title: Noise exposure and hypertension: investigation of a silent relationship.
abstract: BACKGROUND
  Noise is an important occupational hazard worldwide and hypertension a well-known risk factor for cardiovascular disease, which is currently the greatest cause of disability retirement worldwide. The association between noise exposure and auditory effects is well documented in the biomedical literature, but the same is not true about exposure to different levels of noise and extra-auditory effects. It has been shown that noise exposure levels to be considered for non-auditory effects may not be the same as in the case of auditory effects. The frequent presence of noise in workplace environments, the high prevalence of hypertension worldwide, the biological plausibility of the association between noise exposure and high blood pressure and the need for more studies investigating the non-auditory effects of exposures to less than 85 dB(A), were the reasons that led us to develop this study. We aimed at investigating the hypothesis that exposure to different levels of noise is associated with hypertension.
  
  
  METHODS
  We used a cross-sectional design to study the association between occupational noise exposure (≤75, 75-85, and ≥ 85 dB(A)) and hypertension (use of anti-hypertensive medication and/or blood pressure of ≥140/90 mmHg) in 1,729 petrochemical workers at Rio de Janeiro, Brazil. Data were collected from obligatory annual health evaluation records and from environmental measurements of noise and heat levels. We used logistical regression analysis to study the association while controlling for key confounding variables, such as smoking and body mass index.
  
  
  RESULTS
  Using the ≤75 dB(A) as reference category, noise exposure was independently associated to hypertension both at the 75-85 dB(A) (OR 1.56; 95% CI 1.13-2.17) and the ≥85 dB(A) levels (OR 1.58; 95% CI 1.10-2.26). Age, gender and body mass index were also independently associated to high blood pressure.
  
  
  CONCLUSIONS
  Herein, we were able to demonstrate that noise exposure is independently associated to hypertension. Our results are consistent with other studies that used similar methodology and enabled us to verify the occurrence of non-auditory effects in workers exposed to noise levels considered safe for auditory effects.
authors.affiliation: Centro de Estudos da Saúde do Trabalhador e Ecologia Humana, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (CESTEH/ENSP/Fiocruz), Rua Leopoldo Bulhões 1480, Manguinhos, Rio de Janeiro/RJ, Brazil. tcfsouza@gmail.com.
authors.forename: Tatiana Cristina Fernandes
authors.initials: TC
authors.lastname: de Souza
authors.affiliation: Departamento de Ciências Biológicas, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (DCB/ENSP/Fiocruz), Rua Leopoldo Bulhões 1480, Manguinhos, Rio de Janeiro/RJ, Brazil. aperisse@ensp.fiocruz.br.
authors.forename: André Reynaldo Santos
authors.initials: AR
authors.lastname: Périssé
authors.affiliation: Centro de Estudos da Saúde do Trabalhador e Ecologia Humana, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz (CESTEH/ENSP/Fiocruz), Rua Leopoldo Bulhões 1480, Manguinhos, Rio de Janeiro/RJ, Brazil. moura.mrs@gmail.com.
authors.forename: Marisa
authors.initials: M
authors.lastname: Moura
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D019652:Extraction and Processing Industry; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009623:Noise, Occupational / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D000959:Antihypertensive Agents