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. 2021 Sep;154:106387. doi: 10.1016/j.envint.2021.106387

Table 4.

Characteristics of included studies (Part I: study population and study type).

Study Study population
Study type
Study ID Total number of study participants Number of female study participants Country of study population Geographic location (specify as 'national' or list regions or sites) Industrial sector (specify ISIC-4 code provided in worksheet “Industrial sector codes”) Occupation (specify ISCO-08 code provided in worksheet “Occupation code”) Age Study design Study period (month of first collection of any data and month of last collection of any data) Follow-up period (period in months between exposure and outcome)
Chang et al. (2013) 578 0 Taiwan Local 30 7232 27.7 ± 5.3 years Cohort study (prospective) 1998–2008 9.8 ± 5.2 years
Davies (2002) 27,499 (this is the analysis sample) 0 Canada Local 16 8172 Mean 29,7 years, range 10,6–76,3 years Cohort study (retrospective) 1950–1995 Mean 24,3 years, range 1–46 years
Eriksson et al. (2018b) Baseline-5,753 0 Sweden Local Unclear Unclear Baseline 55.3 (2.1) years, range 50–59 years Cohort study (prospective) 1974–1977; 2004 (last noise exposure data) Unclear
Girard et al. (2015)* 644 0 Canada Regional 25 Unclear 55–64 years (cases mean = 60.0, controls mean = 58.8) Case-control 1983–2005/07 Cases - mean: 31.9 years, controls: 29.8 years, all study subjects: 30.5 years
Gopinath et al. (2011) Blue Mountains Eye Study (BMES-1) 1992–4 – 3,654 participants BEMS-2 (1997–1999) −3,509 participants; BEMS-3 (2002–2004)-1,952 participants Unclear
(BMES-1) 1992–4 – controls: 1,348 females,
Exposed:
306 females
BMES −2
–no data about females
BMES-3
1,556 participants-917 females
Australia National No data No data 67.9 ± 9.4 years (unexposed group) and 67.1 ± 8.9 (exposed) Cohort study Baseline: 1997–1999 -incidence study, 2002–2004 - mortality study, cut off point for CHD and stroke death -end of December 2007 Prevalence data was obtained from BMES-2 (baseline), while, incidence analyses used data obtained from both BMES-2 and 5-year follow-up examination (BMES-3).
Huo Yung Kai et al. (2018)* 1,156 About 547 France National No data No data 32 years,
42 years,
52–62 years
Cohort study (prospective) 2001–2006 5 years
Ising et al. (1997) 2,543 0 Germany Local No data No data 31–70 years Case-control study Unclear No data
Kersten and Backe (2015) 4,113 1,059 Germany Regional Unclear 1111, 1112, 1321, 1324, 1330, 1420, 2149, 2263, 2269, 2351, 2359, 2433, 4221, 4323, 6113, 7223, 7233, 7322, 7549, 8111, 8121, 9214, 9216 20–69 years Case-control
study
No data N/A
McNamee et al. (2006)* 1,220 0 United Kingdom Regional 35 7131
≤75 years Case-control 1965–1998 ≤1 month to ≥40 years
Pettersson et al. (2020) 166,088 (analysis sample) 0 Sweden National 41–43 No data 15–67 years Cohort study 1971–1993 17–40 years (ended in 2010)
Song (2013)* 221 cases and 1,105 controls 106 cases and 530 controls Canada National 01 1221 < 30 to > 55 years Case-control 31.12.2001–31.12.2009 180
Stokholm et al. (2013a)
145,190 36,788 Denmark Regional 1–4; 7–9 8160, 7322, 8112, 8121,8122, 8211, 7231, 8172, 1323, 4419, 7549,8219, 1120 <25 years
25–34 years
35–44 years
45–54 years
55–64 years
≥65 years
Cohort study (prospective) 2001–2007 7 years
Stokholm et al. (2013b) 164,247 Unclear Denmark Regional 1–4; 7–9 8160, 7322, 8112, 8121,8122, 8211, 7231, 8172, 1323, 4419, 7549,8219, 1120 Unclear Cohort study (prospective) 2001–2007 7 years
Suadicani et al. (2012) 5,249 (in 1970)
3,387 (in 1985–1986)
0 Denmark National 32, 43 3115, 8211, 8121, 8311, 2163, 5112 62.7 (5.2) years A follow-up study to a cross-sectional survey 1970–1986 16 years
Tessier-Sherman et al. (2017) 2,052 0 USA Unclear Section B Mining and quarrying: 24 Manufacture of basic metals, 32 Other manufacturing 8121 Mean 35.8, SD 8.5 Cohort study (retrospective) After 1 January 1996 to 31 December 2012 72 months; follow-up time - mean 6.5 years
Tong et al. (2017)* 935 0 China Regional Iron and steel enterprise (cold rolling and gas factory) Unclear ≤ 55 years, Essential Hypertension Group − 38.44 ± 8.51 years; Control Group − 38.11 ± 8.04 years Case-control February 2014 to July 2014 No follow-up
Virkkunen et al. (2005) 6,005 0 Finland National Iron and metal work, machine work in plants, woodworking, and chemical process work Unclear 40–56 years at entry Cohort study (prospective) 1982–1999 15.9 years
Study Exposure assessment
Comparator
Study ID Exposure definition (i.e. how was the exposure defined?) Unit for which exposure was assessed Mode of exposure data collection Exposure assessment methods Levels/intensity of exposure (specify unit) Number of study participants in exposed group Number of study participants in unexposed group Definition of comparator (define comparator group, including specific level of exposure)
Chang et al. (2013) 8-hour time-weighted average equivalent sound level with and without adjustment for usage of HPDs (in dBA) Individual Technical device Measurements and questionnaire on HPDs use < 80 dBA;
80-85 dBA;
≥85 dBA (used in our analyses)
205 (< 80 dBA)

221 (80 to <85 dBA)

152 (≥85 dBA)
205 < 80 dBA (low exposure group)
Davies (2002) Duration of exposure to noise levels exceeding a specific threshold in Leq dBA (used in meta-analysis); and Cumulative exposure in dBA-year Individual Historical exposure levels were estimated by a determinants of exposure regression model, developed using 1,900 personal dosimetry measurements A combination of measurements, interviews, hygienists' assessment and modelling For duration of exposure: <3 years (reference),
3–10 years,
10–20 years, 20–30 years,
> 30 years for the thresholds > 85 dBA; (≥85 dBA for > 3 years was used for our analyses)
N/A N/A Exposure to <85 dBA for < 3 years
Eriksson et al. (2018b) To assess occupational noise exposure, a previously developed job-exposure matrix was applied Group level: 129 unique job families Job-exposure matrix Measurements reports <75dBA;
75–85 dBA;
>85 dBA (used in our analyses)
2,823 2,930 Exposure to noise: medium < 75 dBA
Girard et al. (2015)* Exposure to ≥ 90 dBA Individual Technical device Measurements Exposure to ≥ 90 dBA for < 27, 27–36.4, ≥ 36.5 years; Noise levels ≥90 dBA/8h, cases − 46%, control − 50.9% (used in our analyses) 320 324 < 90 dBA/8h
Gopinath et al. (2011) Questionnaires on workplace noise exposure history Individual Questionnaire Self-reported Self-reported exposed status; duration of exposure: 0 years, <1–5 years, >5 years; severity of exposure: none, tolerable, unable to hear speech (used in our analyses) 2,796 1,859 Answer “No” to the question: “Have you ever worked in the noisy industry or noisy farm environment?”
Huo Yung Kai et al. (2018)* The questions used were similar to those used in the
5th European survey on working conditions in the ESTEV study
and in the previous VISAT articles
Individual Data from French prospective VISAT study Self-reported Exposed at baseline or in the preceding
five years to (cannot hear a person who is 2–3 m away
even if talking loudly)
483 673 Answer “No” to a question on occupational exposure to “loud” noise
Ising et al. (1997) Subjective noise categories: 1+2 Refrigerator and typewriter
3. electric lawn-mower
4. electric drill
5. pneumatic drill
Work noise level measured as 1-min mean level in relation to the subjective work noise category Subjective evaluation of noise loudness based on questionnaire Self-reported and objective measurement in the sample of 80 men using Norsonic Type 110 Subjective noise categories
Lower categories (1+2), higher categories (3+4+5) - these noise categories correspond to the median (25 percentiles) of LAeq,T>70 dBA.
395 2,148 Low-noise-exposed workers (noise categories: refrigerator+typewriter)
Kersten and Backe (2015) Occupational noise (LEX,8h,subj) and (LEX,8h,obj) >55 dBA Individual Questionnaire, technical device, and experts judgements Self-reported vocal effort and equipment catalogue specifications 46–61 dBA,
62–84 dBA, 85–94 dBA, 95–124 dBA
1,880 2,233 42–61 dBA
McNamee et al. (2006)* Mean daily noise expo-sure level with adjustment for usage of HPDs (LEP,d in dBA; number (N) of years with LEP,d> 85 dBA;
noise emmission level NIL (NIL=LEP,d +10×log N)
Individual Experts judgements based on company work histories and noise survey records Extrapolation Unexposed, <85 dBA; >1 year exposed to >85 dBA
Total −1402,
cases − 717,
control − 685
Total −800,
cases − 384,
control − 416
<85 dBA
Pettersson et al. (2020) Noise exposure was defined on a job exposure matrix Group level: a noise exposure category was assigned for each working group in the cohort Job-exposure matrix Survey of working conditions carried out
by industrial hygienists
≤ 85 dBA; >85 dBA (after re-calculation by authors) 54,480 111,608 ≤85 dBA
Song (2013)* Cumulative noise exposure (dBA-years) Individual level Job-exposure matrix Job-exposure matrix and record linkage < 85; 85–95; > 95 dBA-years Cases/controls: 69/347 (85–95 dB); 76/419 (> 95 dB) Cases/controls: 76/339 (<85 dBA) <85 dBA-years
Stokholm et al. (2013a) Mean, full-shift noise exposure levels (LAeq values in dBA)
+ cumulative exposure
Individual Technical device Measurements < 70 dB; > 80 dBA for <3, 3–9, 10–19, and ≥20 years;
> 80 dBA for <3, 3–9 (used in our analyses), 10–19, and ≥20 years
87,959 men, 15,728 women 20,443 men, 21,060 women
< 70 dB
Stokholm et al. (2013b) Mean, full-shift noise exposure levels (LAEq values in dBA Individual Technical device Measurements and extrapolation < 70 dB; > 80 dBA for <3, 3–9, 10–19, and ≥20 years;
> 80 dBA for <3, 3–9 (used in our analyses), 10–19, and ≥20 years
496,036 425,763 < 70 dB
Suadicani et al. (2012) Exposure to noise at a level where it is necessary to raise voice Individual level Questionnaire Self-reported vocal effort Exposure to “loud” noise for > 1 years 2,998 workers 1,890 workers, noise level 0 years
0 years of exposure to “loud” noise
Tessier-Sherman et al. (2017) Exposures ever equal or exceed an 8-h time-weighted average Individual level Technical device, personal dosimetry measurements Dosimetry <82 dBA
(referent);
82–84 dBA;
85–87 dBA; >88 dBA (> 82 dBA combined for our analyses)
1,102 950 Occupational exposure to noise <82 dBA
Tong et al. (2017)* 1) The 40-hour time-weighted average (TWA) sound level, in dBA, 2) A cumulative noise exposure (CNE), in dBA x year (dBA-year) Individual level Technical device Cumulative noise exposure (CNE) was determined taking into account noise levels and the years of noise exposure; time-weighted average
according the type of work,
detention time, and work shift situation (used in our analyses)
<85 dBA; ≥85 dBA time-weighted average (used for our analyses) 461 474 <85 dBA time-weighted average
Virkkunen et al. (2005) Exposure to continuous noise (used in our analysis), exposure to impulse noise & continuous noise Individual Job-exposure matrix Job-exposure matrix and record linkage < 80 dBA; 80-85 dBA;
>85 dBA dBA
2,893 3,556 < 80 dBA
Study Outcome assessment
Study ID Definition of outcome Which International Classification of Diseases (ICD) code was reported for the outcome (if any)? Method of outcome assessment Diagnostic assessment method Specification of outcome Number of cases with outcome of interest in exposed group Number of non-cases (i.e. without outcome of interest) in exposed group Number of cases with outcome of interest in unexposed group Number of non-cases (i.e. without outcome of interest) in unexposed group
Chang et al. (2013) Hypertension None Questionnaire, Blood pressure measurements Self-reported diagnosed hypertension or SPB≥ 140 mmHg and/or DBP ≥90 mmHg Incident hypertension 141 437 44 161
Davies (2002) Hypertensive heart disease; ischaemic heart disease (IHD); acute myocardial infarction; stroke mortality Hypertensive diseases (ICD9 401–405.9); IHD (ICD9 411–414.9, 429.2); acute myocardial infarction (ICD 410–410.9); stroke (cerebrovascular disease, ICD9 430–438.9) Death certificate Administrative record Hypertensive heart disease; ischaemic heart disease; acute myocardial infarction; stroke mortality In the groups > 3 years: hypertensive heart disease (n = 22), IHD (n = 693), acute MI (n = 757), stroke (n = 325) Unclear In the reference group < 3 years: hypertensive heart disease (n = 4), IHD (n = 123), acute MI (n = 153), stroke (n = 48) Unclear
Eriksson et al. (2018b) Coronary heart disease and stroke ICD-8, ICD-9, ICD-10. CHD-410–414 (ICD-8, 9), and 120–125 (ICD-10); acute myocardial infarction 410 and 121; stroke 431–438 (ICD −8,9), 161–169 (ICD-10) Hospital discharge national register Hospital discharge national register CHD, stroke, MI CHD-medium noise 453, high noise 71;

Stroke- medium noise 220, high noise 35
CHD - medium noise 2014; high noise −285

Stroke medium noise −2247, high noise −321,
CHD − 480, stroke-262 CHD
2450

Stroke 2668
Girard et al. (2015)* CVD mortality ICD-9: 410, ICD-9: 411–414 + 429.2), CI M9 390–405; 415–459 (except 429.2) Death certificate Administrative record Incident CVD mortality 74 (exposed cases) 0 (exposed cases) 87 (unexposed cases) 0 (unexposed cases)
Gopinath et al. (2011) Angina, acute myocardial infarction, stroke ICD − 9] codes 410.0, 411.0–8, 412, 414.0–9 and ICD- 10 (121.0–9, 122.0–9, 123.0–8, 124.0–9, 125.0–9, ICD −9: 430.0–438.9 and ICD-10160.0–169.9) Medical history of participants, Australian National Death Index Unclear Prevalence/incidence of angina, acute myocardial infarction, stroke Angina − 126 13.8%), AMI-98 (10.7%), stroke − 38 (4.1%), all CVD-171 (18.2%) 675 Angina − 168 (9.2%), AMI-115 (6.4%), stroke − 80 (4.4%), all CVD −218 (17.7%) 1496
Huo Yung Kai et al. (2018)* Hypertension None BP was measured
using an automatic standard sphygmomanometer (OMRON 705CP)
SBP ≥ 140 mmHg and/or a DBP ≥ 90 mmHg
and/or taking a antihypertensive medication
Hypertension 26 99 108 542
Ising et al. (1997) Myocardial infarction ICD 410 Hospital discharge record Hospital discharge record Myocardial infarction 246
927 149 1221
Kersten and Backe (2015) Myocardial infarction None Computer assisted standardized interview Physician diagnostic record Myocardial infarction 166 199 1493 1658
McNamee et al. (2006)* IHD mortality ICD-9: 410–414 Death certificate Administrative record Incident ICD mortality 717
(exposed cases)
685
(unexposed control)
384 (unexposed cases) 416
(unexposed control)
Pettersson et al. (2020) Myocardial infarction and stroke IHD: ICD-8410–412, ICD-
9410–412, and ICD-10I21-I25;
Stroke: ICD-8430–438, ICD-9430–438, and ICD-10I60-I69
National Cause of Death Register Administrative record Myocardial infarction and stroke Myocardial infarction: 1,943


Stroke: 534
Myocardial infarction: 52,537

Stroke: 53,946
Myocardial infarction: 4,164

Stroke: 1,116
Myocardial infarction: 107,444

Stroke: 110,492
Song (2013)* CVD None Questionnaire Self-reported heart disease Positive response 64 (85–95 dB) /78 (> 95 dB) 331 (85–95 dB) /419 (> 95 dB) 76 339
Stokholm et al. (2013a) Hypertension ICD-8 codes, ICD-10 codes, but exact codes uncelar Data on redeemed anti-hypertensive prescription, hospital discharge Administrative record Incidence of hypertension /1000 person-year Men
6,051
Women
1,603
Men
81,908
Women- 19,457
Men
1,536, Women 2,205
Men 18,907, Women 18,855
Stokholm et al. (2013b) Stroke DI61, DI63
D164
Danish National Patient Register Unclear Incident stroke 638 Unclear 343 Unclear
Suadicani et al. (2012) IHD mortality IHD codes 410–412, ICD (1994) 120–125 Danish National Civil Registry Physician diagnoses in national registry IHD mortality 197 deaths due to IHD 2,801 6.4% of 1890 subjects 93.6%
Tessier-Sherman et al. (2017) Hypertension ICD9, 401–404 Central data processing vendor for all employees Administrative datasets Hypertension 244 1,808 No data No data
Tong et al. (2017)* Hypertension None Physical examination Physician diagnostic record Hypertension 182 279 130 344
Virkkunen et al. (2005) Coronary heart disease CHD - codes 410–414 in the ninth revision of the ICD and I20-I25 in the tenth revision CHD end points were obtained from official Finnish registers Hospital discharge record Coronary heart disease 515 2378 509 3047
Study Adjustments of effect estimates in model prioritized by reviewers
Study ID Adjusted for confounding by: age Adjusted for confounding by: sex Adjusted for confounding by: Socioeconomic status (please specify indicator, e.g. level of education) Other potential confounders adjusted for (please specify) Adjusted for mediation by: tobacco smoking Adjusted for mediation by: Alcohol use Adjusted for mediation by: obesity Other potential mediators adjusted for Interactions adjusted for Adjustment for clustering (if any)
Chang et al. (2013) Yes N/A (males only) Educational level Body mass index, employment duration, cigarette use, alcohol intake, exercise Yes Yes Yes No No No
Davies (2002) Yes N/A (males only) No Calendar year and race No No No No No No
Eriksson et al. (2018b) Yes N/A (males only) No No No No No No Interaction between occupational noise and high strain No
Girard et al. (2015)* Yes N/A (males only) No No No No No No No No
Gopinath et al. (2011) Yes Yes Occupational prestige Body mass index, smoking, walking difficulties and self-reported poor health Yes No Yes (stroke incidence model) Yes No No
Huo Yung Kai et al. (2018)* Yes Yes Educational attainment Body mass index, smoking habits, daily alcohol intake, leisure time physical activity, history of diabetes, history of hypercholesterolemia, treatment for hypertension, working status and initial blood pressure No No No Yes No No
Ising et al. (1997) Yes N/A (males only) Social class, education, marital status, housing area Body mass index, Social class, Education, Marital status, residential area, shift work, Current smoking Yes No Yes No No No
Kersten and Backe (2015) Yes (matching variable) Yes (matching variable) Current employment status, <12 years at school Shift work, work >40h per week No No No No No No
McNamee et al. (2006)* Yes N/A (males only) No Pre-employment measures and duration of employment No No No No No No
Pettersson et al. (2020) Yes N/A (males only) No Region No No No No No Yes
Song (2013)* Yes (matching variable) Yes (matching variable) Education, family income Smoking, body mass index, drinking, smoking, physical activity, hypertension Yes Yes Yes Yes No No
Stokholm et al. (2013a) Yes Yes Five categories, blue/white collar Calendar year, employment status No No No No Interaction between sex and occupation Yes
Stokholm et al. (2013b) Yes Yes Socioeconomic status Calendar year, employment status No No No No No No
Suadicani et al. (2012) Yes N/A (males only) Low social class Physical activity, cumulative tobacco consumption, alcohol intake Yes Yes Yes No Age + lifestyle and social class, age + clinical factors, age + all potential confounders No
Tessier-Sherman et al. (2017) Yes N/A (males only) Economic status, job category, annual wages Body mass index, smoking, hearing acuity Yes No Yes Yes No Yes
Tong et al. (2017)* No N/A (males only) No Body mass index, low density lipoprotein cholesterol, hypertension family history, A1166C gene Yes No No Yes No No
Virkkunen et al. (2005) Yes N/A (males only) No Systolic blood pressure No No No Yes No No
Study Prioritized model
Estimate of effect of exposure on outcome
Study ID Are two or more alternative models reported? Which of the alternative models was prioritized/selected for use in the review and/or meta-analysis? Reason for prioritization/selection Treatment effect measure type Was an exposure–response (or dose–response) analysis conducted?
Chang et al. (2013) Yes Relationships between noise exposure and hypertension in total N/A Hazard ratio No
Davies (2002) Yes The model yielding RR of different cardiovascular outcomes in those exposed to > 85 dBA for >3 years vs. exposed to >85 dBA for <3 years This duration of exposure was most biologically plausible, as exposed for <3 years would be unlikely to cause cardiovascular disease Relative risk Trend per increasing duration of exposure (not of interest for pooling)
Eriksson et al. (2018b) Yes – age-adjusted and fully-adjusted model (body mass index, diabetes, hypertension, smoking, cholesterol) Hazard ratio adjusted for age only Overadjustment for potential mediators in the fully-adjusted model Hazard ratio No
Girard et al. (2015)* Yes – models for duration of noise exposure and crude 2x2 table Raw data in descriptive The duration of exposure categories are not comparable to the exposure categories in other studies Calculated relative risk No
Gopinath et al. (2011) Yes – incidence and mortality Only the mortality model, because for the incidence model, the only significant effect was selectively reported, and it was based on only 4 cases with stroke N/A Hazard ratio and Odds ratio Trend per increasing duration of exposure (not of interest for pooling)
Huo Yung Kai et al. (2018)* Yes, crude and adjusted models (age, gender, body mass index, smoking, alcohol, physical activity, diabetes, hypercholesterolemia, employment, educational attainment) Unadjusted model (calculated from raw data) due to gross adjustment for mediators in the adjusted model; Moreover, adjusted estimate was reported only in a Fig. with poor resolution The adjusted models revealed that most of these associations were explained by individual cardiovascular factors, except for the negative effect of high job strain and positive effect of job recognition which had an independent role Odds ratio reported, but we calculated relative risk from raw data No
Ising et al. (1997) Yes – crude and adjusted models Model adjusted for smoking, body mass index, age, social class, education, marital status, shift work, housing area Control for confounding factors with acceptable adjustment for potential mediators Odds ratio No
Kersten and Backe (2015) Yes – models using all occupational groups and stratified by occupational group The model using all occupational groups combined (for men and women) Insufficient number of cases in the stratified models Odds ratio No
McNamee et al. (2006)* Yes – crude and two adjusted; data from both sampling sites vs. data from one site Adjusted model taking into account both sites Control for confounding factors and acceptable adjustments for potential mediators; Moreover, the estimates do not differ between crude and adjusted models Odds ratio Yes
Pettersson et al. (2020) Yes – re-calculated upon request Relative risk adjusted for age and region Parsimony Relative risk No
Song (2013)* Yes – crude and adjusted models Multivariate logistic regression Control for confounding factors and acceptable adjustments for potential mediators Odds ratio No
Stokholm et al. (2013a) Yes – crude and adjusted models Adjusted model Control for confounding factors Relative risk No
Stokholm et al. (2013b) Yes – crude and adjusted models Adjusted model Control for confounding factors Hazard ratio Trend RR by 1-unit dBA-year increase (not of interest for pooling)
Suadicani et al. (2012) Yes – four models Age + lifestyle and social class-adjusted model This model seems the best compromise between parsimony and controlling for confounders Hazard ratio No
Tessier-Sherman et al. (2017) Yes – crude and adjusted models Model adjusted for age, body mass index, smoking Control for confounding factors and acceptable adjustments for potential mediators Relative risk Yes
Tong et al. (2017)* Yes – models for time-weighted average and cumulative noise exposure Time-weighted average model Allows comparison with the other studies that used this noise metric Odds ratio No
Virkkunen et al. (2005) Yes – different follow-up models and estimates for continuous and impulse noise The longest follow-up model and continuous noise The other follow-ups yield similar effect estimates; relatively few workers are exposed to impulse noise Relative risk Trend per increasing level of exposure (could not be pooled)

*The study provided deprioritized evidence and was not included in the main meta-analysis due to it being a single case-control study in the respective model (Girard et al., 2015, McNamee et al., 2006, Tong et al., 2017), unadjusted estimate extracted (Huo Yung Kai et al., 2018) or incomparable noise metric (Song, 2013).