Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Department of Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Environ Res. 2018 Oct;166:647-657. doi: 10.1016/j.envres.2018.05.011. Epub 2018 Jul 10.
The prevalence of diabetes is on rise worldwide and environmental factors are being increasingly recognized to be involved in this rise. An emerging body of evidence has evaluated the impact of long-term exposure to noise on diabetes mellitus, highlighting the need to synthesize this evidence.
To systematically review and conduct meta-analysis of the available evidence on the association between long-term exposure to transport and occupational noise exposure and diabetes mellitus.
Selected databases were searched for available evidence published till September 13th, 2017 following MOOSE guidelines. The quality of articles was assessed using the Newcastle-Ottawa Scale. Random effects meta-analysis was applied to abstract combined estimates for diabetes mellitus per 5 dB increase in noise exposure. We evaluated the heterogeneity applying Cochran's Q test and quantified it using I statistic. Meta-regressions were conducted to identify sources of heterogeneity. Publication bias was evaluated using funnel plot and Egger's test.
Fifteen studies met our inclusion criteria of which nine including five prospective cohorts, two cross-sectional and two case-control studies with a total number of 444460 adult participants and 17430 diabetes mellitus cases included in meta-analyses. We observed a 6% (95% confidence interval (CI): 3%, 9%) increase in the risk of diabetes mellitus per 5 dB increase in noise exposure regardless of its source. Source-specific analyses were suggestive for stronger associations for air traffic noise (combined odds ratio: 1.17; 95% CI: 1.06, 1.29 per 5 dB increase in exposure) flowed by road traffic noise (combined odds ratio: 1.07; 95% CI: 1.02, 1.12). We observed some indications of publication bias; however the findings were robust after trim and fill test. Meta-regression analyses showed that the adjustment in general, and not specifically related to air pollution, could predict the between-study heterogeneity in reported associations.
The results indicate an increased risk of diabetes mellitus associated with noise exposure, mainly related to air and road traffic.
全球范围内糖尿病的患病率呈上升趋势，人们越来越认识到环境因素在这一上升过程中所起的作用。越来越多的证据评估了长期暴露于噪声对糖尿病的影响，突出了综合评估这一证据的必要性。
系统评价和荟萃分析现有的关于长期暴露于交通和职业噪声与糖尿病之间关系的证据。
根据 MOOSE 指南，检索了截至 2017 年 9 月 13 日已发表的相关数据库。使用纽卡斯尔-渥太华量表评估文章质量。应用随机效应荟萃分析，计算噪声每增加 5dB 时糖尿病的综合发生率。我们应用 Cochran's Q 检验评估异质性，并用 I 统计量衡量其程度。进行荟萃回归分析以确定异质性的来源。使用漏斗图和 Egger 检验评估发表偏倚。
有 15 项研究符合纳入标准，其中 9 项研究（包括 5 项前瞻性队列研究、2 项横断面研究和 2 项病例对照研究）共纳入 444460 名成年参与者和 17430 例糖尿病患者。我们发现，噪声每增加 5dB，糖尿病的发病风险增加 6%（95%置信区间：3%，9%），无论噪声源如何。基于噪声源的特异性分析表明，航空交通噪声（每增加 5dB 暴露，合并优势比：1.17；95%置信区间：1.06，1.29）和道路交通噪声（合并优势比：1.07；95%置信区间：1.02，1.12）与糖尿病的相关性更强。我们观察到一些发表偏倚的迹象；但是，经过修剪和填充测试后，结果仍然可靠。荟萃回归分析表明，调整（特别是与空气污染无关的调整）可以预测报告的相关性中的研究间异质性。
结果表明，噪声暴露与糖尿病的发病风险增加有关，主要与航空和道路交通噪声有关。
