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Eur J Epidemiol:大规模跨学科研究:交通噪音不仅导致睡眠质量下降,还会增加心血管疾病和糖尿病风险!家住马路边的悲催了

2017-07-06 王新凯 奇点网

噪音污染已成为继空气污染之后人类公共健康的另一个主要杀手。世卫组织发布的报告显示,全球噪音来源复杂,但影响最大的还是交通,如道路、铁路和飞机的噪音。中国属于噪音污染比较严重的国家,全国有近三分之二的城市居民生活在噪音超标的环境中。

越来越多的证据表明,噪音污染以各种方式影响着我们的健康。



想象一个场景,深夜中的你睡得正香甜,突然被窗外过路骑车轰鸣的发动机声或者鸣笛声惊醒。可能你在惊吓之余,还想骂上两句,甚至到了第二天工作的时候,还会抱怨夜里的噪音没有让你休息好。

不仅如此,夜间噪音干扰造成的急性生理反应,会突然唤醒人体的交感神经和内分泌系统,引起各种应激激素的释放,长此以往,甚至会影响心血管代谢疾病的发生和进展。想想也是,夜里被惊醒后,我们往往能感受到强烈的心跳加速和血压升高。

噪音污染已成为继空气污染之后人类公共健康的另一个主要杀手。世卫组织发布的报告显示,全球噪音来源复杂,但影响最大的还是交通,如道路、铁路和飞机的噪音。中国属于噪音污染比较严重的国家,全国有近三分之二的城市居民生活在噪音超标的环境中。

一直以来,人们对噪音长期影响的研究主要集中在室外场景或特定职业人群,而且大多数研究往往只得出了一个定性的结论,噪音对健康有害。但这并不能准确地告诉我们这些工作和睡觉都在室内的人,究竟交通噪音会对我们的健康产生什么影响,以及多大程度的影响。

2014年,瑞士热带疾病与公共卫生研究所(TPH)开展了一项大规模的科学研究——暴露于交通噪音的短期与长期影响(SiRENE)。这一涵盖声学、人类生态学、心理学、人类睡眠研究和流行病学调查的跨学科项目,旨在研究道路、铁路与飞机噪音暴露对于烦躁情绪、睡眠障碍、心血管及代谢疾病的急性、短期和长期影响。

在以往有关噪音的流行病学研究中,对于环境噪音的评估,通常是基于特定声源的平均声压水平(Leq),简单地可以理解为一段时间内的平均噪音大小(分贝)。SiRENE的研究人员认为,最大声压的分布和噪音事件的间隔,更能体现噪音对睡眠等的影响。于是,他们增加了间隙比(Intermittency Ratio,IR)作为噪音评估指标。

整个研究过程十分庞大复杂,研究团队根据学科领域将其分为3个子项目和6大板块。



SiRENE项目整体框架

子项目1:数据建模。研究人员对1991年、2001年、2011年瑞士全国范围内道路、铁路、飞机噪音暴露进行建模,为整个项目提供数据支撑。

子项目2:实验室研究。主要分析不同的交通噪音暴露对于睡眠结构、白天认知表现、心血管代谢症状的急性和短期影响。

子项目3:人口调查。基于瑞士两项大型持续流行病学研究数据:瑞士成人空气污染和肺部疾病数据库(SAPALDIA)和瑞士人口死因数据(SNC),研究交通噪音暴露对普通人群心血管及代谢结果的长期影响。

就在上个月,于瑞士苏黎世举行的国际噪音生物影响大会(ICBEN)上,研究团队公布了这个历时三年的SiRENE项目最新的研究成果。相关研究论文也分别发表在《国际流行病学杂志》和《欧洲流行病学杂志》。

根据子项目1提供的数据,研究人员给出了每个住宅单元的道路交通噪音暴露示意图。我们可以看到,在主干道路上,Leq是高的,但是IR是低的,也就是说,由于主干道上交通量高,噪音的连续出现,使得分贝值很高,但没有特别突然的噪音事件。而在较小的城市街道上,IR往往更高,特别是在建筑物的正面。



城市住宅单元的道路交通噪音暴露示意

为了更加全面地了解噪音对睡眠的影响,研究人员在睡眠实验中利用脑电图实时量化受试者的睡眠状态。事后分析显示,与安静夜晚环境相比,有噪音暴露(根据项目1数据人工模拟住宅噪音)的受试者,在由清醒状态进入浅度睡眠的时间明显延长(17.48 min vs 13.25 min)。而且,和对照组相比,中高程度的IR会导致老年受试者的深浅睡眠变化次数大幅增加(29.86/30.45 vs 26.69 per hour)。

等到第二天,让这些受试者主观评价自己的睡眠质量,并且观察其白天的精神状态,发现中高程度的IR比持续噪音的负面影响更大。换种说法就是,窗外持续不变的噪音影响可能对你睡眠质量的影响并不大(当然分贝也不能太高),而偶尔出现的中高强度噪音反而会造成更严重的影响。

如果你觉得这些发现并没什么特别,那就接着往下看。对受试者进行的葡萄糖和胰岛素水平分析显示,在受到夜间交通噪声干扰4晚之后,年轻参与者出现了葡萄糖耐量(指机体对血糖浓度的调节能力)受损。有趣的是,在高IR的暴露场景中,有着更显着的结果,而且在高IR噪音干扰之后,一个康复之夜(安静环境)已经不足让受试者恢复到正常水平。



不同噪音环境暴露后口服葡萄糖耐量试验中,葡萄糖和胰岛素的变化

另外,研究人员还发现,交通噪声还会导致糖基化血红蛋白(HbA1c)发生巨大的变化。要知道在那些缺乏血糖控制的糖尿病患者中,这些糖化血红蛋白的量也会显着增加。

这些实验室的发现,也对应了噪音暴露长期影响的流行病学结果。通过分析,在排除空气污染等其它因素影响后,受到最高噪音影响的四分之一受试者比受到最低噪音影响的四分之一受试者,糖尿病的发病风险高出2倍!

研究人员认为,噪音可能通过两个主要途径影响糖尿病风险。一是噪音引起的应激反应,通过“下丘脑-垂体-肾上腺”途径的慢性影响导致代谢障碍和胰岛素抵抗;二是噪音会影响睡眠质量,导致代谢紊乱,使得葡萄糖调节受损和肥胖增加。

在心血管疾病风险方面,研究发现道路噪音与心血管疾病死亡率有着明显的关联。在家庭中受到的道路噪音每增加10分贝,心肌梗塞死亡的风险就增加了4%,高血压和心力衰竭的风险也随着交通噪音的影响而增加。

SiRENE首席研究员、瑞士TPH和巴塞尔大学环境流行病学教授Martin Röösli指出,尤其是晚上经常打断睡眠的噪音事件,这些时不时出现的噪音,比连续的噪音或者有较长安静期的噪声事件,产生更大的影响。而且研究发现,噪音影响健康的门槛要比我们之前认为的还要低。

噪音污染给人类健康带来的影响,已经越来越引起人们的重视,对于噪音污染的相关研究也越来越多。尽管SiRENE研究中的结果只是证明了交通噪音和心血管及代谢疾病存在相关性,但是这项大规模的跨学科研究仍然有着十分重要的意义,特别是对于城市居民而言。

这就像雾霾问题一样,我们不能认为雾霾一定会导致某某疾病,但也不能因为吸了雾霾只是嗓子不舒服,而就忽视它。

原始出处:

Eze IC, Foraster M, et al. Long-term exposure to transportation noise and air pollution in relation to incident diabetes in the SAPALDIA study. Int J Epidemiol. 2017 Mar 13. doi: 10.1093/ije/dyx020.

Héritier H, Vienneau D, et al. Transportation noise exposure and cardiovascular mortality: a nationwide cohort study from Switzerland. Eur J Epidemiol. 2017 Apr;32(4):307-315. doi: 10.1007/s10654-017-0234-2. 

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    2017-07-08 大爰

    学习并分享了谢谢

    0

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  6. 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    2017-07-07 yuandd
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    2017-07-06 忠诚向上

    好好的看看有进步

    0

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    2017-07-06 186****0580(小山羊)

    学习了谢谢了。

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2043331, encodeId=f6aa2043331d5, content=<a href='/topic/show?id=13304400293' target=_blank style='color:#2F92EE;'>#大规模#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44002, encryptionId=13304400293, topicName=大规模)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3fce464, createdName=ylz8403, createdTime=Sun Jul 30 20:02:00 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1936901, encodeId=5ca41936901c4, content=<a href='/topic/show?id=b7c62438600' target=_blank style='color:#2F92EE;'>#交通噪音#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24386, encryptionId=b7c62438600, topicName=交通噪音)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d47b2500175, 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attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f612331, createdName=gds2009, createdTime=Fri Jul 07 15:02:00 CST 2017, time=2017-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498225, encodeId=a613149822506, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Fri Jul 07 15:02:00 CST 2017, time=2017-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1588823, encodeId=00e7158882346, content=<a href='/topic/show?id=00742438078' target=_blank style='color:#2F92EE;'>#交通#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24380, encryptionId=00742438078, topicName=交通)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=84fb17623791, createdName=yuandd, createdTime=Fri Jul 07 15:02:00 CST 2017, time=2017-07-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219160, encodeId=dd51219160aa, content=好好的看看有进步, beContent=null, objectType=article, channel=null, level=null, likeNumber=102, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Thu Jul 06 13:00:49 CST 2017, time=2017-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219130, encodeId=784e21913019, content=学习了谢谢了。, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLPeNmuNF9ibgMfMOAs7Iic5MpiaU8RLmRH67xCKuk5wzfhb7G4ib7ia6z9lrnsTicj1nAUfEOMecZDtvvu/0, createdBy=d7f91939785, createdName=186****0580(小山羊), createdTime=Thu Jul 06 10:14:34 CST 2017, time=2017-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219118, encodeId=d4b221911890, content=好好文章学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K1RUfOKQohib4bXhDtxVgOA9VcKY1LUZkCOmr0v3WupxANz2ibibNHkdevtSruvrhyI29IjXdtvUV48/0, createdBy=6ff82057534, createdName=139****5926, createdTime=Thu Jul 06 09:46:44 CST 2017, time=2017-07-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=219087, encodeId=ecff21908e74, content= 2014年,瑞士热带疾病与公共卫生研究所(TPH)开展了一项大规模的科学研究——暴露于交通噪音的短期与长期影响(SiRENE)。这一涵盖声学、人类生态学、心理学、人类睡眠研究和流行病学调查的跨学科项目,旨在研究道路、铁路与飞机噪音暴露对于烦躁情绪、睡眠障碍、心血管及代谢疾病的急性、短期和长期影响。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Thu Jul 06 08:20:02 CST 2017, time=2017-07-06, status=1, ipAttribution=)]
    2017-07-06 139****5926

    好好文章学习了

    0

  10. 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2014年,瑞士热带疾病与公共卫生研究所(TPH)开展了一项大规模的科学研究——暴露于交通噪音的短期与长期影响(SiRENE)。这一涵盖声学、人类生态学、心理学、人类睡眠研究和流行病学调查的跨学科项目,旨在研究道路、铁路与飞机噪音暴露对于烦躁情绪、睡眠障碍、心血管及代谢疾病的急性、短期和长期影响。, beContent=null, objectType=article, channel=null, level=null, likeNumber=103, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3wrgsNyr5lh6N2MY5xSnbvo4g5sRlc3MZoDdWpMeSdozUCPNhA96wndwQe3X5Z5oYMNxVUdOib63nw/0, createdBy=d8d11998754, createdName=Julie W, createdTime=Thu Jul 06 08:20:02 CST 2017, time=2017-07-06, status=1, ipAttribution=)]
    2017-07-06 Julie W

    2014年,瑞士热带疾病与公共卫生研究所(TPH)开展了一项大规模的科学研究——暴露于交通噪音的短期与长期影响(SiRENE)。这一涵盖声学、人类生态学、心理学、人类睡眠研究和流行病学调查的跨学科项目,旨在研究道路、铁路与飞机噪音暴露对于烦躁情绪、睡眠障碍、心血管及代谢疾病的急性、短期和长期影响。

    0

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