Association of occupational noise exposure, bilateral hearing loss with atherosclerotic cardiovascular disease risk in Chinese adults

Associations of coal mine dust exposure with arterial stiffness and atherosclerotic cardiovascular disease risk in chinese coal miners

OBJECTIVE

Whether coal mine dust exposure increases cardiovascular diseases (CVDs) risk was rarely explored. Our objective was to examine the association between coal mine dust exposure and cardiovascular risk.

METHODS

We estimated cumulative coal mine dust exposure (CDE) for 1327 coal miners by combining data on workplace dust concentrations and work history. We used brachial-ankle pulse wave velocity (baPWV, a representative indicator of arterial stiffness) and ten-year atherosclerotic cardiovascular disease (ASCVD) risk to assess potential CVD risk, exploring their associations with CDE.

RESULTS

Positive dose-response relationships of CDE with baPWV and ten-year ASCVD risk were observed after adjusting for covariates. Specifically, each 1 standard deviation (SD) increase in CDE was related to a 0.27 m/s (95% CI: 0.21, 0.34) increase in baPWV and a 1.29 (95% CI: 1.14, 1.46) elevation in OR (odds ratio) of risk of abnormal baPWV. Moreover, each 1 SD increase in CDE was associated with a 0.74% (95% CI: 0.63%, 0.85%) increase in scores of ten-year ASCVD and a 1.91 (95% CI: 1.62, 2.26) increase in OR of risk of ten-year ASCVD. When compared with groups unexposed to coal mine dust, significant increase in the risk of arterial stiffness and ten-year ASCVD in the highest CDE groups were detected.

CONCLUSION

The study suggested that cumulative exposure to coal mine dust was associated with elevated arterial stiffness and ten-year ASCVD risk in a dose-response manner. These findings contribute valuable insights for cardiovascular risk associated with coal mine dust.

Hearing disorders, genetic predisposition, and risk of new-onset atrial fibrillation: A prospective cohort study in the UK biobank

BACKGROUND

Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with significant morbidity and mortality. Hearing impairment has been linked to several cardiovascular diseases. However, the association between hearing disorders, genetic predisposition, and new-onset AF remains largely unknown.

METHODS

A total of 476,773 participants (mean age 56.5 years) free of AF at baseline (from 2006 to 2010) were included from the UK Biobank study. The presence of hearing disorders including hearing difficulty and tinnitus was self-reported through the touchscreen questionnaire. AF was defined using ICD-10 code: I48 and was followed till February 1st. 2022. The Cox model was used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CI).

RESULTS

During a median follow-up of 13.0 years, the AF incidence rate was 2.9 per 1000 person-years. After adjustments for potential confounders, the presence of hearing difficulty (HR, 1.35; 95% CI: 1.32-1.39) and the use of hearing aid (1.45; 1.37-1.53) were significantly associated with risk of new-onset AF. Compared to individuals without tinnitus, the AF risk increased by 17% among those who experienced tinnitus occasionally (1.17; 1.09-1.25), 23% among those who experienced tinnitus frequently (1.23; 1.10-1.39), and 32% among those who experienced tinnitus consistently (1.32; 1.22-1.42). No significant difference was observed across different groups of genetic risk score for AF onset.

CONCLUSIONS

Our study provides evidence regarding significant associations of hearing difficulty, use of hearing aid, and tinnitus with risk of incident AF. Findings highlight the potential that screening hearing disorders can benefit AF prevention.

Is occupational noise associated with arthritis? Cross-sectional evidence from US population

BACKGROUND

The impact of occupational noise exposure on various diseases, including ear and cardiovascular diseases, has been studied extensively. Nevertheless, the connection between osteoarthritis (OA) and rheumatoid arthritis (RA) and occupational noise exposure remains largely unexplored in real-world scenarios. This study assessed the association between occupational noise exposure and the prevalence of two types of arthritis.

METHODS

This study used database data from 2005 to 2012 and 2015-March 2020 from the prepandemic National Health and Nutrition Examination Survey (NHANES) related to occupational noise exposure and arthritis. Multivariate logistic regression analysis was used to estimate the association between occupational noise exposure and RA/OA, adjusting for age, gender, race, education level, marital status, the ratio of family income to poverty, trouble sleeping, smoking status, alcohol consumption, diabetes, hypertension, body mass index (BMI), metabolic equivalents (METs), and thyroid disease.

RESULTS

This study included 11,053 participants. Multivariate logistic regression analysis demonstrated that previous exposure to occupational noise was positively associated with self-reported RA (OR = 1.43, 95% CI = 1.18-1.73) and OA (OR = 1.25, 95% CI = 1.07-1.46). Compared to individuals without a history of occupational noise exposure, those with an exposure duration of 1 year or greater exhibited higher odds of prevalent RA, though there was no apparent exposure response relationship for noise exposure durations longer than 1 year. The results of our subgroup analyses showed a significant interaction between age and occupational noise exposure on the odds of self-reported prevalent OA.

CONCLUSIONS

Our findings suggest an association between occupational noise exposure and the prevalence of RA and OA. Nevertheless, further clinical and basic research is warranted to better explore their associations.

MiRNA-92a-3p mediated the association between occupational noise exposure and blood pressure among Chinese adults

Evidence on the association between occupational noise exposure and blood pressure is inconsistent, and the underlying mechanism remains unknown. This study aimed to evaluate the association between occupational noise exposure and blood pressure, and explore the potential role of miRNAs in the association. A total of 894 subjects from two companies in Wuhan, China were included. Occupational noise exposure was assessed using cumulative noise exposure (CNE), and six candidate plasma miRNAs (miR-92a-3p, miR-21-5p, miR-200a-3p, miR-200b-3p, miR-200c-3p, and miR-1-3p) which were not only associated with blood pressure/hypertension but also related to oxidative stress were selected according to previous studies and tested. A linear dose-response relationship was found between occupational noise exposure and blood pressure, including systolic blood pressure (SBP) and diastolic blood pressure (DBP). Each 1-unit increase in CNE levels was significantly associated with a 0.130 (95 % confidence interval [CI] = 0.026, 0.234) unit increase in SBP and a 0.141 (95 % CI = 0.063, 0.219) unit increase in DBP. However, the association between occupational noise and hypertension is not statistically significant (P > 0.05). In the meanwhile, occupational noise exposure was negatively associated with miRNA-92a-3p (β = -0.019, 95 % CI = -0.032, -0.006) and miRNA-21-5p (β = -0.031, 95 % CI = -0.052, -0.010), and miRNA-92a-3p mediated 24.66 % of the association between occupational noise exposure and DBP. In addition, bilateral high-frequency hearing loss was not only positively associated with occupational noise exposure (OR = 1.974, 95 % CI = 1.084, 3.702) but also DBP (β = 2.546, 95 % CI = 0.160, 4.932). Our study suggests that occupational noise exposure is positively associated with SBP and DBP, and miRNA-92a-3p partially mediate the association between occupational noise exposure and DBP.

Genotypic and Allelic Frequencies of GJB2 Variants and Features of Hearing Phenotypes in the Chinese Population of the Dongfeng-Tongji Cohort

BACKGROUND

This study aimed to describe the distribution of the genotype and allele frequencies of GJB2 variants in the Chinese population of the Dongfeng Tongji cohort and to analyze the features of the hearing phenotype.

METHODS

We used data from 9910 participants in the Dongfeng Tongji cohort in 2013 and selected nine GJB2 variants. Pure tone audiometry was employed to measure hearing. Differences in genotype and allele frequencies were analyzed via chi-squared test or Fisher's exact test.

RESULTS

Of the 9910 participants, 5742 had hearing loss. The genotype frequency of the GJB2 variant c.109G>A was statistically significantly distributed between the normal and impaired hearing groups, but not for the variant c.235delC. A higher frequency of the c.109G>A homozygous genotype was found in the hearing loss group (0.5%) than in the normal hearing group (0.1%). Patients with c.109G>A and c.235delC homozygous mutations exhibited varying degrees of hearing loss, mainly presenting sloping and flat audiogram shapes.

CONCLUSIONS

A significant difference was found in the genotype frequency of the GJB2 variant c.109G>A between the case and control groups, but not in that of the variant c.235delC. Different degrees of hearing loss and various audiogram shapes were observed in patients with c.109G>A and c.235delC homozygous mutations.

Independent and Combined Associations of Sleep Duration, Bedtime, and Polygenic Risk Score with the Risk of Hearing Loss among Middle-Aged and Old Chinese: The Dongfeng-Tongji Cohort Study

Evidence available on the independent and combined associations of sleep duration, bedtime, and genetic predisposition with hearing loss was lacking. The present study included 15,827 participants from the Dongfeng-Tongji cohort study. Genetic risk was characterized by polygenic risk score (PRS) based on 37 genetic loci related to hearing loss. We conducted multivariate logistic regression models to assess the odds ratio (OR) for hearing loss with sleep duration and bedtime, as well as the joint association and interaction with PRS. Results showed that hearing loss was independently associated with sleeping ≥9 h/night compared to the recommended 7 to <8 h/night, and with bedtime ≤9:00 p.m. and >9:00 p.m. to 10:00 p.m. compared to those with bedtime >10:00 p.m. to 11:00 p.m., with estimated ORs of 1.25, 1.27, and 1.16, respectively. Meanwhile, the risk of hearing loss increased by 29% for each 5-risk allele increment of PRS. More importantly, joint analyses showed that the risk of hearing loss was 2-fold in sleep duration ≥9 h/night and high PRS, and 2.18-fold in bedtime ≤9:00 p.m. and high PRS. With significant joint effects of sleep duration and bedtime on hearing loss, we found an interaction of sleep duration with PRS in those with early bedtime and an interaction of bedtime with PRS in those with long sleep duration on hearing loss (P_int <0.05), and such relationships were more evident in high PRS. Similarly, the above relationships were also observed for age-related hearing loss and noise-induced hearing loss, particularly the latter. In addition, age-modified effects of sleep patterns on hearing loss were likewise observed, with stronger estimation among those aged <65 years. Accordingly, longer sleep duration, early bedtime, and high PRS were independently and jointly related to increased risk of hearing loss, suggesting the importance of considering both genetics and sleep pattern for risk assessment of hearing loss.

Association between occupational noise exposure duration and heart rate variability among Chinese adults: The role of plasma miRNAs

We aimed to explore the association between occupational noise exposure duration and heart rate variability (HRV) and the underlying mechanism. A total of 449 subjects in a manufacturing company in Wuhan, China were included in our study and six candidate miRNAs (miR-200a-3p, miR-200b-3p, miR-200c-3p, miR-1-3p, miR-92a-3p and miR-21-5p) were tested among 200 individuals. Information combining the work histories and the occupational noise monitoring records were used to calculate the exposure of occupational noise, HRV indices were measured by using 3-channel digital Holter monitors, including the standard deviation of all normal R-R intervals (SDNN), the root mean of the square of successive differences between adjacent normal NN intervals (r-MSSD), SDNN index, low-frequency power (LF), high-frequency power (HF) and TP (total power). We found a significant linear negative dose-response relationship between occupational noise exposure duration and HRV indices (P for overall <0.05, P for nonlinear >0.05), including SDNN, r-MSSD, SDNN index, LF and HF. In the continuous models, the β (95% CIs) for each 1-year occupational noise exposure were -0.002 (-0.004, -0.001) for SDNN, -0.002 (-0.004, -0.001) for r-MSSD, -0.002 (-0.004, -0.001) for SDNN index, and -0.006 (-0.012, -0.001) for HF. Meanwhile, we also found that occupational noise exposure duration was significantly associated with lower expression of five miRNAs, when adjusting for other covariates. The β (95% CIs) were -0.039 (-0.067, -0.011) for miRNA-200c-3p, -0.053 (-0.083, -0.022) for miRNA-200a-3p, -0.044 (-0.070, -0.019) for miRNA-200b-3p, -0.032 (-0.048, -0.017) for miRNA-92a-3p, and -0.063 (-0.089, -0.038) for miRNA-21-5p in the continuous models. In addition, we found a positive association between miRNA-1-3p and LF (β = 0.039, 95% CI = 0.002, 0.080). Our study suggests that occupational noise exposure duration is associated with cardiac autonomic dysfunction, and the role of miRNAs in noise induced HRV reduction needs to be confirmed in future studies.

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.

Relationship between occupational noise exposure and hypertension: Cross-sectional evidence from real-world

Background

Occupational noise is one of the most common and prevalent occupational hazards worldwide and may induce adverse auditory and/or non-auditory health effects. However, the relationship between occupational noise exposure and hypertension is controversial and has long been debated.

Methods

Based on large sample cross-sectional data from all registered occupational health examination units from 2021 to 2022 (N = 101,605), this study aimed to analyze the prevalence of hearing loss and hypertension and to explore the influencing factors of hypertension of workers in Wuhan. Descriptive statistics, univariate analyses and multivariate analyses were used. Forest plot and nomograms were constructed for the visualization of predictive results. The ROC curve, AUC, C-index and calibration curves were used to assess the predictive accuracy and validity. DCA was performed to evaluate the net benefit that workers could receive.

Results

Higher rate of high-frequency hearing loss (25.3%), speech frequency hearing loss (8.8%), ECG abnormalities (31.9%) and hypertension (21.0%) were found in workers exposed to occupational noise in Wuhan. Occupational noise exposure (OR = 1.09, 95% CI: 1.01-1.18, p = 0.04), growth of age (OR: 1.07, 95% CI: 1.07-1.07, p < 0.001), overweight (OR: 1.82, 95% CI: 1.73-1.92, p < 0.001), obesity (OR: 3.62, 95% CI: 3.42-3.83, p < 0.001), hyperglycemia (OR: 1.84, 95% CI: 1.73-1.96, p < 0.001), hypercholesterolemia (OR = 1.34; 95% CI 1.22-1.48; p < 0.001), ECG abnormalities (OR = 1.11; 95% CI 1.07-1.15; p < 0.001) and family history of hypertension (OR = 1.69; 95% CI 1.58-1.81; p < 0.001) were risk factors of hypertension for workers. Male workers had a relatively higher hypertension risk than female workers (OR = 1.61; 95% CI 1.54-1.69; p < 0.001). Ear protective measures could not reduce the risk of hypertension in workers. Our nomogram has good predictive accuracy and validity. A dynamic nomogram to predict the workers' risk of hypertension was established publicly available online.

Conclusion

Occupational noise exposure may elevate workers' hypertension risk. More effective and relevant prevention measures should be taken. Our nomogram may help identify high-risk workers and facilitate timely interventions.

Association of noise exposure, plasma microRNAs with arterial stiffness among Chinese workers

Long-term noise exposure is reported to damage cardiovascular system, but the relationship between occupational noise exposure and arterial stiffness (AS) and the underlying mechanism is still unclear. We aimed to investigate the association of occupational noise exposure with arterial stiffness (AS), and further explore the mediation roles of microRNAs (miRNAs). A total of 838 workers were recruited from two companies in Wuhan, Hubei, China. Cumulative occupational noise exposure (CNE) was assessed through noise level of job title and work years in occupational noise. The AS for the participants were evaluated using brachial-ankle pulse wave velocity (baPWV) measured by an oscillometric device. Each 1-unit increase in CNE levels was significantly associated with a 0.002 (95% confidence interval (CI) = 0.001-0.003) unit increase in ln-transformed values of baPWV. In the sex-specific analysis, the association was significant in males (β = 0.002, 95%CI = 0.001-0.003). Meanwhile, the risk of bilateral hearing loss at high frequency was significantly higher in the high-exposed group than non-exposed group (OR = 1.895, 95%CI = 1.024-3.508), and participants with bilateral hearing loss at high frequency had a significantly higher level of ln-transformed baPWV (β = 0.032, 95%CI = 0.003-0.061). Occupational noise exposure and AS were both negatively associated with plasma miR-92a-3p and miR-21-5p, and the two miRNAs mediated 15.0% and 16.8% of the association of occupational noise with AS (P < 0.05). Our findings suggest that occupational noise exposure is positively associated with AS, and plasma miR-92a-3p and miR-21-5p may partly mediate such association.

Stress hormone biosynthesis-based genes and lifestyle moderated the association of noise exposure with blood pressure in a cohort of Chinese tobacco factory workers: A cross-sectional analysis

When evaluating noise-related cardiovascular risk, noise is generally solely assessed as the major stressor. However, cardiovascular effect of other simultaneous exposure events, such as unhealthy lifestyle and genetic variation, is easily neglected. The aim of this study is to estimate the combined effect of noise and lifestyle on blood pressure alteration, particularly under different genetic background. This study included 536 workers from a tobacco factory in Wuhan, China, who were divided into high exposure group and low exposure group according to noise measurement in their working area. All participants took annual physical examination and questionnaire survey to provide information on individual systolic and diastolic blood pressure (SBP and DBP) and lifestyle (smoking, drinking and physical activity). Single nucleotide polymorphism at genes related to stress hormone production were determined. Moderated moderation models were constructed to investigate the interaction effect of noise exposure and lifestyle factors on blood pressure with regard to different genetic background. We identified an expected trend in association between noise exposure and SBP among active smokers (P = 0.086). The moderated moderation analysis showed significant three-way interaction effect (COMT rs4680 × smoking status × noise exposure levels) on SBP or DBP (both P < 0.05). For COMT rs4680 GA+AA genotype carriers, active smoking significantly moderated the association between noise exposure and SBP or DBP (both P < 0.05). The results indicated that for COMT rs4680 A allele carriers, tobacco and noise exposure contribute collectively to blood pressure alteration, supporting that stress hormone production may play a certain role in the smoke-and-noise-induced cardiovascular effect.