果中观察对象和噪声聋作为应变量,CNE、年龄、文化、吸烟、饮酒作为自变量,并将其纳入回归模型进行多因素logistic回归分析,结果显示：CNE、年龄均有统计学意义(P0.05),其余变量无统计学意义,这说明CNE和年龄是听力损失的危险因素。 5.工龄与观察对象和噪声聋的单因素Logistic回归分析结果显示：工龄均有统计学意义(P0.05),这说明工龄是观察对象和噪声聋的危险因素。 6.噪声聋发生率和CNE关系的模型公式为：Y=0.758*[(X-75)/5]A2-0.9874*[(X-75)/5](R2=0.9972)。由此计算出当5%个体发生噪声聋时,此时的CNE为89.50dB(A)年。按机车乘务员平均每天工作8小时,根据现场噪声强度测定结果,依据CNE公式,计算当5%个体发生噪声聋时的暴露年限值T。 ①按机车司机室噪声强度均值74.3dB(A)计算,T=33年。 ②按机车司机室噪声强度最小值65.8dB(A)计算,T=234年。 ③按机车司机室噪声强度最大值88.5dB(A)计算,T=1.3年。结论噪声是机车乘务员的主要职业危害之一。机车乘务员作为听力损失的高危险职业之一,长期在噪声环境下作业,若无适当的保护措施,必将引起暂时性的或永久性的听力损失甚至耳聋。本次通过对机车乘务员听力情况的调查,机车乘务员听力损失率与工龄、年龄、CNE存在正相关关系,随着工龄的延长、年龄的增长、CNE的增加,听力损失程度随之加重。本次调查资料建立的CNE与噪声聋发生率的预测值,即累积噪声暴露阈值89.50dB(A)年,暴露临界阈值为33年。对工龄达20年、年龄达40岁的机车乘务员应密切关注听力变化,如发现观察对象者应定期体检,动态观察；发现语频听力损失者,应及时调离。司机室内噪声如控制不当,不但影响机车乘务员听力,还可影响其工作情绪和劳动能力,从而危及铁路客运安全。通过采取多种综合措施控制噪声强度,加强听力保护教育,定期进行职业性健康体检,增强工人自我保护意识,减少烟酒嗜好等不良习惯,减少工人在噪声强度超标作业场所接触噪声的时间,减少接触噪声的总工龄,并注意做好健康监护工作,逐步完善职业卫生的防控工作,切实保护劳动者的健康利益。
[Abstract]:Background

Railway transportation is one of the important modes of transportation in our country . It plays an important role in the improvement of national economy , social development and people ' s living standards . By the end of 2012 , China ' s railway operating mileage reached 9.80 million km , ranking second in the world ;
High - speed rail operation mileage is 9356 km , ranking first in the world . As the railway locomotive in railway transportation , railway locomotive is an important element in railway transportation . With the development of economy and science and technology in recent years , the process of railway high - speed and light quantization has accelerated , and the stability and safety of railway locomotive have caused great importance to society .

With the increase of the running speed of the railway , the problem of noise caused by the locomotive is particularly serious . The noise is very harmful to the human body . The noise is mainly caused by the damage of the auditory system . The noise is not only deaf but also can cause non - specific injury to the organism , such as dizziness , headache , tinnitus and other symptoms .

Purpose

To understand the effect of noise on the hearing loss of locomotive drivers , to explore the relationship between noise - induced hearing loss and noise exposure dose of locomotive drivers , to analyze the effects of factors such as age , age , culture , smoking and alcohol consumption on the noise - induced hearing loss , and to make suggestions for the prevention and control of occupational noise - induced hearing loss , and to further study the effective measures of noise control in vehicles , protect the health of locomotive operators and guarantee the safety of transportation production .

method

In 2012 , we conducted a detailed investigation on the situation of workers ' age , culture , occupation history , smoking , alcohol consumption and so on .

Results

1 . The noise intensity of the cab of 74 railway locomotives in 8 models is determined . The results show that the noise mean value is 74.3 dB ( A ) , the standard deviation is 5.3 , the minimum value is 65.8 dB ( A ) , the maximum value is 88.5dB ( A ) , the standard limit is 15 vehicles , the superstandard rate is 20.3 % .

2 . The incidence of hearing loss was 22.1 % , higher than that of 550 control group ( 8.5 % ) , and the difference was significant ( P0.05 ) .

3 . With the increase of age , age and cumulative noise exposure ( CNE ) , the incidence of observation target and noise deafness increased gradually , with statistical significance ( P0.001 ) .
At the same time , it was found that the incidence of hearing loss increased gradually with age , age and CNE , and the trend was statistically significant ( P 0.001 ) .

4 . The results showed that CNE , age , culture , smoking and alcohol consumption were used as independent variables . The results showed that CNE and age had statistical significance ( P0.05 ) . The results showed that CNE and age were the risk factors of hearing loss .

5 . The logistic regression analysis of single factor logistic regression analysis showed that the working age was significant ( P0.05 ) , which indicated that the working age was a risk factor for observing the object and hearing loss .

6 . The model formula of the relationship between the incidence of deafness and CNE was : Y = 0.758 * X ( X - 75 ) / 5 - A2 - 0.998 74 * X ( X - 75 ) / 5 - fold ( R2 = 0.9972 ) . As a result , the CNE was 89.50dB ( A ) years when the 5 % individual had a noise deafness . Based on the results of the field noise intensity measurement , the exposure - age limit value T of 5 % of the individual hearing loss was calculated according to the CNE formula .

( 1 ) The average noise intensity of locomotive cab is 74.3 dB ( A ) , T = 33 years .

( 2 ) Calculate the minimum noise intensity of locomotive cab by 65.8 dB ( A ) , and T = 234 years .

( 3 ) The maximum noise intensity of locomotive cab shall be calculated as 88.5dB ( A ) , and T = 1.3 years .

Conclusion

Noise is one of the major occupational hazards of locomotive drivers . As one of the high risk occupations of hearing loss , locomotive drivers operate under noise environment for a long time . If there is no proper protection measures , the hearing loss rate of locomotive drivers will cause temporary or permanent hearing loss or even deafness . Through investigation of the hearing condition of locomotive drivers , the hearing loss rate of locomotive drivers is positively correlated with age , age and CNE . As the age increases , age increases , CNE increases , and the degree of hearing loss increases .

According to the investigation data , the predicted value of CNE and the incidence of noise deafness , that is , the cumulative noise exposure threshold 89.50dB ( A ) , the threshold of exposure is 33 years . For 20 years of age , the locomotive attendant with age of 40 years should pay close attention to the hearing change , if it is found that the observation object should undergo regular physical examination and dynamic observation ;
Those who find the frequency hearing loss should be removed in time .

By taking various comprehensive measures to control the noise intensity , strengthen the hearing protection education , regularly carry out occupational health examination , strengthen the workers ' self - protection consciousness , reduce the total working age of contact noise , pay attention to the health monitoring work , gradually perfect the prevention and control work of occupational health , and effectively protect the health benefits of the workers .

【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R128.1

【参考文献】