GB 16152-1996 Occupational noise-induced hearing loss diagnostic criteria and treatment principles
Some standard content:
National Standard of the People's Republic of China
Diagnostic criteria and principles of management of occupational noise-induced hearing lossGB16152-1996
Occupational noise-induced hearing loss is a progressive sensorineural hearing loss caused by long-term exposure to noise during work. 1 Subject content and scope of application
This standard specifies the diagnostic criteria and management principles of occupational noise-induced hearing loss. It is applicable to the diagnosis and treatment of various degrees of hearing loss caused by exposure to occupational noise.
2 Reference standards
GB4854
Standard zero level for calibration of pure tone audiometer
GB7341
Audiometer
GB7582 Acoustics Otology Relationship between normal air conduction hearing threshold and age and gender GB7583 Acoustics Pure tone air conduction audiometry for hearing protection 3 Diagnostic principles
Based on a clear history of occupational noise exposure, conscious hearing loss or tinnitus symptoms, pure tone audiometry for sensorineural hearing loss, combined with dynamic observation data, on-site hygiene survey, and exclusion of hearing loss caused by other reasons, the diagnosis can be made. 4 Diagnosis and grading standards
Normal: According to Chapter A1 of Appendix A, in the N, N2 area, that is, the hearing loss of each question rate is <25dB. 4.2 Observation object: According to Chapter A1 of Appendix A, hearing loss is divided into grades 1 to V. a
I level.N,+A
1 level,Ni+B or D+A
I level.Ni+C or D+B
N level:D+C
V level:E+B or E+C
4.3 For those whose hearing loss in any ear reaches level V, the average hearing threshold of both ears shall be calculated according to Chapter A2 of Appendix A to assess hearing damage and noise-induced deafness. 4.4 If the conditions are not met, for those whose hearing loss in any high frequency (3000, 40006000Hz) is ≥30dB, the average hearing threshold of both ears can be directly calculated according to Chapter A2 of Appendix A to assess hearing damage and noise-induced deafness. a.
Mild hearing loss
Moderate hearing loss
Severe hearing loss
Noise-induced deafness
Approved by the State Bureau of Technical Supervision on January 29, 1996 26~40dB
41～55 dB
56～70 dB
71～90 dB
Implemented on September 1, 1996
5 Treatment principles
GB16152-1996
5.1 The subjects of observation, hearing loss and noise-induced deafness should strengthen personal hearing protection. Those with other symptoms can receive symptomatic treatment. 5.2 Hearing aids should be worn for those with severe hearing loss and noise-induced deafness. 6 Labor capacity assessment
6.1 For the subjects of observation and those with mild hearing loss, protective measures should be strengthened, and generally there is no need to move away from the noisy working environment. For those with moderate hearing loss, it is possible to consider arranging jobs that do not require high hearing. For those with severe hearing loss and noise-induced deafness, they should be transferred out of the noisy environment. 6.2 For those who are sensitive to noise (i.e. those who have worked in a noisy environment for less than one year) and have reached observation level 1 or above, they should consider being transferred out of the noisy working environment.
7 Requirements for health examinations
7.1 All workers working in a noisy environment should undergo a pre-employment physical examination. The physical examination items focus on otolaryngology, pure tone audiometry, internal medicine and neurology. Workers must have personal hearing protection measures as soon as they enter the factory, and hearing records should be kept in their occupational files. 7.2 A physical examination should be conducted within one year of starting work in a noisy environment. If the hearing is normal, a physical examination should be conducted every two years thereafter. Those who have reached observation level 1 or above, hearing loss and noise-induced deafness should undergo a physical examination once a year. The physical examination items are the same as 7.1. 7.3 A final physical examination should be conducted upon retirement.
8 Occupational contraindications
Permanent sensorineural hearing loss caused by various causes (pure tone air conduction at any frequency of 500, 1000 and 2000 Hz a.
hearing valve)>25 dB.
b. Various diseases that can cause dysfunction of the inner ear auditory nervous system. 260
GB 16152-1996
Classification of occupational noise hearing loss, degree of hearing damage and calculation of noise-induced deafness (supplement)
A1 When using the hearing loss classification chart, speech frequency (500, 1000, 2000 Hz) and high frequency (3000, 4000, 6000 Hz) refer to the range of hearing loss at any frequency in one ear, not the average value of a group of frequencies. "Ten" indicates the combination of speech frequency and high frequency. 500
Occupational noise hearing loss classification chart
6000Hz
>25dBHL
≥45dBHL
>65dBHL
Occupational noise hearing loss classification table
Note: The combination with slashes should exclude other hearing loss. A2 The calculation method of binaural hearing thresholds for occupational noise hearing loss and noise hearing loss is as follows (when calculating the mean value of the hearing threshold, the decimal point is rounded to an integer).
The first step is to make age correction for the hearing threshold values of each frequency, see Chapter B3 of Appendix B. The second step is to calculate the average hearing threshold of one ear:
Average hearing threshold of one ear (dB) -
HLs00 + HL1 00 H + HL2 000 Hh3
The third step is to calculate the average hearing threshold of both ears:
Average hearing threshold of both ears (dB) = Average hearing threshold of better ear (dB) × 4 + Average hearing threshold of worse ear (dB) × 15
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GB 16152-1996
Appendix B
Instructions for correct use of standards
: (reference)
B1 The hearing assessment of occupational noise-induced hearing loss is based on the air conduction results of pure tone audiometry, and the pure tone audiometry results are sensorineural hearing loss. B2 In view of the temporary valve shift of occupational noise hearing loss, the screening time for hearing should be 12~48h after the subject leaves the noise environment. If the results of the screening audiometry have reached the level of hearing damage and noise-induced deafness, a re-examination should be conducted, and the re-examination time is set to one week after leaving the noise environment. The test personnel should be specially trained and qualified. B3 Age correction value of pure tone air conduction valve: When determining occupational noise-induced deafness, the age factor should be considered and the correction should be made according to the median (50%) of the auditory valve level deviation of normal otologists (18 to 70 years old) in GB7582. Table B1 gives the median value of the auditory valve level deviation relative to the age of 18 years old for frequencies from 500 to 6000Hz (rounded to the nearest whole decibel number). This value is the expected statistical distribution of 50% of the normal otologists in males and females aged from 20 to 60 years old. B4 If the pure tone air conduction hearing threshold of a certain frequency is increased to 100dB or the subject still has no reaction to the maximum sound output of the audiometer, it is calculated as 100dB. B5 The exclusion of other causes of deafness as described in the diagnostic principles mainly include: pseudo-deafness, traumatic deafness, drug-induced deafness, infectious-induced deafness, familial deafness, presbycusis, Meniere's disease, sudden deafness, labyrinthitis, acoustic neuroma, various middle ear diseases, etc. B6 If the speech frequency hearing loss is greater than the high frequency hearing loss or the difference in the hearing loss of both ears is 3 levels or more, an otolaryngologist should be consulted to exclude other causes of deafness. If the cause of deafness in the ear with poor hearing is not related to occupational noise, it will not be included, and only the hearing threshold of the better ear can be used to grade the hearing loss. B7 When one ear is mixed deaf, if the bone conduction hearing threshold is increased in accordance with the characteristics of occupational noise-induced deafness and is not the same cause as conductive deafness, it can be assessed according to the bone conduction hearing threshold; if the bone conduction hearing loss may be the same cause as conductive deafness, it should be graded according to the contralateral ear. At the same time, a comprehensive analysis should be conducted in combination with the results of previous regular physical examinations. B8 Personal hearing protection refers to wearing soundproof earplugs, earmuffs or soundproof caps. B9 Assessment steps:
Step 1: Determine whether noise causes sensorineural hearing loss (medical history, physical examination, hearing test). Step 2: Make age corrections to the pure tone audiometry results (air conduction) according to GB7582. Step 3: Classify occupational noise hearing loss according to 4.2 of this standard. If the hearing loss of any ear reaches Grade V, assess the degree of hearing damage and noise-induced hearing loss according to Chapter A2 of Appendix A. Step 4: If the conditions are not met, any frequency of the high frequency (3000, 4000, 6000Hz) is ≥30dB, and the average hearing threshold of both ears can be directly calculated according to Chapter A2 of Appendix A to assess the degree of hearing damage and noise-induced hearing loss. Step 5: Assess the degree of hearing damage and noise-induced hearing loss: a. Calculate the average hearing threshold of one ear (A2):
HLs00 Ht + HL:000 H + HL2 00 h right ear average hearing threshold 2
HL500 Ht + HL1 00 ht + HL2 00 H left ear average hearing threshold
b. Calculate the average hearing threshold of both ears (A2)
better ear average hearing threshold (dB) × 4 + worse ear average hearing threshold (dB) × 1 average hearing threshold of both ears = to
Step 6: Handling principles: Handle in accordance with relevant provisions. B10 The diagnosis certificate issued by a professional institution designated by the health authority is valid. 262
Frequency, Hz
Deviation value, dB
GB16152-1996
500~~6000HzThe median deviation of the frequency relative to the listening level of 18 years old500
20~28
29~~37
52~54
20~~25 20~~2420~25 20~2320~24 20~2227~3327~3226~3125~2926~3024~2725~2923~2634~3833~3632~3630~3231~3428~3030~3227~2939~4137~4037~3933~ 3535~3731~3233~3430~3142-4541-43|40~4236-3738-4033~3435--37323346~4844~4543~4438~3941~4235~3638~3934~35 49~5046~48|45~4740~4143~4437~3840~4151~5349-5048~4942~43|45-46
54~5551~52505144~4547~48
56~57 53~5452~53
49~5041~4245~46
58~5955~5654~5547~4851~52
575856~57
59~6051~52
57~58 47~48
37～38
41～42
54～55
Rate, Hz
Deviation value, dB
Additional notes:
16152-1996
Continued Table B1
This standard is proposed by the Ministry of Health of the People's Republic of China. Female
This standard is drafted by the Beijing Institute of Otolaryngology, and drafted by the Shanghai Institute of Labor Hygiene and Occupational Diseases, the Occupational Disease Prevention and Treatment Institute of West China University of Medical Sciences, and Beijing Hospital. The main drafters of this standard are Meng Xixi and Huang Weining. This standard is interpreted by the Institute of Labor Hygiene and Occupational Diseases, Chinese Academy of Preventive Medicine, which is the technical management unit entrusted by the Ministry of Health. 264
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