Occup Environ Med 68:183-190 doi:10.1136/oem.2010.055269
  • Original article
  • Workplace

Exposure to occupational noise and cardiovascular disease in the United States: the National Health and Nutrition Examination Survey 1999–2004

Editor's ChoicePress Release
  1. Paul A Demers1,2
  1. 1School of Environmental Health, The University of British Columbia, Vancouver, Canada
  2. 2School of Population and Public Health, The University of British Columbia, Vancouver, Canada
  1. Correspondence to Dr Wenqi Gan, School of Environmental Health, University of British Columbia, 316 - 2206 East Mall, Vancouver, BC V6T 1Z3, Canada; wenqi.gan{at}
  • Accepted 12 May 2010
  • Published Online First 5 October 2010


Background Chronic exposure to occupational noise may be associated with increased risk of coronary heart disease (CHD) and hypertension. However, findings are inconsistent and many previous studies are limited by small sample size and inappropriate control for potential confounders. We used a nationally representative US sample to examine associations of self-reported exposure to occupational noise with CHD and hypertension.

Methods This cross-sectional study included 6307 participants of the National Health and Nutrition Examination Survey 1999–2004, aged ≥20 years and employed at the time of interview. Noise exposure assessment was based on self-reported exposure to loud noise in the workplace.

Results Compared with never exposed participants, subjects chronically exposed to occupational noise had a 2–3-fold increased prevalence of angina pectoris, myocardial infarction, CHD and isolated diastolic hypertension. After adjustment for various covariates, the odds ratios (95% CIs) for angina pectoris, CHD and isolated diastolic hypertension were 2.91 (1.35 to 6.26), 2.04 (1.16 to 3.58) and 2.23 (1.21 to 4.12), respectively. There were clear exposure–response relationships for the observed associations. Associations of noise exposure with angina pectoris, myocardial infarction and CHD were particularly strong for participants aged <50 years, men and current smokers. There was no significant increase in levels of cardiovascular biomarkers including blood lipids and circulating inflammatory mediators associated with noise exposure.

Conclusions Chronic exposure to occupational noise is strongly associated with prevalence of CHD, especially for young male current smokers. This study suggests that excess noise exposure in the workplace is an important occupational health issue and deserves special attention.


  • Funding Wenqi Gan was supported by the Canadian Institutes of Health Research Frederick Banting and Charles Best Canada Graduate Scholarship (2008–2011) and by the Michael Smith Foundation for Health Research Senior Graduate Studentship (2008–2011).

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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