Investigating the effect of occupational noise exposure in the risk of atrial fibrillation: a case study among Chinese occupational populations

Purpose: This study examines the link between high occupational noise exposure and atrial fibrillation (AF), given the limited existing evidence.

Methods: We conducted a cross-sectional study among participants from a large heavy industry enterprise in China. High noise exposure was defined as an equivalent A-weighted sound level (LAeq, 8 h) of ≥ 80 dB(A) during an 8 h workday. Statistical analyses included univariate analysis to assess relationships between high noise exposure, cardiovascular risk factors, and AF. Mediation analysis identified potential mediators between high noise exposure and AF. Propensity score matching (PSM) and multivariable analysis were used to evaluate the independent association between high noise exposure and AF.

Results: A total of 4530 participants were included, with 1526 experiencing high noise exposure, and 167 diagnosed with AF. Adjusted mediation analysis revealed that sleep disorders, hypertension, dyslipidemia, and dietary quality were the primary mediators for AF among those exposed to high noise, accounting for 12.4%, 9.6%, 8.9%, and 6.7% of the effect, respectively. PSM analysis showed a significantly higher proportion of AF in individuals with high noise exposure compared to those with low exposure (5.4% vs. 3.0%, P = 0.003). Multivariable analysis indicated that the risk of AF was doubled in individuals with high noise exposure (OR = 1.99, 95% CI 1.38-2.88, P < 0.001).

Conclusion: High occupational noise exposure increases the risk of AF in the working population, acting both as an independent risk factor and through mediation effects. Sleep disorders, hypertension, dyslipidemia, and dietary quality are the main mediators. These findings highlight the importance of integrating noise control with cardiovascular health management in workplace safety policies to prevent AF among industrial workers.

Trial registration number: ChiCTR2300077951, registered on November 24, 2023, in the Chinese Clinical Trial Registry.