职业噪声和高温对心血管系统的影响

The interactive effects of occupational noise exposure and high temperature on cardiovascular system

目的分析不同职业性噪声暴露水平对心血管系统的影响,探讨噪声与其他职业性有害因素(高温、有害气体)之间是否存在交互作用。方法采用回顾性队列研究设计方法,收集安徽省某特大型化工企业2014―2018年的职业健康检查结果。根据噪声暴露评估情况将研究人群分为高暴露组(≥80 dB(A))、中暴露组(70~79 dB(A))和低暴露组(<70 dB(A));参考高温作业分级标准,对环境温度进行分级(I^IV级)。应用SPSS 23.0软件,采用χ~2检验比较作业人员吸烟、饮酒、规律运动等因素在不同暴露组的构成,建立Cox回归模型分析暴露与效应关系。结果与低暴露组相比,暴露于≥80 dB(A)和70~79 dB(A)的职业噪声会增加高血压的发病风险,其风险比(hazard ratio,HR)和95%置信区间分别为1.85(95%CI:1.36~2.52)和1.29(95%CI:1.03~1.60)。暴露于≥80 dB(A)的职业噪声会增加心电图异常的发生风险(HR=1.31,95%CI:1.06~1.63)。共同暴露于高温和≥80 dB(A)职业噪声,高血压的发病风险进一步增加(HR=8.98,95%CI:3.25~24.86)。结论职业性噪声暴露可增加职业人群高血压和心电图异常的发生风险,且职业性噪声与高温存在交互作用。

Objective To investigate the effects of different noise exposure levels on the cardiovascular system, so as to evaluate whether there was an interactive effect between occupational noise exposure and other exposures(ambient temperature or harmful gas exposure). Methods Retrospective cohort study designs were used. Occupational health examination results from 2014 to 2018 in the largest chemical enterprise in Anhui, China, were collected. According to the noise exposure assessment, selected subjects were divided into high-exposure group(≥ 80 dB(A)), medium-exposure group(70-79 dB(A)) and low-exposure group(<70 dB(A)). The ambient temperature was graded(Grade I-IV) according to the high temperature operation classification standard. SPSS 23.0 software was used to establish the Cox regression models to analyze exposure-effect relationship. χ~2 test was applied to compare the constitution of cigarette usage, alcohol intake, regular exercise and others among the three exposure groups. Results Compared with the low-exposure group, workers exposed to occupational noise ≥80 dB(A) and 70-79 dB(A) were at risk for hypertension, respectively, with hazard ratio(HR)and 95% confidence interval of 1.85(95% CI:1.36-2.52) and 1.29(95% CI:1.03-1.60). Occupational exposure to noise levels above 80 dB(A) could increase the risk of electrocardiogram abnormality(HR=1.31, 95%CI: 1.06-1.63). In addition, workers exposed to both high temperature and occupational noise ≥80 dB(A) exhibited a further increased risk of hypertension(HR=8.98,95% CI:3.25-24.86). Conclusions Occupational noise exposure can increase the risk of cardiovascular disease in occupational population, and there is an interactive effect between occupational noise exposure and high temperature.