職業鉛與噪音暴露對於聽覺能力影響－橫斷式研究

Lead Exposure and Effects on Hearing in a Battery Manufacturing Plant-Cross-Sectional Study

10.7005/JOSH.200603.0001

林道龍(Tao-Lung Lin)；莊弘毅(Hung-Yi Chuang)；何啟功(Chi-Kung Ho)；陳秋蓉(Chiu-Jung Chen)；胡佩怡(Pei-Yi Hu)；吳聰能(Trong-Neng Wu)

聽力損失 ； 血中鉛 ； 噪音 ； Hearing loss ； Blood lead level ； Noise level

勞工安全衛生研究季刊

14卷1期（2006 / 03 / 01）

1 - 7

繁體中文

Few epidemiologic studies have been carried out of heavy metals, which have been suggested to be ototoxins in humans, in the environment. Based on these epidemiologic studies, heavy metals such as lead, arsenic and manganese may cause hearing loss in humans and animals. No other metal presents a broader range of problems, from the multiplicity of potential routes of exposure to the spectrum of affected organs and systems, than lead. This cross-sectional study was conducted to examine the relationship among blood lead, noise exposure and auditory ability at a lead battery manufacturing factory. The workers were divided into a lead combined noise-exposed group of 75 workers, and a reference group of 51 persons who were not occupationally exposed to lead and noise. All of the subjects underwent evaluations including self-reported questionnaires, personal histories, clinical examinations, and laboratory tests to determine the blood lead level and pure tone hearing threshold in a soundproof booth. The level of noise in the lead battery manufacturing factory was measured by sound level meters. Among the exposed workers, a significant association was found between hearing thresholds and log PbB. The hearing threshold rose as the log PbB increased, especially at 2000, 4000 and 6000 Hz. Multiple linear regression was applied to determine the effects of lead and noise relative to auditory ability. In the 4000 and 6000 Hz model of linear regression, age and log transformed blood lead levels (log PbB) were associated significantly with auditory ability along with adjustment of noise levels. When considering the effects of age, noise level, smoking, and alcohol consumption, the log transformed blood lead levels (log PbB) nonetheless remained a statistically significant determinant of auditory ability.

Few epidemiologic studies have been carried out of heavy metals, which have been suggested to be ototoxins in humans, in the environment. Based on these epidemiologic studies, heavy metals such as lead, arsenic and manganese may cause hearing loss in humans and animals. No other metal presents a broader range of problems, from the multiplicity of potential routes of exposure to the spectrum of affected organs and systems, than lead. This cross-sectional study was conducted to examine the relationship among blood lead, noise exposure and auditory ability at a lead battery manufacturing factory. The workers were divided into a lead combined noise-exposed group of 75 workers, and a reference group of 51 persons who were not occupationally exposed to lead and noise. All of the subjects underwent evaluations including self-reported questionnaires, personal histories, clinical examinations, and laboratory tests to determine the blood lead level and pure tone hearing threshold in a soundproof booth. The level of noise in the lead battery manufacturing factory was measured by sound level meters. Among the exposed workers, a significant association was found between hearing thresholds and log PbB. The hearing threshold rose as the log PbB increased, especially at 2000, 4000 and 6000 Hz. Multiple linear regression was applied to determine the effects of lead and noise relative to auditory ability. In the 4000 and 6000 Hz model of linear regression, age and log transformed blood lead levels (log PbB) were associated significantly with auditory ability along with adjustment of noise levels. When considering the effects of age, noise level, smoking, and alcohol consumption, the log transformed blood lead levels (log PbB) nonetheless remained a statistically significant determinant of auditory ability.

1. Beckett WS.(2003).ACOEM EVIDENCE-BASED STATEMENT: Noise-induced Hearing Loss.JOEM,45(6),579-581.
2. Counter SA,Vahter M LG,Buchanan LH,Ortega F,Skerfving S.(1997).High lead exposure and auditory sensory-neural function in Andean children.Environ Health Perspect,105,522-526.
3. David C.(2004).Bellinger: Lead.American Academy of pediatrics,113(4),1016-1022.
4. Davis J.,Svendsgaard D.(1987).Lead and child development.Nature,329,297-300.
5. Farahat TM,Abdel-Rasoul GM,El-Assy AR,Kandil SH,Kabil MK(1997).Hearing thresholds of workers in a printing facility.Environ Res,73,189-192.
6. Fechter LD.(1995).Combined effects of noise and chemicals.Occup Med,10,609-621.
7. Holdstein Y,Pratt H,Goldsher M.(1986).Auditory brainstem evoked potentials in asymptomatic lead-exposed subjects.J Laryngol Otol,100,1031-1036.
8. Institute of Occupational Safety and Health(1992).Employees` personal assessment of the work environment and their own physical and psychological conditions.Taipei:Institute of Occupational Safety and Health.
9. Institute of Occupational Safety and Health(1997).Surveilance of occupational chemial hazards.Taipei:Institute of Occupational Safety and Health.
10. Liou S.H,Gu T.L.,Hsu S.W.,Wu D.M.,Chen L.M.(1993).A review of occupational and environmental lead poisoning in Taiwan.Journal of Institute of occupational Safety and Health,1,12-26.
11. Otto DA FD.(1993).Auditory and visual dysfunction following lead exposure.Neurotoxicology,142,191-208.
12. Otto DA,Robinson G,Baumann S,Schroeder S,Mushak P,Kleinbaum D,Boone L.(1985).5year follow-up study of children with low to moderate lead absorption: electrophysiological evaluation.Environ Res,38,168-186.
13. Repko J.,Morgan B.,Nicholson J.(1975).NIOSH Research Report.HEW.
14. Richard P.(1990).An epidemiological perspective of the cause of hearing loss among industrial workers.The Journal of Otolarygology,19,31-34.
15. Rybak LP.(1992).Hearing: the effects of chemicals.Otolaryngol Head Neck Surg,106,678-686.
16. S. Allen Counter,Leo H. Buchanan(2002).Neuro-Ototoxicity in Andean Adults With Chronic Lead and Noise Exposure.J Occup Environ Med,44,30-38.
17. Schwartz J,Otto D.(1987).Blood lead, hearing thresholds and neurobehavioral development in children and youth.Arch Environ Health,42,153-160.
18. Trong-Neng Wu,Chen-Yang Shen,Jim-Shoung Lai,Chain-Fun Goo(2000).Effects of lead and noise exposures on hearing ability.Archives of Environmental Health,55(2),109-114.

1. 郭姿吟,張宸瑋(2023)。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。台灣公共衛生雜誌，42(4)，374-388。