Sensory-neural hearing loss during combined noise and vibration exposure. An analysis of risk factors.

A detailed analysis of risk factors for the development of sensory-neural hearing loss (SNHL) was carried out on 122 forest workers. These forest workers were selected from a larger group (n = 217) by restricting the age range to 30-55 years. The hearing threshold of the left ear at 4000 Hz was measured and the effect of age, exposure, systolic and diastolic blood pressure (DBP), presence of vibration-induced white finger (VWF), tobacco smoking and use of earmuffs were evaluated in multiple linear regression analysis. Robinson's nonlinear model was used to evaluate the rate of hearing loss. Aging was the major risk factor and it explained 15.4% of the variance of the SNHL. The presence of VWF was the second most important single risk factor and explained a further 5.2% of the SNHL. Elevation of DBP correlated significantly with SNHL and explained an additional 4.1% of the SNHL. These main factors were able to explain about 26% of the spread of SNHL. Additional factors in the analysis, e.g. smoking, systolic blood pressure, did not significantly contribute to the genesis of SNHL. When Robinson's model was applied to the SNHL data, on a group basis, we did not observe any exaggerated risk of hearing loss due to combination of noise and vibration. In combined exposure subjects with VWF as well as subjects with enhanced DBP will run a higher risk for SNHL.