| Objectives The association between noise exposure and hypertension and blood pressure level was analyzed by using a mixed cohort study and it is investigated that dose-response relationship between noise exposure years and hypertension and the appropriate years of noise exposure was by determined so as to provide a basis for the prevention and treament of hypertension.Methods The first part adopts the method of retrospective cohort study,in March 2014to August 2016,workers who participated in the occupational health examination without hypertension at the admission were selected as the research subjects and we constructed three subcohort according to entry time,and collected the demographics,noise exposure and physical examination data such as blood pressure,in order to analyses the effect of noise exposure on hypertension in steel workers.The second part adopts the method of prospectie cohort study,in March 2017 to June 2017,workers who participated in the occupational health examination without hypertension at entry time were selecte as subjects.And collected baseline data,and analysis of noise exposure and CNE and blood pressure levels rising.The outcome of following-up was hypertention and blood pressure rising diagnosd by hospital.Chi-square test was used to compare the basic characteristics of the two groups and occupational related factors.Single factor Chi-square test was used to analyze the relationship between noise exposure,noise exposure pattern and noise exposure intensity and hypertension.Cox proportional risk regression model was used in the multivariate analysis.Cox regression model based on restrictive cubic spline was used to analyze the dose-response relationship between the years of noise exposure and cumulative noise exposureand hypertension.The effect of getting away from the noise on hypertension was analyzed by Cox regression.Results 1 Part of the results of the retrospective cohort showed that after adjusting age,gender and other factors,the multivariate analysis show that the risk of hypertension in the noise exposed group was 1.59(1.47-1.72)times as same as that of the control group.The risk of hypertension in continuous noise exposure and intermittent noise exposure was 1.38(1.27-1.51)and 2.10(1.47-3.00)times that of the control group,respectively.In the group with high noise exposure,the incidence risk of hypertension was increased.The nonlinear relationship between noise exposure years and hypertension increased first and then decreased(χ~2=421.01,P<0.001),the risk of hypertension increased after 12 years of noise exposure.The risk of hypertension decreased from 0.99(0.54-1.83)times to 0.35(0.19-0.63)times in 5-10 years of noise exposure.2 The results of prospective cohort studies showed a linear relationship between CNE and d blood pressure rising(χ~2=1.37,P>0.05),blood pressure rising in 90～[d B(A)×years]and 96～[d B(A)×years]groups was 1.17(1.01-1.34)and 1.34(1.11-1.61)times that of the low-exposure group,respectively.But there was no difference in blood pressure rising between the low-dose group and highest dose of CNE.Conclusions 1 Noise exposure,continuous noise exposure and intermittent noise exposure is the risk factors of hypertension.2 Controlling noise exposure can reduce the risk of hypertension within 12 years.The risk of hypertension is decreasing with the length of time of withdrawal from noise exposure.3 The risk of increased blood pressure was positively correlated with CNE,When CNE was lower than 101[d B(A)×years].Figure2;Table26;Reference 143... |
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