The prevalence of occupational exposure to noise: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury,Environment International

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The prevalence of occupational exposure to noise: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury
Environment International ( IF 10.3 ) Pub Date : 2021-04-17 , DOI: 10.1016/j.envint.2021.106380
Liliane R Teixeira ₁ , Frank Pega ₂ , Wagner de Abreu ₁ , Marcia S de Almeida ₁ , Carlos A F de Andrade ₃ , Tatiana M Azevedo ₄ , Angel M Dzhambov ₅ , Weijiang Hu ₆ , Marta R V Macedo ₇ , Martha S Martínez-Silveira ₈ , Xin Sun ₆ , Meibian Zhang ₉ , Siyu Zhang ₆ , Denise T Correa da Silva ₁

Affiliation

Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil; School of Medicine, Universidade de Vassouras, Vassouras, RJ, Brazil.
Workers' State Secretariat of Health, Rio de Janeiro, RJ, Brazil; State Reference Center in Workers' Health, Rio de Janeiro, RJ, Brazil.
Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria.
National Institute for Occupational Health and Poison Control, Center for Disease Control and Prevention, Beijing, People's Republic of China.
Workers' Health Coordination, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, BA, Brazil.
Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, People's Republic of China.

Background

The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of individual experts. Evidence from mechanistic and human data suggests that occupational exposure to noise may cause cardiovascular disease. In this paper, we present a systematic review and meta-analysis of the prevalence of occupational exposure to noise for estimating (if feasible) the number of deaths and disability-adjusted life years from cardiovascular disease that are attributable to exposure to this risk factor, for the development of the WHO/ILO Joint Estimates.

Objectives

We aimed to systematically review and meta-analyse estimates of the prevalence of occupational exposure to noise.

Data sources

We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines, and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts.

Study eligibility and criteria

We included working-age (≥15 years) workers in the formal and informal economies in any WHO Member and/or ILO member State, but excluded children (<15 years) and unpaid domestic workers. We included all study types with an estimate of the prevalence of occupational exposure to noise, categorized into two levels: no (low) occupational exposure to noise (<85dBA) and any (high) occupational exposure to noise (≥85dBA).

Study appraisal and synthesis methods

At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We combined prevalence estimates using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using the RoB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates.

Results

Sixty-five studies (56 cross-sectional studies and nine cohort studies) met the inclusion criteria, comprising 157,370 participants (15,369 females) across 28 countries and all six WHO regions (Africa, Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific). For the main analyses, we prioritized the four included studies that surveyed national probability samples of general populations of workers over the 58 studies of workers in industrial sectors and/or occupations with relatively high occupational exposure to noise. The exposure was generally assessed with dosimetry, sound level meter, or official or company records; in the population-based studies, it was assessed with validated questions. Estimates of the prevalence of occupational exposure to noise are presented for all 65 included studies, by country, sex, 5-year age group, industrial sector, and occupation where feasible. The pooled prevalence of any (high) occupational exposure to noise (≥85dBA) among the general population of workers was 0.17 (95% confidence interval 0.16 to 0.19, 4 studies, 108,256 participants, 38 countries, two WHO regions, I² 98%, low quality of evidence). Subgroup analyses showed that pooled prevalence differed substantially by WHO region, sex, industrial sector, and occupation.

Conclusions

Our systematic review and meta-analysis found that occupational exposure to noise is prevalent among general populations of workers. The current body of evidence is, however, of low quality, due to serious concerns for risk of bias and indirectness. Producing estimates of occupational exposure to noise nevertheless appears evidence-based, and the pooled effect estimates presented in this systematic review are suitable as input data for the WHO/ILO Joint Estimates (if feasible).

Protocol identifier: 10.1016/j.envint.2018.09.040

PROSPERO registration number: CRD42018092272

中文翻译：

职业性噪声暴露的发生率：世界卫生组织/国际劳工组织对与工作相关的疾病和伤害负担联合估计的系统回顾和荟萃分析

背景

世界卫生组织 (WHO) 和国际劳工组织 (ILO) 正在制定与工作相关的疾病和伤害负担的联合估计（WHO/ILO 联合估计），并得到了庞大的个人专家网络的贡献。来自机械和人体数据的证据表明，职业性接触噪音可能会导致心血管疾病。在本文中，我们对职业噪声暴露的流行率进行了系统回顾和荟萃分析，以估计（如果可行）因暴露于该危险因素而导致的心血管疾病死亡人数和伤残调整生命年，制定世界卫生组织/国际劳工组织联合估计。

目标

我们的目的是系统地回顾和荟萃分析对职业噪声暴露流行率的估计。

数据源

我们在电子学术数据库中检索了已发表和未发表的研究中可能相关的记录，包括 Ovid Medline、PubMed、EMBASE 和 CISDOC。我们还检索了电子灰色文献数据库、互联网搜索引擎和组织网站；手动检索先前系统评价的参考清单并包括研究记录；并咨询了其他专家。

学习资格和标准

我们纳入了任何世卫组织成员国和/或国际劳工组织成员国正规和非正规经济中的工作年龄（≥15 岁）工人，但排除了儿童（<15 岁）和无酬家庭工人。我们纳入了所有研究类型，并对职业噪声暴露发生率进行了估计，分为两个级别：无（低）职业噪声暴露（<85dBA）和任何（高）职业噪声暴露（≥85dBA）。

研究评价和综合方法

至少有两名综述作者在第一阶段根据资格标准独立筛选标题和摘要，并在第二阶段筛选潜在合格记录的全文，然后从合格研究中提取数据。我们使用随机效应荟萃分析结合了患病率估计。两名或两名以上综述作者使用专门为 WHO/ILO 联合估算开发的 RoB-SPEO 工具和 QoE-SPEO 方法评估偏倚风险和证据质量。

结果

65 项研究（56 项横断面研究和 9 项队列研究）符合纳入标准，包括 28 个国家和所有 6 个世卫组织区域（非洲、美洲、东地中海、欧洲、东南亚、和西太平洋）。对于主要分析，我们优先考虑了对一般工人群体的全国概率样本进行调查的四项研究，而不是对工业部门和/或职业噪声暴露相对较高的职业工人的 58 项研究。通常通过剂量测定、声级计或官方或公司记录来评估暴露；在基于人群的研究中，通过经过验证的问题对其进行了评估。对所有 65 项纳入的研究，按国家、性别、5 岁年龄组、工业部门和职业（如果可行）提供了职业噪声暴露流行率的估计。一般工人群体中任何（高）职业噪声暴露（≥85dBA）的汇总患病率为 0.17（95% 置信区间 0.16 至 0.19，4 项研究，108,256 名参与者，38 个国家，两个 WHO 区域，I 2 ⁹⁸ % ，证据质量低）。亚组分析显示，不同世卫组织区域、性别、工业部门和职业的汇总患病率存在显着差异。