Abstract
The epidemiologic evidence relating noise and cardiovascular disease was examined by a team of audiologists, cardiologists, and epidemiologists through critical analysis of the extant world literature. While relationships were reported for various cardiovascular parameters, high levels of noise were found to be most strongly associated with elevated blood pressure. Foreign studies revealed prevalence ratios for hypertension ranging from 2.2 to 9.7 among industrial workers exposed to noise of 90–116 dB. Use of the cross-sectional design and failure to analyze blood pressure as a continuous variable limited risk quantification. Deficiencies existed in at least four aspects of study design: noise exposure characterization, health outcome specification, sample selection, and data analysis. Multiple regression and multiple adjustment procedures commonly applied in cardiovascular research were used in only one study. Confounding factors and strong risk modifiers were seldom considered. Retrospective-cohort studies of occupationally exposed workers, intervention studies with noise abatement and hearing protection programs, and other recommendations aimed at improving study designs and developing statistical models for future research are discussed. [Work supported by EPA.]
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