摘要
目的 调查飞行员的听力损失状况,探讨飞行对飞行员听觉功能的影响. 方法 飞行员116名,男性,年龄23～56岁,飞行时间120～6000 h.根据年龄分为4组:飞行员A组61名,年龄23～29岁,平均(24.6±1.7)岁,飞行时间(354.0±200.8)h；飞行员B组20名,年龄30～39岁,平均(34.1±2.6)岁,飞行时间(1866.3±785.9)h；飞行员C组28名,年龄40～49岁,平均(44.0±2.4)岁,飞行时间(2913.6±1085.6)h；飞行员D组7名,年龄50～56岁,平均(52.6±1.9)岁,飞行时间(4528.6±799.4)h.同时选择同年龄的无噪声暴露史的74名普通人群作为对照组:对照A组17名；对照B组21名；对照C组24名；对照D组12名.对受试者进行纯音测听及畸变产物耳声发射(distortion product otoacoustic emissions,DPOAE)检测. 结果 ①飞行员的听力损失主要发生在3000～8000 Hz;飞行员A组和B组中,单耳高频听力损失率高于双耳；随着年龄和飞行时间的增加,飞行员双耳高频听力损失率逐渐增加,在飞行员C组中,单耳和双耳听力损失率相近；在飞行员D组中,单耳高频听力损失率为14.30％,双耳达85.70％.②飞行员组表现为以6000 Hz为中心的听力曲线切迹,在6000 Hz处听力最先下降且最显著；对照A组、B组、C组各频率听阈都在正常范围；对照D组为坡型听力曲线,在8000 Hz处听力下降最显著.③飞行员A组与对照A组纯音听阈比较无统计学差异.飞行员B组听阈值在4000、6000、8000 Hz频率处高于对照B组,差异有统计学意义(t=2.191～3.428,P＜0.05)；飞行员C组听阈值在2000、3000、4000、6000、8000 Hz频率处高于对照C组,差异有统计学意义(t=3.090～5.524,P＜0.05)；飞行员D组听阈值在500、1000、2000、3000、4000、6000 Hz频率处高于对照D组,差异有统计学意义(t=1.225～4.121,P＜0.05).④飞行员组DPOAE引出率在3000、4000、6000 Hz频率处低于对照组；随着年龄和飞行时间的增加,DPOAE引出率逐渐下降；DPOAE引出率6000 Hz处低于4000 Hz处,4000 Hz处低于3000 Hz处. 结论 长时间的飞行可损伤飞行员的听觉功能,听力损失以6000 Hz发生最早且最显著；DPOAE监测噪声性听力损失更敏感；人耳对噪声的易感性存在着个体差异.
Objective To investigate situation of hearing loss in pilots and explore the effects of flight on auditory function of pilots.Methods One hundred and sixteen pilots,aged from 23 to 56 years and flying hours were from 120 to 6000 h,were selected as subjects.The pilots were divided into 4 groups by age:61 pilots were grouped as pilot group A [23-29 yrs,(24.6 ± 1.7) yrs,(354.0-±-200.8) h],20 pilots were grouped as pilot group B [30 39 yrs,(34.1 ± 2.6) yrs,(1866.3±785.9) h],28 pilots were grouped as pilot group C [40-49 yrs,(44.0± 2.4) yrs,(2913.6±1085.6) h] and 7 pilots were grouped as pilot group D [50-56 yrs,(52.6±1.9) yrs,(4528.6±799.4) h)].Meanwhile,age correspondent subjects (non pilots) were selected as control groups,who were grouped as control group A (17 subjects),control group B (21 subjects),control group C (24 subjects) and control group D (12 subjects).They had no history of occupational noise exposure.All subjects were tested by pure tone audiometry from 500-8000 Hz and by the measurement of distortion product of otoacoustic emissions (DPOAE) from 1000-6000 Hz.Results ①Hearing loss of pilots was mainly at 3000 8000 Hz.The occurrence rate of unilateral hearing loss at high frequencies was higher than that of bilateral hearing in pilot group A and pilot group B.The occurrence rate of bilateral hearing loss at high frequencies gradually increased with flight time.The occurrence rate of unilateral hearing loss was almost the same with the bilateral in pilot group C.The occurrence rate of unilateral hearing loss was 14.30％ while bilateral was 85.70％ in pilot group D.②Audiometric notch was observed at the center of 6000 Hz in pilot groups,where the hearing loss firstly and significantly decreased.Control group A,B,and C showed normal hearing at all concerned frequencies.The hearing loss greatly increased at 8000 Hz in control group D and showed slope type variation.③The mean hearing thresholds of pilots group A and control group A had no statistical difference.The mean hearing thresholds of pilot group B at 4000,6000 and 8000 Hz were significantly higher than those of control group B (t=2.191～3.428,P＜0.05).The mean hearing thresholds of pilot group C were significantly higher than those of control group C at frequencies of 2000,3000,4000,6000 and 8000 Hz (t=3.090～5.524,P＜0.05).The mean hearing thresholds of pilot group D were significantly higher than those of control group D at all frequencies except 8000 Hz (t=1.225～4.121,P＜0.05).④DPOAE provocation rates of pilot groups were lower than those of control groups at frequencies of 3000,4000 and 6000 Hz,which were decreased with age and flying time.DPOAE provocation rates were decreased with the increasing frequencies from 3000 Hz to 6000 Hz both in pilot groups and control groups.Conclusion Long term flight will damage auditory function of pilots.The hearing loss firstly and significantly occurs at 6000 Hz.DPOAE is a sensitive measurement for monitoring early noise induced hearing loss.Human ear's susceptibility to noise exhibits individual difference.
出处
《中华航空航天医学杂志》
CSCD
2013年第2期86-90,共5页
Chinese Journal of Aerospace Medicine
