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噪音负荷与心肌梗死风险

Noise burden and the risk of myocardial infarction.

作者信息

Willich Stefan N, Wegscheider Karl, Stallmann Martina, Keil Thomas

机构信息

Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Centre, 10098 Berlin, Germany.

出版信息

Eur Heart J. 2006 Feb;27(3):276-82. doi: 10.1093/eurheartj/ehi658. Epub 2005 Nov 24.

Abstract

AIMS

Chronic noise exposure is associated with adverse pathophysiological effects and may contribute to the progression of cardiovascular disease. We, therefore, determined the risk of noise for the incidence of myocardial infarction.

METHODS AND RESULTS

In a case-control study, 4115 patients (3054 men, 56+/-9 years; 1061 women, 58+/-9 years) consecutively admitted to all 32 major hospitals in Berlin with confirmed diagnosis of acute myocardial infarction were enrolled from 1998 to 2001 in the Noise and Risk of Myocardial Infarction (NaRoMI) study. Controls were matched for gender, age, and hospital. In standardized interviews, information was obtained on environmental and work noise annoyance. The sound levels of environmental and work noise were assessed using traffic noise maps as proxy and international standards for workplaces, respectively. In multivariate logistic regression models, the adjusted odds ratios of noise variables were determined. There was a marginally increased risk of myocardial infarction associated with annoyance by environmental noise in women (adjusted odds ratio 1.47, 95% confidence interval 0.95-2.25, P=0.081) but not in men, and not associated with annoyance by work noise. Environmental sound levels were associated with increased risk in men and women (odds ratios 1.46, 1.02-2.09, P=0.040 and 3.36, 1.40-8.06, P=0.007) and work sound levels in men only (1.31, 1.01-1.70, P=0.045).

CONCLUSION

Chronic noise burden is associated with the risk of myocardial infarction. The risk increase appears more closely associated with sound levels than with subjective annoyance. Further investigation of the gender-related risk of noise exposure may aid in improving prevention.

摘要

目的

长期暴露于噪音环境与不良的病理生理效应相关,并可能促使心血管疾病的发展。因此,我们确定了噪音对心肌梗死发病率的影响。

方法与结果

在一项病例对照研究中,于1998年至2001年期间,从柏林所有32家主要医院连续收治的确诊为急性心肌梗死的4115例患者(3054例男性,年龄56±9岁;1061例女性,年龄58±9岁)纳入心肌梗死的噪音与风险(NaRoMI)研究。对照组按性别、年龄和医院进行匹配。在标准化访谈中,获取有关环境和工作噪音烦恼的信息。分别使用交通噪音地图作为替代指标和工作场所国际标准来评估环境和工作噪音的声级。在多变量逻辑回归模型中,确定噪音变量的调整比值比。女性因环境噪音产生烦恼与心肌梗死风险略有增加相关(调整比值比1.47,95%置信区间0.95 - 2.25,P = 0.081),而男性则不然,且与工作噪音烦恼无关。环境声级与男性和女性的风险增加相关(比值比分别为1.46,1.02 - 2.09,P = 0.040;3.36,1.40 - 8.06,P = 0.007),仅男性的工作声级与之相关(1.31,1.01 - 1.70,P = 0.045)。

结论

长期噪音负担与心肌梗死风险相关。风险增加似乎与声级的关联比与主观烦恼更为密切。进一步研究噪音暴露的性别相关风险可能有助于改进预防措施。

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