目標:工作場所噪音造成的聽力損失,是重要的勞工安全衛生議題,鋼鐵業勞工噪音暴露特別高,但未曾有過系統的探討。本研究收集國內鋼鐵廠勞工聽力檢查資料,評估分析其聽力損失概況。方法:本研究調查獲得13家鋼鐵廠同意提供聽力健檢資料,其中12家依「勞工健康保護規則」規定保存了10年的資料,乃取其1997和1998年可供分析之員工資料,計有7160個案。利用我國勞工聽力常模值,校正年齡因素的影響後,分析由噪音所造成的聽力損失,特別是4kHz和6kHz之聽力損失,並比較其符合勞工噪音健康管理級別的程度。結果:從事噪音作業勞工較差耳的4kHz聽力損失達40分貝以上的有29%,6kHz的聽力損失更達31%,顯示鋼鐵業為噪音作業中較嚴重的行業之一。各年齡層的4kHz和6kHz的聽力損失均嚴重,由噪音和其他因素造成的聽力損失皆高達14分貝,年齡50歲以上甚至高達20分貝。依據醫院判定之健康管理級別區分,只有1人判為第三級管理。結論:鋼鐵業勞工聽力損失與職業噪音管理級別不具相關性,實為嚴重低估,顯示噪音作業勞工聽力損失指標不宜使用三分法或四分或六分法。鋼鐵業應確實實施「勞工聽力保護計畫」保護勞工聽力,以免聽力損失更形嚴重。
Objectives: Hearing loss in the workforce, due to noise exposure, has attracted attention for decades in Taiwan. However, studies on this issue remain scarce. This report describes hearing loss for steel factory workers. Methods: Steel factories in Taiwan are required to comply with ”Workers Health Protection Regulation” by establishing records of routine hearing examinations for workers exposed to noise. We obtained, from 12 factories, 7160 workers' records of hearing examinations conducted in 1997 and 1998. Age-adjusted hearing acuity, particularly in the frequencies of 4kHz and 6kHz, was compared against ”National Labors' Hearing Normal Distribution”. This Was used as a standard for estimating hearing impairment for each worker. Results: Hearing impairment was found for study subjects of all ages. Workers younger than 50 years had an average hearing loss of at least 14 decibels. Workers 50 years of age and above had an average loss of 20 decibels. Approximately 29% of workers had an average loss of 40 decibels or above in 4kHz and 31 % workers had a similar level of hearing loss in 6kHz. Among all steel industrial workers in this study, almost none were classified for hearing protection management level 3. Analysis also' revealed that using the three-, four- or six-distribution method for assessing hearing loss for steel manufacturing workers underestimates their hearing impairment. Conclusions: The steel industries fail to protect workers from hearing loss. This industry must be in compliance with the ”Hearing Protection Project for Workers” act to halt the decline of hearing acuity for their employees.
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