Long-term residential road traffic noise and NO2 exposure in relation to risk of incident myocardial infarction - A Danish cohort study

The impact of co-exposure to air and noise pollution on the incidence of metabolic syndrome from a health checkup cohort

Previous studies have found associations between the incidence of metabolic syndrome (MetS) and exposure to air pollution or road traffic noise. However, investigations on environmental co-exposures are limited. This study aimed to investigate the association between co-exposure to air pollution and road traffic noise and MetS and its subcomponents. Participants living in Taipei City who underwent at least two health checkups between 2010 and 2016 were included in the study. Data were sourced from the MJ Health database, a longitudinal, large-scale cohort in Taiwan. The monthly traffic noise exposure (Lden and Lnight) was computed using a dynamic noise map. Monthly fine particulate data at one kilometer resolution were computed from satellite imagery data. Cox proportional hazards regression models with month as the underlying time scale were used to estimate hazard ratios (HRs) for the impact of PM2.5 and road traffic noise exposure on the risk of developing MetS or its subcomponents. Data from 10,773 participants were included. We found significant positive associations between incident MetS and PM2.5 (HR: 1.88; 95% CI 1.67, 2.12), Lden (HR: 1.10; 95% CI 1.06, 1.15), and Lnight (HR: 1.07; 95% CI 1.02, 1.13) in single exposure models. Results further showed significant associations with an elevated risk of incident MetS in co-exposure models, with HRs of 1.91 (95% CI 1.69, 2.16) and 1.11 (95% CI 1.06, 1.16) for co-exposure to PM2.5 and Lden, and 1.90 (95% CI 1.68, 2.14) and 1.08 (95% CI 1.02, 1.13) for co-exposure to PM2.5 and Lnight. The HRs for the co-exposure models were higher than those for models with only a single exposure. This study provides evidence that PM2.5 and noise exposure may elevate the risk of incident MetS and its components in both single and co-exposure models. Therefore, preventive approaches to mitigate the risk of MetS and its subcomponents should consider reducing exposure to PM2.5 and noise pollution.

California's zero-emission vehicle adoption brings air quality benefits yet equity gaps persist

Zero-emission vehicle (ZEV) adoption is a key climate mitigation tool, but its environmental justice implications remain unclear. Here, we quantify ZEV adoption at the census tract level in California from 2015 to 2020 and project it to 2035 when all new passenger vehicles sold are expected to be ZEVs. We then apply an integrated traffic model together with a dispersion model to simulate air quality changes near roads in the Greater Los Angeles. We found that per capita ZEV ownership in non-disadvantaged communities (non-DACs) as defined by the state of California is 3.8 times of that in DACs. Racial and ethnic minorities owned fewer ZEVs regardless of DAC designation. While DAC residents receive 40% more pollutant reduction than non-DACs due to intercommunity ZEV trips in 2020, they remain disproportionately exposed to higher levels of traffic-related air pollution. With more ZEVs in 2035, the exposure disparity narrows. However, to further reduce disparities, the focus must include trucks, emphasizing the need for targeted ZEV policies that address persistent pollution burdens among DAC and racial and ethnic minority residents.

Long-Term Exposure to Ambient PM2.5 and Hospitalizations for Myocardial Infarction Among US Residents: A Difference-in-Differences Analysis

Background Air pollution has been recognized as an untraditional risk factor for myocardial infarction (MI). However, the MI risk attributable to long-term exposure to fine particulate matter ≤2.5 μm in aerodynamic diameter (PM2.5) is unclear, especially in younger populations, and few studies have represented the general population or had power to examine comorbidities. Methods and Results We applied the difference-in-differences approach to estimate the relationship between annual PM2.5 exposure and hospitalizations for MI among US residents and further identified potential susceptible subpopulations. All hospital admissions for MI in 10 US states over the period 2002 to 2016 were obtained from the Healthcare Cost and Utilization Project State Inpatient Database. In total, 1 914 684 MI hospital admissions from 8106 zip codes were included in this study. We observed a 1.35% (95% CI, 1.11-1.59) increase in MI hospitalization rate for 1-μg/m3 increase in annual PM2.5 exposure. The estimate was robust to adjustment for surface pressure, relative humidity, and copollutants. In the population exposed to ≤12 μg/m3, there was a larger increment of 2.17% (95% CI, 1.79-2.56) in hospitalization rate associated with 1-μg/m3 increase in PM2.5. Young people (0-34 years of age) and elderly people (≥75 years of age) were the 2 most susceptible age groups. Residents living in more densely populated or poorer areas and individuals with comorbidities were observed to be at a greater risk. Conclusions This study indicates long-term residential exposure to PM2.5 could increase risk of MI among the general US population, people with comorbidities, and poorer individuals. The association persists below current standards.

Does air pollution confound associations between environmental noise and cardiovascular outcomes? - A systematic review

BACKGROUND

Exposure to environmental noise is associated with adverse health effects, but there is potential for confounding and interaction with air pollution, particularly where both exposures arise from the same source, such as transport.

OBJECTIVES

To review evidence on confounding and interaction of air pollution in relation to associations between environmental noise and cardiovascular outcomes.

METHODS

Papers were identified from similar reviews published in 2013 and 2015, from the systematic reviews supporting the WHO 2018 noise guidelines, and from a literature search covering the period 2016-2022 using Medline and PubMed databases. Additional papers were identified from colleagues. Study selection was according to PECO inclusion criteria. Studies were evaluated against the WHO checklist for risk of bias.

RESULTS

52 publications, 36 published after 2015, were identified that assessed associations between transportation noise and cardiovascular outcomes, that also considered potential confounding (49 studies) or interaction (23 studies) by air pollution. Most, but not all studies, suggested that the associations between traffic noise and cardiovascular outcomes are independent of air pollution. NO2 or PM2.5 were the most commonly included air pollutants and we observed no clear differences across air pollutants in terms of the potential confounding role. Most papers did not appear to suggest an interaction between noise and air pollution. Eight studies found the largest noise effect estimates occurring within the higher noise and air pollution exposure categories, but were not often statistically significant.

CONCLUSION

Whilst air pollution does not appear to confound associations of noise and cardiovascular health, more studies on potential interactions are needed. Current methods to assess quality of evidence are not optimal when evaluating evidence on confounding or interaction.

Can traffic-related air pollution trigger myocardial infarction within a few hours of exposure? Identifying hourly hazard periods

INTRODUCTION

Traffic-related air pollution can trigger myocardial infarction (MI). However, the hourly hazard period of exposure to nitrogen dioxide (NO2), a common traffic tracer, for incident MI has not been fully evaluated. Thus, the current hourly US national air quality standard (100 ppb) is based on limited hourly-level effect estimates, which may not adequately protect cardiovascular health.

OBJECTIVES

We characterized the hourly hazard period of NO2 exposure for MI in New York state (NYS), USA, from 2000 to 2015.

METHODS

For nine cities in NYS, we obtained data on MI hospitalizations from the NYS Department of Health Statewide Planning and Research Cooperative System and hourly NO2 concentrations from the US Environmental Protection Agency's Air Quality System database. We used city-wide exposures and a case-crossover study design with distributed lag non-linear terms to assess the relationship between hourly NO2 concentrations over 24 h and MI, adjusting for hourly temperature and relative humidity.

RESULTS

The mean NO2 concentration was 23.2 ppb (standard deviation: 12.6 ppb). In the six hours preceding MI, we found linearly increased risk with increasing NO2 concentrations. At lag hour 0, a 10 ppb increase in NO2 was associated with 0.2 % increased risk of MI (Rate Ratio [RR]: 1.002; 95 % Confidence Interval [CI]: 1.000, 1.004). We estimated a cumulative RR of 1.015 (95 % CI: 1.008, 1.021) for all 24 lag hours per 10 ppb increase in NO2. Lag hours 2-3 had consistently elevated risk ratios in sensitivity analyses.

CONCLUSIONS

We found robust associations between hourly NO2 exposure and MI risk at concentrations far lower than current hourly NO2 national standards. Risk of MI was most elevated in the six hours after exposure, consistent with prior studies and experimental work evaluating physiologic responses after acute traffic exposure. Our findings suggest that current hourly standards may be insufficient to protect cardiovascular health.

Long-Term Exposure to Traffic Noise and Risk of Incident Cardiovascular Diseases: a Systematic Review and Dose-Response Meta-Analysis

While noise pollution from transportation has become an important public health problem, the relationships between different sources of traffic noise and cardiovascular diseases (CVDs) remain inconclusive. A comprehensive meta-analysis was therefore conducted to quantitatively assess the effects of long-term exposure to road traffic, railway, and aircraft noise on CVDs and relevant subtypes. We systematically retrieved PubMed, Embase, and Web of Science for articles published before April 4, 2022. Summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated by the fixed- or random-effects models. In total, 23 articles were included in our meta-analysis. The risk of CVDs increased by 2% (RR 1.020, 95% CI 1.006-1.035) and 1.6% (RR 1.016, 95% CI 1.000-1.032) for every 10 dB increment of road traffic and aircraft noise. For CVD subtypes, the risk increased by 3.4% (1.034, 1.026-1.043) for stroke and 5% (1.050, 1.006-1.096) for heart failure with each 10 dB increment of road traffic noise; the risk of atrial fibrillation increased by 1.1% (1.011, 1.002-1.021) with each 10 dB increment of railway noise; and the risk increased by 1% (1.010, 1.003-1.017) for myocardial infarction, 2.7% (1.027, 1.004-1.050) for atrial fibrillation, and 2.3% (1.023, 1.016-1.030) for heart failure with each 10 dB increment in aircraft noise. Further, effects from road traffic, railway, and aircraft noise all followed positive linear trends with CVDs. Long-term exposure to traffic noise is positively related to the incidence risk of cardiovascular events, especially road traffic noise which significantly increases the risk of CVDs, stroke, and heart failure.

The association between air pollution and the daily hospital visits for atrial fibrillation recorded by ECG: a cross-sectional study

BACKGROUND

The relationship between air pollution and atrial fibrillation (AF) recorded by electrocardiograph (ECG) has not yet been illustrated which worsens AF precaution and treatment. This research evaluated the association between air pollution and daily hospital visits for AF with ECG records.

METHODS

The study enrolled 4933 male and 5392 female patients whose ECG reports indicated AF from 2015 to 2018 in our hospital. Such data were then matched with meteorological data, including air pollutant concentrations, collected by local weather stations. A case-crossover study was performed to assess the relationship between air pollutants and daily hospital visits for AF recorded by ECG and to investigate its lag effect.

RESULTS

Our analysis revealed statistically significant associations between AF occurrence and demographic data, including age and gender. This effect was stronger in female (k = 0.02635, p < 0.01) and in patients over 65 y (k = 0.04732, p < 0.01). We also observed a hysteretic effect that when exposed to higher nitrogen dioxide(NO2), counting AF cases recorded by ECG may elevate at lag 0 with a maximum odds ratio(OR) of 1.038 (95% CI 1.014-1.063), on the contrary, O3 reduced the risk of daily visits for AF and its maximum OR was at lag 2, and the OR value was 0.9869 (95% CI 0.9791-0.9948). Other air pollutants such as PM2.5, PM10, and SO2 showed no clear relationship with the recorded AF.

CONCLUSION

The associations between air pollution and AF recorded with ECG were preliminarily discovered. Short-term exposure to NO2 was significantly associated with daily hospital visits for AF management.

Source-Specific Air Pollution Including Ultrafine Particles and Risk of Myocardial Infarction: A Nationwide Cohort Study from Denmark

BACKGROUND

Air pollution is negatively associated with cardiovascular health. Impediments to efficient regulation include lack of knowledge about which sources of air pollution contributes most to health burden and few studies on effects of the potentially more potent ultrafine particles (UFP).

OBJECTIVE

The authors aimed to investigate myocardial infarction (MI) morbidity and specific types and sources of air pollution.

METHODS

We identified all persons living in Denmark in the period 2005-2017, age >50 y and never diagnosed with MI. We quantified 5-y running time-weighted mean concentrations of air pollution at residencies, both total and apportioned to traffic and nontraffic sources. We evaluated particulate matter (PM) with aerodynamic diameter ≤2.5μm (PM2.5), <0.1μm (UFP), elemental carbon (EC), and nitrogen dioxide (NO2). We used Cox proportional hazards models, with adjustment for time-varying exposures, and personal and area-level demographic and socioeconomic covariates from high-quality administrative registers.

RESULTS

In this nationwide cohort of 1,964,702 persons (with 18 million person-years of follow-up and 71,285 cases of MI), UFP and PM2.5 were associated with increased risk of MI with hazard ratios (HRs) per interquartile range (IQR) of 1.040 [95% confidence interval (CI): 1.025, 1.055] and 1.053 (95% CI: 1.035, 1.071), respectively. HRs per IQR of UFP and PM2.5 from nontraffic sources were similar to the total (1.034 and 1.051), whereas HRs for UFP and PM2.5 from traffic sources were smaller (1.011 and 1.011). The HR for EC from traffic sources was 1.013 (95% CI: 1.003, 1.023). NO2 from nontraffic sources was associated with MI (HR=1.048; 95% CI: 1.034, 1.062) but not from traffic sources. In general, nontraffic sources contributed more to total air pollution levels than national traffic sources.

CONCLUSIONS

PM2.5 and UFP from traffic and nontraffic sources were associated with increased risk of MI, with nontraffic sources being the dominant source of exposure and morbidity. https://doi.org/10.1289/EHP10556.

Air pollution and myocardial infarction; effect modification by sociodemographic and environmental factors. A cohort study from Denmark

Air pollution is associated with increased risk of myocardial infarction (MI), but it is unresolved to what extent the association is modified by factors such as socioeconomic status, comorbidities, financial stress, residential green space, or road traffic noise. We formed a cohort of all (n = 1,964,702) Danes, aged 50-85 years, with 65,311 cases of MI during the followed-up period 2005-2017. For all participants we established residential five-year running average exposure to particulate matter <2.5  μm (PM_2.5), ultrafine particles (UFP, <0.1  μm), elemental carbon (EC) and nitrogen dioxide (NO₂). We evaluated risk in population strata, using Aalen additive hazards models to estimate absolute risk and Cox proportional hazards models to estimate relative risk of MI with 95% confidence intervals (CI). PM_2.5 and the other pollutant were associated with MI. Lower education and lower income were associated with higher absolute risks of MI from air pollution, whereas no clear effect modification was apparent for relative risk estimates. For example, 5 μg/m³ higher PM_2.5 was associated with HR for MI of 1.16 (95% CI: 1.10-1.22) among those with only mandatory education and 1.13 (95% CI: 1.03-1.24) among those with long education. The corresponding rate differences per 100,000 person years were 243 (95% CI: 216-271) and 358 (95% CI: 338-379), respectively. Higher level of comorbidity was consistently across all four pollutants associated with both higher absolute and relative risk of MI. In conclusion, people with comorbid conditions or of lower SES appeared more vulnerable to long-term exposure to air pollution and more cases of MI may be prevented by focused interventions in these groups.

The combined effect of air and transportation noise pollution on atherosclerotic inflammation and risk of cardiovascular disease events

BACKGROUND

Air pollution and noise exposures individually associate with major adverse cardiovascular events (MACE) via a mechanism involving arterial inflammation (ArtI); however, their combined impact on ArtI and MACE remains unknown. We tested whether dual (vs. one or neither) exposure associates with greater ArtI and MACE risk and whether MACE risk is mediated via ArtI.

METHODS

Individuals (N = 474) without active cancer or known cardiovascular disease with clinical 18F-FDG-PET/CT imaging were followed for 5 years for MACE. ArtI was measured. Average air pollution (particulate matter ≤ 2.5 μm, PM2.5) and transportation noise exposure were determined at individual residences. Higher exposures were defined as noise > 55 dBA (World Health Organization cutoff) and PM2.5 ≥ sample median.

RESULTS

At baseline, 46%, 46%, and 8% were exposed to high levels of neither, one, or both pollutants; 39 experienced MACE over a median 4.1 years. Exposure to an increasing number of pollutants associated with higher ArtI (standardized β [95% CI: .195 [.052, .339], P = .008) and MACE (HR [95% CI]: 2.897 [1.818-4.615], P < .001). In path analysis, ArtI partially mediated the relationship between pollutant exposures and MACE (P < .05).

CONCLUSION

Air pollution and transportation noise exposures contribute incrementally to ArtI and MACE. The mechanism linking dual exposure to MACE involves ArtI.

Association between exposure to multiple air pollutants, transportation noise and cause-specific mortality in adults in Switzerland

BACKGROUND

Long-term exposure to air pollution and noise is detrimental to health; but studies that evaluated both remain limited. This study explores associations with natural and cause-specific mortality for a range of air pollutants and transportation noise.

METHODS

Over 4 million adults in Switzerland were followed from 2000 to 2014. Exposure to PM_2.5, PM_2.5 components (Cu, Fe, S and Zn), NO₂, black carbon (BC) and ozone (O₃) from European models, and transportation noise from source-specific Swiss models, were assigned at baseline home addresses. Cox proportional hazards models, adjusted for individual and area-level covariates, were used to evaluate associations with each exposure and death from natural, cardiovascular (CVD) or non-malignant respiratory disease. Analyses included single and two exposure models, and subset analysis to study lower exposure ranges.

RESULTS

During follow-up, 661,534 individuals died of natural causes (36.6% CVD, 6.6% respiratory). All exposures including the PM_2.5 components were associated with natural mortality, with hazard ratios (95% confidence intervals) of 1.026 (1.015, 1.038) per 5 µg/m³ PM_2.5, 1.050 (1.041, 1.059) per 10 µg/m³ NO₂, 1.057 (1.048, 1.067) per 0.5 × 10^-5/m BC and 1.045 (1.040, 1.049) per 10 dB Lden total transportation noise. NO₂, BC, Cu, Fe and noise were consistently associated with CVD and respiratory mortality, whereas PM_2.5 was only associated with CVD mortality. Natural mortality associations persisted < 20 µg/m³ for PM_2.5 and NO₂, < 1.5 10^-5/m BC and < 53 dB Lden total transportation noise. The O₃ association was inverse for all outcomes. Including noise attenuated all outcome associations, though many remained significant. Across outcomes, noise was robust to adjustment to air pollutants (e.g. natural mortality 1.037 (1.033, 1.042) per 10 dB Lden total transportation noise, after including BC).

CONCLUSION

Long-term exposure to air pollution and transportation noise in Switzerland contribute to premature mortality. Considering co-exposures revealed the importance of local traffic-related pollutants such as NO₂, BC and transportation noise.

Long-Term Exposure to Transportation Noise and Ischemic Heart Disease: A Pooled Analysis of Nine Scandinavian Cohorts

BACKGROUND

Transportation noise may induce cardiovascular disease, but the public health implications are unclear.

OBJECTIVES

The study aimed to assess exposure-response relationships for different transportation noise sources and ischemic heart disease (IHD), including subtypes.

METHODS

Pooled analyses were performed of nine cohorts from Denmark and Sweden, together including 132,801 subjects. Time-weighted long-term exposure to road, railway, and aircraft noise, as well as air pollution, was estimated based on residential histories. Hazard ratios (HRs) were calculated using Cox proportional hazards models following adjustment for lifestyle and socioeconomic risk factors.

RESULTS

A total of 22,459 incident cases of IHD were identified during follow-up from national patient and mortality registers, including 7,682 cases of myocardial infarction. The adjusted HR for IHD was 1.03 [95% confidence interval (CI) 1.00, 1.05] per 10 dB Lden for both road and railway noise exposure during 5 y prior to the event. Higher risks were indicated for IHD excluding angina pectoris cases, with HRs of 1.06 (95% CI: 1.03, 1.08) and 1.05 (95% CI: 1.01, 1.08) per 10 dB Lden for road and railway noise, respectively. Corresponding HRs for myocardial infarction were 1.02 (95% CI: 0.99, 1.05) and 1.04 (95% CI: 0.99, 1.08). Increased risks were observed for aircraft noise but without clear exposure-response relations. A threshold at around 55 dB Lden was suggested in the exposure-response relation for road traffic noise and IHD.

DISCUSSION

Exposure to road, railway, and aircraft noise in the prior 5 y was associated with an increased risk of IHD, particularly after exclusion of angina pectoris cases, which are less well identified in the registries. https://doi.org/10.1289/EHP10745.

Urbanicity-Perspectives from Neuroscience and Public Health: A Scoping Review

Urban residency is associated with exposure to environmental factors, which can influence health in many ways. Neuroscientific research, as well as Public Health research, aim towards broadening evidence in the field of Urban Health. However, it is unclear whether the association between urban living and mental illnesses is causal rather than explainable by other selective effects. This review seeks to gather information on the current evidence regarding urban living and neurological outcomes to demonstrate how Public Health and Neuroscience could complement each other in the field of Urban Health. A scoping review was conducted in four electronic databases according to the PRISMA-statement guidelines. 25 empirical studies were included. Outcomes such as schizophrenia and psychotic disorders, social and cognitive functioning were scrutinised. Evidence was found for alteration of brain functioning and brain structure. Most studies researching cognitive functioning or cognitive decline displayed possible protective effects of urban living compared to rural living. The different study designs in Public Health and Neuroscience could profit from each other. Although the comparability of studies is limited by the inconsistent assessments of urbanity. Synergies and potentials to combine aspects of Public Health and Neuroscience in the field of Urban Health to improve population health became apparent.

Short-term associations between ambient air pollution and emergency department visits for Alzheimer's disease and related dementias

Dementia is a seriously disabling illness with substantial economic and social burdens. Alzheimer's disease and its related dementias (AD/ADRD) constitute about two-thirds of dementias. AD/ADRD patients have a high prevalence of comorbid conditions that are known to be exacerbated by exposure to ambient air pollution. Existing studies mostly focused on the long-term association between air pollution and AD/ADRD morbidity, while very few have investigated short-term associations. This study aims to estimate short-term associations between AD/ADRD emergency department (ED) visits and three common air pollutants: fine particulate matter (PM_2.5), nitrogen dioxide (NO₂), and warm-season ozone.

Methods

For the period 2005 to 2015, we analyzed over 7.5 million AD/ADRD ED visits in five US states (California, Missouri, North Carolina, New Jersey, and New York) using a time-stratified case-crossover design with conditional logistic regression. Daily estimated PM_2.5, NO_2, and warm-season ozone concentrations at 1 km spatial resolution were aggregated to the ZIP code level as exposure.

Results

The most consistent positive association was found for NO₂. Across five states, a 17.1 ppb increase in NO₂ concentration over a 4-day period was associated with a 0.61% (95% confidence interval = 0.27%, 0.95%) increase in AD/ADRD ED visits. For PM_2.5, a positive association with AD/ADRD ED visits was found only in New York (0.64%, 95% confidence interval = 0.26%, 1.01% per 6.3 µg/m³). Associations with warm-season ozone levels were null.

Conclusions

Our results suggest AD/ADRD patients are vulnerable to short-term health effects of ambient air pollution and strategies to lower exposure may reduce morbidity.

Air quality trends in rural India: analysis of NO2 pollution using satellite measurements

India is a country with more than 67% of its population (947 million) residing in rural areas and 33% in urban areas (472 million) as of 2020. Therefore, health of the people living in rural India is very important for its future development plans, economy and growth. Here, we analyse the rural air quality using satellite measurements of NO₂ in India, as the sources of NO₂ are well connected to the industrial and economic uplift of a nation. Our analyses for the rural regions show distinct seasonal changes with the highest value (2.0 × 10¹⁵ molecules per cm²) in winter and the lowest in monsoon (1.5 × 10¹⁵ molecules per cm²) seasons. About 41% of the total NO₂ pollution in India is from its rural sources, but 59% of the urban sources were focused in the past studies. In addition, around 45% of the rural NO₂ pollution is due to road transport, whereas more than 90% of it in urban India comes from the power sector. Our assessment shows that the NO₂ exposure in rural regions is as serious as that in urban areas, indicating the need for more effective reduction of population exposure and protection of public health. Henceforth, this study reveals that rural India is gradually getting polluted from its nearby regions as well as from the new sources within. This is a big concern for the public health of the large rural population of India.

Acute ambulatory blood pressure response to short-term black carbon exposure: The MobiliSense sensor-based study

Documented relationships between black carbon (BC) exposure and blood pressure (BP) have been inconsistent. Very few studies measured both BC exposure and ambulatory BP across the multiple daily environments visited in the general population, and none adjusted for personal noise exposure, a major confounder. Our study addresses these gaps by considering 245 adults living in the Grand Paris region. Personal exposure to BC was monitored for 2 days using AE51 microaethalometers. Ambulatory BP was measured every 30 min after waking up using Arteriograph 24 monitors (n = 6772). Mixed effect models with a random intercept at the individual level and time-autocorrelation structure adjusted for personal noise exposure were used to evaluate the associations between BC exposure (averaged from 5 min to 1 h before each BP measurement) and BP. To increase the robustness of findings, we eliminated confounding by unmeasured time-invariant personal variables, by modelling the associations with fixed-effect models. All models were adjusted for potential confounders and short-term time trends. Results from mixed models show that a 1-μg/m³ increase in 5-minute averaged BC exposure was associated with an increase of 0.57 mmHg in ambulatory systolic blood pressure (SBP) (95 % CI: 0.30, 0.83) and with an increase of 0.36 mmHg in diastolic blood pressure (DBP) (95 % CI: 0.14, 0.58). The slope of the exposure-response relationship gradually decreased for both SBP and DBP with the increase in the averaging period of BC exposure from 5 min to 1 h preceding each BP measurement. Findings from the fixed-effect models were consistent with these results. There was no effect modification by noise in the associations, across all exposure windows. We found evidence of a relationship between BC exposure and acute increase in ambulatory SBP and DBP after adjustment for personal noise exposure, with potential implications for the development of adverse cardiovascular outcomes.

Environmental noise-induced cardiovascular, metabolic and mental health disorders: a brief review

BACKGROUND

Environmental noise is a pervasive pollutant that is one of the greatest environmental threats to mental, physiological and psychological well-being and has a significant global health burden associated with it. Many epidemiological studies indicate long-term relationship of noise pollution with wide range of metabolic, cardio-vascular and respiratory disorders and diseases.

OBJECTIVE

The goal of this study was to thoroughly analyse available literature on public health implications and various underlying biological mechanisms associated with ambient noise exposure, taking into account both objective and subjective measures of noise exposure.

METHODS

A search of literature for review on environmental noise and associated cardiovascular, mental health and metabolic implications on human health was done using Web of Science, Google Scholar and PubMed databases.

DISCUSSION

Experimental studies indicate that noise exposure leads to endocrine effects, increased incidence of diabetes, impairment of cognitive performance, sleep disturbance and annoyance. Epidemiological evidence indicates that high levels of noise, particularly at night, may cause arterial hypertension and endothelial dysfunction due to higher level of stress hormones and oxidative stress. An increased incidence of cardio-vascular diseases like myocardial infarction, heart rate, ischemic heart disease, stroke and heart failure is associated with noise-induced mental stress. Furthermore, psychological and mental health issues like anxiety and depression are also related with exposure to noise pollution.

CONCLUSION

This article summarises a comprehensive and systematic knowledge established in recent noise research with the spotlight on cardiovascular, metabolic and mental health disorders of environmental noise, providing unique understanding into underlying mechanisms.

A comprehensive experimental study of the influence of temperature on urban road traffic noise under real-world conditions

The effect of road traffic noise in urban environments is an issue of social and scientific interest, due to its public health and economic impacts. Scientific literature showed a decrease in the level of tyre/road noise generated as temperature increases, but usually under standardised traffic conditions in non-urban environments. Based on a wide network for the hourly monitoring of road traffic flow, air temperature and noise levels across the city of Madrid (Spain), this work proposes and applies a new experimental methodology for studying the dependence of urban road traffic noise on temperature. This study was conducted under real-world traffic conditions involving a wide variability in urban configurations and in the type and state of preservation of vehicles, tires and pavements. From the analysis of data for a whole year, a time interval was identified (from Tuesday to Thursday and between 8 a.m. and 8 p.m.) in which the variability in road traffic flow for the whole city of Madrid was stable enough to allow for a linear regression study between temperature and noise levels from urban road traffic. The relationships found were highly significant (p ≤ 0.001) for data from all the noise monitoring stations, with values of higher than 20% and up to 42% for the explanation of the variability in the measured noise levels by temperature at most of the measurement points. The values of the slope coefficients at the noise monitoring stations ranged from -0.036 to -0.125 dB/°C, with an average value of -0.090 ± 0.011 dB/°C. These results are within the range of values reported in the scientific literature for experimental tests conducted under conditions of controlled or free-flowing traffic.

Risk Associations between Vehicular Traffic Noise Exposure and Cardiovascular Diseases: A Residential Retrospective Cohort Study

Environmental noise can induce detrimental health effects such as cardiovascular disease (CVD). The relationship between vehicular traffic noise pollution and CVD was investigated through a retrospective residential cohort study in the city of Pisa. Four exposure classes were defined for noise pollution, using noise propagation maps. The association between noise exposures and cause-specific mortality or hospitalization of the subjects of the cohort was calculated using the hazard ratio (HR) for night and day through a multiple time-dependent and sex-specific Cox regression adjusting for age, the socio-economic deprivation index, and traffic air pollution. Mortality excess for CVD and risk trends for a 1 decibel noise increment were observed among the most exposed women (mortality: HRnight_class4 1.15 (1.03-1.28); Trend_night 1.007 (1.002-1.012); HRday_class4 1.14 (1.02-1.27); Trend_day 1.008 (1.003-1.013)), particularly for ischaemic disease (mortality: Trend_night 1.008 (0.999-1.017); Trend_day 1.009 (0.999-1.018)) and cerebrovascular disease (mortality: HRnight_class3 1.23 (1.02-1.48), HRday_class3 1.24 (1.03-1.49)). Hospitalization analyses confirm mortality results. A decreased risk for hospitalization was also observed among the most exposed men (HRday_class4 0.94 (0.88-1.01), particularly for ischaemic disease (HRnight_class4 0.90 (0.80-1.02); HRday_class4 0.86 (0.77-0.97)) and cerebrovascular disease (HRnight_class4 0.89 (0.78-1.01)). Authors recommend the adoption of prevention measures aimed at mitigating noise and the activation of a monitoring of the risk profile in the Pisa population updating both the residential cohort and health data.

Exposure to transportation noise and risk for cardiovascular disease in a nationwide cohort study from Denmark

BACKGROUND

Transportation noise increases the risk of ischemic heart disease (IHD), but few studies have investigated subtypes of IHD, such as myocardial infarction (MI), angina pectoris, or heart failure. We aimed to study whether exposure to road, railway and aircraft noise increased risk for ischemic heart disease (IHD), IHD subtypes, and heart failure in the entire adult Danish population, investigating exposures at both maximum exposed and silent façades of each residence.

METHODS

We modelled road, railway, and aircraft noise at the most and least exposed façades for the period 1995-2017 for all addresses in Denmark and calculated 10-year time-weighted running means for 2.5 million individuals age ≥50 years, of whom 122,523 developed IHD and 79,358 developed heart failure during follow-up (2005-2017). Data were analyzed using Cox proportional hazards models, adjusted for individual and area-level sociodemographic covariates and air pollution.

RESULTS

We found road traffic noise at the most exposed façade (L_den) to be associated with higher risk of IHD, myocardial infarction (MI), angina pectoris, and heart failure, with hazard ratios (HRs) (95% confidence intervals (CI)) of 1.052 (1.044-1.059), 1.041 (1.032-1.051), 1.095 (1.071-1.119), and 1.039 (1.033-1.045) per 10 dB higher 10-year mean exposure, respectively. These associations followed a near-linear exposure-response relationship and were robust to adjustment for air pollution with PM_2.5. Railway noise at the least exposed façade was associated with heart failure (HR 1.28; 95% CI: 1.004-1.053), but not the other outcomes. Exposure to aircraft noise (>45 dB) seemed associated with increased risk for MI and heart failure.

CONCLUSIONS

We found road traffic noise and potentially railway and aircraft noise to increase risk of various major cardiovascular outcomes, highlighting the importance of preventive actions towards transportation noise.

Application of University Campus Noise Map Based on Noise Propagation Model: A Case in Guangxi University

Considering the characteristics of a campus environment and the rules that govern outdoor sound propagation, this paper identifies traffic noise as the dominant noise source of the campus environment based on the measurement of the noise environment. A noise propagation model that is suitable for university campuses was developed and used it was to create a noise map of the ambient area of the teaching building on the campus of Guangxi University. This noise map was then utilized to analyze the noise environment. The results revealed that for a given teaching building, the noise disturbance on high-rise classrooms is more significant compared to the impact on low-rise classrooms. Attention should then be paid to noise control in the high-rise classroom of the building. By appropriately increasing the distance between the building and the main traffic road or by adopting a judicious soundscape design that considers the shape of the building, it is possible to effectively reduce the interference of noise during teaching activities in a building and improve the sound quality of the campus environment. The results of this study provide a theoretical framework for the governance of the campus acoustic environment.

Noise exposure and risk of myocardial infarction incidence and mortality: a dose-response meta-analysis

The strength and shape of the dose-response relationship between different types of noise and myocardial infarction (MI) remain unclear. Therefore, we aimed to summarize the evidence of the association between various types of noise and MI incidence and mortality through a dose-response meta-analysis. We performed a systematic search of the PubMed, Embase, and Web of Science databases up to December 19, 2021. The generalized least-squares method and restricted cubic splines were used to assess the potential linear and nonlinear dose-response relationships between noise exposure and the risk of MI events. Twenty observational studies with 34 reports met the eligibility criteria. In the linear models, the pooled relative risk and corresponding 95% confidence interval (CI) for MI incidence was 1.04 (95% CI: 1.02 - 1.05), and the MI mortality was 1.02 (95% CI: 1.02 - 1.03) for each 10 dB(A) increase in noise exposure. In addition, we observed an approximately J-shaped dose-response relationship between noise and MI mortality (P_nonlinearity = 0.0037), whereas the threshold for the statistical impact of noise on MI mortality may be 42 dB(A). Our findings support the notion that various types of noise exposure have a positive dose-response relationship with the risk of MI incidence and mortality.

Long-term exposure to transportation noise and risk for atrial fibrillation: A Danish nationwide cohort study

BACKGROUND

Epidemiological studies have linked transportation noise and cardiovascular diseases, however, atrial fibrillation (AF) has received limited attention. We aimed to investigate the association between transportation noise and AF risk.

METHODS

Over the period 1990-2017 we estimated road and railway noise (L_den) at the most and least exposed façades for all residential addresses across Denmark. We estimated time-weighted mean noise exposure for 3.6 million individuals age ≥35 years. Of these, 269,756 incident cases of AF were identified with a mean follow-up of 13.0 years. Analyses were conducted using Cox proportional hazards models with adjustment for individual and area-level sociodemographic covariates and long-term residential air pollution.

RESULTS

A 10 dB higher 10-year mean road traffic noise at the most and least exposed façades were associated with incidence rate ratios (IRR) and 95% confidence intervals (CI) for AF of 1.006 (1.001-1.011) and 1.013 (1.007-1.019), respectively. After further adjustment for PM_2.5, the IRRs (CIs) were 1.000 (0.995-1.005) and 1.007 (1.000-1.013), respectively. For railway noise, the IRRs per 10 dB increase in 10-year mean exposure were 1.017 (1.007-1.026) and 1.035 (1.021-1.050) for the most and least exposed façades, respectively, and were slightly attenuated when adjusted for PM_2.5. Aircraft noise between 55 and 60 dB and ≥60 dB were associated with IRRs of 1.055 (0.996-1.116) and 1.036 (0.931-1.154), respectively, when compared to <45 dB.

CONCLUSION

Transportation noise seems to be associated with a small increase in AF risk, especially for exposure at the least exposed façade.

Evaluation of Acoustic Noise Level and Impulsiveness Inside Vehicles in Different Traffic Conditions

Recently, the issue of sound quality inside vehicles has attracted interest from both researchers and industry alike due to health concerns and also to increase the appeal of vehicles to consumers. This work extends the analysis of interior acoustic noise inside a vehicle under several conditions by comparing measured power levels and two different models for acoustic noise, namely the Gaussian and the alpha-stable distributions. Noise samples were collected in a scenario with real traffic patterns using a measurement setup composed of a Raspberry Pi Board and a microphone strategically positioned. The analysis of the acquired data shows that the observed noise levels are higher when traffic conditions are good. Additionally, the interior noise presented considerable impulsiveness, which tends to be more severe when traffic is slower. Finally, our results suggest that noise sources related to the vehicle itself and its movement are the most relevant ones in the composition of the interior acoustic noise.

Health impact assessment of transportation noise in two Estonian cities

Transportation noise is a growing public health concern worldwide, especially in urban areas, causing annoyance, sleep disturbance, cardiovascular diseases and other health effects. Recently, European Commission (EC) has developed a mutual methodology for assessing health impacts of transportation noise in European Union using strategic noise mapping. Applying this methodology, our aim was to quantify the health effects of road, rail and aircraft noise in two Estonian cities, Tallinn and Tartu. We also aimed to assess sensitivity of this methodology, while implementing lower threshold values and employing additional health outcomes. The proportion of highly annoyed residents due to road traffic noise was 11.6% in Tallinn, and 9.2% in Tartu; around 2.5% residents in both cities could have high sleeping disturbances. As exposure to railway and aircraft noise was relatively low in both cities, people with high annoyance and high sleep disturbance caused by railway and aircraft noise was below 1%. Ischemic heart disease (IHD) cases attributable to road traffic noise was estimated to be 122.6 in Tallinn and 21.5 in Tartu. Altogether transportation noise was estimated to cause 1807 disability adjusted life years (DALYs) in Tallinn and 370 DALYs in Tartu. The health costs were calculated as €126.5 and €25.9 million annually, respectively in the two cities. When we included higher number of health outcomes (stroke incidence, IHD deaths) and lowered exposure threshold by 5 dB, the annual burden of disease was doubled. As the latest epidemiological studies showed transportation noise having larger number of effects on lower noise levels, the results with the currently applied European Commission health impact assessment (HIA) methodology were rather conservative. Despite of uncertainties associated to applied methodology, transportation noise, especially road traffic noise, is an important environmental risk factor, that leads to considerable loss of healthy life years and causes large health costs in urban areas.

Sex/Gender-Differences in the Health Effects of Environmental Noise Exposure on Hypertension and Ischemic Heart Disease-A Systematic Review

Previous studies have demonstrated cardiovascular health effects of environmental noise exposure, partly showing different effect estimates for males and females. This cannot be explained by biological differences between males and females alone. It is assumed that health outcomes and exposure patterns also depend on gender, determined by social, economic, and cultural factors in society. This systematic review evaluated the current state of how sex/gender is integrated in studies on environmental noise associated with hypertension, blood pressure, and ischemic heart diseases. A systematic literature search was conducted in three different databases, identifying thirty studies published between 1 January 2000 and 2 February 2020. Effects varied, with no consistent findings for both males and females. All studies used a binary operationalization of sex/gender, assuming static differences between males and females. The differentiation between biological and social dimensions of sex/gender was not present in any of the studies and the terms “sex” and “gender” were used interchangeably. However, biological and social dimensions of sex/gender were unconsciously taken up in the discussion of the results. Integrating sex/gender-theoretical concepts into future studies offers great potential to increase the validity of research findings, thus making them more useful for prevention efforts, health promotion, and health care.

Residential exposure to traffic-borne pollution as a risk factor for acute cardiocerebrovascular events: a population-based retrospective cohort study in a highly urbanized area

Background

Long-term exposure to traffic-borne noise and air pollution has been variably associated with incidence of acute vascular events, namely acute myocardial infarction, ischaemic stroke and haemorrhagic stroke. This study aims at exploring this association within a highly urbanized city.

Methods

This is a population-based retrospective dynamic cohort study including all residents aged ≥ 35 years in the municipality of Milan over the years 2011–18 (1 087 110 inhabitants). Residential exposure to road traffic noise (day-evening-night levels) and nitrogen dioxide was estimated using a noise predictive model and a land use regression model, respectively. Cox proportional hazards regression analyses were performed to assess the incidence of acute vascular events and specific outcomes in single-exposure and two-exposure models including adjustment for sociodemographic confounders, fine particulate matter and surrounding greenness.

Results

A total of 27 282 subjects (2.5%) had an acute vascular event. Models using nitrogen dioxide produced inconsistent results. The strongest effect was observed for noise, with an optimal cut-off for dichotomization set at 70 dBA (hazard ratio 1.025, 95% confidence interval 1.000–1.050). This association was observed specifically for ischaemic and haemorrhagic stroke. When stratifying by age group and sex, a remarkable effect was found for haemorrhagic stroke in men aged <60 years (hazard ratio 1.439, 95% confidence interval 1.156–1.792).

Conclusions

Living by roads with a day-evening-night noise level above 70 dBA exerts a small but tangible independent effect on the risks of both ischaemic and haemorrhagic stroke. It is urgent to propose mitigation measures against pollution and noise originating from vehicular traffic in order to reduce their impact, especially in the population younger than 60 years.

Long-term exposure to nitrogen dioxide and mortality: A systematic review and meta-analysis

BACKGROUND

Ambient air pollution is among the greatest environmental risks to human health. However, little is known about the health effects of nitrogen dioxide (NO₂), a traffic-related air pollutant. Herein, we aimed to conduct a meta-analysis to investigate the long-term effects of NO₂ on mortality.

METHODS

We conducted a systematic search for studies that were published up to February 2020 and performed a meta-analysis of all available epidemiologic studies evaluating the associations between long-term exposure to NO₂ with all-cause, cardiovascular, and respiratory mortality. Overall pooled effect estimates as well as subgroup-specific pooled estimates (e.g. location, exposure assessment method, exposure metric, study population, age at recruitment, and key confounder adjustment) and 95% confidence intervals were calculated using random-effects models. Risk of bias assessment was accessed by following WHO global air quality guidelines. Publication bias was accessed by visually inspecting funnel plot and Egger's liner regression was used to test of asymmetry.

RESULTS

Our search initially retrieved 1349 unique studies, of which 34 studies met the inclusion criteria. The pooled hazard ratio (HR) for all-cause mortality was 1.06 (95%CI: 1.04-1.08, n = 28 studies, I² = 98.6%) per 10 ppb increase in annual NO₂ concentrations. The pooled HRs for cardiovascular and respiratory mortality per 10 ppb increment were 1.11 (95%CI: 1.07-1.16, n = 20 studies, I² = 99.2%) and 1.05 (95%CI: 1.02-1.08, n = 17 studies, I² = 94.6%), respectively. The sensitivity analysis pooling estimates from multi-pollutant models suggest an independent effect of NO₂ on mortality. Funnel plots indicate that there is no evidence for publication bias in our study.

CONCLUSION

We provide robust epidemiological evidence that long-term exposure to NO₂, a proxy for traffic-sourced air pollutants, is associated with a higher risk of all-cause, cardiovascular, and respiratory mortality that might be independent of other common air pollutants.

Insomnia associated with traffic noise and proximity to traffic-a cross-sectional study of the Respiratory Health in Northern Europe III population

STUDY OBJECTIVES

Exposure to traffic noise increases the risk of sleeping disturbance, but little is known about the effect of traffic-related air pollution on insomnia symptoms. We aimed to investigate the separate associations of self-reported proximity to traffic and traffic noise with insomnia.

METHODS

This is a cross-sectional study of the population included in the Respiratory Health in Northern Europe study, consisting of randomly selected men and women born between 1945 and 1973, from 7 Northern European centers. Hearing traffic noise in the bedroom, bedroom window proximity to traffic, and insomnia symptoms were self-reported. Bedroom window proximity to traffic was used as a surrogate for exposure to traffic-related air pollution. The following insomnia symptoms were assessed: difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening.

RESULTS

A total of 12,963 individuals was included. Traffic noise was positively associated with all three insomnia symptoms: difficulty initiating sleep (odds ratio [OR] = 3.54; 95% confidence interval [CI]: 1.85, 6.76), difficulty maintaining sleep (OR = 2.95; 95% CI: 1.62, 5.37), and early morning awakening (OR = 3.25; 95% CI: 1.97, 5.37). Proximity to traffic without disturbing noise was associated with difficulty initiating sleep (OR = 1.62; 95% CI: 1.45, 1.82).

CONCLUSIONS

This study adds further support to the identification of traffic noise as a risk factor for insomnia. Proximity to traffic without being exposed to noise was associated with an increased risk of difficulty initiating sleep. Our findings indicate that insomnia may be associated with both traffic noise and traffic-related air pollution.

A neurobiological mechanism linking transportation noise to cardiovascular disease in humans

AIMS

Chronic noise exposure associates with increased cardiovascular disease (CVD) risk; however, the role of confounders and the underlying mechanism remain incompletely defined. The amygdala, a limbic centre involved in stress perception, participates in the response to noise. Higher amygdalar metabolic activity (AmygA) associates with increased CVD risk through a mechanism involving heightened arterial inflammation (ArtI). Accordingly, in this retrospective study, we tested whether greater noise exposure associates with higher: (i) AmygA, (ii) ArtI, and (iii) risk for major adverse cardiovascular disease events (MACE).

METHODS AND RESULTS

Adults (N = 498) without CVD or active cancer underwent clinical 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging. Amygdalar metabolic activity and ArtI were measured, and MACE within 5 years was adjudicated. Average 24-h transportation noise and potential confounders were estimated at each individual's home address. Over a median 4.06 years, 40 individuals experienced MACE. Higher noise exposure (per 5 dBA increase) predicted MACE [hazard ratio (95% confidence interval, CI) 1.341 (1.147-1.567), P < 0.001] and remained robust to multivariable adjustments. Higher noise exposure associated with increased AmygA [standardized β (95% CI) 0.112 (0.051-0.174), P < 0.001] and ArtI [0.045 (0.001-0.090), P = 0.047]. Mediation analysis suggested that higher noise exposure associates with MACE via a serial mechanism involving heightened AmygA and ArtI that accounts for 12-26% of this relationship.

CONCLUSION

Our findings suggest that noise exposure associates with MACE via a mechanism that begins with increased stress-associated limbic (amygdalar) activity and includes heightened arterial inflammation. This potential neurobiological mechanism linking noise to CVD merits further evaluation in a prospective population.

Long-term exposure to road traffic noise and incident myocardial infarction: A Danish Nurse Cohort study

Background

Evidence of nonauditory health effects of road traffic noise exposure is growing. This prospective cohort study aimed to estimate the association between long-term exposure to road traffic noise above a threshold and incident myocardial infarction (MI) in Denmark.

Methods

In the Danish Nurse Cohort study, we used data of 22,378 women, at recruitment in 1993 and 1999, who reported information on MI risk factors. The participants' first hospital contact or out-of-hospital death due to MI were followed-up until 2014. We investigated a relationship between residential exposures to road traffic noise levels (L_den) up to 23 years and incident MI (overall, nonfatal, and fatal) using time-varying Cox regression models adjusting for potential confounders and air pollutants. We estimated thresholds of road traffic noise (53, 56, and 58 dB) associated with incident MI in a piece-wise linear regression model.

Results

Of the 22,378 participants, 633 developed MI, 502 of which were nonfatal. We observed a non-linear relationship between the 23-year running mean of L_den and incident MI with a threshold level of 56 dB, above which hazard ratios (95% confidence intervals) were 1.30 (0.97, 1.75) for overall and 1.46 (1.05, 2.03) for nonfatal MI per 10 dB. The association with nonfatal MI attenuated slightly to 1.34 (0.95, 1.90) after adjustment for fine particles.

Conclusions

We found that long-term exposure to road traffic noise above 56 dB may increase the risk of MI. The study findings suggest that road traffic noise above 56 dB may need regulation in addition to the regulation of ambient pollutants.

Long-term exposure to fine particulate matter relates with incident myocardial infarction (MI) risks and post-MI mortality: A meta-analysis

BACKGROUND

Air pollution has become a global challenge, and a growing number of studies have suggested possible relationships between long-term exposure to fine particulate matter (PM_2.5) and risks of cardiovascular events, specifically, myocardial infarction (MI). However, the recently reported results were inconsistent. We thus performed a meta-analysis and sought to assess whether long-term exposure to PM_2.5 relates with incident MI risks and post-MI mortality.

METHODS

EMBASE, Web of Science and PubMed were searched for all potentially eligible studies published before August 2, 2020 using a combination of keywords related to PM_2.5 exposure, its long-term effects and myocardial infarction. Key information was extracted, and calculated hazard ratio (HR) values were combined by selecting corresponding models according to heterogeneity test. A sensitivity analysis and a publication bias assessment were also performed to determine the reliability of the results.

RESULTS

Of the initially identified 2100 citations, 12 studies met our inclusion criteria and observed a total population of approximately 7.2 million. Pooled estimates (per 10 μg/m³ increase) indicated a statistically significant association between long-term PM_2.5 exposure and MI incidence (HR = 1.10, 95% CI: 1.02-1.18) or post-MI mortality (HR = 1.07, 95% CI: 1.04-1.09). Results for MI incidence from Egger's linear regression method (P = 0.515) and Begg's test (P = 0.711) showed no obvious publication bias.

CONCLUSION

Our quantitative analysis reveals a significant link between long-term PM_2.5 exposure and greater MI incidence risks or higher post-MI mortality. Our findings may therefore have implications for individual protection and policy support to improve public health.

Manuscript title: Long─term residential exposure to environmental/transportation noise and the incidence of myocardial infarction

BACKGROUND

Cardiovascular effects of environmental noise are a growing concern. However, the evidence remains largely limited to the association between road traffic noise and hypertension and coronary heart diseases.

OBJECTIVES

To investigate the association between long-term residential exposure to environmental/transportation noise and the incidence of myocardial infarction (MI) in the adult population living in Montreal.

METHODS

An open cohort of adults aged 45 years old and over, living on the island of Montreal and free of MI before entering the cohort was created for the years 2000-2014 with the Quebec Integrated Chronic Disease Surveillance System; a systematic surveillance system from the Canadian province of Quebec starting in 1996. Residential noise exposure was calculated in three ways: 1) total ambient noise levels estimated by Land use regression (LUR) models; 2) road traffic noise estimated by a noise propagation model CadnaA and 3) distances to transportation sources (roads, airport, railways). Incident MI was based on diagnostic codes in hospital admission records. Cox models with time-varying exposures (age as the time axis) were used to estimate the associations with various adjustments (material deprivation indicator, calendar year, nitrogen dioxide, stratification for sex). Indirect adjustment based on ancillary data for smoking was performed.

RESULTS

1,065,414 individuals were followed (total of 9,000,443 person-years) and 40,718 (3.8%) developed MI. We found positive associations between total environmental noise, estimated by LUR models and the incidence of MI. Total noise LUR levels ranged from ~44 to ~79 dBA and varied slightly with the metric used. The adjusted hazard ratios (HRs) (also adjusted for smoking) were 1.12 (95% Confidence Intervals [CI]: 1.08-1.15), 1.11 (95%CI: 1.07-1.14) and 1.10 (95%CI: 1.06-1.14) per 10 dBA noise levels increase respectively in Level Accoustic equivalent 24 h (LAeq24 h), Level day-evening-night (Lden) and night level (Lnight). We found a borderline negative association between road noise levels estimated with CadnaA and MI (HR: 0.99 per 10 dBA; 95%CI: 0.98-1.00). Distances to major roads and highways were not associated with MI while the proximity to railways was positively associated with MI (HR for ≤100 vs > 1000 m: 1.07; 95%CI: 1.01-1.14). A negative association was found with the proximity to the airport noise exposure forecast (NEF25); HR (<1 vs >1000 m) = 0.88 (95%CI: 0.81-0.96).

CONCLUSIONS

These associations suggest that exposure to total environmental noise at current urban levels may be related to the incidence of MI. Additional studies with more accurate road noise estimates are needed to explain the counterintuitive associations with road noise and specific transportation sources.

Evaluation of exposure to road traffic noise: Effects of microphone height and urban configuration

Noise pollution is a major environmental problem due to its impact on human health and implications for other spheres of society. Since road traffic is the main source of noise pollution, the use of measurement methodologies to accurately determine the environmental noise levels to which the façades of buildings in cities are exposed is an important issue. This paper presents an experimental study in urban environments that uses different configurations to evaluate the influence of the position of the microphone and the parking lanes on the levels of road traffic noise to which the population is exposed. In urban settings in which sound waves propagate without obstacles between the lanes of traffic and the receivers, broadband results for the differences between noise levels measured by microphones placed at heights of 4.0 and 1.5 m showed a significant increase with an increase in the distance between the microphone and sound source of between -0.8 and 0.9 dBA over a range from 2 to 8 m. This difference between the two microphones was greater at points where a lane of parked vehicles was located between the road traffic lanes and the receivers were placed near the façades of building. At the same heights, the broadband difference in sound levels ranged from 2.7 to 4.5 dBA. This acoustic shielding effect due to the presence of parked vehicles started to be relevant in the 250 Hz band and increased progressively with frequency. Taking into account these experimental results and the recommendations in the European Noise Directive, it would be important to apply corrections to sound indicators for road traffic noise that are related to the height of the microphone. Making a distinction between urban configurations with and without lines of parked vehicles between the microphone and the road traffic lanes would be advisable.

Acute cardiovascular health effects in a panel study of personal exposure to traffic-related air pollutants and noise in Toronto, Canada

Urban populations are often simultaneously exposed to air pollution and environmental noise, which are independently associated with cardiovascular disease. Few studies have examined acute physiologic responses to both air and noise pollution using personal exposure measures. We conducted a repeated measures panel study of air pollution and noise in 46 non-smoking adults in Toronto, Canada. Data were analyzed using linear mixed-effects models and weighted cumulative exposure modeling of recent exposure. We examined acute changes in cardiovascular health effects of personal (ultrafine particles, black carbon) and regional (PM_2.5, NO₂, O₃, O_x) measurements of air pollution and the role of personal noise exposure as a confounder of these associations. We observed adverse changes in subclinical cardiovascular outcomes in response to both air pollution and noise, including changes in endothelial function and heart rate variability (HRV). Our findings show that personal noise exposures can confound associations for air pollutants, particularly with HRV, and that impacts of air pollution and noise on HRV occur soon after exposure. Thus, both noise and air pollution have a measurable impact on cardiovascular physiology. Noise should be considered alongside air pollution in future studies to elucidate the combined impacts of these exposures in urban environments.

The association between road traffic noise and myocardial infarction: A systematic review and meta-analysis

This systematic review and meta-analysis study aimed to investigate the association between exposure to road traffic noise (RTN) and myocardial infarction (MI). Of 681 studies found by searching in databases, including Scopus, Web of Science, Embase, and PubMed on November 29, 2019, the number of 13 studies, including seven cohort, five case-control, and one cross-sectional studies with 1,626,910 participants and 45,713 cases of MI was included. The pooled relative risk (RR) and 95% confidence interval (CI) of MI were calculated using a random-effect model across studies. Heterogeneity measures by reporting the I-square index. Subgroup analysis according to the designs and sensitivity analysis based on the Jackknife approach was performed. We observed in the eight studies the association was investigated in different noise exposure groups and in the 10 studies (including two conference papers) the risk of MI was provided per specific unit increment of RTN. We ran two independent types of meta-analyses involving a categorical analysis (comparing the highest and the lowest category of noise exposure groups) and an exposure-response analysis (the risk of MI per 10-dB increment of RTN). The pooled RR (95% CI) of MI for the categorical and exposure-response meta-analyses was calculated 1.03 (0.93, 1.13) and 1.02 (1.00, 1.05), respectively. For both types of meta-analyses, subgroup analysis indicates a significant association in the studies with case-control and cross-sectional designs but not cohort studies. For the exposure-response meta-analysis, a significantly greater risk of MI was observed after excluding the two conference papers (RR = 1.03 and 95% CI = 1.00, 1.05) and by further excluding the studies provided originally the risk of MI only for the categorical analysis (RR = 1.02 and 95% CI = 1.01, 1.03). We did not show a significant publication bias across studies. In conclusion, our study suggests a significant odds of association between exposure to RTN and the risk of MI.

Traffic Noise Mitigation Using Single and Double Barrier Caps of Different Shapes for an Extended Frequency Range

The primary function of noise barriers is to shield inhabitants of affected areas from excessive noise generated by road traffic. To enhance the performance of noise barriers while simultaneously adhering to height restrictions, the attachment of structures (caps) of different shapes to the tops of conventional screens can be considered. These caps can significantly impact the diffracted sound energy, thereby increasing the desired global acoustic losses. This work presents a comprehensive study of the acoustic performance of noise barriers with single and double attached caps of different shapes through a calculation of their insertion losses (IL). This study comprehensively addresses and compares different types, sizes, combinations, and numbers of noise barrier caps for different scenarios (including sloping and absorbent grounds) and sources (“car” and “ambulance”) for an extended frequency band up to 10 kHz. To the best of the authors’ knowledge, this is a range that has not previously been analyzed. A variety of different cap shapes were considered including cylinders, rectangles, trapezoids, and Y/T-shaped forms. To calculate the IL, an innovative and fast uniform theory of diffraction (UTD)-based method developed by the authors was applied in all simulations. The results showed that the Y-shaped single and double barrier caps were, in general, the most effective at increasing IL without raising the height of the barrier, thereby successfully managing the aesthetic impact. The results also showed how the consideration of sloping and absorbent floors could also contribute to improved noise abatement.

Short-Term Effects of Air Pollution on Coronary Events in Strasbourg, France-Importance of Seasonal Variations

The aim of this study, is to investigate the effects of a short-term exposure to air pollutants, as assessed by Nitrogen dioxide (NO₂), Particulate Matter PM_2,5 and PM₁₀ concentrations, on coronary event onsets in Strasbourg, France. An observational, analytical, retrospective, epidemiological study was conducted in Strasbourg between 1 January 2012 and 31 December 2014. Higher daily coronary events rates were evidenced when NO₂ concentrations were measured above 40 µg/m³ (1.258 (95% CI 1.142–1.374) vs. 1.110 (95% CI 1.033–1.186); p = 0.015). The NO₂ concentration was higher than 30 µg/m³ for 677 days (61.8%). Higher daily coronary events rates were evidenced when NO₂ concentrations were measured above 30 µg/m³ (1.208 (95% CI 1.128–1.289) vs. 1.067 (95% CI 0.961–1.172) p = 0.009). A marked seasonality of NO₂, PM_2.5, and PM₁₀ concentrations characterized by an increase during winter and a decrease during the summer could be established. The seasonality of coronary events was evidenced simultaneously. After adjustments were made to account for the time and the month, no independent impact of NO₂, PM_2.5 or PM₁₀ on daily coronary events could be demonstrated.

Exposure to Road Traffic Noise and Incidence of Acute Myocardial Infarction and Congestive Heart Failure: A Population-Based Cohort Study in Toronto, Canada

BACKGROUND

Epidemiological evidence for the association between traffic-related noise and the incidence of major cardiovascular events such as acute myocardial infarction (AMI) and congestive heart failure (CHF) is inconclusive, especially in North America.

OBJECTIVES

We evaluated the associations between long-term exposure to road traffic noise and the incidence of AMI and CHF.

METHODS

Our study population comprised ∼1 million people 30-100 years of age who lived in Toronto, Canada, from 2001 to 2015 and were free of AMI (referred to as the AMI cohort) or CHF (the CHF cohort) at baseline. Outcomes were ascertained from health administrative databases using validated algorithms. Annual average noise levels were estimated as the A-weighted equivalent sound pressure level over the 24-h period (LAeq24) and during nighttime (LAeqNight), respectively, using propagation modeling, and assigned to participants' annual six-digit postal code addresses during follow-up. We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident AMI and CHF in relation to LAeq24 and LAeqNight using random-effects Cox proportional hazards models adjusting for individual- and census tract-level covariates, including traffic-related air pollutants [e.g., ultrafine particles (UFPs) and nitrogen dioxide].

RESULTS

During follow-up, there were 37,441 AMI incident cases and 95,138 CHF incident cases. Each interquartile range change in LAeq24 was associated with an increased risk of incident AMI (HR=1.07; 95% CI: 1.06, 1.08) and CHF (HR=1.07; 95% CI: 1.06, 1.09). Similarly, LAeqNight was associated with incident AMI (HR=1.07; 95% CI: 1.05, 1.08) and CHF (HR=1.06; 95% CI: 1.05, 1.07). These results were robust to various sensitivity analyses and remained elevated after controlling for long-term exposure to UFPs and nitrogen dioxide. We found near-linear relationships between noise and the incidence of AMI and CHF with no evidence of threshold values.

CONCLUSION

In this large cohort study in Toronto, Canada, chronic exposure to road traffic noise was associated with elevated risks for AMI and CHF incidence. https://doi.org/10.1289/EHP5809.

Long-term residential road traffic noise and mortality in a Danish cohort

Transportation noise is a growing public health concern worldwide and epidemiological evidence has linked road traffic noise with mortality. However, incongruent effect estimates have been reported between incidence and mortality studies. Therefore, the present study aimed to investigate whether long-term exposure to residential road traffic noise at the most and least exposed façades was associated with all-cause, cardiovascular disease (CVD), ischemic heart disease (IHD), stroke, respiratory, or cancer mortality in a Danish cohort study. In a cohort of 52,758 individuals from Copenhagen and Aarhus, we estimated road traffic noise at the most and least exposed façades, as well as ambient air pollution, at all present and historical residential addresses from 1987 to 2016. Using the Danish cause of death register we identified cause-specific mortality. Analyses were conducted using Cox proportional hazards models. Ten-year time-weighted mean road traffic noise exposure at the most exposed façade was associated with an 8% higher risk for all-cause mortality per interquartile range (IQR; 10.4 dB) higher exposure level (95% CI: 1.05-1.11). Higher risks were also observed for CVD (HR = 1.13, 95% CI: 1.06-1.19) and stroke (HR = 1.11, 95% CI: 0.99-1.25) mortality. Road traffic noise at the least exposed façade (per IQR; 8.4 dB) was associated with CVD (HR = 1.09, 95% CI: 1.03-1.15), IHD (HR = 1.10, 95% CI: 1.01-1.21) and stroke (HR = 1.06, 95% CI: 0.95-1.19) mortality. Results were robust to adjustment for PM_2.5 and NO₂. In conclusion, this study adds to the body of evidence linking exposure to road traffic noise with higher risk of mortality.

Road traffic noise, air pollution and cardiovascular events in a Swedish cohort

Urbanization and increasing road traffic cause exposure to both noise and air pollution. While the levels of air pollutants such as nitrogen oxides (NO_x) have decreased in Sweden during the past decades, exposure to traffic noise has increased. The association with cardiovascular morbidity is less well established for noise than for air pollution, and most studies have only studied one of the two highly spatially correlated exposures. The Swedish Primary Prevention Study cohort consists of men aged 47 to 55 when first examined in 1970-1973. The cohort members were linked to the Swedish patient registry through their personal identity number and followed until first cardiovascular event 1970-2011. The address history during the entire study period was used to assign annual modelled residential exposure to road traffic noise and NO_x. The Cox proportional hazards model with age on the time axis and time-varying exposures were used in the analysis. The results for 6304 men showed a non-significant increased risk of cardiovascular disease for long-term road traffic noise at the home address, after adjusting for air pollution. The hazard ratios were 1.08 (95% CI 0.90-1.28) for cardiovascular mortality, 1.14 (95% CI 0.96-1.36) for ischemic heart disease incidence and 1.07 (95% CI 0.85-1.36) for stroke incidence, for noise above 60 dB, compared to below 50 dB. This study found some support for cardiovascular health effects of long-term exposure to road traffic noise above 60 dB, after having accounted for exposure to air pollution.

Quiet, clean, green, and active: A Navigation Guide systematic review of the impacts of spatially correlated urban exposures on a range of physical health outcomes

BACKGROUND

Recent epidemiologic analyses have considered impacts of multiple spatially correlated urban exposures, but this literature has not been systematically evaluated.

OBJECTIVES

To characterize the long-term impacts of four distinct spatially correlated urban environmental exposures - traffic-related air pollution (TRAP), noise, natural spaces, and neighborhood walkability - by evaluating studies including measures of at least two such exposures in relationship to mortality, cardiovascular disease, chronic respiratory disease, allergy, type 2 diabetes, or reproductive outcomes.

METHODS

Following the Navigation Guide framework, the literature was searched for studies published since 2003 and meeting predefined inclusion criteria. Identified studies were scored individually for risk of bias and all studies related to an exposure-group set were appraised for overall quality and strength of evidence.

RESULTS

A total of 51 individual studies (TRAP and noise: n = 29; TRAP and natural spaces: n = 10; noise and natural spaces: n = 2; TRAP, noise, and natural spaces: n = 7; TRAP, noise, natural spaces, and walkability: n = 3) were included. When TRAP and noise were considered jointly, evidence was sufficient for increased cardiovascular morbidity with higher noise exposures; sufficient for no effect of TRAP on CVD morbidity; sufficient for increased mortality with higher TRAP exposures, but limited for noise; and limited for increased adverse reproductive outcomes with higher TRAP exposures and no effect of noise. Looking at natural spaces and TRAP, there was limited evidence for lower risk of chronic respiratory disease and small increases in birthweight with greater natural space; this relationship with birthweight persisted after adjustment for noise as well. Evidence was inadequate for all other exposure groups and outcomes.

DISCUSSION

Studies that properly account for the complexity of relationships between urban form and physical health are limited but suggest that even highly correlated exposures may have distinct effects.

REVIEW REGISTRATION

PROSPERO 2018 CRD42018106050.

A time-to-event analysis on air pollutants with the risk of cardiovascular disease and mortality: A systematic review and meta-analysis of 84 cohort studies

OBJECTIVE

Air pollution is one of the most substantial problems globally. Aerodynamic toxic of particulate matter with <10 mm in diameter (PM₁₀ ), or <2.5 mm (PM_2.5 ), as well as nitric dioxide (NO₂ ), have been linked with health issues. We aimed to perform a comprehensive analysis of the time-to-event for different types of air pollutants on cardiovascular disease (CVD) events based on cohort studies.

METHODS

A comprehensive search on topics that assesses air pollution and cardiovascular disease with keywords up until July 2019 was performed.

RESULTS

There were a total of 28 215 394 subjects from 84 cohorts. Increased PM_2.5 was associated with composite CVD [HR 1.10 (1.02, 1.19)], acute coronary events [HR 1.15 (1.12, 1.17)], stroke [HR 1.13 (1.06, 1.19)], and hypertension [HR 1.07 (1.01, 1.14)], all-cause mortality [HR 1.07 (1.04, 1.09)], CVD mortality [HR 1.10 (1.07, 1.12)], and ischemic heart disease (IHD) mortality [HR 1.11 (1.07, 1.16)]. Association with AF became significant after removal of a study. Increased PM₁₀ was associated with heart failure [HR 1.25 (1.04, 1.50)], all-cause mortality [HR 1.16 (1.06, 1.27)], CVD mortality [HR 1.17 (1.04, 1.30)], and IHD mortality [HR 1.03 (1.01, 1.05)]. Increased of NO₂ was associated with increased composite CVD [HR 1.15 (1.02, 1.29)], atrial fibrillation [HR 1.01 (1.01, 1.02)], acute coronary events [HR 1.08 (1.02, 1.13)], all-cause mortality [HR 1.23 (1.14, 1.32)], CVD mortality [HR 1.17 (1.10, 1.25)], and IHD mortality [HR 1.05 (1.03, 1.08)].

CONCLUSION

Air pollutants are associated with an increased incidence of cardiovascular diseases, all-cause mortality, and CVD mortality.

Effect of parking lanes on assessing the impact of road traffic noise on building façades

The use of strategic noise maps as a means for estimating population exposure to environmental noise and defining action plans to mitigate its effects on human health has become a reality since the publication of the European Noise Directive. In this context, it is known that some differences can be found between the values obtained for sound indicators through simulation and measurements due to different causes. One of these factors is the presence of elements in urban environments not currently considered in calculation methods but certainly present in validation measurements. This paper presents an assessment of the acoustic shielding effect due to parked vehicles on urban streets using computational methods. First of all, a process of validation of the software model by means of different simulation methods and in situ measurements was carried out. Then, a study was developed varying different variables related to urban planning and noise modelling, as well as considering different typologies of real streets according to a categorisation method. Broadband results show that this shielding effect can be significant in common configurations in urban environments, even to receiver heights of 4 m considered as a reference in strategic noise maps. The magnitude of this effect varied depending on the distances between the building façade, parked vehicles and sound sources, as well as the receiver height. Differences up to 4 dBA in sound levels were found in several configurations between situations without and with cars parked at 4 m, although in some specific cases it reached up to 8 dBA. Therefore, results of this study indicated that parking lane shielding effect should be considered in calculations and validation measurements for strategic noise maps in order to obtain an adequate estimation of population exposure to road traffic noise.

Long-Term Exposure to Air Pollution and Incidence of Myocardial Infarction: A Danish Nurse Cohort Study

BACKGROUND

Air pollution exposure has been linked to coronary heart disease, although evidence on PM2.5 and myocardial infarction (MI) incidence is mixed.

OBJECTIVES

This prospective cohort study aimed to investigate associations between long-term exposure to air pollution and MI incidence, adjusting for road traffic noise.

METHODS

We used data from the nationwide Danish Nurse Cohort on 22,882 female nurses (>44 years of age) who, at recruitment in 1993 or 1999, reported information on cardiovascular disease risk factors. Data on MI incidence was collected from the Danish National Patient Register until the end of 2014. Annual mean concentrations of particulate matter (PM) with a diameter <2.5 μg/m3 (PM2.5), PM10, nitrogen dioxide (NO2), and nitrogen oxides (NOx) at the nurses' residences since 1990 (PM10 and PM2.5) or 1970 (NO2 and NOx) were estimated using the Danish Eulerian Hemispheric Model/Urban Background Model/AirGIS (DEHM/UBM/AirGIS) dispersion model. We used time-varying Cox regression models to examine the association between 1- and 3-y running means of these pollutants, as well as 23-y running means of NO2 and NOx, with both overall and fatal incident MI. Associations were explored in three progressively adjusted models: Model 1, adjusted for age and baseline year; Model 2, with further adjustment for potential confounding by lifestyle and cardiovascular disease risk factors; and Model 3, with further adjustment for road traffic noise, modeled as the annual mean of a weighted 24-h average (Lden).

RESULTS

Of the 22,882 women, 641 developed MI during a mean follow-up of 18.6 y, 121 (18.9%) of which were fatal. Reported hazard ratios (HRs) were based on interquartile range increases of 5.3, 5.5, 8.1, and 11.5 μg/m3 for PM2.5, PM10, NO2, and NOx, respectively. In Model 1, we observed a positive association between a 3-y running mean of PM2.5 and an overall incident MI with an HR= 1.20 (95% CI: 1.07, 1.35), which attenuated to HR= 1.06 (95% CI: 0.92, 1.23) in Model 2. In Model 1 for incident fatal MI, we observed a strong association with a 3-y running mean of PM2.5, with an HR= 1.69 (95% CI: 1.33, 2.13), which attenuated to HR= 1.35 (95% CI: 1.01, 1.81) in Model 2. Similar associations were seen for PM10, with 3-y, Model 2 estimates for overall and fatal incident MI of HR= 1.06 (95% CI: 0.91, 1.23) and HR= 1.35 (95% CI: 1.01, 1.81), respectively. No evidence of an association was observed for NO2 or NOx. For all pollutants, associations in Model 2 were robust to further adjustment for road traffic noise in Model 3 and were similar for a 1-y running mean exposure.

CONCLUSIONS

We found no association between long-term exposure to PM2.5, PM10, NO2, or NOx and overall MI incidence, but we observed positive associations for PM2.5 and PM10 with fatal MI. We present novel findings that the association between PM and MI incidence is robust to adjustment for road traffic noise. https://doi.org/10.1289/EHP5818.

de Sousa V, Martins A. Characterization of Noise Level Inside a Vehicle under Different Conditions

Vehicular acoustic noise evaluations are a concern of researchers due to health and comfort effects on humans and are fundamental for anyone interested in mitigating audio noise. This paper focuses on the evaluation of the noise level inside a vehicle by using statistical tools. First, an experimental setup was developed with microphones and a microcomputer located strategically on the car’s panel, and measurements were carried out with different conditions such as car window position, rain, traffic, and car speed. Regression analysis was performed to evaluate the similarity of the noise level from those conditions. Thus, we were able to discuss the relevance of the variables that contribute to the noise level inside a car. Finally, our results revealed that the car speed is strongly correlated to interior noise levels, suggesting the most relevant noise sources are in the vehicle itself.

Evidence Relating to Environmental Noise Exposure and Annoyance, Sleep Disturbance, Cardio-Vascular and Metabolic Health Outcomes in the Context of IGCB (N): A Scoping Review of New Evidence

WHO published the Environmental Noise Guidelines for the European Region in 2018, based on seven systematic reviews including studies published between 2000 and 2014. Since then, new studies were published. At the request of the UK Department for Environment, Food and Rural Affairs (DEFRA), a review on annoyance, sleep disturbance, cardiovascular and metabolic effects in relation to environmental noise was prepared. The aim was to advise the Interdepartmental Group on Costs and Benefits Noise Subject Group (IGCB(N)) whether this new evidence warrants an update of their recommendations. Four databases for observational studies were screened and data were extracted on design, type and measurements of exposures and outcomes and confounders and their associations. The quality of the studies was indirectly assessed for cardiovascular and metabolic effects by only including studies with a case control or cohort design. For studies on annoyance and sleep disturbance, the risk of bias was expressed in exposure misclassification, selective participation and confounding. The update yielded 87 papers, pertaining to 108 new studies of which 40 new studies were on annoyance, 42 on sleep disturbance and 26 concerning cardiovascular and metabolic effects. The number, size and quality of the new studies suggest new meta-analyses could be undertaken over the sources and effects included in the WHO reviews.