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目的:探讨中国人群职业性噪声暴露和心血管疾病风险的关联性。方法:于2019年12月，从东风同济队列中纳入2008年9月至2010年6月东风汽车有限公司的退休职工21 412人作为研究对象，职业性噪声暴露根据现场监测数据或工种信息进行评价；听力评估在8 931人中进行，以双耳500、1 000、2 000、4 000 Hz的平均听阈均≥25 dB定义双耳听力损失。采用logistic回归分析职业性噪声暴露、双耳听力损失和心血管疾病十年风险的关联性。结果:与无职业性噪声暴露的工人比较，职业性噪声暴露≥20年的工人心血管疾病的十年风险明显升高（n OR＝1. 20，95%n CI：1. 01~ 1.41，n P=0.001）；在性别的亚组分析中，男性工人心血管疾病的十年风险明显升高（n OR＝2. 34，95%n CI：1. 18~ 4. 66，n P<0.001），但在女性中没有统计学意义（n OR＝1. 15，95%n CI：0. 97~ 1. 37，n P=0.153）。在双耳听力损失的分析结果中，作为高噪声暴露指标，双耳听力损失与心血管疾病十年风险升高有关（n OR＝1. 17，95%n CI：1. 05~ 1. 44，n P< 0.001），且这种关联在男性（n OR＝1. 24，95%n CI：1. 07~ 2. 30，n P<0.001）、年龄≥60岁（n OR＝2. 30，95%n CI：1. 84~ 2. 88，n P<0.001）和噪声暴露人群（n OR＝1. 66，95%n CI：1. 02~ 2. 70，n P=0.001）中更加明显。n 结论:职业性噪声暴露可能是心血管疾病的危险因素。“,”Objective:To explore the association between occupational noise exposure and cardiovascular disease (CVD) risk in a large Chinese population.Methods:In December 2019, the study included 21412 retired participants from the Dongfeng-Tongji Cohort Study at baseline from September 2008 to June 2010, occupational noise exposure was evaluated through workplace noise level and/or the job titles. In a subsample of 8931 subjects, bilateral hearing loss was defined as a pure-tone mean of 25 dB or higher at 0.5, 1 , 2, and 4 kHz in both ears. Logistic regression models were used to explore the association of occupational noise exposure, bilateral hearing loss with 10-year CVD risk.Results:Compared with participants without occupational noise exposure, the 10-year CVD risk was significantly higher for noise exposure duration ≥20 years (n OR=1.20, 95%n CI:1.01-1.41 , n P=0.001) after adjusting for potential confounders. In the sex-specific analysis, the association was only statistically significant in males (n OR=2.34, 95%n CI: 1.18-4.66, n P<0.001) , but not in females (n OR=1.15, 95%n CI:0.97-1.37, n P=0.153). In the subsample analyses, bilateral hearing loss, which was an indicator for exposure to loud noise, was also associated with a higher risk of 10-year CVD (n OR= 1.17, 95% n CI:1.05-1.44, n P <0.001) , especially for participants who were males ( n OR =1.24, 95% n CI:1.07-2.30, n P<0.001) , aged equal and over 60 years old (n OR=2.30, 95%n CI: 1.84-2.88, n P<0.001) , and exposed to occupational noise (n OR=1.66, 95%n CI: 1.02-2.70, n P=0.001).n Conclusion:Occupational noise exposure may be a risk factor for CVD.