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系統識別號 U0026-1008201914324600
論文名稱(中文) 噪音特性對噪音性永久聽力損失之影響
論文名稱(英文) Effects of Noise Characteristics on Noise-Induced Permanent Threshold Shift (NIPTS)
校院名稱 成功大學
系所名稱(中) 環境醫學研究所
系所名稱(英) Institute of Environmental and Occupational Health
學年度 107
學期 2
出版年 108
研究生(中文) 莊涵琇
研究生(英文) Han-Hsiu Chuang
學號 S76064052
學位類別 碩士
語文別 中文
論文頁數 117頁
口試委員 指導教授-蔡朋枝
口試委員-林明彥
口試委員-林政佑
口試委員-徐新益
中文關鍵字 噪音特性  噪音型式  噪音頻率  聽力損失  噪音性永久聽力損失 
英文關鍵字 Noise characteristics  Noise pattern  Noise frequency  Noise-induced permanent threshold shift (NIPTS) 
學科別分類
中文摘要 摘要
職業噪音暴露是工作場所中最常見的危害之一,鋼鐵工業在鋼鐵製造過程中可能會產生90分貝以上的噪音,也會產生不同特性的噪音 (含型式及頻率),目前的研究發現,在暴露之噪音型式方面,穩定性噪音及變動性噪音在足夠的暴露之下會導致聽力損失;在暴露之噪音頻率方面,人耳對於高音頻較敏感且在不同音頻的暴露之下均會產生暫時性聽力損失。由於目前的研究對於長期暴露之下,不同噪音特性對於永久性聽力損失的差異仍不清楚,且並無探討噪音特性的暴露對於永久性聽力損失是否具有交互作用,故本研究的目的在於探討不同噪音特性對噪音性永久聽力損失(NIPTS)之影響。
本研究選自南台灣的某一鋼鐵製造公司,受試者接受問卷調查、耳鏡檢查,純音聽力檢測 PTA)和全天個人噪音暴露劑量測量,本研究利用噪音計、頻譜分析器來測量鋼鐵製造業勞工暴露的噪音型式與頻率分布範圍,以職業暴露矩陣(JEM)描述每位勞工長期累積的噪音暴露,並針對勞工一天八小時接受之暴露音量在長期暴露之下其聽力損失情形進行分析,對於噪音特性將分為三部分作分析,第一部分將依勞工暴露的噪音型式分為兩組(穩定性噪音、變動性噪音),第二部分將依勞工噪暴露的音頻率分為三組(低音頻為主之噪音、高音頻為主之噪音、均頻噪音),第三部分將依勞工暴露的噪音特性分為六組(低音頻為主之穩定性噪音、高音頻為主之穩定性噪音、均頻穩定性噪音、低音頻為主之變動性噪音、高音頻為主之變動性噪音、均頻變動性噪音),使用單變量回歸模型來比較每種潛在的危險因子與NIPTS之間的關聯,使用多變量回歸模型,校正潛在的干擾因子,以分析不同噪音特性對於勞工NIPTS的影響。
本次研究共170位勞工納入研究,平均暴露音量為92.9分貝,勞工雙耳聽力損失平均為22.8dB。勞工暴露於高音頻為主的噪音環境之下,其長期累積的噪音暴露大於88.92分貝時,其聽力損失會比暴露於低音頻為主的勞工嚴重,此外,若一天八小時暴露於76.42分貝的高音頻為主之噪音環境,長期暴露之下會達到聽力損失(PTS>25dB)。勞工暴露於穩定性噪音環境之下,其長期累積的噪音暴露大於95.53分貝時,其聽力損失會比暴露於變動性噪音的勞工嚴重,此外,若一天八小時暴露於82.27分貝的穩定性噪音環境,長期暴露之下會達到聽力損失(PTS>25dB)。勞工暴露於高音頻為主的穩定性噪音環境之下,其長期累積的噪音暴露大於91.04分貝時,其聽力損失會比暴露於低音頻為主的變動性噪音勞工嚴重,此外,若一天八小時暴露於78.50分貝的高音頻為主之穩定性噪音環境,長期暴露之下會達到聽力損失(PTS>25dB)。
本研究結果發現,勞工暴露於高音頻為主與穩定性噪音環境之下,其聽力損失情形較為嚴重,此外,針對不同噪音特性,一天八小時容許暴露音量也會不同。
英文摘要 ABSTRACT
INTRODUCTION
Occupational noise exposure is one of the most common hazards in the workplace. The steel manufacturing process may produce over 90 dBA of noise with different noise patterns and frequencies. Previous studies have shown that there is different sensitivity for human ears to different noise frequencies. Human ears are more sensitive to high frequencies, and less sensitive to low frequencies. Furthermore, There are some studies showed that human and animals exposed to different noise frequencies would result in temporary threshold shift (TTS). For noise patterns, previous studies reveal that a 10-year exposure to steady noise would result in the most severe estimated hearing threshold level at 4000 Hz. Workers who exposed to fluctuating noise had higher hearing threshold levels than non-exposure group. 25% people of exposure group have hearing threshold levels are larger than 25dB. However, the relationships between the noise-induced permanent threshold shift (NIPTS) and long-term exposures to noise with different characteristics, including noise frequencies and noise patterns, and the interaction of the above still remain unknown, and hence worth further investigation.

MATERIAL AND METHODS
In the present study, a steel manufacturing company located in southern Taiwan was selected. Tests include a structured interview, an otoscope examination, pure tone audiometry (PTA), and a personal noise measurement. The noise meters and spectrum analyzers will be used to measure the noise characteristics. The Job exposure matrix (JEM) is used to characterize the long-term cumulative noise exposure of each participant, and analyze the workers’ hearing loss under long-term exposure for 8 hours work shift. According to the exposed noise patterns and noise frequencies, workers will be divided into two groups of patterns (including the steady and fluctuating noise groups) and three groups (including the low-dominant, high-dominant, and uniform frequency groups), respectively. And workers will be classified into six groups according their different noise characteristics exposure (including the steady low-dominant, steady high-dominant, steady uniform frequency, fluctuating low-dominant, fluctuating high-dominant, and fluctuating uniform frequency noise groups). A univariate regression model is used to compare the association between each possible risk factor and NIPTS. With adjustment of the possible confounding variables, the multivariate regression model is used to analysis the influence of different noise characteristics on workers’ NIPTS.
RESULTS AND DISSCUSSION
Data collected from 170 middle aged male workers are analyzed. The mean cumulative noise exposure (Leq-total) is 92.9dBA-year. The mean of PTS is 25.4dB. There is a significant dose-response relationship between cumulative noise exposure and hearing threshold levels in the groups with different noise frequencies, except for low-dominant frequency group. The hearing threshold of high-dominant frequency noise group became more serious than low-dominant frequency noise group when cumulative noise exposure was larger than 88.92dBA-year. When workers expose to 76.42dBA high-dominant frequency noise for long-term would cause the hearing loss. There is a significant dose-response relationship between cumulative noise exposure and hearing threshold levels in the groups with different noise patterns, and the hearing threshold of steady noise group became more serious than fluctuating noise group when cumulative noise exposure was larger than 95.53dBA-year. When workers expose to 82.27dBA steady noise for long-term would cause the hearing loss. There is a significant dose-response relationship between cumulative noise exposure and hearing threshold levels in the group except for steady high-dominant frequency noise and fluctuating low-dominant frequency noise group, and the hearing threshold of steady high-dominant frequency noise group became more serious than fluctuating low-dominant frequency noise group when cumulative noise exposure was larger than 91.04dBA-year. When workers expose to 78.50dBA steady high-dominant frequency noise for long-term would cause the hearing loss.

CONCLUSIONS
High-dominant frequency noise may cause more damage than low-dominant frequency noise on hearing loss when the noise levels are high enough (72.9dBA) for 40-year exposure. Steady noise may cause more damage than fluctuating noise on hearing loss when the noise levels are high enough (79.51dBA) for 40-year exposure. There is interaction between noise frequencies and noise patterns in workers’ hearing losses. Steady high-dominant frequency noise may cause more damage than fluctuating low-dominant frequency noise on hearing loss when the noise levels are high enough (75.02dBA) for 40-year exposure. Workers’ permissible exposure limit for 8 hours work shift can be established according to different noise characteristics.
論文目次 Table of Contents
摘要 I
ABSTRACT III
致謝 V
Table of Contents VI
List of Figures VIII
List of Tables XI
Chapter 1 Introduction 1
1-1 Research background 1
1-2 Objectives of the study 3
Chapter 2 Literature review 4
2-1 Physical aspects of noise 4
2-1-1 Measuring of noise 4
2-1-2 Industrial noise 5
2-1-3 Noise characteristics 5
2-1-4 Quantitative noise exposure assessment: Job-exposure matrix 6
2-2 Hearing loss 7
2-2-1 Index and definition of hearing loss 7
2-2-2 Noise-induced hearing loss (NIHL) 9
2-2-3 Different noise characteristics induced hearing loss 10
2-2-3-1 Noise frequencies induced hearing loss 10
2-2-3-2 Noise patterns induced hearing loss 11
2-3 Standards and regulations of noise 13
2-3-1 NIOSH criteria 14
2-3-2 OSHA criteria 14
Chapter 3 Materials and Methods 16
3-1 Study framework 16
3-2 Study population 17
3-2-1 Selection of subjects 17
3-2-2 Questionnaire 18
3-2-3 Similar exposure groups 18
3-3 Noise exposure measurement 18
3-3-1 Workplace noise assessment 18
3-3-2 Worker’s individual noise assessment 19
3-4 Evaluation of hearing status 19
3-5 Sampling analysis methods 20
3-5-1 Noise exposure assessment 20
3-5-2 The grouping of noise patterns groups 21
3-5-3 The grouping of noise frequencies groups 22
3-5-4 The combination of different noise characteristics groups 25
3-6 Statistical analysis 26
Chapter 4 Results and Discussions 27
4-1 Workplace noise assessment 27
4-1-1 The assessment of different noise frequencies in workplace 27
4-1-2 The assessment of different noise patterns in workplace 50
4-2 Noise exposure of male workers 67
4-2-1 Demographic and personal characteristics of the subjects 67
4-2-2 The influence of different noise frequencies on workers hearing losses 68
4-2-2-1 Discussions of different noise frequencies on workers hearing losses 75
4-2-3 The influence of different noise patterns on workers hearing losses 76
4-2-3-1 Discussions of different noise patterns on workers hearing losses 82
4-2-4 The influence of different noise characteristics on workers hearing losses 85
4-2-4-1 Discussions of different noise characteristics on workers hearing losses 93
Chapter 5 Limitations and Conclusions 95
5-1 Limitation of the study 95
5-2 Conclusions 95
References 97
Appendix 103
The influence of different noise frequencies on workers hearing losses 103
The influence of different noise patterns on workers hearing losses 108
The influence of different noise characteristics on workers hearing loss 112



List of Figures
Figure 2 1Curves illustrating the expected growth of hearing threshold level at 4000 Hz with years of exposure 12
Figure 3 1Study framework 17
Figure 3 2 Pure-low frequency 23
Figure 3 3 Low-dominant frequency 23
Figure 3 4 Medium frequency 24
Figure 3 5 High-dominant frequency 24
Figure 3 6 Pure-high frequency 24
Figure 3 7 Uniform frequency 25
Figure 4 1 Noise levels at different frequencies of sampling A in W421 28
Figure 4 2 Noise levels at different frequencies of sampling B in W421 28
Figure 4 3 Noise levels at different frequencies of sampling C in W421 29
Figure 4 4 Noise levels at different frequencies of sampling D in W421 29
Figure 4 5 Noise levels at different frequencies of sampling E in W421 30
Figure 4 6 Noise levels at different frequencies of sampling F in W421 30
Figure 4 7 Noise levels at different frequencies of sampling G in W421 31
Figure 4 8 Noise levels at different frequencies of sampling H in W421 31
Figure 4 9 Noise levels at different frequencies of sampling I in W421 32
Figure 4 10 Noise levels at different frequencies of sampling J in W421 32
Figure 4 11 Noise levels at different frequencies of sampling K in W421 33
Figure 4 12 Noise levels at different frequencies of sampling L in W421 33
Figure 4 13 Noise levels at different frequencies of sampling M in W421 34
Figure 4 14 Noise levels at different frequencies of sampling N in W421 34
Figure 4 15 Noise levels at different frequencies of sampling A in W423 36
Figure 4 16 Noise levels at different frequencies of sampling B in W423 36
Figure 4 17 Noise levels at different frequencies of sampling C in W423 37
Figure 4 18 Noise levels at different frequencies of sampling D in W423 37
Figure 4 19 Noise levels at different frequencies of sampling E in W423 38
Figure 4 20 Noise levels at different frequencies of sampling F in W423 38
Figure 4 21 Noise levels at different frequencies of sampling G in W423 39
Figure 4 22 Noise levels at different frequencies of sampling H in W423 39
Figure 4 23 Noise levels at different frequencies of sampling I in W423 40
Figure 4 24 Noise levels at different frequencies of sampling J in W423 40
Figure 4 25 Noise levels at different frequencies of sampling A in W521 41
Figure 4 26 Noise levels at different frequencies of sampling B in W521 42
Figure 4 27 Noise levels at different frequencies of sampling C in W521 42
Figure 4 28 Noise levels at different frequencies of sampling D in W521 43
Figure 4 29 Noise levels at different frequencies of sampling E in W521 43
Figure 4 30 Noise levels at different frequencies of sampling F in W521 44
Figure 4 31 Noise levels at different frequencies of sampling A in W522 45
Figure 4 32 Noise levels at different frequencies of sampling B in W522 45
Figure 4 33 Noise levels at different frequencies of sampling C in W522 46
Figure 4 34 Noise levels at different frequencies of sampling D in W522 46
Figure 4 35 Noise levels at different frequencies of sampling E in W522 47
Figure 4 36 Noise levels at different frequencies of sampling F in W522 47
Figure 4 37 Noise levels at different frequencies of sampling in W541 48
Figure 4 38 Noise levels at different frequencies of sampling in W542 49
Figure 4 39 The variability of noise level of sampling 1 in W421 50
Figure 4 40 The variability of noise level of sampling 2 in W421 51
Figure 4 41The variability of noise level of sampling 3 in W421 51
Figure 4 42 The variability of noise level of sampling 4 in W421 52
Figure 4 43 The variability of noise level of sampling 5 in W421 52
Figure 4 44 The variability of noise level of sampling 6 in W421 53
Figure 4 45 The variability of noise level of sampling 7 in W421 53
Figure 4 46 The variability of noise level of sampling 8 in W421 54
Figure 4 47The variability of noise level of sampling 9 in W421 54
Figure 4 48 The variability of noise level of sampling 1 in W423 55
Figure 4 49 The variability of noise level of sampling 2 in W423 55
Figure 4 50 The variability of noise level of sampling 3 in W423 56
Figure 4 51 The variability of noise level of sampling 4 in W423 56
Figure 4 52 The variability of noise level of sampling 1 in W521 57
Figure 4 53 The variability of noise level of sampling 2 in W521 57
Figure 4 54 The variability of noise level of sampling 3 in W521 58
Figure 4 55 The variability of noise level of sampling 4 in W521 58
Figure 4 56 The variability of noise level of sampling 5 in W521 59
Figure 4 57 The variability of noise level of sampling 6 in W521 59
Figure 4 58 The variability of noise level of sampling 7 in W521 60
Figure 4 59 The variability of noise level of sampling 8 in W521 60
Figure 4 60 The variability of noise level of sampling 1 in W522 61
Figure 4 61 The variability of noise level of sampling 2 in W522 61
Figure 4 62 The variability of noise level of sampling 3 in W522 62
Figure 4 63 The variability of noise level of sampling 4 in W522 62
Figure 4 64 The variability of noise level of sampling 5 in W522 63
Figure 4 65 The variability of noise level of sampling 6 in W522 63
Figure 4 66 The variability of noise level of sampling 7 in W522 64
Figure 4 67 The variability of noise level of sampling 8 in W522 64
Figure 4 68 The variability of noise level of sampling 9 in W522 65
Figure 4 69 The variability of noise level of sampling 1 in W541 65
Figure 4 70 The variability of noise level of sampling 2 in W541 66
Figure 4 71 The variability of noise level of sampling 1 in W542 66
Figure 4 72 The variability of noise level of sampling 2 in W542 67
Figure 4 73 Dose-response relationship between cumulative noise exposure and hearing threshold level in the groups of noise frequencies 73
Figure 4 74 Dose-response relationship between noise level and hearing threshold level in the groups of noise frequencies 75
Figure 4 75 Dose-response relationship between cumulative noise exposure and hearing threshold level in the groups of noise patterns 80
Figure 4 76 Dose-response relationship between noise level and hearing threshold level in the groups of noise patterns 82
Figure 4 77 The association between amplitude change and hearing loss 84
Figure 4 78 Dose-response relationship between cumulative noise exposure and hearing threshold level in the groups of noise characteristics 90
Figure 4 79 Dose-response relationship between noise level and hearing threshold level in the groups of noise characteristics 92
Figure 4 80 Comparison of high-dominant frequency noise, steady noise, and steady high-dominant frequency noise 94
Figure 7 1 Dose-response relationship between cumulative noise exposure and hearing threshold level in the groups of noise frequencies 106
Figure 7 2 Dose-response relationship between noise level and hearing threshold level in the groups of noise frequencies 107
Figure 7 3 Dose-response relationship between cumulative noise exposure and hearing threshold level in the groups of noise patterns 110
Figure 7 4 Dose-response relationship between noise level and hearing threshold level in the groups of noise patterns 111
Figure 7 5 Dose-response relationship between cumulative noise exposure and hearing threshold level in the groups of noise characteristics 116
Figure 7 6 Dose-response relationship between noise level and hearing threshold level in the groups of noise characteristics 117



List of Tables
Table 2 1WHO grades of hearing loss 8
Table 2 2 Occupational NIHL results of previous studies 10
Table 2 3 Comparison of hearing conservation regulations, interpretations, and recommendations 15
Table 4 1 Leq of sampling area in W421 27
Table 4 2 Leq of sampling area in W423 35
Table 4 3 Leq of sampling area in W521 41
Table 4 4 Leq of sampling area in W522 44
Table 4 5 Leq of sampling area in W541 and W542 48
Table 4 6 Demographic and personal characteristics of the subjects (n=170) 68
Table 4 7 Demographic and personal characteristics of the subjects in different noise frequencies group 69
Table 4 8 Simple linear regression model of hearing threshold levels by different noise frequencies groups 71
Table 4 9 Multivariate regression model of hearing threshold levels by different noise frequencies groups 72
Table 4 10 Correlation between hearing threshold levels and cumulative noise exposure by different noise frequencies groups 73
Table 4 11 Predicted hearing threshold in different noise level and predicted noise level in the hearing loss level (PTS=25dB) 74
Table 4 12 Demographic and personal characteristics of the subjects in different noise patterns group 77
Table 4 13 Simple linear regression model of hearing threshold levels by different noise patterns groups 78
Table 4 14 Multivariate regression model of hearing threshold levels by different noise patterns groups 79
Table 4 15 Correlation between hearing threshold levels and cumulative noise exposure by different noise patterns groups 79
Table 4 16 Predicted hearing threshold in different noise level and predicted noise level in the hearing loss level (PTS=25dB) 81
Table 4 17 Demographic and personal characteristics of the subjects in different noise characteristics group 86
Table 4 18 Simple linear regression model of hearing threshold levels by different noise characteristics groups 88
Table 4 19 Multivariate regression model of hearing threshold levels by different noise characteristics groups 89
Table 4 20 Correlation between hearing threshold levels and cumulative noise exposure by different noise characteristics groups 90
Table 4 21 Predicted hearing threshold in different noise level and predicted noise level in the hearing loss level (PTS=25dB) 92
Table 7 1 Demographic and personal characteristics of the subjects in different noise frequencies group 103
Table 7 2 Simple linear regression model of hearing threshold levels by different noise frequencies groups 104
Table 7 3 Multivariate regression model of hearing threshold levels by different noise frequencies groups 105
Table 7 4 Correlation between hearing threshold levels and cumulative noise exposure by different noise frequencies groups 105
Table 7 5 Predicted hearing threshold in different noise level and predicted noise level in the hearing loss level (PTS=25dB) 106
Table 7 6 Demographic and personal characteristics of the subjects in different noise patterns group 108
Table 7 7 Simple linear regression model of hearing threshold levels by different noise patterns groups 109
Table 7 8 Multivariate regression model of hearing threshold levels by different noise patterns groups 109
Table 7 9 Correlation between hearing threshold levels and cumulative noise exposure by different noise patterns groups 109
Table 7 10 Predicted hearing threshold in different noise level and predicted noise level in the hearing loss level (PTS=25dB) 110
Table 7 11 Demographic and personal characteristics of the subjects in different noise characteristics group 113
Table 7 12 Simple linear regression model of hearing threshold levels by different noise characteristics groups 114
Table 7 13 Multivariate regression model of hearing threshold levels by different noise characteristics groups 115
Table 7 14 Correlation between hearing threshold levels and cumulative noise exposure by different noise characteristics groups 115
Table 7 15 Predicted hearing threshold in different noise level and predicted noise level in the hearing loss level (PTS=25dB) 117
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