Revisión sistemática y evidencia sobre exposición profesional a ruido y efectos extra-auditivos de naturaleza cardiovascular

Abstract

[ES] Trabajo de revisión que tiene como objetivo conocer el nivel de evidencia existente sobre los efectos cardiovasculares debidos a la exposición profesional al ruido, mediante el análisis sistemático de la producción científica publicada entre 1995 y 2008. La búsqueda de las referencias bibliográficas se realizó mediante términos "Major Topic" y "MeSH" para MEDLINE y términos "Decriptors" para OSH update. Se recuperaron un total de 236 referencias y se incluyeron en la revisión todos los estudios experimentales, estudios de cohortes y estudios casos control y aquellos estudios trasversales que cumplieron, al menos, con cinco de los nueve criterios que la declaración STROBE establece para los estudios observacionales. Fueron seleccionados para su revisión a texto completo un total de 23 artículos: 12 estudios transversales, 7 estudios de cohortes, dos estudios casos control, 1 meta-análisis y 1 estudio experimental. La asignación del nivel de evidencia se realizó de acuerdo a los criterios SIGN. La selección y revisión de los artículos se realizó mediante revisión por pares, los casos de discrepancia entre pares se resolvió mediante consenso. En relación con los efectos cardiovasculares de la exposición laboral a ruido, nuestra revisión encuentra un mayor nivel de evidencia (1++) para el incremento de la tensión arterial e incremento de la frecuencia cardiaca. Estudios con nivel de evidencia 2++ muestran resultados en esa misma dirección. La enfermedad isquémica, infarto agudo de miocardio y coronariopatía muestran un nivel de evidencia 2++. La alteraciones metabólicas de lípidos y alteraciones de parámetros vasculares disponen de un nivel bajo de evidencia3. El control del ruido en entornos laborales es un factor de prevención del riesgo cardio-vascular. HTA, riesgo coronario y otras enfermedades cardiovasculares deben considerarse en los protocolos de vigilancia médica específica de los trabajadores expuestos a ruido. Review aimed to identify the level of scientific evidence about the relationship between cardiovascular diseases and occupational noise exposure, by a systematic analysis of the scientific literature published between 1995 and 2008. "Major Topic" and "MeSH" terms for MEDLINE and "Decriptors" for OSH update was used for the search of references. We retrieved a total of 236 references. Experimental studies, cohort studies and case control studies were all included in the review and those cross-sectional studies with at least five of the nine criteria from the STROBE declaration provides for observational studies. 23 articles were selected for full text review: 12 cross-sectional studies, 7 cohort studies, two case control studies, 1 meta-analysis and 1 experimental study. The evidence level was performed according to SIGN criteria. The selection and review of articles was done by peer review, cases of disagreement between pairs was resolved by consensus. Our review found a higher level of evidence (1++) for increasing blood pressure and increased heart rate and occupational noise exposure. Studies with a level of evidence 2++ show results in the same direction. Ischemic heart disease, myocardial infarction and coronary diseases show a level of evidence 2++. Metabolic changes of lipid parameters and vascular abnormalities have a low level of evidence3. Noise control in working environments is a measure for cardiovascular risk prevention. Hypertension, coronary risk and other cardiovascular diseases should be considered in medical surveillance practice of workers exposed to noise.[EN] Review aimed to identify the level of scientific evidence about the relationship between cardiovascular diseases and occupational noise exposure, by a systematic analysis of the scientific literature published between 1995 and 2008. “Major Topic” and “MeSH” terms for MEDLINE and “Decriptors” for OSH update was used for the search of references. We retrieved a total of 236 references. Experimental studies, cohort studies and case control studies were all included in the review and those cross-sectional studies with at least five of the nine criteria from the STROBE declaration provides for observational studies. 23 articles were selected for full text review: 12 cross-sectional studies, 7 cohort studies, two case control studies, 1 meta-analysis and 1 experimental study. The evidence level was performed according to SIGN criteria. The selection and review of articles was done by peer review, cases of disagreement between pairs was resolved by consensus. Our review found a higher level of evidence (1++) for increasing blood pressure and increased heart rate and occupational noise exposure. Studies with a level of evidence 2++ show results in the same direction. Ischemic heart disease, myocardial infarction and coronary diseases show a level of evidence 2++. Metabolic changes of lipid parameters and vascular abnormalities have a low level of evidence 3. Noise control in working environments is a measure for cardiovascular risk prevention. Hypertension, coronary risk and other cardiovascular diseases should be considered in medical surveillance practice of workers exposed to noise.