Hearing function of gold miners with and without a history of tuberculosis treatment: a retrospective data review

Abstract Introduction: South Africa has a high prevalence of co-existing tuberculosis and HIV. As ototoxicity linked to the treatments for these conditions occurs with concomitant exposure to other ear toxins such as hazardous noise exposure, it is important to investigate the combination impact of these toxins. Limited published evidence exists on the co-occurrence of these conditions within this population. Objectives: The objective of this study was to compare the hearing function of gold miners with (treatment group) and without (non-treatment group) the history of tuberculosis treatment, in order to determine which group had increased risk of noise induced hearing loss. Furthermore, possible influence of age and HIV in these two groups was examined. Methods: A retrospective record review of 102 miners' audiological records, divided into two groups, was conducted, with data analyzed both qualitatively and quantitatively. Results: Findings suggest that gold miners with a history of tuberculosis treatment have worse hearing thresholds in the high frequencies when compared to those without this history; with evidence of a noise induced hearing loss notch at 6000 Hz in both groups. Pearson's correlations showed values between 0 and 0.3 (0 and −0.3) which are indicative of a weak positive (negative) correlation between HIV and hearing loss, as well as between hearing loss and age in this population. Conclusions: Current findings highlight the importance of strategic hearing conservation programs, including ototoxicity monitoring, and the possible use of oto-protective/chemo-protective agents in this population.

摘要：南非肺结核与人类免疫缺陷病毒（HIV）合并感染的患病率较高。由于针对这两类疾病的治疗所引发的耳毒性（ototoxicity），常与有害噪声暴露等其他耳毒性物质的暴露同时发生，因此探究这些毒素的联合影响具有重要意义。目前针对该人群中这些疾病合并发生的公开研究证据较为有限。
研究目标：本研究旨在对比有肺结核（tuberculosis）治疗史的金矿矿工（治疗组）与无肺结核治疗史的金矿矿工（非治疗组）的听力功能，以确定哪一组人群的噪声性听力损失（noise induced hearing loss）风险更高。此外，本研究还考察了年龄与HIV感染对这两组人群听力的潜在影响。
研究方法：本研究对102名矿工的听力学记录进行了回顾性审查，将其分为两组，并采用定性与定量相结合的方法对数据进行分析。
研究结果：结果显示，与无肺结核治疗史的矿工相比，有肺结核治疗史的金矿矿工高频听力阈值更差；两组人群均在6000Hz处出现了噪声性听力损失切迹。皮尔逊（Pearson）相关分析结果显示，相关系数介于0至0.3（0至-0.3）之间，表明该人群中HIV感染与听力损失之间存在弱正（负）相关关系，听力损失与年龄之间同样存在此类弱相关关系。
研究结论：本次研究结果凸显了制定针对性听力保护方案的重要性，其中包括耳毒性监测，以及在该人群中可能应用的耳保护剂/化学保护剂。