累积噪声暴露量与高血压患病率的剂量-反应关系

INVESTIGATION OF DOSE-RESPONSE RELATIONSHIP BETWEEN CUMULATIVE NOISE EXPOSURE AND HYPERTENSIVE PREVALENCE IN FEMALE TEXTILE WORKERS

本文应用累积噪声暴露量的概念,在Logistic回归模型中分析了噪声暴露与纺织女工高血压患病率的关系。发现应用累积噪声暴露量可以解决噪声作业工龄与年龄高度相关在Logistic回归模型中互相干扰的问题。调整后的累积噪声暴露量的Odds Ratio为1.033,与另一模型中调整后噪声强度的Odds Ratio的1.03l非常接近,同时P值降低。表明噪声暴露与高血压病的发生之间有累积效应关系。应用累积噪声暴露量后,年龄的Odds Ratio由1.101上升为1.157,P值也由0.323降低为<0.001;父母高血压史和吃菜咸淡的Odds Ratio与应用噪声强度和噪声作业工龄的模型非常接近。用后退法比较最大似然值差值的方法证实,年龄对高血压病的危险性约为噪声的3倍、父母高血压史和吃莱咸淡分别为噪声的2倍和1.6倍。作者对年龄与工龄高度相关在职业流行病学研究中造成的困难以及应用累积噪声暴露量解决这一困难的机理进行了讨论。

Cumulative noise exposure(CNE)could cut down the high correlation between age and working years to avoidcollinearity of them in logistic model for better results.The adjusted odds ratio(OR)of CNE (1.033,P=0.034)was slightly higher than sound pressure level(SPL,OR=1.031,P=0.047)in another logistic model.It supportedthe working hypothesis about cumulative effect for noise induced hypertension.In logistic model with CNE,OR ofage was 1.157(P<0.001),which was higher than 1.101(P=0.323)in another model with both SPL and workingyears.The OR of parents hypertensive history and self reported salt intake habit,was very near to that in the twomodels.The difficults about high correlation between age and working years in occupational epidemiological re-searches and the mechanism of overcoming them by CNE were discussed.