title: Systematic review of the cardiovascular effects of occupational noise.
abstract: BACKGROUND
  Cross-sectional studies of occupational noise and cardiovascular effects show an association between noise and hypertension but for coronary heart disease or other cardiovascular diseases (CVDs) the evidence is not convincing.
  
  
  OBJECTIVE
  To assess possible associations between occupational noise exposure and the risk for cardiovascular effects in follow-up studies published after 1999.
  
  
  METHODS
  We performed a systematic critical literature review of original articles from key literature databases of associations between workplace noise and health. The studies were identified by search in Ovid Medline, Ovid Embase, Web of Science, Scopus and ProQuest Health and Safety Sciences Abstracts. We selected prospective studies of adequate quality with a measure of association between occupational noise exposure and cardiovascular health for the meta-analysis.
  
  
  RESULTS
  Twelve papers, all prospective and mostly with high quality but with methodological shortcomings in exposure assessment, were included in the review and meta-analysis. Exposure to noise at work was consistently positively associated with hypertension [Hazard ratio (HR) = 1.68; 95% confidence interval (CI) 1.10-2.57] and CVD [relative risk (RR) = 1.34; 95% CI 1.15-1.56]. In addition, we found a trivial effect of noise exposure on CVD mortality (HR = 1.12; 95% CI 1.02-1.24).
  
  
  CONCLUSIONS
  Occupational noise exposure is strongly associated with hypertension. For other cardiovascular effects, this meta-analysis suggests a weak association, but the evidence is limited. More longitudinal studies on the effects of occupational noise on the cardiovascular system are warranted.
authors.affiliation: Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, P.O. Box 8149 Dep., N-0033 Oslo, Norway. Marit.Skogstad@stami.no.
authors.forename: M
authors.initials: M
authors.lastname: Skogstad
authors.affiliation: Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, P.O. Box 8149 Dep., N-0033 Oslo, Norway.
authors.forename: H A
authors.initials: HA
authors.lastname: Johannessen
authors.affiliation: Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, P.O. Box 8149 Dep., N-0033 Oslo, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Tynes
authors.affiliation: Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, P.O. Box 8149 Dep., N-0033 Oslo, Norway.
authors.forename: I S
authors.initials: IS
authors.lastname: Mehlum
authors.affiliation: Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, P.O. Box 8149 Dep., N-0033 Oslo, Norway.
authors.forename: K C
authors.initials: KC
authors.lastname: Nordby
authors.affiliation: Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, P.O. Box 8149 Dep., N-0033 Oslo, Norway.
authors.forename: A
authors.initials: A
authors.lastname: Lie
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000209:etiology; D009623:Noise, Occupational / Q000009:adverse effects*; D009784:Occupational Diseases / Q000209:etiology* / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects*
keywords: Cardiovascular disease; epidemiologic methods; noise.