职业性噪声暴露与心血管疾病风险的关联性研究

Association between occupational noise exposure and the risk of cardiovascular diseases

目的探讨中国人群职业性噪声暴露和心血管疾病风险的关联性。方法于2019年12月,从东风同济队列中纳入2008年9月至2010年6月东风汽车有限公司的退休职工21412人作为研究对象,职业性噪声暴露根据现场监测数据或工种信息进行评价;听力评估在8931人中进行,以双耳500、1000、2000、4000 Hz的平均听阈均≥25 dB定义双耳听力损失。采用logistic回归分析职业性噪声暴露、双耳听力损失和心血管疾病十年风险的关联性。结果与无职业性噪声暴露的工人比较,职业性噪声暴露≥20年的工人心血管疾病的十年风险明显升高(OR=1.20,95%CI:1.01~1.41,P=0.001);在性别的亚组分析中,男性工人心血管疾病的十年风险明显升高(OR=2.34,95%CI:1.18~4.66,P<0.001),但在女性中没有统计学意义(OR=1.15,95%CI:0.97~1.37,P=0.153)。在双耳听力损失的分析结果中,作为高噪声暴露指标,双耳听力损失与心血管疾病十年风险升高有关(OR=1.17,95%CI:1.05~1.44,P<0.001),且这种关联在男性(OR=1.24,95%CI:1.07~2.30,P<0.001)、年龄≥60岁(OR=2.30,95%CI:1.84~2.88,P<0.001)和噪声暴露人群(OR=1.66,95%CI:1.02~2.70,P=0.001)中更加明显。结论职业性噪声暴露可能是心血管疾病的危险因素。

Objective To explore the association between occupational noise exposure and cardiovascular disease(CVD)risk in a large Chinese population.Methods In December 2019,the study included 21412 retired participants from the Dongfeng-Tongji Cohort Study at baseline from September 2008 to June 2010,occupational noise exposure was evaluated through workplace noise level and/or the job titles.In a subsample of 8931 subjects,bilateral hearing loss was defined as a pure-tone mean of 25 dB or higher at 0.5,1,2,and 4 kHz in both ears.Logistic regression models were used to explore the association of occupational noise exposure,bilateral hearing loss with 10-year CVD risk.Results Compared with participants without occupational noise exposure,the 10-year CVD risk was significantly higher for noise exposure duration≥20 years(OR=1.20,95%CI:1.01-1.41,P=0.001)after adjusting for potential confounders.In the sex-specific analysis,the association was only statistically significant in males(OR=2.34,95%CI:1.18-4.66,P<0.001),but not in females(OR=1.15,95%CI:0.97-1.37,P=0.153).In the subsample analyses,bilateral hearing loss,which was an indicator for exposure to loud noise,was also associated with a higher risk of 10-year CVD(OR=1.17,95%CI:1.05-1.44,P<0.001),especially for participants who were males(OR=1.24,95%CI:1.07-2.30,P<0.001),aged equal and over 60 years old(OR=2.30,95%CI:1.84-2.88,P<0.001),and exposed to occupational noise(OR=1.66,95%CI:1.02-2.70,P=0.001).Conclusion Occupational noise exposure may be a risk factor for CVD.