中文摘要：

目的了解金属制造业噪声作业工人上岗前听力损失情况,分析其影响因素。方法采用判断抽样的方法,以1 597名行上岗前职业健康检查的金属制造业拟从事噪声作业的工人为研究对象,收集其上岗前职业健康检查的相关资料,分析其听力损失情况及影响因素。结果 1 597名研究对象中,631人（占39.5%）既往有接触职业性噪声（有噪声接触史组）,接触工龄M为0.20（0.10～0.30）年;966人（占60.5%）既往无接触职业性噪声（无噪声接触史组）。听力损失检出率为46.1%（737/1 597）;其中,职业禁忌证检出率为13.9%（222/1 597）,其他类型听力损失检出率为32.2%（515/1 597）。有噪声接触史组人群职业禁忌证和其他类型听力损失的检出率均高于无噪声接触史组（16.5%vs 12.2%,50.6%vs 43.3%,P〈0.05）。对于职业禁忌证和其他类型听力损失,男性人群的发生风险均高于女性[优势比（OR）分别为1.958、2.331,P〈0.01],年龄〉25岁人群的发生风险均高于年龄≤25岁者（OR分别为2.390、2.245,P〈0.01）,既往有职业性噪声接触史人群的发生风险均高于无职业性噪声接触史者（OR分别为1.536、1.287,P〈0.05）。结论开展噪声作业人员上岗前职业健康检查有利于早期发现职业禁忌证;应重视男性、年龄较大以及既往有职业性噪声接触史人员的上岗前职业健康检查。

英文摘要：

Objective To examine the hearing status of pre-job workers exposed to noise in metal manufacturing industries,and to analyze the related influencing factors. Methods A judgement sampling method was adopted to choose1 597 pre-job workers exposed to noise in metal manufacturing industries as the study subjects. The data of workers＇ occupational health examination was collected,and the influencing factors of hearing loss were analyzed. Results Among the 1 597 individuals,631（ 39. 5%） cases reported occupational noise exposure history（ noise exposure group） with the length of service of 0. 20（ 0. 10-0. 30） years; 966（ 60. 5%） cases denied occupational noise exposure history（ no-noise exposure group）. The hearing loss detection rate was 46. 1%（ 737 /1 597）; among them,the occupational contraindication detection rate was 13. 9%（ 222 /1 597）,and the detection rate of other kinds of hearing loss was 32. 2%（ 515 /1 597）.The detection rates in workers with occupational contraindication and the other kinds of hearing loss in noise exposure group were higher than those in the non-noise exposure group（ 16. 5% vs 12. 2%,50. 6% vs 43. 3%,P〈0. 05）. The male workers had higher incidence than female workers [the odds ratio（ OR） were 1. 958 and 2. 331,respectively,P〈0. 01）;the workers with age 25 years had higher incidence than those with age ≤ 25 years（ OR were 2. 390 and 2. 245,respectively,P〈0. 01）; the noise exposure workers had higher incidence than non-noise exposure ones（ OR were 1. 536 and 1. 287,respectively,P〈0. 05）. Conclusion Pre-job occupational health examination is helpful for early detection of occupational contraindication in noise exposure workers. Attention should be paid to the male workers,the older workers,and those with occupational noise exposure history when conducting occupational health examination.