Noise and hand-arm vibration exposure in relation to the risk of hearing loss.

The aim of this study was to examine the possible association of combined exposure of noise and hand-arm vibration (HAV) and the risk of noise-induced hearing loss. Workers in a heavy engineering industry were part of a dynamic cohort. Of these workers, 189 had HAV exposure, and their age and hearing status were recorded in the same year and were, therefore, included in the analysis. Data on HAV duration and acceleration was gathered through questionnaires, observations, and measurements. All available audiograms were categorized into normal and hearing loss. The first exposure variable included the lifetime HAV exposure. The lifetime HAV exposure was multiplied by the acceleration of HAV for the second and third exposure variable. Logistic regression using the Generalized Estimation Equations method was chosen to analyze the data to account for the repeated measurements. The analysis was performed with both continuous exposure variables and with exposure variables grouped into exposure quartiles with hearing loss as an outcome and age as a covariate. With continuous exposure variables, the odds ratio (OR) with a 95% confidence interval (CI) for hearing loss was equal to or greater than one for all exposure variables. When the exposure variables were grouped into quartiles, the OR with a 95% CI was greater than one at the third and fourth quartile. The results show that working with vibrating machines in an environment with noise exposure increases the risk of hearing loss, supporting an association between exposure to noise and HAV, and the noise-induced hearing loss.