Background

Exposure to occupational noise might increase the risk of hypertension. However, limited cohort studies have investigated the relationship between time-varying exposure to occupational noise and the development of hypertension.

Methods

We conducted a 17-year cohort study involving 2459 workers to assess the relationship between time-varying exposure to occupational noise and incident hypertension in the aerospace industry. We performed an extended Cox proportional hazard model considering occupational noise exposure as time-varying covariates. Furthermore, we employed the distributed lag nonlinear models (DLNMS) to examine the exposure-response relationship.

Results

In the extended Cox proportional model, as workers were exposed to noise over 80 dBA, the hazard ratios (HRs) of hypertension significantly increased with a noise increase of 5 dBA (HR = 1.16, 95% CI: 1.04–1.29). In exposure-response associations, the HRs of hypertension steadily increased between noise levels of 82 and 106 dBA (HRs ranged from 1.04 to 1.46). After additionally adjusting for personal protection equipment (PPE), the HRs decreased dramatically between 107 and 124 dBA (HRs ranged from 1.45 to 1.00).

Conclusions

Our study refined the exposure assessment by integrating time-varying exposures to occupational noise and taking work history into consideration. Our findings suggested that workers exposed to noise levels between 82 and 106 dBA for 3–17 years may increase the risk of hypertension with a non-linear exposure-response pattern. We further provided evidence that workers wearing PPE could effectively reduce noise exposure and avoid the development of hypertension.

中文翻译：

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职业噪声随时间的变化与高血压的关系：一项前瞻性队列研究。

背景

接触职业噪声可能会增加患高血压的风险。然而，有限的队列研究研究了随时间变化的职业噪声暴露与高血压发展之间的关系。

方法

我们进行了一项为期17年的队列研究，涉及2459名工人，以评估航空航天行业随时间变化的职业噪声暴露与突发性高血压之间的关系。我们执行了扩展的Cox比例风险模型，将职业噪声暴露视为随时间变化的协变量。此外，我们采用了分布式滞后非线性模型（DLNMS）来检查曝光-响应关系。

结果

在扩展的Cox比例模型中，当工人暴露于80 dBA以上的噪声中时，高血压的危险比（HRs）显着增加，噪声增加5 dBA（HR = 1.16，95％CI：1.04-1.29）。在暴露-反应关联中，高血压的HR在82和106 dBA的噪声水平之间稳定增加（HR的范围为1.04至1.46）。在对个人防护设备（PPE）进行额外调整之后，HR急剧下降，介于107和124 dBA之间（HR范围从1.45到1.00）。

结论

我们的研究通过整合随时间变化的职业噪声暴露并考虑工作历史来完善暴露评估。我们的研究结果表明，工作人员在3至17年内暴露于82至106 dBA之间的噪声水平可能会以非线性的暴露反应模式增加患高血压的风险。我们进一步提供的证据表明，穿着PPE的工人可以有效减少噪声暴露并避免高血压的发展。