个性化耳塞贴合度测试发现近三分之二军事航空人员衰减低于目标值：个体化指导前后结果的回顾性分析

文献信息

中文摘要

背景： 噪声性听力损失（NIHL）仍然是一个重要的职业健康问题，尤其是在高强度噪声工作环境中。尽管一次性泡沫耳塞（DFE）被广泛使用，但其提供的保护取决于佩戴的贴合程度。我们检查了军事航空人员的初始耳塞衰减情况、在初始低于目标值的参与者中接受个体化现场指导并重复贴合后观察到的变化，以及既往指导与基线衰减之间的关联。
方法： 这项回顾性、单中心观察性研究分析了2020年至2022年间评估的183名军事航空人员常规收集的职业健康贴合度测试数据。平均年龄为22.84 ± 6.23岁，91.3%为男性。使用3M E-A-Rfit双耳验证系统测量耳塞衰减。平均双耳衰减低于20 dB的参与者接受个体化现场指导并重复贴合程序。
结果： 在初始贴合期间，118名参与者（64.5%）未达到20 dB目标。在该组中，指导并重复贴合后平均双耳衰减从14.47 dB上升至22.57 dB，提高了8.10 dB（p < 0.001）。报告既往接受过耳塞使用指导的参与者基线衰减也高于未接受过指导者（19.47 vs. 16.52 dB；p = 0.002）。
结论： 定量贴合度测试发现近三分之二的受评估人员初始衰减不足。简短的个体化指导后重复贴合与初始低于目标值者衰减的显著改善相关。将个性化贴合度测试和针对性指导纳入职业听力保护计划可能改善对NIHL的防护。

英文摘要

BACKGROUND: Noise-induced hearing loss (NIHL) remains an important occupational health problem, especially in high-intensity noise work settings. Although disposable foam earplugs (DFE) are widely used, the protection they provide depends on how well they are fitted. We examined initial earplug attenuation in military aviation personnel, the change observed after individualized on-site instruction and repeat fitting among participants initially below target, and the association between previous instruction and baseline attenuation.
METHODS: This retrospective, single-center observational study analyzed routinely collected occupational-health fit-testing data from 183 military aviation personnel evaluated between 2020 and 2022. Mean age was 22.84 ± 6.23 years, and 91.3% were male. Earplug attenuation was measured using the 3M E-A-Rfit Dual-Ear Validation System. Participants with mean binaural attenuation below 20 dB received individualized on-site instruction and repeated the fitting procedure.
RESULTS: During initial fitting, 118 participants (64.5%) did not achieve the 20 dB target. In this group, mean binaural attenuation rose from 14.47 to 22.57 dB after instruction and repeat fitting, an improvement of 8.10 dB (p < 0.001). Participants who reported having received previous earplug-use instruction also had higher baseline attenuation than those without previous instruction (19.47 vs. 16.52 dB; p = 0.002).
CONCLUSION: Quantitative fit testing identified inadequate initial attenuation in nearly two-thirds of the personnel assessed. Brief individualized instruction followed by repeat fitting was associated with a substantial improvement in attenuation among those initially below target. Incorporating personal fit testing and targeted instruction into occupational hearing-conservation programs may improve protection against NIHL.