Effects of earplugs on catecholamine and cortisol excretion in noise-exposed textile workers

A Comprehensive Review on Social Inequalities and Pregnancy Outcome-Identification of Relevant Pathways and Mechanisms

Scientific literature tends to support the idea that the pregnancy and health status of fetuses and newborns can be affected by maternal, parental, and contextual characteristics. In addition, a growing body of evidence reports that social determinants, measured at individual and/or aggregated level(s), play a crucial role in fetal and newborn health. Numerous studies have found social factors (including maternal age and education, marital status, pregnancy intention, and socioeconomic status) to be linked to poor birth outcomes. Several have also suggested that beyond individual and contextual social characteristics, living environment and conditions (or "neighborhood") emerge as important determinants in health inequalities, particularly for pregnant women. Using a comprehensive review, we present a conceptual framework based on the work of both the Commission on Social Determinants of Health and the World Health Organization (WHO), aimed at describing the various pathways through which social characteristics can affect both pregnancy and fetal health, with a focus on the structural social determinants (such as socioeconomic and political context) that influence social position, as well as on intermediary determinants. We also suggest that social position may influence more specific intermediary health determinants; individuals may, on the basis of their social position, experience differences in environmental exposure and vulnerability to health-compromising living conditions. Our model highlights the fact that adverse birth outcomes, which inevitably lead to health inequity, may, in turn, affect the individual social position. In order to address both the inequalities that begin in utero and the disparities observed at birth, it is important for interventions to target various unhealthy behaviors and psychosocial conditions in early pregnancy. Health policy must, then, support: (i) midwifery availability and accessibility and (ii) enhanced multidisciplinary support for deprived pregnant women.

Non-auditory effects of industrial chronic noise exposure on workers; change in salivary cortisol pattern

Background

Noise has different auditory and non-auditory effects on human. In noisy environments, noise as a non-specific stressor can activates the hypothalamic-pituitary-adrenal axis (HPA, cortisol). The aim of this study was to evaluate the effect of chronic exposure to noise on salivary cortisol on industrial workers.

Methods

This cross-sectional study had a case/control design. 136 male workers (68 workers were exposed to chronic industrial noise, and 68 other workers were exposed to background noise) voluntarily enrolled in the study. The equivalent noise level was measured at workstations and salivary cortisol for both case and control groups was measured at the beginning (6 AM) and also at the end of work shift (4 PM). The amount of change in the average of the values of the two groups were compared with each other.

Results

The measured Leq_8h (equivalent continuous sound level) in case and control groups were 87.43 dB-A and 67.6 dB-A, respectively. Comparison of salivary cortisol levels change in groups shows a significant differences in control groups for salivary cortisol in the morning and in the evening samples (p < 0.05); but not in the case group (p = 0.052). Also, comparison of salivary cortisol levels changes with noise exposure experience in the case subgroups revealed no significant difference (p > 0.05).

Conclusion

This study showed that chronic exposure to industrial noise can lead to a change in pattern of salivary cortisol secretion especially in the evening (at the end of the work shift), in a way that instead of its normal decrease, an increase happened.

Relationship between occupational noise exposure and hypertension: A cross-sectional study in steel factories

BACKGROUND

Hazardous exposure to occupational noise may be associated with an increased risk of cardiovascular disease and hypertension. This study was performed to assess the relationship between noise exposure and hypertension prevalence in steelworkers.

METHODS

A cross-sectional survey using self-reported noise exposure and audiometrically measured hearing loss was performed. One thousand eight hundred and seventy-four workers were interviewed. Multiple logistic regression was used to calculate odds ratios for hypertension by noise exposure. Linear regression analysis was used to test associations between noise exposure and systolic blood pressure (SBP) and diastolic blood pressure (DBP).

RESULTS

Occupational noise-exposed subjects had significantly higher blood pressure levels than nonexposed subjects (SBP: 123.18 ± (standard deviation) 12.44 vs 119.80 ± 12.50 mm Hg; DBP: 77.86 ± 9.34 vs 75.49 ± 8.73 mmHg). The prevalence of hypertension was approximately 5% in the control group without noise exposure or hearing impairment and increased from 6% to 21% across the range of increasing degree of hearing loss and, separately, of cumulative exposure time. Noise exposure (any) was associated with an increase in the prevalence of hypertension (odds ratio, 2.03, 95% confidence interval [CI]: 1.15-3.58). Noise-induced hearing loss and cumulative noise exposure time were positively correlated with BP (hearing loss: SBP: β = .09, 95% CI: 0.04-0.15 mm Hg, DBP: β = .11, 95% CI: 0.06-0.17 mm Hg; cumulative exposure time: SBP: β = .10, 95% CI: 0.04-0.15 mm Hg, DBP: β = .09, 95% CI: 0.04-0.15 mm Hg).

CONCLUSIONS

Noise exposure measured in two different ways was strongly associated with the prevalence of hypertension in steelworkers. Reducing noise in the steel factory could be a way of decreasing the risk of hypertension in this population.

Recent and long-term occupational noise exposure and salivary cortisol level

Environmental and occupational noise exposure have been related to increased risk of cardiovascular disease, hypothetically mediated by stress-activation of the hypothalamic-pituitary-adrenal (HPA) axis. The objective of this study was to investigate the relation between recent and long-term occupational noise exposure and cortisol level measured off work to assess a possible sustained HPA-axis effect. We included 501 industrial, finance, and service workers who were followed for 24h during work, leisure, and sleep. Ambient occupational noise exposure levels were recorded every 5s by personal dosimeters and we calculated the full-shift LAEq value and estimated duration and cumulative exposure based on their work histories since 1980. For 332 workers who kept a log-book on the use of hearing protection devices (HPD), we subtracted 10 dB from every noise recording obtained during HPD use and estimated the noise level at the ear. Salivary cortisol concentration was measured at 20.00 h, the following day at awakening, and 30 min after awakening on average 5, 14 and 14.5h after finishing work. The mean ambient noise exposure level was 79.9 dB(A) [range: 55.0-98.9] and the mean estimated level at the ear 77.7 dB(A) [range: 55.0-94.2]. In linear and mixed regression models that adjusted for age, sex, current smoking, heavy alcohol consumption, personal income, BMI, leisure-time noise exposure level, time since occupational noise exposure ceased, awakening time, and time of saliva sampling, we observed no statistically significant exposure response relation between recent, or long-term ambient occupational noise exposure level and any cortisol parameter off work. This was neither the case for recent noise level at the ear. To conclude, neither recent nor long-term occupational noise exposure levels were associated with increased cortisol level off work. Thus, our results do not indicate that a sustained activation of the HPA axis, as measured by cortisol, is involved in the causal pathway between occupational noise exposure and cardiovascular disease.

An exploratory spatial analysis to assess the relationship between deprivation, noise and infant mortality: an ecological study

BACKGROUND

Few studies have explored how noise might contribute to social health inequalities, and even fewer have considered infant mortality or its risk factors as the health event of interest.In this paper, we investigate the impact of neighbourhood characteristics - both socio-economic status and ambient noise levels - on the spatial distribution of infant mortality in the Lyon metropolitan area, in France.

METHODS

All infant deaths (n = 715) occurring between 2000 and 2009 were geocoded at census block level. Each census block was assigned multi-component socio-economic characteristics and Lden levels, which measure exposure to noise. Using a spatial-scan statistic, we examined whether there were significant clusters of high risk of infant mortality according to neighbourhood characteristics.

RESULTS

Our results highlight the fact that infant mortality is non-randomly distributed spatially, with clusters of high risk in the south-east of the Lyon metropolitan area (RR = 1.44; p = 0.09). After adjustments for socio-economic characteristics and noise levels, this cluster disappears or shifts according to in line with different scenarios, suggesting that noise and socio-economic characteristics can partially explain the spatial distribution of infant mortality.

CONCLUSION

Our findings show that noise does have an impact on the spatial distribution of mortality after adjustments for socio-economic characteristics. A link between noise and infant mortality seems plausible in view of the three hypothetical, non-exclusive, pathways we propose in our conceptual framework: (i) a psychological pathway, (ii) a physiological disruption process and (iii) an unhealthy behaviours pathway. The lack of studies makes it is difficult to compare our findings with others. They require further research for confirmation and interpretation.

Changes in urinary catecholamines in response to noise exposure in workers at Sarcheshmeh Copper Complex, Kerman, Iran

Noise is one of the most harmful agents in the workplace. In addition to the adverse effects of noise on the auditory system, as a stressor it may cause increased blood pressure, cardiovascular disease, anxiety, and impaired secretion of hormones. The purpose of this study was to evaluate changes in urinary catecholamines in workers exposed to industrial noise. This is an experimental study of the workers at the smelter section of Sarcheshmeh Copper Industries done on two separate days. During the first day, urine samples from 20 workers who did not use any hearing protection device, were collected during an 8-h work shift and on the second day the same was done but they were asked to use earplugs. Also 20 people were selected as a control group from people who were not exposed to noise at work. Urinary catecholamine levels were measured with ELISA kits. The mean urinary epinephrine and norepinephrine levels in the workers (without earplugs) was respectively 8.69 and 35.56 μg/8h on the first day and on the second day (with earplugs) dropped to 6.45 and 30.95 μg/8h. Noise reduction by earplugs led to almost significant reductions in urinary epinephrine (p = 0.05) and significant reductions in norepinephrine (p = 0.02). The results showed that with noise reduction the urinary excretion of stress hormones, especially norepinephrine significantly decreases and workers are probably less prone to stress-related disorders.

Towards a general framework for including noise impacts in LCA

PURPOSE

Several damages have been associated with the exposure of human beings to noise. These include auditory effects, i.e., hearing impairment, but also non-auditory physiological ones such as hypertension and ischemic heart disease, or psychological ones such as annoyance, depression, sleep disturbance, limited performance of cognitive tasks or inadequate cognitive development. Noise can also interfere with intended activities, both in daytime and nighttime. ISO 14'040 also indicated the necessity of introducing noise, together with other less developed impact categories, in a complete LCA study, possibly changing the results of many LCA studies already available. The attempts available in the literature focused on the integration of transportation noise in LCA. Although being considered the most frequent source of intrusive impact, transportation noise is not the only type of noise that can have a malign impact on public health. Several other sources of noise such as industrial or occupational need to be taken into account to have a complete consideration of noise into LCA. Major life cycle inventories (LCI) typically do not contain data on noise emissions yet and characterisation factors are not yet clearly defined. The aim of the present paper is to briefly review what is already available in the field and propose a new framework for the consideration of human health impacts of any type of noise that could be of interest in the LCA practice, providing indications for the introduction of noise in LCI and analysing what data is already available and, in the form of a research agenda, what other resources would be needed to reach a complete coverage of the problem.

MAIN FEATURES

The literature production related to the impacts of noise on human health has been analysed, with considerations of impacts caused by transportation noise as well as occupational and industrial noise. The analysis of the specialist medical literature allowed for a better understanding of how to deal with the epidemiological findings from an LCA perspective and identify areas still missing dose-response relations. A short review of the state-of-science in the field of noise and LCA is presented with an expansion to other contributions in the field subsequent to the comprehensive work by Althaus et al. (2009a; 2009b). Focusing on the analogy between toxicological analysis of pollutants and noise impact evaluation, an alternative approach is suggested, which is oriented to the consideration of any type of noise in LCA and not solely of transportation noise. A multi-step framework is presented as a method for the inclusion of noise impacts on human health in LCA.

RESULTS AND DISCUSSION

A theoretical structural framework for the inclusion of noise impacts in LCA is provided as a basis for future modelling expansions in the field. Rather than evaluating traffic/transportation noise, the method focuses on the consideration of the noise level and its impact on human health, regardless of the source producing the noise in an analogous manner as considered in the fields of toxicology and common noise evaluation practices combined. The resulting framework will constitute the basis for the development of a more detailed mathematical model for the inclusion of noise in LCA. The toxicological background and the experience of the analysis of the release of chemicals in LCA seem to provide sufficient ground for the inclusion of noise in LCA: taken into account the physical differences and the uniqueness of noise as an impact, the procedure applied to the release of chemicals during a product life cycle is key for a valuable inclusion of noise in the LCA logic.

CONCLUSIONS

It is fundamental for the development of research in the field of LCA and noise to consider any type of noise. Further studies are needed to contribute to the inclusion of noise sources and noise impacts in LCA. In this paper, a structure is proposed that will be expanded and adapted in the future and which forms the basic framework for the successive modelling phase.

Noise, stress, and annoyance in a pediatric intensive care unit

OBJECTIVE

To measure and describe hospital noise and determine whether noise can be correlated with nursing stress measured by questionnaire, salivary amylase, and heart rate.

DESIGN

Cohort observational study.

SETTING

Tertiary care center pediatric intensive care unit.

SUBJECTS

Registered nurses working in the unit.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Eleven nurse volunteers were recruited. An audiogram, questionnaire data, salivary amylase, and heart rate were collected in a quiet room. Each nurse was observed for a 3-hr period during patient care. Heart rate and sound level were recorded continuously; saliva samples and stress/annoyance ratings were collected every 30 mins. Variables assessed as potential confounders were years of nursing experience, caffeine intake, patients' Pediatric Risk of Mortality Score, shift assignment, and room assignment. Data were analyzed by random effects multiple linear regression using Stata 6.0. The average daytime sound level was 61 dB(A), nighttime 59 dB(A). Higher average sound levels significantly predicted higher heart rates (p =.014). Other significant predictors of tachycardia were higher caffeine intake, less nursing experience, and daytime shift. Ninety percent of the variability in heart rate was explained by the regression equation. Amylase measurements showed a large variability and were not significantly affected by noise levels. Higher average sound levels were also predictive of greater subjective stress (p =.021) and annoyance (p =.016).

CONCLUSIONS

In this small study, noise was shown to correlate with several measures of stress including tachycardia and annoyance ratings. Further studies of interventions to reduce noise are essential.

Reactivity and recovery from different types of work measured by catecholamines and cortisol: a systematic literature overview

OBJECTIVES

To review occupational health, laboratory, and sports literature on neuroendocrine reactivity and recovery from mental, combined mental and physical, or physical tasks.

METHODS

A systematic literature search was performed in eight databases. Studies with catecholamines or cortisol as effect variables measured in blood, urine, or saliva were included.

RESULTS

After application of inclusion and exclusion criteria, 77 studies from the initial 559 identified were taken into account. In occupational settings it was found that relatively few studies were conclusive about recovery, which formed a contrast with sports research. For reactivity and recovery up to 1 hour after performing the task, half of the studies considered physical tasks and more than two thirds showed incomplete recovery compared with baseline excretion of catecholamines and cortisol. Recovery extending to 3 days after the task was performed was often incomplete for cortisol after combined mentally and physically demanding tasks, and less often after solely mental or physical tasks. This type of recovery was more often incomplete for adrenaline (epinephrine) than for noradrenaline (norepinephrine), which was the case after mental as well as combined mental and physical tasks.

CONCLUSIONS

The results from laboratory and sports research may be transferable to some occupations, but more research is needed on the course of recovery relative to health effects in occupational settings.

The influence of stressors on biochemical reactions--a review of present scientific findings with noise

For every faculty of perception there is, according to the degree of irritation, a biochemical or psychobiological activation. This is also true for the perception of sound or noise. Initially, these processes allow for the adjustment of the organism to a changed situation (eustress). Prolonged effects of stressors may ultimately lead to regulatory disturbances and induce pathological processes (distress). The pathogenetic concept that psychobiological stresses (e.g. noise) may be connected with the well-known risk factors of cardiovascular diseases, through excitation of the central nervous system, is based on the known stress models. The central connective factors are the activation hormones of the adrenal gland, also referred to as stress hormones. From blood and urine parameters recorded in epidemiological and experimental studies under the influence of acute or chronic noise, a simplified model of the pathogenetic mechanism has been developed. Fundamental conditions for future assessing the "stress hormones" have been derived, by means of which premorbid conditions can be determined on a population or group basis.