瑞典男性职业噪声暴露及其与工作压力的联合效应以及冠心病和中风风险的纵向研究。
Longitudinal study of occupational noise exposure and joint effects with job strain and risk for coronary heart disease and stroke in Swedish men.
作者信息
Eriksson Helena Pernilla, Andersson Eva, Schiöler Linus, Söderberg Mia, Sjöström Mattias, Rosengren Annika, Torén Kjell
机构信息
Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
出版信息
BMJ Open. 2018 Apr 3;8(4):e019160. doi: 10.1136/bmjopen-2017-019160.
OBJECTIVES
The aims were to investigate whether occupational noise increased the risk for coronary heart disease (CHD) and stroke and to elucidate interactions with stressful working conditions in a cohort of Swedish men.
DESIGN
This is a prospective cohort study on CHD and stroke in Swedish men followed until death, hospital discharge or until 75 years of age, using Swedish national registers on cause of death and hospital discharges. Baseline data on occupation from 1974 to 1977 were used for classification of levels of occupational noise and job demand-control. Cox regression was used to analyse HRs for CHD and stroke.
SETTING
Swedish men born in 1915-1925.
PRIMARY AND SECONDARY OUTCOME MEASURES
CHD and stroke.
PARTICIPANTS
The participants of the study were men from the Primary Prevention Study, a random sample of 10 000 men born in 1915-1925 in Gothenburg. Subjects with CHD or stroke at baseline or were not employed were excluded. The remaining subjects with complete baseline data on occupation, weight, height, hypertension, diabetes, serum cholesterol and smoking constituted the study sample (5753 men).
RESULTS
There was an increased risk for CHD in relation to noise levels 75-85 dB(A) and >85 dB(A) compared with <75 dB(A) (HR 1.15, 95% CI 1.01 to 1.31, and HR 1.27, 95% CI 0.99 to 1.63, respectively). Exposure to noise peaks also increased the risk for CHD (HR 1.19, 95% CI 1.03 to 1.38). Among those with high strain (high demands and low control) combined with noise >75 dB(A), the risk for CHD further increased (HR 1.80, 95% CI 1.19 to 2.73). There was no significantly increased risk for stroke in any noise category.
CONCLUSIONS
Exposure to occupational noise was associated with an increased risk for CHD and the risk further increased among those with concomitant exposure to high strain. None of the analysed variables were related to increased risk for stroke.
目的
旨在调查职业噪声是否会增加冠心病（CHD）和中风的风险，并阐明瑞典男性队列中职业噪声与紧张工作条件之间的相互作用。
设计
这是一项针对瑞典男性冠心病和中风的前瞻性队列研究，随访至死亡、出院或75岁，使用瑞典国家死亡原因和出院登记册。1974年至1977年的职业基线数据用于职业噪声水平和工作需求 - 控制的分类。Cox回归用于分析冠心病和中风的风险比（HR）。
研究对象
1915年至1925年出生的瑞典男性。
主要和次要观察指标
冠心病和中风。
参与者
研究参与者来自初级预防研究中的男性，是在哥德堡随机抽取的10000名1915年至1925年出生的男性。排除基线时患有冠心病或中风或未就业的受试者。其余具有职业、体重、身高、高血压、糖尿病、血清胆固醇和吸烟完整基线数据的受试者构成研究样本（5753名男性）。
结果
与<75 dB(A)相比，噪声水平为75 - 85 dB(A)和>85 dB(A)时，冠心病风险增加（HR分别为1.15，95%CI 1.01至1.31，以及HR 1.27，95%CI 0.99至1.63）。暴露于噪声峰值也会增加冠心病风险（HR 1.19，95%CI 1.03至1.38）。在高压力（高需求和低控制）且噪声>75 dB(A)的人群中，冠心病风险进一步增加（HR 1.80，95%CI 1.19至2.73）。在任何噪声类别中，中风风险均未显著增加。
结论
暴露于职业噪声与冠心病风险增加相关，同时暴露于高压力环境中的人群风险进一步增加。所分析的变量均与中风风险增加无关。
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