Risk of cardiovascular mortality, stroke and coronary heart mortality associated with aircraft noise around Congonhas airport, São Paulo, Brazil: a small-area study

Abstract

Background Noise pollution is increasingly recognised as a public health hazard, yet limited evidence is available from low- and middle-income countries (LMIC), particularly for specific sources. Here, we investigated the association between day-night average (Ldn) aircraft noise and the risk of death due to cardiovascular disease (CVD), stroke and coronary heart disease (CHD) at small-area level around São Paulo‘s Congonhas airport, Brazil during the period 2011–2016. Methods We selected 3259 census tracts across 16 districts partially or entirely exposed to ≥50 dB aircraft noise levels around the Congonhas airport, using pre-modelled 5 dB Ldn noise bands (≤50 dB to > 65 dB). We estimated the average noise exposure per census tract using area-weighting. Age, sex and calendar year-specific death counts for CVD, stroke and CHD were calculated by census tract, according to the residential address at time of death. We fitted Poisson regression models to quantify the risk associated with aircraft noise exposure, adjusting for age, sex, calendar year and area-level covariates including socioeconomic development, ethnicity, smoking and road traffic related noise and air pollution. Results After accounting for all covariates, areas exposed to the highest levels of noise (> 65 dB) showed a relative risk (RR) for CVD and CHD of 1.06 (95% CI: 0.94; 1.20) and 1.11 (95%CI: 0.96; 1.27), respectively, compared to those exposed to reference noise levels (≤50 dB). The RR for stroke ranged between 1.05 (95%CI: 0.95;1.16) and 0.91 (95%CI: 0.78;1.11) for all the noise levels assessed. We found a statistically significant positive trend for CVD and CHD mortality risk with increasing levels of noise (p = 0.043 and p = 0.005, respectively). No significant linear trend was found for stroke. Risk estimates were generally higher after excluding road traffic density, suggesting that road traffic air and noise pollution are potentially important confounders. Conclusions This study provides some evidence that aircraft noise is associated with increased risk of CVD and CHD mortality in a middle-income setting. More research is needed to validate these results in other LMIC settings and to further explore the influence of residual confounding and ecological bias. Remarkably, 60% of the study population living near the Congonhas airport (~ 1.5 million) were exposed to aircraft noise levels > 50 dB, well above those recommended by the WHO (45 dB), highlighting the need for public health interventions.

Associations between long-term aircraft noise exposure, cardiovascular disease, and mortality in US cohorts of female nurses

“…Yet, limited research has examined associations between aircraft noise exposure and CVD. 3,5,6,[18][19][20][21][22][23][24][25][26] Within the United States, only a few studies have been conducted, in which authors found relationships between aircraft noise exposure and CVD-related events, yet were limited to zip-code-level data 18 or one time point of exposure data. [24][25][26] Furthermore, previous literature has shown mixed results when examining relationships between aircraft noise and CVD incidence, CVD mortality, and all-cause mortality.…”

“…[24][25][26] Furthermore, previous literature has shown mixed results when examining relationships between aircraft noise and CVD incidence, CVD mortality, and all-cause mortality. 3,5,6,[18][19][20][21][22][23] In a longitudinal study examining modeled annual average exposures to aircraft noise in Switzerland, the authors found positive associations between noise and mortality from myocardial infarction (MI) comparing ≥60 dB(A) with <45 dB(A), but not with all-cause or other cardiovascular-specific mortality. 19 In an updated study from Vienneau et al on the same cohort with extended years from 2000 to 2011, investigators reported associations of noise with mortality from CVD and CVD-subtype mortality.…”

Being a Fair Neighbor—Towards a Psychometric Inventory to Assess Fairness-Related Perceptions of Airports by Residents—Development and Validation of the Aircraft Noise-Related Fairness Inventory (fAIR-In)

“…The harmful health effects of aircraft noise have repeatedly been demonstrated in a large number of studies and include a wide range of different effects from annoyance due to noise [ 1 , 2 ], sleep disturbance [ 3 , 4 ], increased risks for cardiovascular diseases [ 5 , 6 , 7 ], myocardial infarction [ 8 ], hypertension [ 9 ] and coronary heart disease [ 6 ] as well as decreased mental health [ 10 ]. Annoyance and disturbance due to noise [ 1 ] can be considered as one of the most important effects of noise.…”

Aircraft Noise Distribution as a Fairness Dilemma—A Review of Aircraft Noise through the Lens of Social Justice Research

“…Exposure to aircraft noise has been associated with a variety of different adverse health outcomes [1]. These range from annoyance due to noise [2][3][4][5][6], sleep disturbance during the night [7][8][9][10][11], associations with cardiovascular diseases [12], myocardial infarction [13], coronary heart disease [14], and blood pressure [15]. The harmful effect of noise has already been demonstrated for infants and children, on health, perception, and learning, e.g., through the deterioration of reading and oral comprehension in school children [16][17][18][19].…”