Impact of exposure to noise on the risk of hypertension: A systematic review and meta-analysis of cohort studies

Noise and Light Exposure and Cardiovascular Outcomes: A Review of Evidence, Potential Mechanisms and Implications

Cardiovascular diseases (CVD) are the leading cause of global non-communicable disease-related deaths. In recent years there has been increasing discussion about the influence of environmental risk factors, including noise and light, on the occurrence and course of these conditions. Recent studies highlight the impact of road traffic noise on an elevated risk of stroke and increased mortality in the course of coronary artery disease (CAD). In the case of threats arising from light pollution, there are more limited published studies; however, these show an increased hospitalization risk associated with CAD. Existing analyses cannot dismiss these environmental factors, highlighting the need for further research. Future studies should investigate not only road traffic noise but also consider railway and aircraft noise. Additionally, research on light pollution should include younger individuals too. In the future, incorporating individual assessments of noise and light pollution exposure, along with the identification of particularly vulnerable groups, could contribute to refining methods of individual risk stratification and implementing new preventive strategies.

A Comprehensive Review of Auditory and Non-Auditory Effects of Noise on Human Health

OBJECTIVE

Excessive noise is unpleasant and induces several physiological and psychological effects. Noise pollution is a potential threat to humans, particularly those continuously exposed for extended periods throughout the day over many years. This review aims to examine the various auditory and non-auditory outcomes associated with prolonged exposure to noise pollution.

MATERIALS AND METHODS

The review utilized a combination of relevant keywords to search the electronic databases. After screening based on the applied selection criteria for title, abstract, and full text, 44 articles were finally selected for critical review.

RESULTS

We identified and analyzed research findings related to noise-induced hearing loss, tinnitus, and sleep disturbances along with non-auditory issues such as annoyance, cognitive impairments, and mental stress associated with cardiovascular disorders. Furthermore, the existing studies were compared and collated to highlight the unique challenges and significance of noise pollution as a distinctive environmental concern and to explore the ongoing efforts in its research and prevention, including the early detection and potential reversal of noise-induced hearing loss.

CONCLUSION

The fundamental health consequences of noise pollution underscore the need for extensive research encompassing emerging noise sources and technologies to establish a health management system tailored to address noise-related health concerns and reduce noise exposure risk among populations. Finally, further research is warranted to ensure improved measurement of noise exposure and related health outcomes, especially in the context of occupational noise.

Co-exposure of petrochemical workers to noise and mixture of benzene, toluene, ethylbenzene, xylene, and styrene: Impact on mild renal impairment and interaction

Epidemiological evidence concerning effects of simultaneous exposure to noise and benzene, toluene, ethylbenzene, xylene, and styrene (BTEXS) on renal function remains uncertain. In 2020, a cross-sectional study was conducted among 1160 petrochemical workers in southern China to investigate effects of their co-exposure on estimated glomerular filtration rate (eGFR) and mild renal impairment (MRI). Noise levels were assessed using cumulative noise exposure (CNE). Urinary biomarkers for BTEXS were quantified. We found the majority of workers had exposure levels to noise and BTEXS below China's occupational exposure limits. CNE, trans, trans-muconic acid (tt-MA), and the sum of mandelic acid and phenylglyoxylic acid (PGMA) were linearly associated with decreased eGFR and increased MRI risk. We observed U-shaped associations for both N-acetyl-S-phenyl-L-cysteine (SPMA) and o-methylhippuric acid (2-MHA) with MRI. In further assessing the joint effect of BTEXS (β, -0.164 [95% CI, -0.296 to -0.033]) per quartile increase in all BTEXS metabolites on eGFR using quantile g-computation models, we found SPMA, tt-MA, 2-MHA, and PGMA played pivotal roles. Additionally, the risk of MRI associated with tt-MA was more pronounced in workers with lower CNE levels (P = 0.004). Multiplicative interaction analysis revealed antagonisms of CNE and PGMA on MRI risk (P = 0.034). Thus, our findings reveal negative dose-effect associations between noise and BTEXS mixture exposure and renal function in petrochemical workers. With the exception of toluene, benzene, xylene, ethylbenzene, and styrene are all concerning pollutants for renal dysfunction. Effects of benzene, ethylbenzene, and styrene exposure on renal dysfunction were more pronounced in workers with lower CNE.

2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association

BACKGROUND

The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Environmental exposures and blood pressure in adolescents and adults in the T1D exchange clinic registry

AIMS

To examine the associations between environmental determinants of health and blood pressure and whether age, sex, or race moderated the associations among 18,754 adolescents and adults from the type 1 diabetes (T1D) Exchange Clinic Registry.

METHODS

We used multivariable linear regression. Environmental determinants included exposure to ambient fine particulate matter (PM2.5, obtained from an integrated model), nitrogen dioxide (NO2), noise and light pollution, and the normalized difference vegetation index (NDVI, a marker of green space) at the ZIP code level of residence.

RESULTS

Higher exposure to PM2.5 and NO2, and lower NDVI, was associated with higher systolic and diastolic blood pressure, and higher light pollution exposure were similarly associated with higher diastolic blood pressure. These associations between environmental exposures and blood pressure remained significant after accounting for other covariates (age, sex, race/ethnicity, BMI, and T1D duration). With aging, the negative association between NDVI and blood pressure weakened.

CONCLUSIONS

These findings emphasize the significance of minimizing exposure to environmental pollutants, including PM2.5 and NO2, as well as ensuring access to areas with higher NDVI, to promote cardiovascular health in individuals with T1D.

Interventions for family support in cardiometabolic disease: An integrative review

AIM

To evaluate how family support affects cardiometabolic outcomes.

DESIGN

Integrative literature review.

SOURCES

PubMed, CINAHL, EMBASE and Scopus were searched for peer-reviewed primary research published between 2016 and 2021.

METHODS

Independent screening of 1661 citations resulted in 17 international publications involving 16 experimental studies selected. Data were analysed using a constant comparison method.

RESULTS

While the interventions varied regarding target, duration, setting and the profession of the interventionists, all studies demonstrated some level of the effectiveness for family involvement and support in the management of cardiometabolic diseases. The studies found improvement in health behaviours and clinical/psychosocial outcomes for the patients and the family members.

CONCLUSION

Based on the findings from this review, we recommend utilizing the following for future family interventions in the management of diabetes and/or hypertension: (1) broader definitions of family and structures; (2) a community participatory/action-research method with embedded healthcare workers; (3) an interdisciplinary approach with attention to goal-setting; (4) multimodal interventions including technology; (5) culturally tailoring interventions for relevance as needed; and (6) clear direction regarding support role and tools.

Noise and Air Pollution as Risk Factors for Hypertension: Part I-Epidemiology

Traffic noise and air pollution are 2 major environmental health risk factors in urbanized societies that often occur together. Despite cooccurrence in urban settings, noise and air pollution have generally been studied independently, with many studies reporting a consistent effect on blood pressure for individual exposures. In the present reviews, we will discuss the epidemiology of air pollution and noise effects on arterial hypertension and cardiovascular disease (part I) and the underlying pathophysiology (part II). Both environmental stressors have been found to cause endothelial dysfunction, oxidative stress, vascular inflammation, circadian dysfunction, and activation of the autonomic nervous system, thereby facilitating the development of hypertension. We also discuss the effects of interventions, current gaps in knowledge, and future research tasks. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed well below the current guideline recommendations. To this end, an important goal for the future is to increase the acceptance of environmental risk factors as important modifiable cardiovascular risk factors, given their substantial impact on the burden of cardiovascular disease.

Heart Disease and Stroke Statistics-2023 Update: A Report From the American Heart Association

BACKGROUND

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).

METHODS

The American Heart Association, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2023 Statistical Update is the product of a full year's worth of effort in 2022 by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. The American Heart Association strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional COVID-19 (coronavirus disease 2019) publications, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains.

RESULTS

Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.

CONCLUSIONS

The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.

Investigating the effect of workplace noise exposure on cardiovascular disease risk factors in a power plant industry: A case-control study

BACKGROUND

Occupational noise exposure is a significant health problem. In addition to hearing impairments, noise as a stressor may cause cardiovascular problems.

OBJECTIVE

This study aimed to investigate the effect of exposure to workplace noise on cardiovascular disease risk factors.

METHODS

This case-control study was conducted in 2021 in a power plant in Iran. In this study, the health status of 406 employees in both exposed (n = 203) and non-exposed (n = 203) to noise groups was examined for cardiovascular disease risk factors. Also, the trend of changes in the studied variables from 2012 to 2020 in exposed employees was examined. Data were collected from participants' annual physical examinations and occupational noise exposure measurements. To measure the noise in the present study, the KIMO-DB300 noise level meter was used. Data were analyzed in SPSS-26 software.

RESULTS

The results revealed that mean fasting blood sugar (FBS), triglyceride, liver enzyme (SGOT), blood pressure, and body mass index were significantly different in the two groups (p-value<0.05). There was no significant difference in the mean of creatinine, cholesterol, and liver enzyme (SGPT) between the two groups (p-value>0.05). In the exposed group, the mean of all studied variables except diastolic blood pressure was statistically different during the study years (p-value<0.05).

CONCLUSION

This study demonstrates that exposure to noise above the permissible level can affect the cardiovascular disease risk factors, so it is recommended to apply engineering and management measures like using Hearing Conservation Programme (HCP) to reduce the risk of these diseases with periodically assessing the health status of employees and timely diagnosis.

End-stage renal disease incidence in a cohort of US firefighters from San Francisco, Chicago, and Philadelphia

BACKGROUND

Firefighters perform strenuous work in hot environments, which may increase their risk of chronic kidney disease. The purpose of this study was to evaluate the risk of end-stage renal disease (ESRD) and types of ESRD among a cohort of US firefighters compared to the US general population, and to examine exposure-response relationships.

METHODS

ESRD from 1977 through 2014 was identified through linkage with Medicare data. ESRD incidence in the cohort compared to the US population was evaluated using life table analyses. Associations of all ESRD, systemic ESRD, hypertensive ESRD, and diabetic ESRD with exposure surrogates (exposed days, fire runs, and fire hours) were examined in Cox proportional hazards models adjusted for attained age (the time scale), race, birth date, fire department, and employment duration.

RESULTS

The incidence of all ESRD was less than expected (standardized incidence ratio (SIR) = 0.79; 95% confidence interval = 0.69-0.89, observed = 247). SIRs for ESRD types were not significantly increased. Positive associations of all ESRD, systemic ESRD, and hypertensive ESRD with exposed days were observed: however, 95% confidence intervals included one.

CONCLUSIONS

We found little evidence of increased risk of ESRD among this cohort of firefighters. Limitations included the inability to evaluate exposure-response relationships for some ESRD types due to small observed numbers, the limitations of the surrogates of exposure, and the lack of information on more sensitive outcome measures for potential kidney effects.

The association of noise exposure with stroke incidence and mortality: A systematic review and dose-response meta-analysis of cohort studies

BACKGROUND AND AIMS

Noise exposure is a major public health challenge with important implications for cardiovascular health. However, the association between noise exposure and stroke risk remains controversial. Therefore, we aimed to evaluate the role of noise exposure on stroke incidence and mortality by conducting a dose-response meta-analysis of cohort studies.

METHODS

The relevant publications were retrieved via PubMed, Embase, Web of Science, and Scopus up to June 26, 2022. The potential linear and curve relationship between noise and stroke were fitted using the generalized least squares method and restricted cubic spline. We estimated the pooled relative risk (RR) with 95% confidence interval (CI) by random-effect models. The Grading of Recommendations Assessment Development and Evaluation (GRADE) approach was used to evaluate the strength of the results.

RESULTS

In total, 21 cohort studies with 16,075,204 participants and 311,878 cases were included in the analysis. The risk of stroke incidence increased up to 4% (95% CI:1.02-1.06) and stroke mortality increased up to 3% (95% CI:1.00-1.07), every 10 dB(A) increment in noise exposure. Moreover, each 10 dB(A) increment in noise exposure was associated with a 4% (95% CI:1.01-1.07) increase in ischemic stroke and a 2% (95% CI:1.00-1.04) increase in hemorrhagic stroke. According to GRADE criteria, the evidence level in this study was rated as moderate.

CONCLUSIONS

The current findings provide further evidence of a dose-response relationship between exposure to noise and the risk of stroke incidence and mortality. Additionally, we update and fill a knowledge gap that the statistically significant increase in stroke incidence when noise decibels are >65 dB(A).

Relationship Between Occupational Noise and Hypertension in Modern Enterprise Workers: A Case–Control Study

Objective: The association between occupational noise exposure and hypertension is controversial. Thus, we aimed to assess the relationship between occupational noise exposure and hypertension.

Methods: This was a case‒control study, and 509 cases and 1,018 controls from an automobile company were included between July and October 2013. Occupational noise exposure was defined as exposure to noise level ≥80 dB(A) (Lex, 8 h) or cumulative noise exposure (CNE) ≥ 80 dB(A)-years. To assess the associations of noise level and CNE with hypertension, univariate and multivariate logistic regression were performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). The restricted cubic spline function was used to establish dose‒response curves.

Results: A noise level ≥80 dB (A) (Lex, 8 h) was significantly associated with hypertension (OR 2.48, 95% CI 1.89–3.24). CNE ≥80 dB (A)-years was significantly associated with hypertension (OR 1.53, 95% CI 1.18–2.00). Nonlinear relationships between noise level, CNE and hypertension were found (p- nonlinear<0.05).

Conclusion: Our study suggests that occupational noise exposure is a potential risk factor for hypertension in automobile company workers.

Occupational risk factors for hypertension

The identification and characterization of the modifiable risk factors of hypertension is of great value for public health and clinical medicine to achieve primary prevention. A large amount of literature on the effects of occupational factors on blood pressure and hypertension has been published. In this review, I summarize current evidence regarding the role of occupational factors in hypertension. The results of this review suggest that there is sufficient evidence to support the association between increased risk of hypertension and job stress, shift work, occupational lead exposure, and noise exposure. The association of hypertension with physical inactivity, sedentary behavior, and occupational exposure to mercury, arsenic, cadmium, or carbon disulfide remains inconclusive, although several studies have reported this finding. This review will serve as a step toward future research and provide baseline information for developing strategic interventions to prevent hypertension in the working population.

Urban Noise Exposure and Cardiometabolic Diseases: An Exploratory Cross-Sectional Study in Lisbon

Introduction: Urban noise pollution has been associated with an increased risk of developing metabolic syndrome. Nevertheless, existing observational studies relating to noise exposure and metabolic syndrome are based on non-generalizable cohorts. Lisbon remains a noisy city where this association has not been evaluated, and for this reason, we studied the relationship between exposure to urban noise and the prevalence of type 2 diabetes mellitus, obesity, and hypertension. Methods: Diurnal, evening and nocturnal noise emission levels were obtained for each street in the city from the Lisbon noise map. After allocation of all roads to the respective parish of Lisbon, the noise emission for each parish was averaged for each day period. The number of adult patients with type 2 diabetes mellitus, obesity and hypertension in 2014, 2015 and 2016 in each parish of Lisbon was obtained from the Regional Health Administration of Lisbon and Tagus Valley. Prevalence as a percentage of the population was determined using the number of residents in each parish determined in the 2011 population census. Spearman’s non-parametric correlation coefficient was used due to the non-normal distribution of the variables, at the 5% significance level (α = 0.05). Results: No correlations were found between daytime, afternoon or night-time noise exposure and the prevalence of type 2 diabetes mellitus, obesity or hypertension, although correlations were found between the cardiometabolic variables. Nevertheless, noise levels in Lisbon were above the legally established limit and the World Health Organization guidelines for environmental noise exposure in the European region. Conclusion: Our results do not agree with previous studies and should be faced as preliminary due to a strong biological plausibility for an association between noise exposure and cardiometabolic diseases and to encourage further studies, with longitudinal cohorts.

Indoor nocturnal noise is associated with body mass index and blood pressure: a cross-sectional study

BACKGROUND

Studies have demonstrated that noise is associated with various health problems, such as obesity and hypertension. Although the evidence of the associations of noise with obesity and hypertension is inconsistent, there seems to be a stronger association of the latter. This study aimed to investigate the associations of noise with body mass index (BMI) and blood pressure in adults living in multi-story residential buildings.

METHODS

A cross-sectional study was conducted in Hong Kong from February 2018 to September 2019. The Weinstein Noise Sensitivity Scale, Pittsburgh Sleep Quality Index, ENRICHD Social Support Instrument, Patient Health Questionnaire, Perceived Stress Scale, and Hospital Anxiety and Depression Scale were administered to the participants. BMI and blood pressure were assessed. Nocturnal noise exposure and total sleep duration were measured for a week.

RESULTS

Five hundred adults (66.4% female), with an average age of 39 years (range: 18-80), completed the study. The average levels of nocturnal noise, BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were 51.3 dBA, 22.2 kg/m2, 116.0 mmHg, and 75.4 mmHg, respectively. After adjusting for sociodemographic characteristics, nocturnal noise was associated with BMI (b = 0.54, 95% CI: 0.01 to 1.06, p = 0.045) and SBP (b = 2.90, 95% CI: 1.12 to 4.68, p = 0.001). No association was detected between nocturnal noise and DBP (b = 0.79, 95% CI: - 0.56 to 2.13, p = 0.253). Specifically, higher nocturnal noise was associated with higher BMI (b = 0.72, 95% CI: 0.07 to 1.38, p = 0.031) and SBP (b = 3.91, 95% CI: 2.51 to 5.31, p < 0.001) in females but only higher SBP (b = 3.13, 95% CI: 1.35 to 4.92, p < 0.001) in males. The association between noise and SBP remained significant (b = 2.41, 95% CI: 0.62 to 4.20, p = 0.008) after additionally adjusting for lifestyle, diagnosis of hypertension, psychometric constructs, and sleep.

CONCLUSIONS

Indoor nocturnal noise was associated with BMI and blood pressure in females but only blood pressure in males. It is important to control nocturnal noise or use soundproofing materials in buildings to reduce noise exposure.