UBC Faculty Research and Publications

Hypertension in BC sawmill workers exposed to high noise levels Sbihi, Hind; Davies, Hugh W.; Demers, Paul A. 2007

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Hypertension in BC Sawmill  workers exposed to high  noise levels Hind Sbihi, Hugh W. Davies, Paul A. DemersOutline 1.Background2.Methods3.Analyses 4.Results5.Strengths and limitations1. Background Noise and Cardiovascular DiseasesNoise ??Stress ???non auditory? health effectsCognitive  processesPathology  Physiology?Hormonal and metabolic perturbations ?Cardiovascular diseases:?Annoyance?Sleep disturbance?Chronic heart disease?Hypertension1. BackgroundMotivation?Burden of Hypertension.?Ubiquitous nature of noise.?Epidemiological evidence still inconsistent (van Kempenet al, 2000)Public health issueLimitations in methodology2. MethodsPopulation?Settings ?Employed at least 1 year in one of 14 sawmills in BC ?follow up: April 1991 to July 1998?Characteristics?Linkage with Hospital discharge files and medical billing system ??10832 subjects.?Race: Caucasian (89%) -South Asian (9%) -Chinese (2%)?Gender : 99% male ?1% female2. MethodsDefinitions ?Case definition?ICD 9 classification codes 401-405.?3 doctor visits in a 2 month period and/or 1 visit at the hospital ?Quantitative assessment of noise exposure: ?1900 noise dosimetrymeasurements ??regression models to predict each unique  mill/job/time combination (n=3700) (Davies et al.,  1998) 2. Methods ?Metrics for noise exposure ?Cumulative exposure?Duration of exposure above thresholds of 85, 90, and 95 dB(A).101010*log*TjLeqjj1n=?? ?? ?3. Analyses ?Life Table analyses (PC LTAS, NIOSH)?Apportion person years?Poisson regression ?Lowest exposed group used as baseline?Only men included?Adjusted for race, age, and calendar year4. Results ?Hypertension in Males (n=828)0.5Re< 9595 - 99100 - 104105 - 109110-115>115 cumulative noise exposure (dBA*Year) ?Risk of hypertension rises monotonically with increasing exposure?significant test for trend 4. Results ?Hypertension incidence0.5Relative Risk (log scale)< 33 - 910 - 1920 - 29> 29< 33 - 910 - 19>19< 33 - 910 - 19>19  Threshold > 85dB(A)       Threshold >90 dB(A)           Threshold >95 dB(A) Duration of Exposure (years)5. Strengths ?Methodology?Longitudinal design?Large cohort?Administrative Data?Exposure assessment5. Limitations Individual risk factors smoking rates and lung cancer analysesCase definition Sensitivity analysesConclusion ?Noise is associated with an increased risk of hypertension when exposed to high levels  and/or over a long period.?Results were robust across case definitions?South Asian (mostly Sikhs) had double the risk (RR=2.1 CI: 1.7 ?2.5) compared with Chinese (RR=1.3 CI: 0.8 ?2.0) and Caucasian subjects (baseline group). Acknowledgments ?WeiweiDu?the Heart and Stroke Foundation

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