Study On The Influence Of Blood Cadmium And Lead Levels On Hearing Loss In Residents And Health Management Strategy

Objective:A case-control study was conducted to understand the current situation of blood cadmium and lead levels in Zhejiang residents,to study the relationship between blood cadmium and lead levels and hearing loss,to analyze the interactions of those elements and hearing loss,and to explore the influencing factors of blood cadmium and lead levels.Based on collaborative governance,stakeholder theory and health management,this research provides countermeasures for residents to prevent hearing loss.Methods:From October 2016 to June 2018,a 1:1 matched design was used to collect 1008 hearing loss and 1008 normal hearing residents with similar age,sex and region in five city hospitals of Zhejiang Province.Hearing tests and blood heavy metal content tests were carried out.Paired t test and chi-square test were used to analyze the differences in general demographic characteristics,lifestyle and disease status between the case group and the control group.Conditional logistic regression was used to analyze the effect of blood cadmium and lead on hearing loss of residents.Cross-generative analysis was used to explore whether there was interaction between blood cadmium and lead on hearing loss.Multivariate linear regression was used to analyze the influencing factors of blood cadmium and lead content of residents.Results:(1)After logarithmic transformation,the blood cadmium level was 0.34±0.24 ?g/L in the case group and 0.32±0.22 ?g/L in the control group.The blood lead level was 1.58±0.17 ?g/dL in the case group and 1.57±0.16 ?g/dL in the control group.(2)After adjusting for confounding factors,conditional logistic regression analysis showed that the risk of hearing loss in the group with the highest blood cadmium level was 1.497 times that in the group with the lowest blood lead level(95%CI:1.049,2.134).And the risk of hearing loss in the group with the highest blood lead level was 1.017 times that in the group with the lowest blood lead level(95%CI: 0.701,1.476).(3)Compared with normal cadmium and lead levels,the risk of hearing loss increased by 69.4% in those with cadmium levels(OR=1.694,95%CI :1.107,2.593).And the risk of hearing loss increased by176.7%(OR=2.767,95%CI:0.278,27.570)in those who have excessive Cadmium and lead level.But these data are not statistically significant.(4)Age,gender,smoking may affect the blood cadmium level of residents;Age,gender,exposure to secondhand smoke and drinking also have an impact on the blood lead level of residents.Conclusion:Firstly,blood cadmium content is a risk factor for hearing loss.Secondly,blood cadmium and lead content are influenced by general demographic characteristics such as age and sex,smoking,drinking and exposure to second-hand smoke.Thirdly,countermeasures and suggestions should be put forward to control the blood cadmium and lead level of residents and reduce the risk of hearing loss from the aspects of the government's implementation of macro-control responsibilities,enterprises' strengthening of source control,community health service organizations' giving play to the advantages of the grass-roots level,and social forces taking social responsibilities.