A nested case-control study on association between self-reported occupational sulfur dioxide exposure and hypertension

Guoxiu Shi; Li Zhang; Yanli Liu; Xiaofei Zhang; Kang Lyu; Qin Shi; Chun Yin; Feng Kang; Yana Bai; Shan Zheng

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A nested case-control study on association between self-reported occupational sulfur dioxide exposure and hypertension

VernacularTitle:自报职业二氧化硫暴露对高血压发病影响的巢式病例对照研究
Author: Guoxiu SHI ¹ ; Li ZHANG ¹ ; Yanli LIU ¹ ; Xiaofei ZHANG ¹ ; Kang LYU ¹ ; Qin SHI ¹ ; Chun YIN ² ; Feng KANG ² ; Yana BAI ¹ ; Shan ZHENG ¹
Author Information

1. Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, China.
2. Workers' Hospital of Jinchuan Group Co. Ltd, Jinchang, Gansu 737100, China.
Publication Type:Investigation
Keywords: hypertension; sulfur dioxide; self-reported occupational exposure; nested case-control study; Jinchang cohort
From: Journal of Environmental and Occupational Medicine 2022;39(8):856-862
CountryChina
Language:Chinese
Abstract: Background Current evidence on whether occupational sulfur dioxide (SO₂) exposure affects the risk of hypertension is still limited, and the research results of the effect of environmental SO₂ exposure on risk of hypertension remain inconsistent. Objective To analyze the association between self-reported occupational exposure to SO₂ and the risk of hypertension, and the potential dose-response relationship between the years of exposure to SO₂ and the risk of hypertension. Methods Based on the Jinchang cohort, a nested case-control study design was adopted. A total of 841 newly diagnosed hypertension patients were followed up as the case group, and the control group was selected with 1∶1 individual matching based on non-occupational factors and occupational factors, respectively. The former matching conditions included age ±2 years old, same gender, working age ±2 years, and home address in the same sub-district. The latter was limited to working in the same workshop on the basis of the former conditions. Finally, the former included 717 controls and the latter included 488 controls. A unified questionnaire was used to collect general demographic characteristics, lifestyle habits, history of diabetes, family history of hypertension, and information on occupational exposure to SO₂ (self-reported history of occupational exposure to SO₂ and years of exposure to SO₂). Conditional logistic regression model was used to analyze the association between occupational exposure to SO₂ and hypertension, and the dose-response relationship between the years of SO₂ exposure and the risk of hypertension. Results In the nested case-control study matching with the non-occupational factors, the OR of hypertension in workers with self-reported occupational exposure to SO₂ was 2.39 (95%CI: 1.68-3.39); while when matching with the occupational factors, the OR of hypertension in workers with self-reported occupational exposure to SO₂ was 1.48 (95%CI: 1.04-2.12). The results of the dose-response relationship showed that as the SO₂ exposure years increased from 1-9 years, 10-19 years, 20-29 years, and 30 years and above, in the nested case-control study matching with non-occupational factors, the ORs of hypertension were 1.85 (95%CI: 0.68-5.08), 1.46 (95%CI: 0.58-3.67), 1.64 (95%CI: 1.00-2.67), and 4.95 (95%CI: 2.63-9.31), respectively; in the nested case-control study matching with occupational factors, the ORs of hypertension were 0.98 (95%CI: 0.40-2.41), 1.84 (95%CI: 0.72-4.70), 1.37 (95%CI: 0.82-2.29), and 2.44 (95%CI: 1.37-4.35), respectively. The two dose-response relationships were positive by χ² trend test (P_trend<0.05). Conclusion Self-reported occupational exposure to SO₂ is associated with the risk of hypertension in the study population, and the hypertension risk increases with the increase of SO₂ exposure years.