为了更新证据的现状并评估其质量,我们对环境噪声暴露对心脏代谢系统的影响进行了系统评价,作为新的WHO欧洲区域环境噪声指南的输入.我们确定了600个与道路噪声影响研究相关的参考文献,铁路和空中交通,和心脏代谢系统上的风力涡轮机,在2000年1月至2015年8月之间发布。只有61项研究,调查不同的终点,包括允许估计暴露响应关系的信息。这些研究用于荟萃分析,并使用建议分级评估对证据质量进行评估,开发和评估(等级)。大多数研究涉及交通噪音和高血压,但大多数都是横断面的,并且有很高的偏倚风险。最全面的证据是道路交通噪音和心脏疾病(IHD)。结合7项纵向研究的结果,道路交通噪声与IHD发生率之间的关联,每10dB(LDEN)的相对风险(RR)为1.08(95%CI:1.01-1.15)。我们认为这些证据的质量很高。只有少数研究报告了交通噪音和中风之间的关联,糖尿病,和/或肥胖。这些关联的证据质量从中等到非常低,取决于交通噪声源和结果。为了全面评估噪声暴露对心血管和代谢系统的影响,我们需要更多更优质的证据,主要基于纵向研究。
To update the current state of evidence and assess its quality, we conducted a systematic review on the effects of environmental noise exposure on the cardio-metabolic systems as input for the new WHO environmental noise
guidelines for the European Region. We identified 600 references relating to studies on effects of noise from road, rail and air traffic, and wind turbines on the cardio-metabolic system, published between January 2000 and August 2015. Only 61 studies, investigating different end points, included information enabling estimation of exposure response relationships. These studies were used for meta-analyses, and assessments of the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A majority of the studies concerned traffic noise and hypertension, but most were cross-sectional and suffering from a high risk of bias. The most comprehensive evidence was available for road traffic noise and Ischeamic Heart Diseases (IHD). Combining the results of 7 longitudinal studies revealed a Relative Risk (RR) of 1.08 (95% CI: 1.01-1.15) per 10 dB (LDEN) for the association between road traffic noise and the incidence of IHD. We rated the quality of this evidence as high. Only a few studies reported on the association between transportation noise and stroke, diabetes, and/or obesity. The quality of evidence for these associations was rated from moderate to very low, depending on transportation noise source and outcome. For a comprehensive assessment of the impact of noise exposure on the cardiovascular and metabolic system, we need more and better quality evidence, primarily based on longitudinal studies.