人人文库网 > 毕业设计 > 文献翻译 > 暴露于道路交通和铁路噪音以及血压和自我报告的高血压的关联：一项队列研究【中文11361字】
Exposure to road traffic and railway noise and(1).pdf
暴露于道路交通和铁路噪音以及血压和自我报告的高血压的关联：一项队列研究【中文11361字】
收藏
资源目录
压缩包内文档预览：
编号：9306125
类型：共享资源
大小：516.14KB
格式：ZIP
上传时间：2018-03-05
上传人：闰***
认证信息
个人认证
冯**（实名认证）
河南
IP属地：河南
13
积分
- 关 键 词：
-
暴露
道路交通
以及
铁路
噪音
血压
自我
报告
讲演
呈文
高血压
关联
一项
队列
研究
钻研
中文
- 资源描述：
-
暴露于道路交通和铁路噪音以及血压和自我报告的高血压的关联：一项队列研究【中文11361字】,暴露,道路交通,以及,铁路,噪音,血压,自我,报告,讲演,呈文,高血压,关联,一项,队列,研究,钻研,中文
- 内容简介：
-
RESEARCHOPENACCESSEXPOSURETOROADTRAFFICANDRAILWAYNOISEANDASSOCIATIONSWITHBLOODPRESSUREANDSELFREPORTEDHYPERTENSIONACOHORTSTUDYMETTESRENSEN1,MARTINHVIDBERG2,BARBARAHOFFMANN3,ZORANAJANDERSEN1,RIKKEBNORDSBORG1,KENNETHGLILLELUND4,JRGENJAKOBSEN5,ANNETJNNELAND1,KIMOVERVAD6,7ANDOLERAASCHOUNIELSEN1ABSTRACTBACKGROUNDEPIDEMIOLOGICALSTUDIESSUGGESTTHATLONGTERMEXPOSURETOTRANSPORTNOISEINCREASESTHERISKFORCARDIOVASCULARDISORDERSTHEEFFECTOFTRANSPORTNOISEONBLOODPRESSUREANDHYPERTENSIONISUNCERTAINMETHODSIN19931997,57,053PARTICIPANTSAGED5064YEARWEREENROLLEDINAPOPULATIONBASEDCOHORTSTUDYATENROLMENT,SYSTOLICANDDIASTOLICBLOODPRESSUREWASMEASUREDINCIDENTHYPERTENSIONDURINGAMEANFOLLOWUPOF53YEARSWASASSESSEDBYQUESTIONNAIRERESIDENTIALLONGTERMROADTRAFFICNOISELDENWASESTIMATEDFOR1AND5YEARPERIODSPRECEDINGENROLMENTANDPRECEDINGDIAGNOSISOFHYPERTENSIONRESIDENTIALEXPOSURETORAILWAYNOISEWASESTIMATEDATENROLMENTWECONDUCTEDACROSSSECTIONALANALYSISOFASSOCIATIONSBETWEENROADTRAFFICANDRAILWAYNOISEANDBLOODPRESSUREATENROLMENTWITHLINEARREGRESSION,ADJUSTINGFORLONGTERMAIRPOLLUTION,METEOROLOGYANDPOTENTIALLIFESTYLECONFOUNDERSN44,083INCIDENTSELFREPORTEDHYPERTENSIONWASANALYZEDWITHCOXREGRESSION,ADJUSTINGFORLONGTERMAIRPOLLUTIONANDPOTENTIALLIFESTYLECONFOUNDERSRESULTSWEFOUNDA026MMHGHIGHERSYSTOLICBLOODPRESSURE95CONFIDENCEINTERVALSCI011063PER10DBAINCREASEIN1YEARMEANROADTRAFFICNOISELEVELS,WITHSTRONGERASSOCIATIONSINMEN059MMHGCI013105PER10DBAANDOLDERPARTICIPANTS065MMHG008122PER10DBAROADTRAFFICNOISEWASNOTASSOCIATEDWITHDIASTOLICBLOODPRESSUREORHYPERTENSIONEXPOSURETORAILWAYNOISEABOVE60DBWASASSOCIATEDWITH8HIGHERRISKFORHYPERTENSION95CI219,P011CONCLUSIONSWHILEEXPOSURETOROADTRAFFICNOISEWASASSOCIATEDWITHSYSTOLICBLOODPRESSUREINSUBGROUPS,WEWERENOTABLETOIDENTIFYASSOCIATIONSWITHHYPERTENSIONKEYWORDSBLOODPRESSURE,TRANSPORTNOISE,ROADTRAFFIC,RAILWAY,EPIDEMIOLOGY,COHORTBACKGROUNDINCREASINGNOISEFROMTRAFFICOCCURSINPARALLELWITHINDUSTRIALIZATIONANDURBANIZATIONEXPOSURETONOISECANINTERFEREWITHRELAXATIONANDCONCENTRATIONANDDURINGTHENIGHT,NOISEEXPOSUREATNORMALURBANLEVELSHASBEENASSOCIATEDWITHSLEEPDISTURBANCES1,2THISISBELIEVEDTORESULTINASTRESSREACTIONWITHACTIVATIONOFTHESYMPATHETICANDENDOCRINESYSTEM,WHICHCANLEADTOCHANGESINBLOODPRESSUREBP,HEARTRATEANDRELEASEOFSTRESSHORMONES35ANOVERVIEWFROM2006OFTHEEFFECTSOFEXPOSURETOTRANSPORTNOISEROAD,AIRANDRAILONCARDIOVASCULARHEALTHCONCLUDEDTHATTRANSPORTNOISEISASSOCIATEDWITHHYPERTENSION6,WHICHHASMOSTLYBEENVERIFIEDBYLATERSTUDIESONROADTRAFFICNOISE713,WHEREASTHETWOSTUDIESINVESTIGATINGRAILWAYNOISEAREINCONCLUSIVE11,13THEMAJORITYOFTHESTUDIESONTRAFFICNOISEANDHYPERTENSIONARECROSSSECTIONALANDNOSTUDIESHAVEPROSPECTIVELYINVESTIGATEDTHEASSOCIATIONBETWEENROADTRAFFICNOISEANDTHEINCIDENCEOFHYPERTENSIONTHEOVERVIEWFROM2006FOUNDNOCONSISTENTASSOCIATIONSBETWEENTRANSPORTNOISEANDTHESYSTOLICANDDIASTOLICBP,WHICHCORRESPONDENCEMETTESCANCERDKCONTRIBUTEDEQUALLY1INSTITUTEOFCANCEREPIDEMIOLOGY,DANISHCANCERSOCIETY,COPENHAGEN,DENMARKFULLLISTOFAUTHORINFORMATIONISAVAILABLEATTHEENDOFTHEARTICLESRENSENETALENVIRONMENTALHEALTH2011,1092HTTP/WWWEHJOURNALNET/CONTENT/10/1/922011SRENSENETALLICENSEEBIOMEDCENTRALLTDTHISISANOPENACCESSARTICLEDISTRIBUTEDUNDERTHETERMSOFTHECREATIVECOMMONSATTRIBUTIONLICENSEHTTP/CREATIVECOMMONSORG/LICENSES/BY/20,WHICHPERMITSUNRESTRICTEDUSE,DISTRIBUTION,ANDREPRODUCTIONINANYMEDIUM,PROVIDEDTHEORIGINALWORKISPROPERLYCITEDMIGHTBEEXPLAINEDBYTHEFACTTHATTHESTUDIESCONDUCTEDSOFARSUFFEREDFROMINSUFFICIENTPOWERANDNARROWEXPOSURERANGES6RAILWAYNOISEHASGENERALLYBEENCONSIDEREDASTHELEASTANNOYINGTRANSPORTATIONSOURCE1,AND,THEREFORE,ITHASNOTACHIEVEDTHESAMEATTENTIONASROADTRAFFICANDAIRPORTNOISEHOWEVER,RECENTSTUDIESSUGGESTTHATNOCTURNALRAILWAYNOISEISASDISTURBINGTOSLEEPASROADTRAFFICNOISE14,15ANDTHATRAILWAYNOISEHASIMPORTANTSHORTTERMIMPACTONTHECARDIOVASCULARSYSTEM16ANDMIGHTINCREASETHERISKFORHYPERTENSION13THEFEWSTUDIESTHATHAVEINVESTIGATEDEFFECTSOFEXPOSURETOLONGTERMAIRPOLLUTIONONBPANDHYPERTENSIONHASFOUNDAIRPOLLUTIONTOBEPOSITIVELYASSOCIATEDWITHSYSTOLICANDDIASTOLICBPASWELLASWITHHYPERTENSION1719ALTHOUGHEXPOSURETOROADTRAFFICNOISEANDAIRPOLLUTIONHAVEBEENFOUNDTOCORRELATEANDBOTHARESUSPECTEDOFAFFECTINGBP,ONLYTWOSTUDIESONHYPERTENSIONHASINCLUDEDBOTHEXPOSURESINTHESAMEMODEL7,20THERESULTSSUGGESTTHATEXPOSURETOROADTRAFFICNOISEISASSOCIATEDWITHAHIGHERRISKFORHYPERTENSIONBOTHBEFOREANDAFTERADJUSTMENTFORAIRPOLLUTIONINTHISSTUDYWETESTEDTHEHYPOTHESISTHATLONGTERMEXPOSURETOROADTRAFFICANDRAILWAYNOISEINCREASESYSTOLICANDDIASTOLICBPASWELLASTHERISKFORHYPERTENSION,TAKINGEXPOSURETOAIRPOLLUTIONINTOACCOUNTMETHODSSTUDYPOPULATIONTHESTUDYWASBASEDONTHEDIET,CANCERANDHEALTHCOHORTWHERE160,725RANDOMLYCHOSENSUBJECTS,LIVINGINTHECOPENHAGENORAARHUSAREA,WEREINVITEDTOPARTICIPATEBETWEEN1993AND1997THEYWEREARANDOMSAMPLEOFALLELIGIBLECANCERFREESUBJECTSBETWEEN5064YEARSOFAGEATTIMEOFINVITATION21ALLINALL57,053SUBJECTSACCEPTEDTHEINVITATIONANDWEREENROLLEDINTOTHECOHORTAFOLLOWUPSURVEYOFALLELIGIBLECOHORTPARTICIPANTSEXCLUDINGDEADOREMIGRATEDPARTICIPANTSWASCONDUCTEDIN20002002INTOTAL,54,379PARTICIPANTS96RECEIVEDANINVITATIONANDAFOLLOWUPQUESTIONNAIREBYMAIL,INCLUDINGQUESTIONSONHEALTHSTATUSTHERESPONSERATEWAS833,CORRESPONDINGTO45,271PARTICIPANTSPARTICIPATIONWASBASEDONWRITTENINFORMEDCONSENTTHESTUDYWASCONDUCTEDINACCORDANCEWITHTHEHELSINKIDECLARATIONANDAPPROVEDBYTHELOCALETHICALCOMMITTEESATENROLMENT,EACHPARTICIPANTCOMPLETEDSELFADMINISTEREDQUESTIONNAIRESINCLUDINGQUESTIONSONLIFESTYLEHABITSSUCHASQUESTIONSONTOBACCOSMOKING,ALCOHOLINTAKEANDSPORTDURINGLEISURETIMEANDHEALTHSTATUS,SUCHASWHETHERTHEYSUFFEREDOREVERHADSUFFEREDFROMHYPERTENSION,ANDWHETHERTHEYRECEIVEDORHADEVERRECEIVEDMEDICATIONFORHYPERTENSIONHEIGHTANDWEIGHTWEREMEASUREDACCORDINGTOSTANDARDIZEDPROTOCOLSEXPOSUREASSESSMENTTHELEVELOFROADTRAFFICNOISEWASMODELEDATEACHADDRESSATWHICHTHECOHORTMEMBERSHADLIVEDFROMFIVEYEARSPRECEDINGENROLMENTUNTILFOLLOWUPIN20002002BYUSEOFSOUNDPLANVERSION65,HTTP/WWWSOUNDPLANDK/THISNOISECALCULATIONPROGRAMIMPLEMENTSTHEJOINTNORDICPREDICTIONMETHODFORROADTRAFFICNOISE,WHICHHASBEENTHESTANDARDMETHODFORNOISECALCULATIONINSCANDINAVIADURINGMANYYEARS22,23THEINPUTVARIABLESFORTHENOISEMODELWERE1GEOGRAPHICALCOORDINATESANDHEIGHTOFEACHDWELLINGOVERTERRAIN,2ROADLINESWITHINFORMATIONONYEARLYAVERAGEDAILYTRAFFIC,TRAFFICCOMPOSITION,TRAFFICSPEEDANDROADTYPEMOTORWAY,RURALHIGHWAY,ROADWIDERTHAN6M,ANDOTHERROAD,3BUILDINGPOLYGONSFORALLBUILDINGSINCLUDINGINFORMATIONONBUILDINGHEIGHTTOINCLUDESCREENINGFROMBUILDINGSWEASSUMEDTHATTHETERRAINWASFLAT,WHICHISAREASONABLEASSUMPTIONINDENMARK,ANDTHATURBANAREAS,ROADS,ANDAREASWITHWATERWEREHARDSURFACESWHEREASALLOTHERAREASWEREACOUSTICALLYPOROUSNOINFORMATIONWASAVAILABLEONNOISEBARRIERSROADTRAFFICNOISEWASCALCULATEDASTHEAWEIGHTEDLEVELLAEQATTHEMOSTEXPOSEDFAADEOFTHEDWELLINGATEACHADDRESSFORTHEDAY07001900H,EVENING19002200HANDNIGHT22000700HANDEXPRESSEDASLDENBYAPPLYINGA5DBAPENALTYFORTHEEVENINGANDA10DBAPENALTYFORTHENIGHT24THENOISEMODELUSEDISVERYSIMILARTOTHEMODELRECOMMENDEDBYTHEEUDIRECTIVEINMOSTPOINTS,EXCEPTSMALLCORRECTIONSTOBETTERSUITDANISHCONDITIONSINCLUDINGCALCULATINGNOISEINLEVELWITHTHEDWELLINGEU4MABOVEGROUNDANDUSEOFTHEEVENINGPERIOD19002200HEU19002300HEXPOSURETORAILWAYNOISEWASCALCULATEDASTHEAWEIGHTEDEQUIVALENTLEVELLAEQ,24HATENROLMENTWITHTHEJOINTNORDICPREDICTIONMETHODFORRAILWAYNOISEBASEDONINFORMATIONABOUTTRAFFICIN19932000THEMODELCALCULATEDEXPOSURESINTHERANGEOF60TO80DBSCREENINGBYDESIGNATEDNOISESCREENSANDBUILDINGSWASNOTCONSIDEREDTHEESTIMATEDLEVELOFRAILWAYNOISEISASSUMEDTOBEREPRESENTATIVEFORTHEWHOLESTUDYPERIOD19902002,ASNEITHERHIGHSPEEDRAILTRACKSNOROTHERNEWRAILTRACKSHAVEBEENOPENEDINDENMARKDURINGTHEPERIOD,ANDMOREOVER,CARGORAILTRAFFICHASBEENSTABLETHENOISEIMPACTFROMAIRPORTSANDAIRFIELDSWASDETERMINEDFROMINFORMATIONABOUTNOISEZONESOBTAINEDFROMLOCALENVIRONMENTALAUTHORITIESTHEPROGRAMSDANSIMANDINM3,WHICHFULFILLTHEJOINTNORDICCRITERIAFORAIRTRAFFICNOISECALCULATIONS,WEREUSEDTHENOISECURVESFORRAILWAYANDAIRCRAFTNOISEWERETRANSFORMEDINTODIGITALMAPS,ANDNOISELEVELSWERELINKEDTOEACHADDRESSBYGEOCODESONLYVERYFEWOFTHEINCLUDEDCOHORTMEMBERS10YEARSSOCIOECONOMICSTATUSSESOFMUNICIPALITIESORDISTRICTFORCOPENHAGENMUNICIPALITYATENROLMENTCOPENHAGENISTHELARGESTDANISHMUNICIPALITYANDWASSPLITINTO10DISTRICTSWITHREGARDTOSESAVERAGENUMBEROFCITIZENSINTHEMUNICIPALITIES/DISTRICTSWAS43,000INTHREEGROUPSLOW,MEDIUMANDHIGHSESBASEDONBASELINEMUNICIPALITY/DISTRICTINFORMATIONONEDUCATION,WORKMARKETAFFILIATIONANDINCOMEBODYMASSINDEXBMI,KG/M2,LINEARSMOKINGSTATUSNEVER,FORMER,CURRENTALCOHOLINTAKEYES/NOG/DAYAMONGDRINKERS,LINEARSPORTDURINGLEISURETIMEYES/NOH/WEEKAMONGACTIVE,LINEARAIRPOLLUTIONNOX,G/M3,MEANTIMEWEIGHTEDAVERAGEEXPOSUREPERIODS1AND5YEARPRECEDINGBPMEASUREMENTSEASONWINTER,SPRING,SUMMERANDAUTUMNANDMEANOFAMBIENTTEMPERATUREANDHUMIDITYTHETHREEDAYSPRECEDINGTHEBPMEASUREMENTASANALTERNATIVEWAYOFMODELING,WECATEGORIZEDTHEEXPOSUREINTOTHREEGROUPSUSINGTHE50THAND90THPERCENTILESASCUTPOINTSWECONDUCTEDTWOSENSITIVITYANALYSES1ONLYPARTICIPANTSWITHNORMALBPWEREINCLUDEDSYSTOLICBP140AND/ORDIASTOLICBP90,N25,248AND2SUBJECTSONANTIHYPERTENSIVEMEDICATIONWEREINCLUDEDTOTHESTUDYBASERESULTINGINATOTALPOPULATIONOF50,315PARTICIPANTSINEXPLORATORYANALYSES,WETESTEDFORINTERACTIONSBETWEENMODELEDLONGTERMEXPOSURETOROADTRAFFICNOISE1YEARANDGENDER,AGE,YEARSOFEDUCATION,SES,TEMPERATUREABOVEANDBELOW15CANDDIAGNOSISOFCARDIOVASCULARDISEASEBEFOREENROLMENTFOLLOWUPFORHYPERTENSIONINCIDENTHYPERTENSIONWASANALYZEDWITHACOXPROPORTIONALHAZARDSMODELWITHAGEASTHEUNDERLYINGTIME30WEUSEDLEFTTRUNCATIONATAGEOFENROLMENT,SOTHATSUBJECTSWERECONSIDEREDATRISKFROMENROLMENTINTOTHECOHORT,ANDRIGHTCENSORINGATAGEOFEVENTSRENSENETALENVIRONMENTALHEALTH2011,1092HTTP/WWWEHJOURNALNET/CONTENT/10/1/92PAGE3OF11SELFREPORTEDHYPERTENSIONORAGEATFOLLOWUPSURVEY,WHICHEVERCAMEFIRSTALLANALYSESWERESTRATIFIEDBYGENDERANDCALENDARYEAREXPOSURETOLONGTERMAIRPOLLUTIONWASMODELEDASTIMEDEPENDENTVARIABLESUSINGTHELONGTERMTIMEWEIGHTEDAVERAGENOXCONCENTRATIONS1AND5YEARMEANSATAGIVENAGETHEINCIDENCERATERATIOSIRRSFORHYPERTENSIONINASSOCIATIONWITHMODELEDLONGTERMROADTRAFFICNOISEWASCALCULATEDUSINGTHEPRECEDING1AND5YEARMEANROADTRAFFICNOISEEXPOSURECONTINUOUSATTHETIMEOFDIAGNOSISEVENTCOMPAREDWITHTHEPRECEDING1AND5YEARMEANROADTRAFFICNOISEEXPOSUREOFALLCOHORTMEMBERSATRISKATTHATPOINTINTIMEWHERETHEYHADTHESAMEAGEASTHEEVENTPERSONALSO,IRRSFORHYPERTENSIONINASSOCIATIONWITHEXPOSURETORAILWAYNOISEATBASELINEABOVE60DBWASCALCULATEDWECONDUCTEDANALYSESADJUSTEDFORAPRIORIDEFINEDCONFOUNDERSINTWOSTEPS1GENDER2FURTHERADJUSTMENTFORBASELINEINFORMATIONONSMOKINGSTATUS,LENGTHOFSCHOOLATTENDANCE,ALCOHOLINTAKE,BMI,SPORTDURINGLEISURETIME,SES,AREA,CALENDARYEARANDAIRPOLLUTIONLINEARITYTHEASSUMPTIONOFLINEARITYOFTHEASSOCIATIONSBETWEENBOTHROADTRAFFICNOISEMEASUREDINDECIBELANDTHECOVARIATESAIRPOLLUTION,AGE,BMI,ALCOHOLINTAKE,SPORTDURINGLEISURETIMEANDAMBIENTTEMPERATUREANDHUMIDITYANDHEALTHOUTCOMESBPANDHYPERTENSIONWASEVALUATEDBOTHVISUALLYANDBYFORMALTESTINGWITHLINEARSPLINEMODELSWITHBOUNDARIESPLACEDATTHENINEDECILESFORTHEINCLUDEDCOHORTMEMBERSSYSTOLICANDDIASTOLICBPORCASESHYPERTENSION31WEFOUNDNODEVIATIONFROMLINEARITYFORROADTRAFFICNOISEINRELATIONTOTHEHEALTHOUTCOMESFORAIRPOLLUTIONTHEASSOCIATIONBETWEENTHEEXPOSUREVARIABLESANDTHEHEALTHOUTCOMESDIDNOTDEVIATEDFROMLINEARITYAFTERTRANSFORMATIONBYTHELOGARITHMANDFORAMBIENTTEMPERATURETHEASSOCIATIONDIDNOTDEVIATEAFTERADDINGASQUAREDTERMTHEREMAININGCOVARIATESDIDNOTDEVIATEFROMLINEARITYRESULTSSYSTOLICANDDIASTOLICBPOUTOF57,053SUBJECTS,WEEXCLUDED571WITHCANCERDIAGNOSESBEFOREBASELINE,2,737WITHINCOMPLETERESIDENTIALADDRESSINFORMATION,63WITHOUTBPMEASUREMENT,2,961WITHMISSINGINFORMATIONONCOVARIATES,6,285WITHHYPERTENSIVEMEDICINEATORPRIORTOENROLMENTAND353EXPOSEDTOMORETHAN55DBARESIDENTIALAIRCRAFTNOISE,LEAVING44,083PARTICIPANTSTABLE1SHOWSTHEDISTRIBUTIONOFBASELINECHARACTERISTICSACCORDINGTOEXPOSUREABOVEANDBELOW55DBA1YEARROADTRAFFICNOISEATENROLMENTAMONGTHE44,083COHORTPARTICIPANTSINTHECROSSSECTIONALBPSTUDYPARTICIPANTSLIVINGATRESIDENCESWITHLOWROADTRAFFICNOISEEXPOSURETENDEDTOHAVEHIGHERSES,TOSMOKELESS,TOBEMOREPHYSICALLYACTIVEANDTOBEEXPOSEDTOLOWERLEVELSOFAIRPOLLUTIONANDRAILWAYNOISETHANPARTICIPANTSLIVINGINHIGHEXPOSEDAREASTHEDISTRIBUTIONSOFSYSTOLICANDDIASTOLICBPWERESLIGHTLYRIGHTSKEWEDHOWEVER,SIMILARRESULTSWEREOBSERVEDFORUNTRANSFORMEDANDLOGTRANSFORMEDVALUESANDREGRESSIONESTIMATESFORTHEUNTRANSFORMEDDATAAREPRESENTEDTHESPEARMANCORRELATIONBETWEENROADTRAFFICNOISEANDNOXWAS069AND070FOR1AND5YEARMEANS,RESPECTIVELY,AND097BETWEEN1AND5YEARSOFEXPOSURETOROADTRAFFICNOISEASSOCIATIONSBETWEENROADTRAFFICNOISEANDTHESYSTOLICANDDIASTOLICBPARESHOWNINTABLE2INTHECATEGORICALANALYSESTHEHIGHESTEXPOSUREGROUP10HIGHESTEXPOSEDHADA079MMHG95CI004162ANDA085MMHG95CI002167HIGHERSYSTOLICBPCOMPAREDWITHTHELOWESTEXPOSUREGROUPFOR1YEARAND5MEAN,RESPECTIVELYTHELINEARANALYSESSHOWEDA02695CI011063MMHGHIGHERLEVELOFSYSTOLICBPPER10DBAHIGHERLEVELOFROADTRAFFICNOISE1YEARMEANNOASSOCIATIONSBETWEENROADTRAFFICNOISEANDDIASTOLICBPWEREOBSERVEDASSOCIATIONSBETWEENROADTRAFFICNOISEANDBPSEEMEDTOBEMODIFIEDBYGENDERWITHONLYEFFECTAMONGMEN059MMHGPER10DBA95CI013105,BYAGEWITHONLYEFFECTAMONGPARTICIPANTSABOVE60YEARSOFAGE065MMHGPER10DBA95CI008122ANDBYOUTDOORTEMPERATUREWITHONLYEFFECTATOUTDOORTEMPERATURESABOVE15C087MMHGPER10DBA95CI007166TABLE3THERESEEMEDTOBENOEFFECTMODIFICATIONBYEDUCATIONORSESINASENSITIVITYANALYSISINCLUDINGONLYPARTICIPANTSWITHNORMALBP,THEHIGHESTEXPOSUREGROUP10HIGHESTEXPOSEDHADA007MMHG95CI054069HIGHERSYSTOLICBPCOMPAREDWITHTHELOWESTEXPOSUREGROUP1YEARMEANINANOTHERSENSITIVITYANALYSISINCLUDINGSUBJECTSONANTIHYPERTENSIVEMEDICATION,RESULTINGINATOTALPOPULATIONOF50,315PARTICIPANTS,THEHIGHESTEXPOSUREGROUP10HIGHESTEXPOSEDHADA090MMHG95CI010171HIGHERSYSTOLICBPCOMPAREDWITHTHELOWESTEXPOSUREGROUP1YEARMEANEXPOSURETORAILWAYNOISEATLEVELSBETWEEN60AND70DBWASASSOCIATEDWITHA003MMHGHIGHERSYSTOLICBP95CI044051,N6,886,ANDLEVELSABOVE70DBWASASSOCIATEDWITHA084MMHG95CI105274,P038HIGHERSYSTOLICBPN363ASCOMPAREDWITHTHEREFERENCEGROUPLESSTHAN60DBSIMILARLY,THEESTIMATESFORDIASTOLICBPWERE003MMHG95CI029022AND062MMHG95CI039162INTHEMEDIUMANDHIGHEXPOSUREGROUP,RESPECTIVELYHYPERTENSIONOUTOFTHE45,271PERSONSTHATFILLEDINTHEFOLLOWUPQUESTIONNAIREWEEXCLUDED7110WITHHYPERTENSIONATORSRENSENETALENVIRONMENTALHEALTH2011,1092HTTP/WWWEHJOURNALNET/CONTENT/10/1/92PAGE4OF11PRIORTOENROLMENT,1841PARTICIPANTSWITHMISSINGORCONTRADICTORYANSWERSTOTHEHYPERTENSIONQUESTIONSGIVENATENROLMENTANDFOLLOWUP,2897WITHINCOMPLETERESIDENTIALADDRESSINFORMATION,148WITHMISSINGINFORMATIONONCOVARIATES,AND640EXPOSEDTOMORETHAN55DBARESIDENTIALAIRCRAFTNOISEDURINGTHEFOLLOWUPPERIOD,LEAVINGASTUDYBASEOF32,635PARTICIPANTSAMONGTHESE,3145PARTICIPANTSREPORTEDTHATTHEYHADBEENDIAGNOSEDWITHHYPERTENSIONWITHINTHEFOLLOWUPPERIODTHEDISTRIBUTIONOFBASELINECHARACTERISTICACCORDINGTOEXPOSURETOROADTRAFFICNOISEAMONGTHE32,635PARTICIPANTSFOLLOWEDUPFORHYPERTENSIONWASVERYSIMILARTOTHEDISTRIBUTIONSSHOWNINTABLE1RESULTSNOTSHOWNTABLE1BASELINECHARACTERISTICSACCORDINGTOEXPOSURETOROADTRAFFICNOISEABOVEANDBELOW55DBALDENATENROLMENTOF44,083COHORTPARTICIPANTSMEANLDENLEVELSTHEYEARPRECEDINGENROLMENTCHARACTERISTIC,ATENROLMENT6734,407023039085079004162006011033055062LINEARTRENDPER10DBA44,0830090180370260110630170070130270505YEARMEANDBAC6734,407040023102085002167004012032055060LINEARTRENDPER10DBA44,083007021035014024053047003018023078ALLANALYSESINCLUDECENTREOFENROLMENTASRANDOMFACTORALIFESTYLEFACTORSSMOKING,BMI,LENGTHOFSCHOOLATTENDANCE,MUNICIPALITYSES,ALCOHOLINTAKEANDPHYSICALACTIVITYBTIMEWEIGHTEDAVERAGECONCENTRATIONOFNOXATRESIDENCES1AND5YEARSPRECEDINGENROLMENTCTHECUTOFFPOINTSBETWEENEXPOSUREGROUPSWERETHE50THAND90THPERCENTILESFORTHEPARTICIPANTSATTHETIMEOFENROLMENTINTOTHECOHORTSRENSENETALENVIRONMENTALHEALTH2011,1092HTTP/WWWEHJOURNALNET/CONTENT/10/1/92PAGE6OF11DEGREEOFUNCERTAINTY,EGBECAUSEOFINACCURATEINPUTDATA,WHICHWOULDRESULTINEXPOSUREMISCLASSIFICATIONFURTHERMORE,WEDIDNOTHAVEINFORMATIONONNOISEBARRIERSFORROADTRAFFICNOISEANDNEITHERNOISEBARRIERSNORSCREENINGBYBUILDINGSFORRAILWAYNOISEHOWEVER,ASTHEMODELSDOESNOTDISTINGUISHBETWEENPARTICIPANTSWITHHIGHORLOWBP/RISKOFHYPERTENSIONSUCHMISCLASSIFICATIONISBELIEVEDTOBENONDIFFERENTIALANDINFLUENCETHERISKESTIMATESTOWARDSTHENEUTRALVALUEALSO,WEHAVEPREVIOUSLYFOUNDTHATMODELEDROADTRAFFICNOISEWASPOSITIVELYASSOCIATEDWITHTHERISKFORSTROKEINTHESAMECOHORT32,WHICHSPEAKSINFAVOROFTHEMODELEDVALUESALIMITATIONISTHATWEONLYHADINFORMATIONONRESIDENTIALADDRESSESWEBELIEVETHATSUCHIMPRECISIONINTHENOISEEXPOSUREASSESSMENTISSIMILARBETWEENPARTICIPANTSWITHHIGHANDLOWBPANDMAY,THEREFORE,HAVEATTENUATEDTHERISKESTIMATESNEITHERDIDWEHAVEINFORMATIONONBEDROOMLOCATION,WINDOWOPENINGHABITS,NEIGHBORNOISEANDHEARINGIMPAIRMENT,WHICHMIGHTALLINFLUENCETHENOISEEXPOSUREHOWEVER,STUDIESHAVEFOUNDTHEEFFECTOFNOISETOBESTRONGERWHENTHESEFACTORARECONSIDERED6,36,SUGGESTINGTHATTHEEFFECTOFNOISEMIGHTBEUNDERESTIMATEDINTHEPRESENTSTUDYALIMITATIONOFTHEBPPARTOFTHISSTUDYISTHECROSSSECTIONALDESIGNWITHNOREPEATEDMEASURESFORTHEPARTICIPANTSTHEBPMEASUREISVARIABLEANDDEPENDSONMANYDIFFERENTFACTORSSUCHASAGE,GENDERANDTEMPERATURETHOUGHWEHAVEADJUSTEDFORMANYOFTHESEPOSSIBLECONFOUNDERS,THERESULTSSHOULDBEREPLICATEDINADESIGNWITHREPEATEDMEASURESBEFOREFIRMCONCLUSIONSCANBEMADETHEMEASUREMENTOFSYSTOLICANDDIASTOLICBPINOURSTUDYWASSTANDARDIZEDBUTNOTINACCORDANCEWITHSTANDARDRECOMMENDATIONSFORDIAGNOSINGHYPERTENSIONWHERESEVERALMEASUREMENTSOFBPAREREQUESTEDIFTHESYSTOLICBPWAS160MMHGORMOREORTHEDIASTOLICBPWAS95MMHGORMORE,THEMEASUREMENTWASREPEATEDANDONLYTHELOWESTMEASUREMENTWASREGISTEREDTHISHASMOSTLIKELYRESULTEDINASYSTEMATICBIASTOWARDSLOWERVALUESINPARTICIPANTSWITHHIGHBP,WHICHCOULDHAVEBIASEDTHEBPESTIMATETOWARDSTHENEUTRALVALUEASENSITIVITYANALYSIS,WITHRESTRICTIONOFTHESAMPLETOPARTICIPANTSWITHNORMALBPVALUES,AND,THUS,THETABLE3MODIFICATIONOFASSOCIATIONSBETWEENTHEPRECEDING1YEARLDENANDSYSTOLICBLOODPRESSUREBYBASELINECHARACTERISTICSCOVARIATESNDIFFERENCESINSYSTOLICBLOODPRESSUREMMHG95CIPER10DBAINCREASEIN1YEAREXPOSURETOROADTRAFFICNOISEPPINTERACTIONGENDER001WOMEN22,928004048040087MEN21,155059013105001AGE00860YEARS32,96201302805305460YEARS11,121065008122003YEARSOFEDUCATION037714,38102702507803181020,239040006087009119,463008070054080MUNICIPALITYSESA063LOW6,268057022136016MEDIUM28,572019023061037HIGH9,243032032095033OUTDOORTEMPERATUREC0091538,894018020057035155,189087007166003PRIORDIAGNOSISOFCARDIOVASCULARDISEASEB029YES998115054285018NO43,085024013062021ANALYSESADJUSTEDBYAGE,GENDER,CALENDARYEAR,AREA,LIFESTYLEFACTORSSMOKING,BMI,LENGTHOFSCHOOLATTENDANCE,MUNICIPALITYSES,ALCOHOLINTAKEANDP
- 温馨提示:
1: 本站所有资源如无特殊说明，都需要本地电脑安装OFFICE2007和PDF阅读器。图纸软件为CAD,CAXA,PROE,UG,SolidWorks等.压缩文件请下载最新的WinRAR软件解压。
2: 本站的文档不包含任何第三方提供的附件图纸等，如果需要附件，请联系上传者。文件的所有权益归上传用户所有。
3.本站RAR压缩包中若带图纸，网页内容里面会有图纸预览，若没有图纸预览就没有图纸。
4. 未经权益所有人同意不得将文件中的内容挪作商业或盈利用途。
5. 人人文库网仅提供信息存储空间，仅对用户上传内容的表现方式做保护处理，对用户上传分享的文档内容本身不做任何修改或编辑，并不能对任何下载内容负责。
6. 下载文件中如有侵权或不适当内容，请与我们联系，我们立即纠正。
7. 本站不保证下载资源的准确性、安全性和完整性, 同时也不承担用户因使用这些下载资源对自己和他人造成任何形式的伤害或损失。
人人文库网所有资源均是用户自行上传分享，仅供网友学习交流，未经上传用户书面授权，请勿作他用。
|
2:不支持迅雷下载,请使用浏览器下载
3:不支持QQ浏览器下载,请用其他浏览器
4:下载后的文档和图纸-无水印
5:文档经过压缩，下载后原文更清晰
|
川公网安备: 51019002004831号