Table 2.
Summary of findings for noise exposure and blood pressure
| Outcomes | Relative or absolute effects(95% CI) | No of participants(studies) | Certainty of the evidence(GRADE) |
|---|---|---|---|
| Blood pressure – cross-sectional assessed with: exposure to road traffic noise | SBP for adults: MD per 10 dBA increase: 0.01, 95% CI: –0.18, 0.19 [39,45,49,101] DBP for adults: MD per 10 dBA increase: -0.31, 95% CI: –0.46, 0.15[39,45,49,101] SBP for preschool: <60 dBA vs ≥60 dBA: MD: 4.58, 95% CI: 3.43, 5.73[30,75] DBP for preschool: <60 dBA vs ≥60 dBA: MD: 1.05, 95% CI: -3.28, 5.37[30,75] SBP for 8–14 year olds: MD per 10 dBA increase: –0.02, 95% CI: –0.43, 0.40[28,40,71] DBP for 8–14 year olds: MD per 10 dBA increase: -0.19, 95% CI: –0.81, 0.43[28,40,71] | 104,586(9 observational studies) | ⊕○○○VERY LOW *,† |
| Blood pressure – cohort/case control assessed with: exposure to road traffic noise | SBP for adolescents: MD per 10 dBA increase: –0.13, 95% CI: –0.60, 0.35[32,42] SBP for children: MD per 10 dBA increase: –0.11, 95% CI: –0.21, 0[32,92] DBP for children: MD per 10 dBA increase: –0.04, 95% CI: –0.14, 0.05[32,92] | 5752(3 observational studies) | ⊕○○○VERY LOW †,‡ |
| Blood pressure – cross-sectional assessed with: exposure to air traffic noise | SBP: <60 dBA vs ≥60 dBA: MD: 0.63, 95% CI: –1.87, 3.13[33,76,96] DBP: <60 dBA vs ≥60 dBA: MD 0.58, 95% CI: –0.90, 2.05[33,76,96] | 750(3 observational studies) | ⊕○○○VERY LOW †,$ |
| Blood pressure – cohort assessed with: exposure to air traffic noise | [92]: beta of estimated change per 1 dBA for pooled cohortsAt school Leq 7–23 h: SBP 0.08, 95% CI: –0.02, 0.18; DBP 0.05, 95% CI: –0.04, 0.14At home Leq 7–23 h: SBP 0.1, 95% CI: 0–0.2; DBP 0.08, 95% CI: –0.01, 0.17At home Leq 23–7 h: SBP 0.09, 95% CI: 0, 0.18; DBP: 0.07, 95% CI: –0.01, 0.14 | 853(1 observational study) | ⊕○○○VERY LOW †,|| |
| Blood pressure – cross-sectional assessed with: exposure to occupational noise | SBP: MD per 10 dBA increase: 0.14, 95% CI: 0, 0.28[36,53,60,85] DBP: MD per 10 dBA increase: 0.23, 95% CI: 0, 0.45[36,53,60,85] SBP: <85 dBA vs ≥85 dBA: MD: 5.26, 95% CI: 2.23, 8.29[24,27,54,64,68,73,82,84] DBP: <85 dBA vs ≥85 dBA: MD: 3.31, 95% CI: 0.70, 5.92[24,27,54,64,68,73,82,84] SBP: <70 dBA vs ≥70 dBA: MD: 11.78, 95% CI: 7.13, 16.42[47,48,78] DBP: <70 dBA vs ≥70 dBA: MD: 9.32, 95% CI: 7.83, 10.81[47,48,78] | 17,216(15 observational studies) | ⊕○○○VERY LOW †,¶ |
| Blood pressure – cohort/case control assessed with: exposure to occupational noise | SBP: MD per 10 dBA increase: –0.06, 95% CI: –0.92, 0.81[25,37] DBP: MD per 10 dBA increase: 0.27, 95% CI: –0.42, 0.96[26,58,59] SBP: <85 dBA vs ≥85 dBA: MD: 5.38, 95% CI: –0.39, 11.16[26,58,59] DBP: <85 dBA vs ≥85 dBA: MD: 3.80, 95% CI: –1.96, 9.56[26,58,59] SBP: <80 dBA vs ≥80 dBA: MD: 2.02, 95% CI: 0.62, 3.42[42,44,87,88,89,90,97] DBP: <80 dBA vs ≥80 dBA: MD: 3.13, 95% CI: 1.81, 4.46[42,44,87,88,89,90,97] | 6,980(12 observational studies) | ⊕○○○VERY LOW †,# |
| Blood pressure – cross-sectional assessed with: exposure to railway noise | [39]:Beta of association per 10 dB(A):Railway (night): SBP 0.84, 95% CI: 0.22, 1.46; DBP 0.44, 95% CI: 0.06, 0.81Railway (day): SBP 0.6, 95% CI: 0.07,1.13; DBP 0.21, 95% CI: –0.11, 0.53 | 6,450(1 observational study) | ⊕○○○VERY LOW †,** |
| Blood pressure – cohort assessed with: exposure to railway noise | [32]: beta per 6.9 dBAAge 12: SBP –0.15, 95% CI: –0.77, 0.46; DBP: 0.01, 95% CI: –0.42. 0.44Age 16: SBP –0.9, 95% CI: –0.85, 0.67; DBP: 0.08, 95% CI: –0.46, 0.62[45]: beta for association of BP with 10 microgram/m^3 increase in annual average home outdoor NO2<55 dB nighttime traffic noise: SBP –0.4, 95% CI: –2.05, 1.6; DBP –0.05, 95% CI: –1.6, 0.9>55 dB nighttime traffic noise: SBP 1.95, 95% CI: 0.5, 3; DBP 0.1, 95% CI: –0.4, 0.5 | 6,002(2 observational studies) | ⊕○○○VERY LOW †,†† |
| Blood pressure – cohort assessed with: exposure to ambient noise | [29]: Social (room conversation) vs Ambient (background sound): SBP MD: 3.70, 95% CI: –6.56, 13.96; DBP MD: 1.10, 95% CI: –4.53, 6.73Social (hall conversation) vs Ambient (background sound): SBP MD: 1.40, 95% CI: –8.89, 11.6; DBP MD: –1.60, 95% CI: –7.23, 4.03Ambient (environmental sound) vs Ambient (background sound): SBP MD: 1.60, 95% CI: –9.62, 12.82; DBP MD: –0.60, 95% CI: –5.81, 4.61[35]: Increase in SBP (mmHg) per 5 dBA increase: 1.43, 95% CI: 1.19, 1.67Increase in DBP (mmHg) per 5 dBA increase: 1.40, 95% CI: 1.20, 1.60 | 75(2 observational studies) | ⊕○○○VERY LOW †,††,‡‡ |
| Blood pressure – clinical trial assessed with: exposure to lab-simulated noise | Noise 30 vs control: MD: 3.29 mmHg higher, 95% CI: –0.14, 6.72[52,80] Noise 60 vs control: MD: 2.67, 95% CI: –1.61, 6.94[52,79,80] | 210(3 observational studies) | ⊕○○○VERY LOW †,††,‡‡ |
CI: confidence interval; GRADE, Grading of Recommendations, Assessment, Development, and Evaluation; SBP: systolic blood pressure; DBP: diastolic blood pressure; MD: mean difference. GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of the effect. *Critical concern with confounding. Moderate concern with measurement of exposure. Serious concern with missing data and measurement of outcome. †Concerns with imprecision because the 95% CI cannot exclude the potential for meaningful benefit or harm.‡Moderate concern with measurement of exposure and measurement of outcome. Critical concern with missing data. $Critical concern with confounding. Moderate concerns with measurement of exposure, missing data, and measurement of outcome. ||Moderate concern with measurement of exposure and missing data. ¶Critical concern with confounding. Serious concern with measurement of exposure, missing data, and measurement of outcome. Moderate concern with selection of participants. #Critical concern with confounding, measurement of exposure, and missing data. Serious concern with measurement of outcome. **Moderate concern with measurement of exposure and measurement of outcome. ††Moderate concern with measurement of exposure and missing data. Serious concern with measurement of outcome. ‡‡Critical concern with confounding. Concerns for imprecision because the small sample included does not meet the optimal information size and suggests the fragility of the estimate. $$Critical concern with confounding. Moderate concern with missing data. Serious concern with measurement of outcome.