Environmental noise exposure and health outcomes: an umbrella review of systematic reviews and meta-analysis.
Environmental noise exposure and health outcomes: an umbrella review of systematic reviews and meta-analysis.
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环境噪声暴露和健康结果：系统评价和荟萃分析的综合评价。
DOI：
10.1093/eurpub/ckad044
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发表时间：
2023
影响因子：
4.4
通讯作者：
Guang Hao
中科院分区：
文献类型：
--
作者：
Xia Chen;Mingliang Liu;Lei Zuo;Xiaoyi Wu;Mengshi Chen;Xingli Li;Ting An;Li Chen;Wenbin Xu;Shuang Peng;Haiyan Chen;Xiaohua Liang;Guang Hao
背景
环境噪声越来越被认为是一个紧迫的公共卫生问题，但目前的研究质量需要评估。评价环境噪声暴露与健康结果之间关系的显著性、效度和潜在偏倚。
方法
我们对环境噪声暴露和任何健康结果的荟萃分析的证据进行了全面审查。进行了系统检索，直至2021年11月。检索PubMed、科克伦、Scopus、Web of Science、Embase和合格研究的参考文献。质量由AMSTAR和推荐、评估、发展和评价分级（GRADE）进行评估。
结果
在23项系统性综述和荟萃分析中确定的31种独特的健康结局中，环境噪声暴露更有可能导致一系列不良结局。5%的研究在方法学质量上属于中等水平，其余的则属于低到非常低的水平，而大多数GRADE证据被评为低甚至更低。职业性噪声暴露组言语频率（RR：6.68，95%CI：3.41-13.07）和高频噪声（RR：4.46，95%CI：2.80-7.11）听力损失的危险增量最大。来自不同来源的高噪声暴露与心血管疾病（34%）及其死亡率（12%），血压升高（58-72%），糖尿病（23%）和不良生殖结果（22-43%）的风险增加有关。此外，剂量-反应关系显示，糖尿病、缺血性心脏病（IHD）、心血管（CV）死亡率、中风、焦虑和抑郁的风险随着噪声暴露的增加而增加。
结论
发现CV疾病和死亡率、糖尿病、听力障碍、神经系统疾病和不良生殖结局与人类环境噪声暴露（尤其是职业噪声）存在不良关联。这些研究大多数质量较低，未来需要更多高质量的纵向研究设计进行进一步验证。
BACKGROUND
Environmental noise is becoming increasingly recognized as an urgent public health problem, but the quality of current studies needs to be assessed. To evaluate the significance, validity and potential biases of the associations between environmental noise exposure and health outcomes.
METHODS
We conducted an umbrella review of the evidence across meta-analyses of environmental noise exposure and any health outcomes. A systematic search was done until November 2021. PubMed, Cochrane, Scopus, Web of Science, Embase and references of eligible studies were searched. Quality was assessed by AMSTAR and Grading of Recommendations, Assessment, Development and Evaluation (GRADE).
RESULTS
Of the 31 unique health outcomes identified in 23 systematic reviews and meta-analyses, environmental noise exposure was more likely to result in a series of adverse outcomes. Five percent were moderate in methodology quality, the rest were low to very low and the majority of GRADE evidence was graded as low or even lower. The group with occupational noise exposure had the largest risk increment of speech frequency [relative risk (RR): 6.68; 95% confidence interval (CI): 3.41-13.07] and high-frequency (RR: 4.46; 95% CI: 2.80-7.11) noise-induced hearing loss. High noise exposure from different sources was associated with an increased risk of cardiovascular disease (34%) and its mortality (12%), elevated blood pressure (58-72%), diabetes (23%) and adverse reproductive outcomes (22-43%). In addition, the dose-response relationship revealed that the risk of diabetes, ischemic heart disease (IHD), cardiovascular (CV) mortality, stroke, anxiety and depression increases with increasing noise exposure.
CONCLUSIONS
Adverse associations were found for CV disease and mortality, diabetes, hearing impairment, neurological disorders and adverse reproductive outcomes with environmental noise exposure in humans, especially occupational noise. The studies mostly showed low quality and more high-quality longitudinal study designs are needed for further validation in the future.