Occupational Noise Exposure May Increase Risk of Developing Diabetes

Occupational noise exposure should be considered as one of the many environmental stressors that play a role in diabetes. 

Diabetes is a multifactorial disease caused by an integrated interaction between polygenic genetic factors and environmental factors. These environmental factors include diet, stress, lack of physical activity, and environmental stressors such as contaminated soil and water. Studies have indicated that long term exposure to noise may increase the risk of developing diabetes. The adverse effects of noise are not limited to hearing loss. Noise exposure also has a systemic impact on cardiovascular harm, putting patients at risk for hyperglycemia and diabetes.  

A meta-analysis was conducted for a systematic, comprehensive evaluation to assess the relationship between noise exposure and diabetes. A total of 817 articles were initially identified through PubMed and Web of Science. A total of 29 articles were screened for full-text upon removal of duplicate articles and excluded articles. Upon assessing the full-text articles, eight articles were utilized for the meta-analysis. The reports were from 2009 to 2019 and were found using the search terms “noise” and “diabetes.” Articles included for the study had to meet the inclusion criteria of assessing the relationship between noise exposure and diabetes, contain an odds ratio (OR) data point and a 95% confidence interval (CI) OR, and contain information on the population size. Articles were excluded if the study was not on human data, or had non-English data, incomplete data, and inadequate literature quality per the Newcastle-Ottawa Scale.  

The stata13 analysis software was utilized in the study, and a heterogeneity test was performed, assuming the articles in the meta-analysis were homogenous. If the p ≤ 0.05, then the results were deemed to be heterogeneous. If p > 0.05, then the fixed effects model was utilized. If the meta-analysis studies were not homogenous after heterogeneous analysis, then the random-effects model was adapted.  

Eight studies were utilized for the meta-analysis after screening for duplication and screening based on the inclusion and exclusion criteria. Five out of the eight studies were cohort studies, and the remaining three studies were cross-sectional studies. A total of eight articles contained 514,570 patients, and of those, 23,708 patients had diabetes. Due to low heterogeneity in both the cohort and the cross-functional studies (I2=53.1%, p =0.074 vs. I2=52%, p = 0.124, respectively), the random-effects model was used to analyze the data. An overall effect value determined the association between noise exposure and diabetes (OR = 1.08, 95% CI: 1.03-1.12). Two studies showcased a correlation between the exposure noise and an increased risk of diabetes (OR = 1,08, 95% CI: 1.04-1.12 and OR = 1.09, 95% CI: 0.89-1.34). A sensitivity analysis and publication bias was done to ensure if studies were eliminated, the results showed no statistical significance, and the results remained stable.   

Exposure to the stimulation of noise adds immediate emergency stress to the human body. This noise exposure may increase the patient’s cortisol level and increase glucagon production, putting patients at an increased risk of hyperglycemia and diabetes. Due to the correlation between noise exposure and diabetes, patients’ occupations and living conditions should be considered for diabetes management and holistic care. This meta-analysis consisted of three cohorts and five cross-sectional studies. Future analyses of more studies and larger population size should be conducted, since only eight studies were utilized in this meta-analysis.  

Practice Pearls: 

• Occupational noise may increase immediate stress to the body, putting patients at a greater chance of increased systemic cortisol level and glucagon production. 
• Social history and occupational history should be taken and updated regularly to provide holistic health care and consideration in managing patients with diabetes. 
• Patients that may face high occupational noise levels, or who live in busy cities with high noise levels, may be prone to hearing loss and should be monitored accordingly. 

Shin, Saeha, et al. “Association Between Road Traffic Noise and Incidence of Diabetes Mellitus and Hypertension Journal of the American Heart Association Dec 2020 

Wang, Huimin, et al. “Association between Noise Exposure and Diabetes: Meta-Analysis.” Environmental Science and Pollution Research,  

Shana Indawala, PharmD Candidate, University of South Florida Health, Taneja College of Pharmacy