Cardiovascular

Body mass index modifies the noise-hypertension link: a cross-sectional study in automobile workers.

Ji H, Liu D, Chen Y • PeerJ • 2026

PubMed 42965093 DOI 10.7717/peerj.21872
TL;DR

The association between occupational noise exposure duration and hypertension risk was modified by BMI in automobile manufacturing workers: it was more pronounced among normal-weight workers and was attenuated and no longer statistically significant at higher BMI levels.

Key Findings

Results

About one in five workers in the automobile manufacturing plant had hypertension.

  • 21.6% of participants had hypertension.
  • The study was a cross-sectional design among workers at an automobile manufacturing plant.
  • Demographics, occupational history, and medical examination data were collected.
Results

Longer occupational noise exposure duration was positively associated with hypertension risk.

  • Modified Poisson regression models were used to estimate prevalence ratios (PRs).
  • The abstract reports the overall association as positive; the BMI-specific estimates are given in separate findings.
Results

Continuous BMI showed a significant negative interaction with noise exposure duration on hypertension.

  • Interaction PR = 0.987, 95% CI [0.979-0.995], P = 0.001.
  • The modifying effect of continuous BMI was evaluated by adding an interaction term to the models.
Results

The noise-duration/hypertension association weakened as BMI increased and was absent at a BMI of 28.0 kg/m2.

  • At BMI 18.5 kg/m2, each additional year of noise exposure increased hypertension risk by 11.9% (PR = 1.119, 95% CI [1.047-1.196]).
  • At BMI 24.0 kg/m2, the association was attenuated but significant (PR = 1.041, 95% CI [1.008-1.075]).
  • At BMI 28.0 kg/m2, no significant association was observed (PR = 0.987, 95% CI [0.956-1.019]).
Results

The Johnson-Neyman technique identified a BMI of 27.02 kg/m2 as the threshold above which the noise-hypertension association was no longer statistically significant.

  • The technique was used to determine the point at which the association ceased to be significant across the continuous BMI range.
  • The threshold lies in the overweight range.
Results

A sensitivity analysis using binary BMI categories confirmed the effect modification.

  • The association was attenuated and not statistically significant in overweight/obese individuals but remained significant in normal-weight individuals.
  • The negative interaction between noise exposure duration and BMI remained significant (PR = 0.919, 95% CI [0.863-0.979], P = 0.010).
Conclusions

The authors conclude BMI may be an important consideration in occupational health surveillance and hypertension risk assessment for noise-exposed workers, pending longitudinal studies.

  • The cross-sectional design limits causal inference.
  • The authors state the findings warrant further longitudinal investigation.

What This Means

This study looked at workers at a car manufacturing plant to see whether years of exposure to workplace noise were linked to high blood pressure, and whether body weight (measured by BMI) changed that link. About 21.6% of the workers had hypertension. Overall, more years of noise exposure were associated with a higher likelihood of having hypertension. The link depended strongly on BMI. Among lean workers (BMI 18.5), each extra year of noise exposure was associated with about 11.9% higher hypertension risk. At a BMI of 24 the association was smaller, and at a BMI of 28 it was no longer detectable. The analysis put the cutoff at a BMI of about 27, above which the association was not statistically significant. Analyses that simply split workers into normal-weight versus overweight/obese groups gave the same pattern. This research suggests that noise-related hypertension risk may be especially visible in normal-weight workers, and that BMI could be worth considering when monitoring the health of noise-exposed workers. However, because the study captured one point in time, it cannot show cause and effect or explain why the pattern appears. The authors call for longer-term studies to confirm the findings.

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Citation

Ji H, Liu D, Chen Y. (2026). Body mass index modifies the noise-hypertension link: a cross-sectional study in automobile workers.. PeerJ. https://doi.org/10.7717/peerj.21872