Co-exposure to noise, N,N-dimethylformamide, and toluene on 24-hour ambulatory blood pressure in synthetic leather workers.

Independent exposure to noise, N,N-dimethylformamide (DMF), or toluene has been associated with cardiovascular effects, but the combined effects are not clear. This study investigated ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) in workers co-exposed to noise, DMF, and toluene. Twenty workers in a synthetic leather manufacturing company were recruited as study subjects. Personal noise exposure and ambulatory blood pressure were measured concomitantly for 24 hr; airborne co-exposure to DMF and toluene during the working period was also analyzed to identify solvents exposure. Linear mixed-effects regressions were used to estimate effects on ambulatory blood pressure by controlling potential confounders. Four high-combined-exposure workers (83 +/- 8 dBA; DMF: 3.23 +/- 2.15 ppm, toluene: 1.09 +/- 1.13 ppm) had the higher means of 16 +/- 7 mmHg in 24-hr DBP (p = 0.027) and 21 +/- 8 mmHg in working-time DBP (p = 0.048) than seven low-combined-exposure workers (73 +/- 12 dBA; DMF: 0.41 +/- 0.02 ppm, toluene: 0.12 +/- 0.01 ppm). Three high-noise-exposure workers (84 +/- 7 dBA) also had a marginal increase of 13 +/- 6 mmHg in DBP at work (p = 0.076) compared with the control group. No significant differences in SBP and DBP were found between six high-solvent-exposure workers (DMF: 1.24 +/- 1.25 ppm, toluene: 2.63 +/- 1.29 ppm) and office workers during any periods. After the Bonferroni correction, there were no significant differences in ambulatory blood pressure between three high-exposure groups and the low-exposure groups. Our findings suggest no interactive effects of co-exposure to noise, DMF, and toluene on workers' ambulatory blood pressure.