Talbott E O, Gibson L B, Burks A, Engberg R, McHugh K P
University of Pittsburgh Graduate School of Public Health, Department of Epidemiology, Pennsylvania 15261, USA.
Arch Environ Health. 1999 Mar-Apr;54(2):71-8. doi: 10.1080/00039899909602239.
In this study, we investigated the role of occupational noise exposure and blood pressure among workers at 2 plants. A noise-exposed plant (plant 1, > or = 89 dBA) and a less-noise-exposed plant (plant 2, < or = 83 dBA) were chosen. Exposure was based on department-wide average noise measures; on the basis of job location and adjusting for layoffs during their employment at the plant, a cumulative time-weighted average noise level was calculated for each worker. The study population comprised 329 males in plant 1 and 314 males in plant 2. Their ages ranged from 40 to 63 y (mean ages = 49.6 and 48.7, respectively), and they had worked at least 15 y at the plant. The clinical examination was administered prior to the workday and measured height, weight, pulse, and blood pressure. In addition, we noted medical and personal-habits histories, including alcohol intake and cigarette smoking patterns. We used a questionnaire to determine in-depth occupation, military history, noisy hobbies, and family history of hypertension. When individuals who took blood-pressure medication were removed from the analysis, t tests for differences in average blood pressure between plants showed a mean systolic blood pressure of 123.3 mm Hg in plant 1 versus 120.8 mm Hg in plant 2 (p = .06) and a mean diastolic blood pressure of 80.3 mm Hg versus 77.8 mm Hg in Plant 1 and 2, respectively (p = .014). On the basis of data from the combined plants, multivariate analysis revealed that age, body mass index, cumulative noise exposure, current use of blood pressure medications, and alcohol intake were significant predictors for systolic blood pressure. Cumulative noise exposure was a significant predictor of diastolic blood pressure in plant 1 but not in plant 2, possibly reflecting a threshold effect.
在本研究中，我们调查了两家工厂工人的职业噪声暴露与血压之间的关系。选取了一家噪声暴露工厂（工厂1，噪声水平≥89分贝）和一家噪声暴露较少的工厂（工厂2，噪声水平≤83分贝）。暴露情况基于全部门平均噪声测量值；根据工作地点，并对其在工厂工作期间的裁员情况进行调整，计算出每名工人的累积时间加权平均噪声水平。研究对象包括工厂1的329名男性和工厂2的314名男性。他们的年龄在40至63岁之间（平均年龄分别为49.6岁和48.7岁），且在工厂工作至少15年。在工作日之前进行临床检查，测量身高、体重、脉搏和血压。此外，我们还记录了医疗和个人习惯史，包括饮酒量和吸烟模式。我们使用问卷来确定详细的职业、军事史、嘈杂爱好以及高血压家族史。在分析中剔除服用降压药的个体后，对两工厂平均血压差异进行的t检验显示，工厂1的平均收缩压为123.3毫米汞柱，而工厂2为120.8毫米汞柱（p = 0.06）；工厂1和工厂2的平均舒张压分别为80.3毫米汞柱和77.8毫米汞柱（p = 0.014）。基于两家工厂合并后的数据，多变量分析显示，年龄、体重指数、累积噪声暴露、当前是否使用降压药以及饮酒量是收缩压的重要预测因素。累积噪声暴露是工厂1舒张压的重要预测因素，但在工厂2中并非如此，这可能反映了一种阈值效应。
