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OBJECTIVES: The aim of this study was to assess the joint effect of job strain and both road-traffic and occupational noise on myocardial infarction (MI). METHOD: We conducted a population based case–control study on first time MI in Stockholm County during 1992–1994. Participants answered a questionnaire and underwent a physical examination. Residential road-traffic noise exposure was based on residential history combined with information on traffic intensity and distance to nearby roads. Occupational noise exposure was assessed by occupational history combined with a job-exposure matrix derived from measurements. Job strain was based on questions regarding psychological demands and decision latitude. A total of 3050 study participants (1252 cases and 1798 controls) were included in the study. RESULTS: An increased risk of MI was indicated among participants exposed to road-traffic noise [odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.01–1.51], occupational noise (OR 1.17, 95% CI 0.98–1.41) and job strain (OR 1.39, 95% CI 1.17–1.65). Participants exposed to one, two, or three of these factors showed an increased risk (OR 1.16, 95% CI 0.97–1.40, OR 1.57, 95% CI 1.24–1.98, and OR 2.27, 95% CI 1.41–3.64, respectively). Exposure to two or three of these factors occurred among about 20% of the controls. CONCLUSION: Our results indicate that exposure to a combination of noise exposure and job strain increases the risk of MI substantially. Such exposures affect a considerable part of the population, which has relevance for prioritization of preventative measures.

Objectives The aim of this study was to assess the joint effect of job strain and both road-traffic and occupational noise on myocardial infarction (MI). Method We conducted a population based case-control study on first time Ml in Stockholm County during 1992-1994. Participants answered a questionnaire and underwent a physical examination. Residential road-traffic noise exposure was based on residential history combined with information on traffic intensity and distance to nearby roads. Occupational noise exposure was assessed by occupational history combined with a job-exposure matrix derived from measurements. Job strain was based on questions regarding psychological demands and decision latitude. A total of 3050 study participants (1252 cases and 1798 controls) were included in the study. Results An increased risk of MI was indicated among participants exposed to road-traffic noise [odds ratio (OR) 1.23, 95% confidence interval (95% CI) 1.01-1.51], occupational noise (OR 1.17, 95% CI 0.98-1.41) and job strain (OR 1.39, 95% CI 1.17-1.65). Participants exposed to one, two, or three of these factors showed an increased risk (OR 1.16, 95% CI 0.97-1.40, OR 1.57, 95% CI 1.24-1.98, and OR 2.27, 95% CI 1.41-3.64, respectively). Exposure to two or three of these factors occurred among about 20% of the controls. Conclusion Our results indicate that exposure to a combination of noise exposure and job strain increases the risk of MI substantially. Such exposures affect a considerable part of the population, which has relevance for prioritization of preventative measures. [ABSTRACT FROM AUTHOR]