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在国家健康与营养检查调查(2011 - 2012年)中自我报告的职业噪声终生暴露与类风湿关节炎患病率

Lifetime exposure to self-reported occupational noise and prevalent rheumatoid arthritis in the National Health and Nutrition Examination Survey (2011-2012).

作者信息

Dzhambov Angel M, Dimitrova Donka D

机构信息

a Department of Hygiene and Ecomedicine, Faculty of Public Health , Medical University of Plovdiv , Plovdiv , Bulgaria.

b Department of Health Management and Healthcare Economics, Faculty of Public Health , Medical University of Plovdiv , Plovdiv , Bulgaria.

出版信息

Int J Occup Environ Health. 2017 Jul;23(3):215-221. doi: 10.1080/10773525.2018.1451809. Epub 2018 Mar 20.

Abstract

Multiple risk factors for rheumatoid arthritis (RA) have been studied, but there is a dearth of research on occupational noise, which is highly prevalent in the United States (U.S.). This study aimed to determine whether occupational noise exposure was associated with an elevated risk of prevalent RA in the U.S. general population. Data from the 2011 to 2012 cross-sectional, population-based National Health and Nutrition Examination Survey were used for secondary analysis. Self-reported lifetime exposure to very loud noise was linked to self-reported doctor-diagnosed RA in a sample of 4192 participants. Weighted logistic regression was used to obtain nationally representative prevalence odds ratios (OR). The main and fully adjusted models yielded OR = 3.98 (95% CI: 1.74, 9.11) and OR = 2.84 (95% CI: 1.23, 6.57) for participants exposed for ≥ 15 years compared to never exposed participants. Excluding those diagnosed with RA more than five years before the interview, the effect dropped to OR = 3.67 (95% CI: 1.06, 12.75) in the main model, and was no longer significant in the fully adjusted model (OR = 2.68, 95% CI: 0.80, 8.96). The only significant effect modifier was race/ethnicity, with higher risk in Non-Hispanic whites. To conclude, long-term occupational noise exposure might be a modifiable risk factor for RA, but currently, the evidence base is very thin and tenuous.

摘要

类风湿关节炎(RA)的多种风险因素已得到研究,但对于在美国极为普遍的职业噪音,相关研究却十分匮乏。本研究旨在确定职业噪音暴露是否与美国普通人群中RA的患病风险升高有关。利用2011年至2012年基于人群的横断面国家健康与营养检查调查数据进行二次分析。在4192名参与者的样本中,自我报告的终生暴露于极强噪音与自我报告的医生诊断的RA相关。采用加权逻辑回归来获得具有全国代表性的患病率比值比(OR)。与从未暴露的参与者相比,暴露≥15年的参与者在主要模型和完全调整模型中的OR分别为3.98(95%CI:1.74,9.11)和2.84(95%CI:1.23,6.57)。排除在访谈前五年以上被诊断为RA的参与者后,主要模型中的效应降至OR = 3.67(95%CI:1.06,12.75),在完全调整模型中不再显著(OR = 2.68,95%CI:0.80,8.96)。唯一显著的效应修饰因素是种族/族裔,非西班牙裔白人的风险更高。总之,长期职业噪音暴露可能是RA的一个可改变的风险因素,但目前,证据基础非常薄弱且不确凿。

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