1990-2023年中国听力损失疾病负担变化及职业噪声暴露归因分析---基于GBD 2023数据

Changes in the disease burden of hearing loss in China from 1990 to 2023 and attributable analysis of occupational noise exposure: Based on GBD 2023 data

摘要

目的 基于2023年全球疾病负担研究数据，分析1990-2023年中国听力损失的疾病负担变化趋势、性别与年龄分布特征及职业噪声暴露归因情况，并预测未来负担趋势。方法 提取1990-2023年中国听力损失的患病人数、伤残调整生命年(disability-adjusted life years, DALYs)、年龄标准化患病率(age-standardised prevalence rate, ASPR)和年龄标准化伤残调整生命年率(age-standardised DALY rate, ASDR)。采用对数线性回归模型计算估计年均百分比变化(estimated annual percentage change, EAPC)评估时间趋势。应用自回归综合移动平均模型预测2024-2043年ASPR和ASDR变化趋势，并分析职业噪声暴露对DALYs的归因比例。结果 2023年，中国听力损失患病人数为4.84亿例，DALYs为1413.16万年。1990-2023年间，患病人数和DALYs分别增加148.3%和135%。ASPR呈上升趋势[EAPC为0.20%，95%置信区间为(0.15%，0.24%)]，ASDR变化无统计学意义。男性ASPR和ASDR均高于女性，且疾病负担随年龄增长而增加，其中50~74岁人群负担最为突出。预测结果显示，2024-2043年ASPR将持续上升，而ASDR呈稳定或轻度下降趋势。2023年中国听力损失DALYs中约21.6%归因于职业噪声暴露。结论 1990-2023年中国听力损失疾病负担总体上升，男性负担高于女性，50~74岁人群为主要受累人群。人口增长、人口老龄化及职业噪声暴露可能是重要影响因素。加强高危人群筛查与职业噪声防控有助于减轻未来疾病负担。

Abstract

Objective The objective of this study is to analyse temporal trends in the burden of hearing loss in China from 1990 to 2023 using data from the Global Burden of Disease Study 2023. The study will examine sex- and age-specific patterns, the contribution of occupational noise exposure, and future burden trends. Methods The dataset encompasses prevalent cases, disability-adjusted life years (DALYs), age-standardised prevalence rate (ASPR), and age-standardised DALY rate (ASDR) of hearing loss in China from 1990 to 2023. The temporal trends under scrutiny were assessed by the estimation of the annual percentage change (EAPC), a process facilitated by log-linear regression models. The utilisation of an autoregressive integrated moving average (ARIMA) model was instrumental in the projection of ASPR and ASDR from 2024 to 2043. The proportion of DALYs attributable to occupational noise exposure was also analysed. Results In 2023, China had 484 million prevalent cases of hearing loss and 14.13 million DALYs. From 1990 to 2023, prevalent cases and DALYs increased by 148.3% and 135%, respectively. The ASPR demonstrated a marked upward trajectory [EAPC=0.20%, 95%CI(0.15%, 0.24%)], while the ASDR exhibited no substantial alteration. The findings of this study demonstrate that both ASPR and ASDR were higher in males than in females. Furthermore, the burden increased with age, particularly among individuals aged 50-74 years. Projections indicate that ASPR will undergo an upward trajectory from 2024 to 2043, while ASDR is expected to remain stable or exhibit a modest decline. In 2023, approximately 21.6% of DALYs were attributable to occupational noise exposure. Conclusion The prevalence of hearing impairment in China exhibited an upward trend from 1990 to 2023. The male population and individuals within the 50-74 age bracket are subject to a greater burden. The phenomenon under scrutiny has been hypothesised to be the result of population growth, ageing, and occupational noise exposure. The enhancement of early screening and occupational noise control measures has the potential to mitigate the future burden of hearing loss.

关键词

听力损失 / 患病人数 / 残疾 / 疾病趋势

Key words

Hearing loss / Prevalent cases / Disability / Disease trends

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基金资助

湖南省自然科学基金项目(2026JJ82708)