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职业噪声与高血压风险:系统评价与荟萃分析。

Occupational Noise and Hypertension Risk: A Systematic Review and Meta-Analysis.

机构信息

Division of Occupational Health, Department of Occupational Safety and Environment, Regional Government of South Hesse, 65197 Wiesbaden, Germany.

Associate Professor of Occupational Medicine, Justus-Liebig-University, 35392 Giessen, Germany.

出版信息

Int J Environ Res Public Health. 2020 Aug 28;17(17):6281. doi: 10.3390/ijerph17176281.

Abstract

A number of epidemiological studies report an association between occupational noise exposure and arterial hypertension. Existing systematic reviews report conflicting results, so we conducted an updated systematic review with meta-analysis. We registered the review protocol with PROSPERO (registration no.: CRD 42019147923) and searched for observational epidemiological studies in literature databases (Medline, Embase, Scopus, Web of Science). Two independent reviewers screened the titles/abstracts and full texts of the studies. Two reviewers also did the quality assessment and data extraction. Studies without adequate information on recruitment, response, or without a comparison group that was exposed to occupational noise under 80 dB(A) were excluded. The literature search yielded 4583 studies, and 58 studies were found through hand searching. Twenty-four studies were included in the review. The meta-analysis found a pooled effect size (ES) for hypertension (systolic/diastolic blood pressure ≥140/90 mmHg) due to noise exposures ≥80 dB(A) of 1.81 (95% CI 1.51-2.18). There is no substantial risk difference between men and women, but data concerning this question are limited. We found a positive dose-response-relationship: ES = 1.21 (95% CI 0.78-1.87) ≤ 80 dB(A), ES = 1.77 (95% CI 1.36-2.29) >80-≤85 dB(A), and ES = 3.50 (95% CI 1.56-7.86) >85-≤90 dB(A). We found high quality of evidence that occupational noise exposure increases the risk of hypertension.

摘要

一些流行病学研究报告称,职业性噪声暴露与动脉高血压之间存在关联。现有的系统评价报告结果相互矛盾,因此我们进行了一项更新的系统评价和荟萃分析。我们在 PROSPERO(注册号:CRD42019147923)中注册了该综述方案,并在文献数据库(Medline、Embase、Scopus、Web of Science)中搜索了观察性流行病学研究。两名独立的评审员筛选了研究的标题/摘要和全文。两名评审员还进行了质量评估和数据提取。排除了那些在招募、反应方面信息不足,或者没有与接触 80dB(A)以下职业噪声的对照组进行比较的研究。文献检索共得到 4583 篇研究,通过手工检索还发现了 58 篇研究。共有 24 篇研究纳入综述。荟萃分析发现,噪声暴露≥80dB(A)导致高血压(收缩压/舒张压≥140/90mmHg)的合并效应大小(ES)为 1.81(95%CI1.51-2.18)。男性和女性之间没有显著的风险差异,但关于这个问题的数据有限。我们发现了一个正的剂量-反应关系:ES=1.21(95%CI0.78-1.87)≤80dB(A),ES=1.77(95%CI1.36-2.29)>80-≤85dB(A),ES=3.50(95%CI1.56-7.86)>85-≤90dB(A)。我们发现有高质量的证据表明职业性噪声暴露会增加高血压的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/765a/7504405/4861bdecfebe/ijerph-17-06281-g001.jpg

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