职业噪声所致年龄相关及其他听力损失的时空分布：基于GBD 2021的全球、亚洲及中国层面疾病负担比较研究

文献信息

中文摘要

背景： 职业噪声暴露是年龄相关及其他听力损失（ARoHL）的关键可预防危险因素。然而，其长期趋势、社会经济不平等、空间模式及未来负担在全球、亚洲和中国层面仍不明确。
方法： 我们从2021年全球疾病负担研究中提取伤残调整生命年（DALYs）和年龄标化DALY率（ASDR）。采用社会人口指数（SDI）、人类发展指数（HDI）、不平等斜率指数和集中指数评估社会经济差异。为分析时间趋势、年龄-时期-队列效应、空间聚集及未来负担，我们使用了Joinpoint回归、年龄-时期-队列模型、全局和局部Moran's I以及贝叶斯年龄-时期-队列（APC）预测。
结果： 2021年，全球、亚洲和中国的ASDR分别为每10万人口91.12、107.24和133.99。在三个区域中，DALYs均在70-74岁达到峰值，并观察到显著的空间聚集。ASDR与SDI和HDI呈负相关。全球社会经济不平等随时间下降，而亚洲的绝对不平等略有增加。过去三十年间，所有区域的ASDR持续上升。到2041年，预计全球、亚洲和中国的ASDR将分别达到每10万人123.45、136.60和168.17。
结论： 职业噪声所致ARoHL的负担持续上升，并具有明显的地理聚集和社会经济差异。加强职业噪声法规、改善工作场所声环境并扩大听力保护对于减轻听力健康负担至关重要。

英文摘要

BACKGROUND: Occupational noise exposure is a key preventable risk factor for age-related and other hearing loss (ARoHL). However, long-term trends, socioeconomic inequalities, spatial patterns, and future burdens remain unclear at global, Asian, and Chinese levels.
METHODS: We extracted disability-adjusted life years (DALYs) and age-standardized DALY rates (ASDR) from the 2021 Global Burden of Disease Study. Socioeconomic disparities were evaluated using the socio-demographic index (SDI), the human development index (HDI), the Slope Index of Inequality, and the Concentration Index. To analyze temporal trends, age-period-cohort effects, spatial clustering, and future burdens, we used Joinpoint regression, Age-period-cohort models, global and local Moran's I, and Bayesian APC projection.
RESULTS: In 2021, ASDR was 91.12, 107.24, and 133.99 per 100,000 population globally, in Asia, and in China, respectively. In all three regions, DALYs peaked at 70-74 years, and significant spatial clustering was observed. ASDR was negatively associated with SDI and HDI. Global socioeconomic inequalities decreased over time, whereas absolute inequality slightly increased in Asia. ASDR continuously increased across all regions over the past three decades. By 2041, projected ASDR is projected to reach 123.45, 136.60, and 168.17 per 100,000 people globally, in Asia, and in China.
CONCLUSION: The burden of occupational noise-induced ARoHL has risen persistently with marked geographic clustering and socioeconomic disparities. Strengthening occupational noise regulations, improving workplace acoustic environments and expanding hearing protection are critical to reduce the hearing health burden.