调查职业性噪声暴露对房颤风险的影响:中国职业人群的个案研究。

IF 2.6 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Archives of Occupational and Environmental Health Pub Date : 2025-01-10 DOI:10.1007/s00420-024-02119-2
Zheng Liu, Jianyu Duan, Xuan Zhang, Hongyan Liu, Yue Pan, Wei Chong
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引用次数: 0

摘要

目的:在现有证据有限的情况下,本研究探讨了高职业噪声暴露与心房颤动(AF)之间的联系。方法:我们对中国一家大型重工业企业的参与者进行了横断面研究。高噪声暴露定义为工作日8小时内的等效A加权声级(LAeq, 8 h)≥80 dB(A)。统计分析包括单因素分析,以评估高噪声暴露、心血管危险因素和房颤之间的关系。中介分析确定了高噪声暴露与房颤之间的潜在中介。倾向评分匹配(PSM)和多变量分析用于评估高噪声暴露与房颤之间的独立关联。共纳入4530名参与者,其中1526人经历高噪声暴露,167人诊断为房颤。调整后的中介分析显示,睡眠障碍、高血压、血脂异常和饮食质量是高噪声暴露者房颤的主要中介,分别占12.4%、9.6%、8.9%和6.7%的影响。PSM分析显示,高噪声暴露个体AF的比例明显高于低噪声暴露个体(5.4%比3.0%,P = 0.003)。多变量分析显示,高噪声暴露人群发生房颤的风险增加了一倍(OR = 1.99, 95% CI 1.38 ~ 2.88, P)。结论:高职业噪声暴露增加了工作人群发生房颤的风险,既是独立的危险因素,也是中介效应。睡眠障碍、高血压、血脂异常和饮食质量是主要的调节因素。这些发现强调了在工作场所安全政策中将噪音控制与心血管健康管理结合起来以预防工业工人房颤的重要性。试验注册号:ChiCTR2300077951,于2023年11月24日在中国临床试验注册中心注册。
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Investigating the effect of occupational noise exposure in the risk of atrial fibrillation: a case study among Chinese occupational populations.

Purpose: This study examines the link between high occupational noise exposure and atrial fibrillation (AF), given the limited existing evidence.

Methods: We conducted a cross-sectional study among participants from a large heavy industry enterprise in China. High noise exposure was defined as an equivalent A-weighted sound level (LAeq, 8 h) of ≥ 80 dB(A) during an 8 h workday. Statistical analyses included univariate analysis to assess relationships between high noise exposure, cardiovascular risk factors, and AF. Mediation analysis identified potential mediators between high noise exposure and AF. Propensity score matching (PSM) and multivariable analysis were used to evaluate the independent association between high noise exposure and AF.

Results: A total of 4530 participants were included, with 1526 experiencing high noise exposure, and 167 diagnosed with AF. Adjusted mediation analysis revealed that sleep disorders, hypertension, dyslipidemia, and dietary quality were the primary mediators for AF among those exposed to high noise, accounting for 12.4%, 9.6%, 8.9%, and 6.7% of the effect, respectively. PSM analysis showed a significantly higher proportion of AF in individuals with high noise exposure compared to those with low exposure (5.4% vs. 3.0%, P = 0.003). Multivariable analysis indicated that the risk of AF was doubled in individuals with high noise exposure (OR = 1.99, 95% CI 1.38-2.88, P < 0.001).

Conclusion: High occupational noise exposure increases the risk of AF in the working population, acting both as an independent risk factor and through mediation effects. Sleep disorders, hypertension, dyslipidemia, and dietary quality are the main mediators. These findings highlight the importance of integrating noise control with cardiovascular health management in workplace safety policies to prevent AF among industrial workers.

Trial registration number: ChiCTR2300077951, registered on November 24, 2023, in the Chinese Clinical Trial Registry.

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来源期刊
International Archives of Occupational and Environmental Health
International Archives of Occupational and Environmental Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
5.60
自引率
6.70%
发文量
127
审稿时长
3 months
期刊介绍: International Archives of Occupational and Environmental Health publishes Editorials, Review Articles, Original Articles, and Letters to the Editor. It welcomes any manuscripts dealing with occupational or ambient environmental problems, with a special interest in research at the interface of occupational health and clinical medicine. The scope ranges from Biological Monitoring to Dermatology, from Fibers and Dust to Human Toxicology, from Nanomaterials and Ultra-fine Dust to Night- and Shift Work, from Psycho-mental Distress and Burnout to Vibrations. A complete list of topics can be found on the right-hand side under For authors and editors. In addition, all papers should be based on present-day standards and relate to: -Clinical and epidemiological studies on morbidity and mortality -Clinical epidemiological studies on the parameters relevant to the estimation of health risks -Human experimental studies on environmental health effects. Animal experiments are only acceptable if relevant to pathogenic aspects. -Methods for studying the topics mentioned above.
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