摘要一
國小學校環境噪音與學童聽力損失及上課干擾情況探討
目的
先前研究發現環境噪音的暴露可能會引起煩擾及聽力損失。台灣曾有兩篇研究針對單一航空站附近學校學童暴露於航空噪音所造成的聽力效應的探討，但結果並不一致。本研究之目的為評估學校環境噪音與學童聽力損失及干擾情況間關係。
方法
本研究針對台北、嘉義、台南與高雄設有民航局噪音監測站之國小進行環境噪音監測以與民航局噪音監測站值作比對；並選取校園內全音頻音壓值低於衛生署所規定之45dBA之教室作為聽力室，針對六年級學童進行500、1K、2k、4k、6k及8k Hz處之純音聽力檢查，藉此評估學童聽力損失之情況。亦針對台灣地區設有環保署與民航局噪音監測站的國小進行老師、學生與家長的問卷調查，評估其自覺學校環境噪音干擾情況。分析中採用民航局提供之3年8小時噪音時量平均值(Leq)及噪音最大值平均值(Lmax)作為受測學校噪音暴露分類之依據。
結果
12所受測國小中共有270名學童納入純音聽力檢查分析中(男生136名，女生134 名)。受測學校之環境噪音暴露量分布(mean±SD)為61.6±2.3 dBA。以純音聽力閾值平均值(PTA)、高頻純音聽力閾值平均值(HPTA)及各音頻處聽力閾值作為評估受測學童聽力損失程度之依據。受測學童之PTA 在左右耳分別為9.6±4.7、9.1±4.7dBHL；HPTA為7.8±5.7、6.5±5.1 dBHL。學校噪音Leq越高的學校，其學童在8KHz及HPTA之聽力損失越嚴重(p<0.05)；Lmax越高學校，卻是在1KHz及PTA受到影響。共有2284名學童進行問卷調查，受測學校之噪音暴露量分布為63.1±4.1 dBA。學童自覺受到學校噪音干擾的比例分布為13.0±11.6 %。相對於學校噪音值低於60dBA的學校而言，當學校噪音超過63.3dBA時，會有顯著較高的風險會干擾或中斷上課 (OR=2.55；95%CI=1.74-3.73)。
結論
本研究發現高環境噪音暴露學校之國小學童之聽力損失情況以Leq作指標時，學童在HPTA及8k Hz處聽損較嚴重；若以Lmax作指標，則在PTA及1KHz處聽損較嚴重。且學童與老師會受學校噪音而干擾或打斷上課。

摘要二
國小學校環境噪音影響學童實地語音辨識力之研究
目的
先前研究發現環境噪音的暴露可能會影響語言溝通及學童在學校的表現。至今對學校噪音影響學童上課的干擾情況並無一量化的方式。本研究的目的為評估量化當前學校環境噪音對學童實地語音辨識力所造成的干擾程度。
方法
本研究針對台北、嘉義、台南與高雄12所設有民航局噪音監測站之國小隨機選取各校兩班六年級學生650名進行實地語音辨識力測試。採用標準化中國語音均衡字彙表作為測試內容，以75、80、85、90、95dB(A)作為施測音量，藉以模擬老師授課音量，並計算學童測試得分作為語音辨識力之判別依據。另在空教室內藉訊號產生器產生75、80、85、90、95dBA之全頻音，於教室內各點進行音量量測，模擬製作空教室中之噪音衰減圖。結合各施測教室之噪音衰減圖及學童受測時之座標位置，推估受測學童接收來自音源之實際音量。將學童實際接收來自音源之音量減去民航局所提供之該校3年8小時學校噪音均能音量值，得一訊號/噪音比值(S/N ratio)，探討S/N ratio與語音辨試力測試得分間相關性，藉此量化評估學童受學校環境噪音干擾其聽取上課時語音的情形。
結果
共393名學童納入實地語音辨識力調查分析當中。利用Linear regression檢定S/N ratio與學童語音辨識力測驗成績間相關性發現兩者有顯著相關；並得一利用S/N ratio來估計學童測驗成積之方程式：語音辨識力總得分(%)=37.9+2.8 (S/N ratio)-0.04(S/N ratio)2。根據民航局三年平均資料，有將近80%設有噪音測站國小之噪音監測值高於60dBA以上。以方程式推估結果發現，若授課音量分別為95、90、85dBA，且學校航空噪音高於60dB時，分別會有>67.9%、>58.6%及>49.4%的語音無法被辨識。
結論
以目前的學校噪音情況，會對學童上課造成相當程度的干擾。由於民航局之噪音監測資料無法區分噪音來源，故無法確定造成干擾之噪音源為何。將是以後重要之研究方向。

Abstract I
Effects of Environmental Noise on Hearing Loss and
Annoyance in School Children
Objectives. Previous research suggests that exposure to environmental noise may result in annoyance and hearing loss. In Taiwan, the studies of hearing loss on children due to high background noise are inconclusive. The objective of this study is to assess the association between school noise exposure, hearing loss, and annoyance in children.
Methods. Audiometry and self-reported annoyance of the sixth grade children are compared among 12 schools with noise monitoring station from Taipei, Chayi, Tainan and Kaoshiung. Audiometry is done at 500, 1k, 2k, 4k, 6k, and 8k Hz in a quiet room (LAeq<45dBA) of the selected schools to assess hearing loss in children. Questionnaire is given to children, their parents and teachers to evaluate annoyance in the class. Exposure status is classified based on the noise monitoring station data on daytime 8 hours average (Leq) and average of maximum (Lmax) in the past 3 years.
Results. A total of 270 children (136 boys and 134 girls) among 12 schools completed auidometry. Noise exposure distribution (mean±SD) of the test schools is 61.6±2.3 dBA. Hearing level are compared according to the average of hearing threshold at 500, 1k, 2k Hz (PTA) and at 4k, 6k, 8k Hz (HPTA). PTA distribution of both ears are 9.1±4.7, 9.6±4.7 dBHL and HPTA are 6.5±5.1, 7.8±5.7 dBHL among test children. Simple linear regression analysis indicated that hearing threshold at 8kHz and high frequency pure tone average (HPTA) are associated with level of average daytime school noise (p<0.05) in the past 3 years, and 1kHz and pure tone average (PTA) are associated with Lmax. Total of 2284 children completed questionnaire and 13.0±11.6% of them reported annoyance by noise in class. Higher levels of annoyance was reported by children in schools with higher levels of environmental noise (OR=2.55, 95% CI=1.74-3.73).
Conclusions. At the current noise exposure, school children were annoyed at class. Hearing loss and annoyance in school children are associated with the level of school environmental noise.

Abstract II
Association Between Environmental Noise and Field Word
Recognition Test of School Children
Objectives. Previous research suggests that exposure to environmental noise may result in interference of speech communication and affected school performance. However, data is lacking on the quantity of interference in school children’s comprehension of class material. The objective of the study is to quantify the effect of environmental noise on school children’s word recognition.
Methods. Field word recognition test of sixth-grade children are compared among 12 schools with noise monitoring station from Taipei, Chayi, Tainan and Kaoshiung. Standardized phonetically balanced word lists with sound pressure of 75, 80, 85, 90, and 95 dBA are used in the field to test the word recognition ability of children under the interference of background noise. To create a signal contour map of classroom, random noise generator SF-06 is used to generate sound level of 75, 80, 85, 90, 95dBA and sound level meter NL-11 is used to measure the sound level at different positions in an empty classroom. Received sound level by test children are derived from combination of coordinate of seat and noise contour map of classroom. Signal to noise ratio (S/N ratio) are derived by subtracting classroom noise level from received signal level by test children. Relationship of S/N ratio and score of word recognition test are assessed to evaluate the interference of comprehension in students.
Results. Total of 393 children of 24 classes among 12 test schools were included in the analysis. Linear regression analysis indicates that S/N ratio are associated with word recognition ability and also provides an equation for S/N ratio to infer the score of word recognition test (Score(%)=37.88+2.77*S/N ratio–0.04(S/N ratio)2). According to the noise monitoring station data of daytime 8 hours average in the past 4 years, over 80% schools had monitored school noise of higher than 60 dBA. By the equation, when the teaching sound levels are 95, 90, 85dBA and the school noise is higher than 60dBA, >67.9%, >58.6%, and >49.4% test words cannot be comprehended correctly.
Conclusions. The study shows that present school noise causes significant interference with speech, which should not be ignored. However, the study cannot specify the sources of noise. Further study is therefore warranted in order to prevent interference on teaching.

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