Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran.
Sci Total Environ. 2020 Aug 20;731:139226. doi: 10.1016/j.scitotenv.2020.139226. Epub 2020 May 6.
This systematic review and meta-analysis study aimed to investigate the association between exposure to road traffic noise (RTN) and myocardial infarction (MI). Of 681 studies found by searching in databases, including Scopus, Web of Science, Embase, and PubMed on November 29, 2019, the number of 13 studies, including seven cohort, five case-control, and one cross-sectional studies with 1,626,910 participants and 45,713 cases of MI was included. The pooled relative risk (RR) and 95% confidence interval (CI) of MI were calculated using a random-effect model across studies. Heterogeneity measures by reporting the I-square index. Subgroup analysis according to the designs and sensitivity analysis based on the Jackknife approach was performed. We observed in the eight studies the association was investigated in different noise exposure groups and in the 10 studies (including two conference papers) the risk of MI was provided per specific unit increment of RTN. We ran two independent types of meta-analyses involving a categorical analysis (comparing the highest and the lowest category of noise exposure groups) and an exposure-response analysis (the risk of MI per 10-dB increment of RTN). The pooled RR (95% CI) of MI for the categorical and exposure-response meta-analyses was calculated 1.03 (0.93, 1.13) and 1.02 (1.00, 1.05), respectively. For both types of meta-analyses, subgroup analysis indicates a significant association in the studies with case-control and cross-sectional designs but not cohort studies. For the exposure-response meta-analysis, a significantly greater risk of MI was observed after excluding the two conference papers (RR = 1.03 and 95% CI = 1.00, 1.05) and by further excluding the studies provided originally the risk of MI only for the categorical analysis (RR = 1.02 and 95% CI = 1.01, 1.03). We did not show a significant publication bias across studies. In conclusion, our study suggests a significant odds of association between exposure to RTN and the risk of MI.
本系统评价和荟萃分析研究旨在探讨道路交通噪声(RTN)暴露与心肌梗死(MI)之间的关联。通过在数据库中搜索,包括 Scopus、Web of Science、Embase 和 PubMed,于 2019 年 11 月 29 日检索到 681 项研究,其中包括 13 项研究,包括 7 项队列研究、5 项病例对照研究和 1 项横断面研究,共纳入 1626910 名参与者和 45713 例 MI。使用随机效应模型计算了荟萃分析中 MI 的合并相对风险(RR)和 95%置信区间(CI)。通过报告 I 平方指数来衡量异质性。根据设计进行亚组分析,并基于 Jackknife 方法进行敏感性分析。我们观察到,在 8 项研究中,在不同的噪声暴露组中研究了这种关联,在 10 项研究(包括 2 篇会议论文)中,提供了每特定单位增量 RTN 的 MI 风险。我们进行了两种独立类型的荟萃分析,包括分类分析(比较噪声暴露组的最高和最低类别)和暴露反应分析(每增加 10dB 的 RTN 患 MI 的风险)。分类和暴露反应荟萃分析的合并 RR(95%CI)分别为 1.03(0.93,1.13)和 1.02(1.00,1.05)。对于这两种类型的荟萃分析,亚组分析表明,在病例对照和横断面设计的研究中存在显著关联,但在队列研究中没有。对于暴露反应荟萃分析,在排除了两篇会议论文后(RR=1.03 和 95%CI=1.00,1.05),并且在进一步排除仅提供分类分析风险的研究后(RR=1.02 和 95%CI=1.01,1.03),观察到 MI 的风险显著增加。我们没有显示研究之间存在显著的发表偏倚。总之,我们的研究表明 RTN 暴露与 MI 风险之间存在显著的关联。