Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Environ Res. 2023 Feb 1;218:115037. doi: 10.1016/j.envres.2022.115037. Epub 2022 Dec 9.
Studies of the association between aircraft noise and hypertension are complicated by inadequate control for potential confounders and a lack of longitudinal assessments, and existing evidence is inconclusive.
We evaluated the association between long-term aircraft noise exposure and risk of hypertension among post-menopausal women in the Women's Health Initiative Clinical Trials, an ongoing prospective U.S.
Day-night average (DNL) and night equivalent sound levels (L) were modeled for 90 U.S. airports from 1995 to 2010 in 5-year intervals using the Aviation Environmental Design Tool and linked to participant geocoded addresses from 1993 to 2010. Participants with modeled exposures ≥45 A-weighted decibels (dB [A]) were considered exposed, and those outside of 45 dB(A) who also did not live in close proximity to unmodeled airports were considered unexposed. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mmHg or inventoried/self-reported antihypertensive medication use. Using time-varying Cox proportional hazards models, we estimated hazard ratios (HRs) for incident hypertension when exposed to DNL or L ≥45 versus <45 dB(A), controlling for sociodemographic, behavioral, and environmental/contextual factors.
RESULTS/DISCUSSION: There were 18,783 participants with non-missing DNL exposure and 14,443 with non-missing L exposure at risk of hypertension. In adjusted models, DNL and L ≥45 db(A) were associated with HRs of 1.00 (95% confidence interval [CI]: 0.93, 1.08) and 1.06 (95%CI: 0.91, 1.24), respectively. There was no evidence supporting a positive exposure-response relationship, and findings were robust in sensitivity analyses. Indications of elevated risk were seen among certain subgroups, such as those living in areas with lower population density (HR: 0.84; 95%CI: 0.72, 0.98) or nitrogen dioxide concentrations (HR: 0.82; 95%CI: 0.71, 0.95), which may indicate lower ambient/road traffic noise. Our findings do not suggest a relationship between aircraft noise and incident hypertension among older women in the U.S., though associations in lower ambient noise settings merit further investigation.
由于潜在混杂因素控制不足和缺乏纵向评估，飞机噪声与高血压之间关联的研究较为复杂，现有证据尚无定论。
我们在美国妇女健康倡议临床试验中评估了长期飞机噪声暴露与绝经后妇女高血压风险之间的关联，该试验为正在进行的前瞻性美国研究。
使用航空环境设计工具，在 1995 年至 2010 年的 5 年间隔内，为美国 90 个机场建立日-夜平均（DNL）和夜间等效声级（L）模型，并将其与 1993 年至 2010 年参与者的地理位置地址相关联。模型中暴露值≥45 加权分贝（dB[A]）的参与者被认为是暴露组，而暴露值<45dB[A]但没有居住在未建模机场附近的参与者被认为是未暴露组。高血压定义为收缩压/舒张压≥140/90mmHg或登记/自我报告的降压药物使用。使用时间变化的 Cox 比例风险模型，我们估计了暴露于 DNL 或 L≥45 与<45dB[A]时的高血压发病风险比（HR），控制了社会人口统计学、行为和环境/背景因素。
结果/讨论：共有 18783 名参与者有非缺失的 DNL 暴露数据，14443 名参与者有非缺失的 L 暴露数据，有发生高血压的风险。在调整后的模型中，DNL 和 L≥45dB[A]分别与 HR1.00（95%置信区间[CI]：0.93，1.08）和 1.06（95%CI：0.91，1.24）相关。没有证据支持阳性暴露反应关系，并且在敏感性分析中结果是稳健的。在某些亚组中观察到了风险升高的迹象，例如居住在人口密度较低（HR：0.84；95%CI：0.72，0.98）或二氧化氮浓度较低（HR：0.82；95%CI：0.71，0.95）地区的人群，这可能表明环境/道路交通噪声较低。我们的研究结果表明，在美国的老年女性中，飞机噪声与高血压之间没有关联，尽管在环境噪声较低的情况下的关联值得进一步研究。
