臺灣博碩士論文加值系統

中 文 摘 要
[ 目的 ] 本研究以橫斷式研究法(Cross-sectional study)探討北部某城市公車司機的聽力篩檢的結果，以探討公車司機聽力障礙的現況及與技工、文職人員的差異( 描述性流行病學 )，並試圖分析造成差異的可能原因( 分析性流行病學 )。
[ 方法 ] 自民國九十三年四月起，選擇北部某城市公車處全體員工為調查對象，成功收集345名有效樣本。依照職業別分成三組，司機組240人，技工組45人，文職組60人，完成問卷、純音聽力檢查、語言辨識力檢查，並測量記錄各組分別的環境噪音。各組在年齡，工作年資，教育程度之間沒有統計上的差別。
[ 結果 ] 整體而言， 在自覺聽力障礙盛行率為21.4%，而純音聽力障礙為12.1%、語言辨識力障礙為56.2%，高頻噪音傷害盛行率為21.7%。三組在純音聽力障礙狀況、高頻噪音傷害的狀況沒有出現有意義的差別，但是在語言辨識力障礙上，單變項分析發現司機組和技工組均較文職組為差 [ 勝率比（Odds Rtio, OR）司機/文職 = 3.39 ( 95% CI : 1.74-6.61) ; 技工/文職= 5.20 ( 95% CI : 2.18-12.43 ) ]，再經多變項分析發現年齡是最主要的因素 ( β=0.04，S.E.=0.02，p=0.01 )。在自覺聽力障礙盛行率為21.4%，而純音聽力為12.1%、語言辨識力障礙者56.2%，噪音傷害為21.7%。
[ 結論 ] 顯示目前在司機、技工和文職人員間，聽力障礙和噪音傷害沒有明顯的差異，造成語言辨識力差別主要原因是年齡，沒有差異的原因可能是因為樣本太少，將來大規模的篩檢仍然值得注意可能出現的差異。盛行率的差異顯示目前的環境中，自覺聽力和純音聽力檢查正常的員工，有許多已經有語言辨識力障礙的問題，也顯示僅以目前純音聽力檢查，無法完全反應目前勞工聽力障礙的現況，而陽性預測值和敏感性偏低也顯示自覺聽力障礙並不適作為單一的篩檢工具，配合儀器的檢查仍有其必要性。

ABSTRACT
Background: This was a cross-sectional study of a hearing screening and associated related risk factors for bus drivers in Keelong City, northern Taiwan. We attempted to determine the conditions of hearing impairment, speech discriminative disturbance, and acoustic trauma among drivers, technicians, and officers, and we tried to find possible factors associated with the results.
Methods: Since April 2004, 345 staff members of the Bus Management Office in Keelong were included in the present study; they were divided into three groups: drivers (n=240), technicians (n=45), and officers (n=60). Pure-tone audiometry (PTA) and a speech discrimination score (SDS) were applied, and a questionnaire was given to the study population. Environmental noise was also measured.
Results: In general, the prevalence of abnormal Self-report, PTA, SDS and acoustic trauma were 21.4%, 12.1%, 56.2% and 21.7% respectively. There were no significant differences in PTA and acoustic trauma among the three groups, but the SDS of drivers and technicians significantly differed from that of officers (odds ratio (OR) of drivers and officers = 3.39 (95% confidence interval (CI): 1.74~6.61); OR of technicians and officers = 5.20 (95% CI: 2.18~12.43)). Age was the only factor with an effect on the difference in SDS according to the multiple logistic regression (β = 0.04, S.E. = 0.02, p = 0.01).
Conclusions: Among drivers, technicians, and officers, there were no significant differences in the results of the hearing screening, including PTA and acoustic trauma, except for SDS which was mainly affected by age. The preliminary results of the present study are perhaps limited by the small sample size, but a massive screening might reveal different findings, so further investigation would be worthwhile. The difference between prevalence of Self-report, PTA and SDS reveals members suffering with speech discrimination problems even their PTA and Self-report hearing are normal. Self-reported hearing impairment had a poor sensitivity, and therefore, examinations using test equipment are still recommended for occupational members at present.

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