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Objectives  We investigated the association between occupational noise exposure and the risk of elevated blood pressure and hypertension by stage in young adults.    Methods  We utilized 124,286 young adults (18–40 years) from the Project ELEFANT study. We categorized occupational noise exposure as  high  (75 dBA noise exposure for more than 4 hours per day) or  low , and measured blood pressure (mmHg) and categorized participants by hypertension stage (normal, elevated, Stage 1, Stage 2). We applied adjusted logistic regression models to identify associations with hypertension risk, and we further examined the noise-BMI, noise-gender, and noise-residence interactions on hypertension risk in separate models.    Results  High occupational noise exposure was associated with increases in blood pressure among participants with elevated blood pressure (Estimate = 0.23, 95% CI: 1.09, 1.46,  p  = 0.0009), in Stage 1 hypertension (Estimate = 0.15, 95% CI: 1.06, 1.25,  p  = 0.0008), and in Stage 2 hypertension (Estimate = 0.41 95% CI: 1.31, 1.73,  p< 0.0001). Likewise, noise exposure-BMI interaction was consistently positively associated with increases in blood pressure in participants with elevated blood pressure (Estimate = 0.71, 95% CI: 1.55, 2.69,  p <0.0001), in Stage 1 hypertension (Estimate = 0.78, 95% CI: 1.82, 2.61,  p <0.0001), and in Stage 2 hypertension (Estimate = 2.06, 95% CI: 5.64, 10.81,  p <0.0001). The noise exposure-male interaction showed higher risk for hypertension compared to the noise exposure-female interaction in participants with elevated blood pressure (Estimate = 1.24, 95% CI: 2.56, 4.71,  p <0.0001), Stage 1 (Estimate = 1.67, 95% CI: 4.34, 6.42,  p <0.0001) and Stage 2 hypertension (Estimate = 1.70, 95% CI: 3.86, 7.77,  p <0.0001). Finally, we found that noise exposure-urban interaction was consistently associated with an increase in blood pressure in elevated blood pressure (Estimate = 0.32, 95% CI: 1.19, 1.62,  p <0.0001) and in Stage 2 hypertension (Estimate = 0.44, 95% CI: 1.31, 1.80,  p <0.0001).

Occupational noise exposure is associated with hypertension in China: Results from project ELEFANT