Dzhambov Angel M
Arh Hig Rada Toksikol. 2016 Sep 1;67(3):247-258. doi: 10.1515/aiht-2016-67-2774.
There is compelling evidence from animal experiments that noise exposure suppresses testosterone in males by affecting the hypothalamic-pituitary-testicular axis. Virtually nothing is known about its effect in humans. Therefore, the aim of this study was to explore the association between occupational noise exposure and serum testosterone in a representative sample of the general population. The sample has been taken from the National Health and Nutrition Examination Survey (NHANES) data for the period between 1999 and 2004 and is limited to employed men aged 16-85+ years at the time. The associations between noise exposure (either established according to the Occupational Information Network - ONET categories or self-reported) and total and free testosterone (TT and FT, respectively) were analysed using linear regression models with increasing adjustments. In the fully adjusted model (n=414), the third quartile of the ONET noise exposure was associated with lower TT and FT, which reached statistically significant decrease of -58.32 ng dL-1 (95 % CI: -111.22, -5.42) and -1.58 ng dL-1 (95 % CI: -2.98, -0.18), respectively. In stratified analyses, younger, lower income, normal weight, better hearing, and workers not using hearing protection at work experienced significantly more severe adverse effects than the rest. The odds for hypogonadism (TT<300 ng dL-1) did not significantly rise with one interquartile range increment in O*NET noise exposure (OR=1.24, 95 % CI: 0.64, 2.39). Self-reported loud noise exposure did not significantly decrease TT when all men were considered (n=214) and only in the men ≥37 years did it decrease TT significantly by -87.55 ng dL-1 (95 % CI: -158.35, -16.74). In conclusion, noise exposure was associated with lower TT and FT only in some population subgroups and these associations were non-linear.
动物实验中有令人信服的证据表明，噪声暴露通过影响下丘脑 - 垂体 - 睾丸轴来抑制男性的睾酮水平。而关于其对人类的影响，实际上所知甚少。因此，本研究的目的是在一般人群的代表性样本中探索职业噪声暴露与血清睾酮之间的关联。该样本取自1999年至2004年期间的美国国家健康与营养检查调查（NHANES）数据，且仅限于当时年龄在16 - 85岁及以上的在职男性。使用逐步调整的线性回归模型分析噪声暴露（根据职业信息网络 - ONET类别确定或自我报告）与总睾酮和游离睾酮（分别为TT和FT）之间的关联。在完全调整模型（n = 414）中，ONET噪声暴露的第三个四分位数与较低的TT和FT相关，分别达到具有统计学意义的下降 -58.32 ng dL-1（95% CI： -111.22， -5.42）和 -1.58 ng dL-1（95% CI： -2.98， -0.18）。在分层分析中，年龄较小、收入较低、体重正常、听力较好以及工作时未使用听力保护装置的工人比其他人经历的不良影响明显更严重。随着O*NET噪声暴露增加一个四分位数间距，性腺功能减退（TT < 300 ng dL-1）的几率没有显著上升（OR = 1.24，95% CI：0.64，2.39）。当考虑所有男性（n = 214）时，自我报告的高强度噪声暴露并没有显著降低TT，只有在年龄≥37岁的男性中，TT才显著降低 -87.55 ng dL-1（95% CI： -158.35， -16.74）。总之，噪声暴露仅在某些人群亚组中与较低的TT和FT相关，且这些关联是非线性的。
