生产性噪声与铅联合暴露对高血压的影响:一项基于卷烟厂工人的纵向研究  

Combined effect of industrial noise and lead exposure on hypertension:A longitudinal study based on cigarette factory workers

作　　者：张尚怡 姚勇 刘艳茹 刘明盛 陈振龙 易桂林 殷文军 ZHANG Shangyi;YAO Yong;LIU Yanru;LIU Mingsheng;CHEN Zhenlong;YI Guilin;YIN Wenjun(School of Public Health,Hubei University of Medicine,Shiyan,Hubei 442000,China;Wuhan Prevention and Treatment Center for Occupa-tional Diseases(The Joint Graduate Training Base of the School of Public Health and Health Sci-ences,Hubei University of Medicine),Wuhan,Hubei 430015,China)

机构地区：[1]湖北医药学院公共卫生与健康学院,湖北十堰442000 [2]武汉市职业病防治院(湖北医药学院公共卫生与健康学院研究生联合培养基地),湖北武汉430015

出　　处：《环境与职业医学》2025年第1期49-55,共7页Journal of Environmental and Occupational Medicine

基　　金：武汉市卫健委科研项目资助项目(WX23B32);湖北医药学院研究生科技创新项目(YC2023059)。

摘　　要：[背景]高血压是常见的慢性非传染性疾病,既往研究较少关注生产性噪声和铅联合暴露对高血压的影响。[目的]本研究旨在探讨生产性噪声和铅联合暴露与高血压患病风险之间的关联,为相关职业人群高血压防治提供科学依据。[方法]以2010年湖北省某卷烟厂工人为研究对象,收集人口学基本特征、体检数据等信息,检测噪声接触水平和血铅浓度。按照噪声接触水平80 dB(A),将研究人群分为对照组和噪声暴露组。采用连续7年随访的纵向数据,拟合混合效应模型和广义估计方程模型(GEE)分析血铅和血压的相关性。使用限制性立方样条模型分析血铅与高血压发生风险之间的剂量-反应关系。拟合广义估计方程分析血铅和噪声暴露的交互作用对高血压的影响。[结果]本研究共纳入419名工人,2010年研究对象的平均年龄为(39.06±7.34)岁。在调整所有协变量后,广义估计方程模型结果显示,在对照组和噪声暴露组中,血铅均与高血压发生风险之间存在正相关(P<0.05)。限制性立方样条模型结果显示,血铅浓度与高血压患病风险之间呈非线性剂量-反应关系。对照组中,血铅浓度高于18.12μg·L^(-1)时,高血压患病风险增加;噪声暴露组中,血铅浓度高于15.54μg·L^(-1)时,高血压患病风险增加(P<0.05)。交互作用分析结果显示,噪声和血铅交互作用对高血压的发生具有正向作用,相乘交互作用指标为1.75[95%置信区间(95%CI):1.05~2.91],超额相对危险度为1.04(95%CI:0.4~2.04),归因比为0.43(95%CI:0.15~0.71)。[结论]生产性噪声和铅联合暴露与高血压患病风险之间存在正向关联。当职业人群暴露于≥80 dB(A)的噪声水平,且血铅水平高于15.45μg·L^(-1)时,可能增加高血压患病风险。[Background]Hypertension is a common chronic noncommunicable disease.The combined ef-fects of productive noise and lead exposure on hypertension have been rarely explored in previous studies.[Objective]To investigate the combined effects of industrial noise and lead exposure on hyper-tension risk,and to provide a scientific basis for hypertension prevention and treatment in occu-pational population.[Methods]Participants were recruited from a cigarette factory in Hubei Province in 2010.Data on demographic characteristics,and physical examination results were collected.Noise exposure level and blood lead concentration were measured.Based on a noise exposure level of 80 dB(A),the participants were classified into a control group and a noise-exposed group.Mixed-effects model and generalized estimating equation(GEE)were applied to analyze the association between blood lead level and blood pressure using a set of 7-year longitudinal data.Restricted cubic spline model was used to evaluate a potential dose-response relationship between blood lead levels and hypertension risk.GEE analysis was conducted to explore the potential inter-action between noise and lead exposure on hypertension.[Results]A total of 419 workers were included in this study,with an average age of(39.06±7.34)years in 2010.After adjusting for co-variates,the GEE model indicated a positive association between blood lead level and hypertension risk in both the control and the noise-exposed groups(P<0.05).The restricted cubic spline models revealed a nonlinear dose-response relationship between blood lead level and hypertension risk.In the control group,hypertension risk increased when blood lead level exceeded 18.12μg∙L−1(P<0.05).In the noise-exposed group,hypertension risk increased when blood lead level exceeded 15.54μg∙L^(−1)(P<0.05).The interaction analysis demonstrated a positive interaction between noise and blood lead on hypertension risk,with a multiplicative interaction index of 1.75[95% confidence interval(CI):1.05,2.91],a relative e

关 键 词：生产性噪声 铅 联合暴露 高血压 纵向研究 

分 类 号：R13[医药卫生—劳动卫生]