HEMS运行中的听力损失：对空中救援直升机机组人员在多日紧急值班期间暂时性听阈位移的听力学测试的前瞻性分析。
Hearing loss in HEMS operations: a prospective analysis of audiometric tests for temporary hearing threshold shift of an air rescue helicopter crew during several days of emergency duty.
文献信息
| PMID | 42773414 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Michelle Hohm |
| 作者单位 | Hannover Medical School, Hannover, Germany. |
| 期刊 | International journal of emergency medicine |
| SCI 分区 | Q2 |
| IF | 2.2 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 直升机紧急医疗服务（HEMS）机组人员在工作时暴露于不同程度的噪声中。噪声水平经常超过85 dB(A)，并可能高达108 dB(A)。噪声暴露会降低注意力并造成听力损伤。本研究旨在评估空中救援机组人员的客观听力敏感度位移。
方法： 在两个月值班期间，收集了一架Airbus EC 135的HEMS机组人员在500至8000 Hz频率的听力学数据。听力学测试在轮班开始和结束时进行，如有可能，在每次HEMS操作后三十分钟进行。要求机组人员在每次测量前完成一份关于耳鸣和无听力保护下暴露于高噪声水平的问卷。听力学测量结果使用线性混合模型对整个组以及飞行员和医疗人员中有无额外听力保护的亚组进行分析。
结果： 在17天中，每日HEMS飞行中位数为6次，共对18名机组人员进行了n=236次听力学测试，其中四人（22%）为飞行员，十四人（78%）为医疗人员。平均噪声暴露持续时间为169.9（±49.2）分钟。平均飞行持续时间为50（±40.2）分钟。在所有亚组中，受试者在轮班开始时能够在平均8.2（±11.1）dB(A)的水平听到测试音，在轮班结束时为11.7（±12.1）dB(A)。左耳和右耳之间听阈的初始差异在整个工作轮班中趋于均衡（开始时β=2.9，p<0.001，对比噪声暴露后0.2，p=0.434）。未佩戴额外听力保护的医疗人员的听阈位移（6.8 dB(A)）大于飞行员（1.9 dB(A)）和使用额外听力保护的医疗人员（0.5 dB(A)）。最大的听阈水平出现在4000至8000 Hz之间的频率。
结论： HEMS机组人员的听力敏感度在一个轮班过程中显著下降。未受保护的医疗人员似乎比飞行员受影响更大。左耳的听阈水平大于右耳，并且最严重地影响高频声音的听觉能力。仅头盔可能无法提供足够的听力保护。
英文摘要
BACKGROUND: Helicopter Emergency Medical (HEMS) crews are exposed to varying levels of noise at work. Noise levels regularly exceed 85 dB(A) and can be as high as 108 dB(A). Noise exposure can reduce concentration and cause hearing damage. The present study was conducted to assess objective Hearing sensitivity shift of air rescue crews.
METHODS: Audiometric data of HEMS crew of an Airbus EC 135 were collected during two months of duty at frequencies from 500 to 8000 Hz. Audiometric tests were performed at the beginning and end of a shift and, if possible, thirty minutes after every HEMS operation. Crew members were asked to complete a questionnaire before every measurement on ringing in the ears and exposure to elevated noise levels without hearing protection. Results of the audiometric measurements were analysed using linear mixed models for the whole group and for subgroups of pilots and medical personnel with and without additional hearing protection.
RESULTS: On 17 days with a median daily number of 6 HEMS flights, a total of n = 236 audiometric tests were conducted for 18 crew members, of whom four (22%) were pilots and fourteen (78%) were medical personnel. The mean noise exposure duration was 169.9 (± 49.2) minutes. The mean flight duration was 50 (± 40.2) minutes. Across all subgroups, subjects were able to hear a test tone at a mean level of 8.2 (± 11.1) dB(A) at the beginning of a shift and 11.7 (± 12.1) dB(A) at the end of a shift. The initial difference of hearing threshold between the left and the right ear was evened out over the work shift (beginning β = 2.9 p < 0,001vs. after noise exposure 0.2, p = 0.434). Hearing threshold shift was greater in medical personnel who wore no additional hearing protection (6.8 dB(A)) than in pilots (1.9 dB(A)) and medical personnel who used additional hearing protection (0.5 dB(A)). The greatest hearing threshold level occurred at frequencies between 4000 and 8000 Hz.
CONCLUSIONS: Hearing sensitivity of HEMS crews substantially declines over the course of a shift. Unprotected medical personnel seems more affected than pilots. Hearing threshold level is greater in left ears than in right ears and most severely affects the ability to hear high-frequency sounds. Helmets alone may not provide adequate hearing protection.