Transportation noise and risk of stroke: a nationwide prospective cohort study covering Denmark

Sørensen, Mette; Poulsen, Aslak Harbo; Hvidtfeldt, Ulla Arthur; Münzel, Thomas; Thacher, Jesse D.; Ketzel, Matthias; Brandt, Jørgen; Christensen, Jesper Heile; Levin, Gregor; Raaschou‐Nielsen, Ole

doi:10.1093/ije/dyab024

Cited by 30 publications

(27 citation statements)

References 28 publications

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“…We also modeled 10-y mean L den max and L den min exposures as categorical variables, with adjustment for Model 2 covariates. For road traffic noise, we estimated HRs for categorical exposures representing 3-dB exposure increments (corresponding to a doubling of acoustical energy) relative to reference categories of 35-< 45 dB for road L den max and 35-< 40 dB for road L den min, consistent with previous studies (Sørensen et al 2021b;Thacher et al 2021). For railway noise, we estimated HRs for 3-dB exposure categories (ranging from 35-< 38 to ≥70 dB for rail L den max, and 35-< 38 to ≥65 dB for rail L den min) relative to no exposure (i.e., using participants who had no railway noise exposure during the 10-y period as the reference group).…”

Section: Methodsmentioning

confidence: 55%

Long-Term Exposure to Transportation Noise and Risk for Type 2 Diabetes in a Nationwide Cohort Study from Denmark

Thacher

Poulsen

Hvidtfeldt

et al. 2021

Environ Health Perspect

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BACKGROUND: Epidemiologic studies have linked transportation noise to increased morbidity and mortality, particularly for cardiovascular outcomes. However, studies investigating metabolic outcomes such as diabetes are limited and have focused only on noise exposures estimated for the loudest residential façade. OBJECTIVES: We aimed to examine the influence of long-term residential exposure to transportation noise at the loudest and quietest residential façades and the risk for type 2 diabetes. METHODS: Road traffic and railway noise exposures (Lden) at the most and least exposed façades were estimated for all dwellings in Denmark during 1990-2017. Aircraft noise was estimated in 5-dB categories. Ten-year time-weighted mean noise exposures were estimated for 3:56 million individuals ≥35 years of age. From 2000 to 2017, 233,912 incident cases of type 2 diabetes were identified using hospital and prescription registries, with a mean follow-up of 12.9 y. We used Cox proportional hazards models adjusting for individual-and area-level covariates and long-term residential air pollution. The population-attributable fraction (PAF) was also computed. RESULTS: Hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes in association with 10-dB increases in 10-y mean road traffic noise at the most and least exposed façades, respectively, were 1.05 (95% CI: 1.04, 1.05) and 1.09 (95% CI: 1.08, 1.10). Following subsequent adjustment for fine particulate matter [particulate matter ≤2:5 lm in aerodynamic diameter] (10-y mean), the HRs (CIs) were 1.03 (95% CI: 1.03, 1.04) and 1.08 (95% CI: 1.07, 1.09), respectively. For railway noise, the HRs per 10-dB increase in 10-y mean exposure were 1.03 (95% CI: 1.02, 1.04) and 1.02 (95% CI: 1.01, 1.04) for the most and least exposed façades, respectively. Categorical models supported a linear exposure-outcome relationship for road traffic noise and, to a lesser extent, for railway noise. Aircraft noise >45 dB was associated with a 1-4% higher likelihood of type 2 diabetes compared with those who were unexposed. We found road traffic and railway noise associated with a PAF of 8.5% and 1.4%, respectively, of the diabetes cases. DISCUSSION: Long-term exposure to road, railway, and possibly aircraft traffic noise was associated with an increased risk of type 2 diabetes in a nationwide cohort of Danish adults. Our findings suggest that diabetes should be included when estimating the burden of disease due to transportation noise.

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Section: Methodsmentioning

confidence: 55%

Long-Term Exposure to Transportation Noise and Risk for Type 2 Diabetes in a Nationwide Cohort Study from Denmark

Thacher

Poulsen

Hvidtfeldt

et al. 2021

Environ Health Perspect

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“… 61 In agreement with our findings, a recent nationwide Danish study found road traffic noise to increase the risk of incident stroke, whereas no clear associations were observed for railway noise. 62 Studies on exposure to transportation noise and stroke are not, however, consistent, 63 64 thus indicating a need for further studies.…”

Section: Discussionmentioning

confidence: 99%

Residential exposure to transportation noise in Denmark and incidence of dementia: national cohort study

Cantuaria

Waldorff

Wermuth

et al. 2021

BMJ

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Objective To investigate the association between long term residential exposure to road traffic and railway noise and risk of incident dementia. Design Nationwide prospective register based cohort study. Setting Denmark. Participants 1 938 994 adults aged ≥60 years living in Denmark between 1 January 2004 and 31 December 2017. Main outcome measures Incident cases of all cause dementia and dementia subtypes (Alzheimer’s disease, vascular dementia, and Parkinson’s disease related dementia), identified from national hospital and prescription registries. Results The study population included 103 500 participants with incident dementia, and of those, 31 219 received a diagnosis of Alzheimer’s disease, 8664 of vascular dementia, and 2192 of Parkinson’s disease related dementia. Using Cox regression models, 10 year mean exposure to road traffic and railway noise at the most (L den max) and least (L den min) exposed façades of buildings were associated with a higher risk of all cause dementia. These associations showed a general pattern of higher hazard ratios with higher noise exposure, but with a levelling off or even small declines in risk at higher noise levels. In subtype analyses, both road traffic noise and railway noise were associated with a higher risk of Alzheimer’s disease, with hazard ratios of 1.16 (95% confidence interval 1.11 to 1.22) for road L den max ≥65 dB compared with <45 dB, 1.27 (1.22 to 1.34) for road L den min ≥55 dB compared with <40 dB, 1.16 (1.10 to 1.23) for railway L den max ≥60 dB compared with <40 dB, and 1.24 (1.17 to 1.30) for railway L den min ≥50 dB compared with <40 dB. Road traffic, but not railway, noise was associated with an increased risk of vascular dementia. Results indicated associations between road traffic L den min and Parkinson’s disease related dementia. Conclusions This nationwide cohort study found transportation noise to be associated with a higher risk of all cause dementia and dementia subtypes, especially Alzheimer’s disease.

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“…However, the study had only 13 ischaemic and 21 haemorrhagic exposed cases. Notably, studies on transportation noise have also found positive associations with ischaemic stroke (and not haemorrhagic stroke),21 22 37 and with pathophysiological risk factors for ischaemic stroke including subclinical atherosclerosis and impaired endothelial function 5. This suggests the involvement of noise in causing vascular damage, and may provide a pathophysiological basis to explain the higher risk of ischaemic stroke in relation to occupational noise exposure.…”

Section: Discussionmentioning

confidence: 97%

Occupational noise exposure and risk of incident stroke: a pooled study of five Scandinavian cohorts

et al. 2022

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ObjectivesTo investigate the association between occupational noise exposure and stroke incidence in a pooled study of five Scandinavian cohorts (NordSOUND).MethodsWe pooled and harmonised data from five Scandinavian cohorts resulting in 78 389 participants. We obtained job data from national registries or questionnaires and recoded these to match a job-exposure matrix developed in Sweden, which specified the annual average daily noise exposure in five exposure classes (LAeq8h): <70, 70–74, 75–79, 80–84, ≥85 dB(A). We identified residential address history and estimated 1-year average road traffic noise at baseline. Using national patient and mortality registers, we identified 7777 stroke cases with a median follow-up of 20.2 years. Analyses were conducted using Cox proportional hazards models adjusting for individual and area-level potential confounders.ResultsExposure to occupational noise at baseline was not associated with overall stroke in the fully adjusted models. For ischaemic stroke, occupational noise was associated with HRs (95% CI) of 1.08 (0.98 to 1.20), 1.09 (0.97 to 1.24) and 1.06 (0.92 to 1.21) in the 75–79, 80–84 and ≥85 dB(A) exposure groups, compared with <70 dB(A), respectively. In subanalyses using time-varying occupational noise exposure, we observed an indication of higher stroke risk among the most exposed (≥85 dB(A)), particularly when restricting analyses to people exposed to occupational noise within the last year (HR: 1.27; 95% CI: 0.99 to 1.63).ConclusionsWe found no association between occupational noise and risk of overall stroke after adjustment for confounders. However, the non-significantly increased risk of ischaemic stroke warrants further investigation.

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Transportation noise and risk of stroke: a nationwide prospective cohort study covering Denmark

Cited by 30 publications

References 28 publications

Long-Term Exposure to Transportation Noise and Risk for Type 2 Diabetes in a Nationwide Cohort Study from Denmark

Long-Term Exposure to Transportation Noise and Risk for Type 2 Diabetes in a Nationwide Cohort Study from Denmark

Residential exposure to transportation noise in Denmark and incidence of dementia: national cohort study

Occupational noise exposure and risk of incident stroke: a pooled study of five Scandinavian cohorts

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