de Souza Tatiana Cristina Fernandes, Périssé André Reynaldo Santos, Moura Marisa
Centro de Estudos da Saúde do Trabalhador e Ecologia Humana, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (CESTEH/ENSP/Fiocruz), Rua Leopoldo Bulhões 1480, Manguinhos, Rio de Janeiro/RJ, Brazil.
Departamento de Ciências Biológicas, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (DCB/ENSP/Fiocruz), Rua Leopoldo Bulhões 1480, Manguinhos, Rio de Janeiro/RJ, Brazil.
BMC Public Health. 2015 Apr 3;15:328. doi: 10.1186/s12889-015-1671-z.
Noise is an important occupational hazard worldwide and hypertension a well-known risk factor for cardiovascular disease, which is currently the greatest cause of disability retirement worldwide. The association between noise exposure and auditory effects is well documented in the biomedical literature, but the same is not true about exposure to different levels of noise and extra-auditory effects. It has been shown that noise exposure levels to be considered for non-auditory effects may not be the same as in the case of auditory effects. The frequent presence of noise in workplace environments, the high prevalence of hypertension worldwide, the biological plausibility of the association between noise exposure and high blood pressure and the need for more studies investigating the non-auditory effects of exposures to less than 85 dB(A), were the reasons that led us to develop this study. We aimed at investigating the hypothesis that exposure to different levels of noise is associated with hypertension.
We used a cross-sectional design to study the association between occupational noise exposure (≤75, 75-85, and ≥ 85 dB(A)) and hypertension (use of anti-hypertensive medication and/or blood pressure of ≥140/90 mmHg) in 1,729 petrochemical workers at Rio de Janeiro, Brazil. Data were collected from obligatory annual health evaluation records and from environmental measurements of noise and heat levels. We used logistical regression analysis to study the association while controlling for key confounding variables, such as smoking and body mass index.
Using the ≤75 dB(A) as reference category, noise exposure was independently associated to hypertension both at the 75-85 dB(A) (OR 1.56; 95% CI 1.13-2.17) and the ≥85 dB(A) levels (OR 1.58; 95% CI 1.10-2.26). Age, gender and body mass index were also independently associated to high blood pressure.
Herein, we were able to demonstrate that noise exposure is independently associated to hypertension. Our results are consistent with other studies that used similar methodology and enabled us to verify the occurrence of non-auditory effects in workers exposed to noise levels considered safe for auditory effects.
噪声是全球范围内一种重要的职业危害因素，而高血压是心血管疾病的一个众所周知的危险因素，心血管疾病目前是全球致残退休的最大原因。生物医学文献中充分记载了噪声暴露与听觉影响之间的关联，但对于不同噪声水平暴露与听觉外影响之间的情况却并非如此。研究表明，考虑非听觉影响的噪声暴露水平可能与听觉影响的情况不同。工作场所环境中经常存在噪声、全球高血压的高患病率、噪声暴露与高血压之间关联的生物学合理性以及需要更多研究来调查低于85分贝（A）暴露的非听觉影响，这些都是促使我们开展本研究的原因。我们旨在研究不同噪声水平暴露与高血压相关的假设。
我们采用横断面设计，研究巴西里约热内卢1729名石化工人的职业噪声暴露（≤75、75 - 85和≥85分贝（A））与高血压（使用抗高血压药物和/或血压≥140/90毫米汞柱）之间的关联。数据收集自强制性年度健康评估记录以及噪声和热水平的环境测量。我们使用逻辑回归分析来研究这种关联，同时控制关键的混杂变量，如吸烟和体重指数。
以≤75分贝（A）作为参照类别，在75 - 85分贝（A）水平（比值比1.56；95%置信区间1.13 - 2.17）和≥85分贝（A）水平（比值比1.58；95%置信区间1.10 - 2.26）时，噪声暴露均与高血压独立相关。年龄、性别和体重指数也与高血压独立相关。
在此，我们能够证明噪声暴露与高血压独立相关。我们的结果与其他采用类似方法的研究一致，并使我们能够证实，在被认为对听觉影响安全的噪声水平下工作的工人中存在听觉外影响。
