Exposure to workplace noise and the risk of cardiovascular disease events and mortality among older adults
Introduction
Although cardiovascular disease (CVD) is the leading cause of death worldwide (Alberti, 1998, Anon., 1998), established CVD risk factors account for only around 50% of variance in the incidence of myocardial infarction (Morris et al., 2001, Willich et al., 2006). Noise is identified as the most ubiquitous of hazardous workplace exposures (Davies et al., 2005).
Chronic workplace noise exposure may be associated with an increased risk of CVD, such as coronary heart disease (CHD) (Gan et al., 2011, Melamed et al., 1999, Passchier-Vermeer and Passchier, 2000, Virkkunen et al., 2005). However, data from previous studies are equivocal (McNamee et al., 2006, Willich et al., 2006). Many published studies did not adequately adjust for potential confounders and/or were limited by small sample sizes, cross-sectional study design and/or did not capture the exposure reduction resulting from hearing protection device use (Davies et al., 2005, Gan et al., 2011, van Kempen et al., 2002). Using 6307 participants aged 20+ years, the National Health and Nutrition Examination Survey (NHANES) showed that chronic workplace noise exposure was associated with a 2- to 3-fold higher prevalence of CVD (Gan et al., 2011). Conversely, a German case–control study of 4115 patients, demonstrated that occupational noise exposure was not associated with risk of myocardial infarction in men (p = 0.05) and women (p = 0.67) (Willich et al., 2006). Additionally, some but not all studies have shown a link between occupational noise exposure and increased risk of CHD death (Davies et al., 2005, McNamee et al., 2006).
Using a cohort of adults aged 55 years and older, we compared the prevalence and incidence of CVD and stroke, and CVD mortality among those without and without workplace noise exposure.
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Study participants
The Blue Mountains Eye Study (BMES) is a population-based cohort study, as described elsewhere (Mitchell et al., 1995). During 1992–4, 3654 participants 49 years or older were examined (82.4% participation; BMES-1). BMES-2 (1997–1999) included 3509 participants; 2335 who were reexamined from the baseline cohort (75.1%) and a further 1174 who were examined because they qualified by moving into the area or into the age bracket (extension study). At BMES-3 (2002–2004) or 10-year follow-up, 1952
Results
Those exposed to workplace noise compared to those not exposed were more likely to be younger, male, current smoker, have poor-self reported health, CVD, angina and AMI, and higher levels of physical activity, and consume more dietary fats (Table 1). Participants were on average 2 and 9 years younger than surviving and deceased non-participants, respectively (Table 2). Deceased non-participants differed from participants in all characteristics apart from workplace noise exposure, systolic and
Discussion
Workplace noise exposure, particularly, chronic exposure was significantly associated with prevalent angina and CVD. We show that persons exposed to severe workplace noise for a short duration (five years or less) at baseline, had a 3-fold higher risk of incident stroke at follow-up. Finally, less than 1 to 5 years of occupational noise exposure prior to the baseline study was associated with a 60% increased risk of dying from CVD ten years later.
Participants reporting exposure to noise in
Conclusions
Workplace noise exposure was significantly associated with the prevalence of CVD and angina. The link between less than 1 to 5 years of severe noise exposure in the workplace and increased risk of incident stroke is a novel finding. Less than 1 to 5 years duration of occupational noise exposure compared to being never exposed was also associated with a 60% higher risk of CVD mortality over 10 years. These data could help inform preventive strategies, particularly focusing on those persons who are
Funding
The Blue Mountains Eye Study was supported by the Australian National Health and Medical Research Council (Grant Nos. 974159, 991407, 211069, 262120). The authors also acknowledge financial support from the HEARing CRC, established and supported under the Australian Government's Cooperative Research Centres Program.
Conflict of interest statement
None.
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