ArticleFrontiers in public health2026
Cardiovascular composite events and the healthy worker effect among noise-exposed workers: a retrospective cohort study.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Occupational noise exposure is prevalent, but its cardiovascular effects are under recognized. Most studies are cross-sectional, focus on single endpoints, and rarely account for the healthy worker effect (HWE). This study aimed to identify risk factors for cardiovascular composite events in noise-exposed workers and further assess this effect. Methods: This retrospective cohort study enrolled 1,381 noise-exposed workers with normal blood pressure and normal electrocardiogram at baseline in 2020. All participants were followed annually through 2023. The primary endpoint was a composite cardiovascular event (hypertension or electrocardiographic abnormality). Cox proportional hazards models were used to identify associated factors. Restriction analysis, restricted cubic spline analysis, and sensitivity analyses were performed to assess robustness. Results: Multivariable Cox regression identified systolic blood pressure (SBP) (HR = 1.012, 95% CI 1.005-1.020, Conclusion: Smoking and elevated SBP are independent risk factors for cardiovascular composite events in noise-exposed workers. The apparent protective effect of work duration is consistent with the HWE. Combined exposure to noise with dust or chemical agents significantly increases the risk of hypertension.
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