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Altug H, Ogurtsova K, Breyer-Kohansal R, Schiffers C, Ofenheimer A, Tzivian L, Hartl S, Hoffmann B, Lucht S, Breyer MK. Associations of long-term exposure to air pollution and noise with body composition in children and adults: Results from the LEAD general population study. ENVIRONMENT INTERNATIONAL 2024; 189:108799. [PMID: 38865830 DOI: 10.1016/j.envint.2024.108799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 04/30/2024] [Accepted: 06/02/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND While long-term air pollution and noise exposure has been linked to increasing cardiometabolic disease risk, potential effects on body composition remains unclear. This study aimed to investigate the associations of long-term air pollution, noise and body composition. METHODS We used repeated data from the LEAD (Lung, hEart, sociAl, boDy) study conducted in Vienna, Austria. Body mass index (BMI; kg/m2), fat mass index (FMI; z-score), and lean mass index (LMI; z-score) were measured using dual-energy x-ray absorptiometry at the first (t0; 2011-ongoing) and second (t1; 2017-ongoing) examinations. Annual particulate matter (PM10) and nitrogen dioxide (NO2) concentrations were estimated with the GRAMM/GRAL model (2015-2021). Day-evening-night (Lden) and night-time (Lnight) noise levels from transportation were modeled for 2017 following the European Union Directive 2002/49/EC. Exposures were assigned to residential addresses. We performed analyses separately in children/adolescents and adults, using linear mixed-effects models with random participant intercepts and linear regression models for cross-sectional and longitudinal associations, respectively. Models were adjusted for co-exposure, lifestyle and sociodemographics. RESULTS A total of 19,202 observations (nt0 = 12,717, nt1 = 6,485) from participants aged 6-86 years (mean age at t0 = 41.0 years; 52.9 % female; mean PM10 = 21 µg/m3; mean follow-up time = 4.1 years) were analyzed. Among children and adolescents (age ≤ 18 years at first visit), higher PM10exposure was cross-sectionally associated with higher FMI z-scores (0.09 [95 % Confidence Interval (CI): 0.03, 0.16]) and lower LMI z-scores (-0.05 [95 % CI: -0.10, -0.002]) per 1.8 µg/m3. Adults showed similar trends in cross-sectional associations as children, though not reaching statistical significance. We observed no associations for noise exposures. Longitudinal analyses on body composition changes over time yielded positive associations for PM10, but not for other exposures. CONCLUSION Air pollution exposure, mainly PM10, was cross-sectionally and longitudinally associated with body composition in children/adolescents and adults. Railway/road-traffic noise exposures showed no associations in both cross-sectional and longitudinal analyses.
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Affiliation(s)
- Hicran Altug
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany.
| | - Katherine Ogurtsova
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Hietzing, Vienna, Austria
| | | | - Alina Ofenheimer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Lilian Tzivian
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany; Institute of Clinical and Preventive Medicine, University of Latvia, Riga, Latvia
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Sigmund Freud University, Faculty of Medicine, Vienna, Austria
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany
| | - Sarah Lucht
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany; Cardinal Health, Dublin, OH, USA
| | - Marie-Kathrin Breyer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Vienna, Austria
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Vienneau D, Wicki B, Flückiger B, Schäffer B, Wunderli JM, Röösli M. Long-term exposure to transportation noise and diabetes mellitus mortality: a national cohort study and updated meta-analysis. Environ Health 2024; 23:46. [PMID: 38702725 PMCID: PMC11068573 DOI: 10.1186/s12940-024-01084-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 04/22/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Long-term exposure to transportation noise is related to cardio-metabolic diseases, with more recent evidence also showing associations with diabetes mellitus (DM) incidence. This study aimed to evaluate the association between transportation noise and DM mortality within the Swiss National Cohort. METHODS During 15 years of follow-up (2001-2015; 4.14 million adults), over 72,000 DM deaths were accrued. Source-specific noise was calculated at residential locations, considering moving history. Multi-exposure, time-varying Cox regression was used to derive hazard ratios (HR, and 95%-confidence intervals). Models included road traffic, railway and aircraft noise, air pollution, and individual and area-level covariates including socio-economic position. Analyses included exposure-response modelling, effect modification, and a subset analysis around airports. The main findings were integrated into meta-analyses with published studies on mortality and incidence (separately and combined). RESULTS HRs were 1.06 (1.05, 1.07), 1.02 (1.01, 1.03) and 1.01 (0.99, 1.02) per 10 dB day evening-night level (Lden) road traffic, railway and aircraft noise, respectively (adjusted model, including NO2). Splines suggested a threshold for road traffic noise (~ 46 dB Lden, well below the 53 dB Lden WHO guideline level), but not railway noise. Substituting for PM2.5, or including deaths with type 1 DM hardly changed the associations. HRs were higher for males compared to females, and in younger compared to older adults. Focusing only on type 1 DM showed an independent association with road traffic noise. Meta-analysis was only possible for road traffic noise in relation to mortality (1.08 [0.99, 1.18] per 10 dB, n = 4), with the point estimate broadly similar to that for incidence (1.07 [1.05, 1.09] per 10 dB, n = 10). Combining incidence and mortality studies indicated positive associations for each source, strongest for road traffic noise (1.07 [1.05, 1.08], 1.02 [1.01, 1.03], and 1.02 [1.00, 1.03] per 10 dB road traffic [n = 14], railway [n = 5] and aircraft noise [n = 5], respectively). CONCLUSIONS This study provides new evidence that transportation noise is associated with diabetes mortality. With the growing evidence and large disease burden, DM should be viewed as an important outcome in the noise and health discussion.
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Affiliation(s)
- Danielle Vienneau
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Benedikt Wicki
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
| | - Benjamin Flückiger
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
| | - Beat Schäffer
- Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Acoustics/Noise Control, Empa, Dübendorf, Switzerland
| | - Jean Marc Wunderli
- Swiss Federal Laboratories for Materials Science and Technology, Laboratory for Acoustics/Noise Control, Empa, Dübendorf, Switzerland
| | - Martin Röösli
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, CH-4123, Switzerland
- University of Basel, Basel, Switzerland
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Bozigar M, Laden F, Hart JE, Redline S, Huang T, Whitsel EA, Nelson EJ, Grady ST, Levy JI, Peters JL. Aircraft noise exposure and body mass index among female participants in two Nurses' Health Study prospective cohorts living around 90 airports in the United States. ENVIRONMENT INTERNATIONAL 2024; 187:108660. [PMID: 38677085 DOI: 10.1016/j.envint.2024.108660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 04/29/2024]
Abstract
OBJECTIVE Aircraft noise exposure is linked to cardiovascular disease risk. One understudied candidate pathway is obesity. This study investigates the association between aircraft noise and obesity among female participants in two prospective Nurses' Health Study (NHS and NHSII) cohorts. METHODS Aircraft day-night average sound levels (DNL) were estimated at participant residential addresses from modeled 1 dB (dB) noise contours above 44 dB for 90 United States (U.S.) airports in 5-year intervals 1995-2010. Biennial surveys (1994-2017) provided information on body mass index (BMI; dichotomized, categorical) and other individual characteristics. Change in BMI from age 18 (BMI18; tertiles) was also calculated. Aircraft noise exposures were dichotomized (45, 55 dB), categorized (<45, 45-54, ≥55 dB) or continuous for exposure ≥45 dB. Multivariable multinomial logistic regression using generalized estimating equations were adjusted for individual characteristics and neighborhood socioeconomic status, greenness, population density, and environmental noise. Effect modification was assessed by U.S. Census region, climate boundary, airline hub type, hearing loss, and smoking status. RESULTS At baseline, the 74,848 female participants averaged 50.1 years old, with 83.0%, 14.8%, and 2.2% exposed to <45, 45-54, and ≥55 dB of aircraft noise, respectively. In fully adjusted models, exposure ≥55 dB was associated with 11% higher odds (95% confidence interval [95%CI]: -1%, 24%) of BMIs ≥30.0, and 15% higher odds (95%CI: 3%, 29%) of membership in the highest tertile of BMI18 (ΔBMI 6.7 to 71.6). Less-pronounced associations were observed for the 2nd tertile of BMI18 (ΔBMI 2.9 to 6.6) and BMI 25.0-29.9 as well as exposures ≥45 versus <45 dB. There was evidence of DNL-BMI trends (ptrends ≤ 0.02). Stronger associations were observed among participants living in the West, arid climate areas, and among former smokers. DISCUSSION In two nationwide cohorts of female nurses, higher aircraft noise exposure was associated with higher BMI, adding evidence to an aircraft noise-obesity-disease pathway.
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Affiliation(s)
- Matthew Bozigar
- School of Nutrition and Public Health, College of Health, Oregon State University, 160 SW 26th Street, Corvallis, OR 97331, USA.
| | - Francine Laden
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Jaime E Hart
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Susan Redline
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Medicine, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA 02215, USA
| | - Tianyi Huang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Elizabeth J Nelson
- College of Arts and Sciences, Boston University, 725 Commonwealth Avenue, Boston, MA 02215, USA
| | - Stephanie T Grady
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA
| | - Junenette L Peters
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, USA
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Basner M, Barnett I, Carlin M, Choi GH, Czech JJ, Ecker AJ, Gilad Y, Godwin T, Jodts E, Jones CW, Kaizi-Lutu M, Kali J, Opsomer JD, Park-Chavar S, Smith MG, Schneller V, Song N, Shaw PA. Effects of Aircraft Noise on Sleep: Federal Aviation Administration National Sleep Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7024. [PMID: 37947580 PMCID: PMC10650692 DOI: 10.3390/ijerph20217024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/28/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
Aircraft noise can disrupt sleep and impair recuperation. The last U.S. investigation into the effects of aircraft noise on sleep dates back more than 20 years. Since then, traffic patterns and the noise levels produced by single aircraft have changed substantially. It is therefore important to acquire current data on sleep disturbance relative to varying degrees of aircraft noise exposure in the U.S. that can be used to check and potentially update the existing noise policy. This manuscript describes the design, procedures, and analytical approaches of the FAA's National Sleep Study. Seventy-seven U.S. airports with relevant nighttime air traffic from 39 states are included in the sampling frame. Based on simulation-based power calculations, the field study aims to recruit 400 participants from four noise strata and record an electrocardiogram (ECG), body movement, and sound pressure levels in the bedroom for five consecutive nights. The primary outcome of the study is an exposure-response function between the instantaneous, maximum A-weighted sound pressure levels (dBA) of individual aircraft measured in the bedroom and awakening probability inferred from changes in heart rate and body movement. Self-reported sleep disturbance due to aircraft noise is the secondary outcome that will be associated with long-term average noise exposure metrics such as the Day-Night Average Sound Level (DNL) and the Nighttime Equivalent Sound Level (Lnight). The effect of aircraft noise on several other physiological and self-report outcomes will also be investigated. This study will provide key insights into the effects of aircraft noise on objectively and subjectively assessed sleep disturbance.
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Affiliation(s)
- Mathias Basner
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Ian Barnett
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Michele Carlin
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Grace H. Choi
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Joseph J. Czech
- Harris Miller Miller & Hanson Inc. (HMMH), Anaheim, CA 92805, USA
| | - Adrian J. Ecker
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Yoni Gilad
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | | | - Christopher W. Jones
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Marc Kaizi-Lutu
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | | | | | - Sierra Park-Chavar
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Michael G. Smith
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Victoria Schneller
- Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Nianfu Song
- Center for Clinical Epidemiology & Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Pamela A. Shaw
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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Rahmanian M, Zare Sakhvidi MJ, Mehrparvar AH, Zare Sakhvidi F, Dadvand P. Association between occupational noise exposure and diabetes: A systematic review and meta-analysis. Int J Hyg Environ Health 2023; 252:114222. [PMID: 37454581 DOI: 10.1016/j.ijheh.2023.114222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 06/21/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND In addition to the well-known risk factors of diabetes, evidence is accumulating on the negative role of environmental and occupational factors such as noise exposure. We conducted a systematic review and meta-analysis on the association between long-term occupational noise exposure and diabetes. METHODS We systematically searched evidence in PubMed, Scopus, and Web of Science (until August 2022) according to the PRISMA protocol. Risk of bias was assessed using the Newcastle-Ottawa scale. Random-effects meta-analysis was applied separately for risk ratio (odds ratio, relative risk) and hazard ratio. We evaluated the heterogeneity and publication bias. We applied meta-regressions to identify sources of heterogeneity. The overall body of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. RESULTS Of 533 retrieved articles, twelve studies (11 on non-gestational, and one on gestational diabetes) on total 106,045 population (23,996 diabetic cases) met our inclusion criteria; of which eight studies were cross-sectional, three were cohorts, and one was case-control. Only 40% of papers (five out of 12) had fair, good or very good quality, and most of the papers had poor or very poor quality in terms of risk of bias. We observed a non-significant increased risk of diabetes in association with occupational noise exposure (combined risk estimates: 1.16, 95% confidence interval [CI]: 0.97: 1.34; I2 = 57.7%). Doing separate meta-analyses on cohort and rest of studies, we found similar findings (cohort studies (n = 3): combined risk estimate: 1.17; 95% CI: 0.84: 1.50; I2 = 79%; cross-sectional studies (n = 8): combined risk estimate: 1.26; 95% CI: 0.93: 1.58; I2 = 50.4%). We found no indication of publication bias. CONCLUSIONS The overall evidence on the association between occupational noise exposure and diabetes is heterogeneous, limited, and mostly with low quality. More robust studies in terms of population selection, exposure and outcome assessment, and adjustment for confounders are necessary.
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Affiliation(s)
- Masoud Rahmanian
- Department of Endocrinology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fariba Zare Sakhvidi
- Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain
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Nguyen DD, Whitsel EA, Wellenius GA, Levy JI, Leibler JH, Grady ST, Stewart JD, Fox MP, Collins JM, Eliot MN, Malwitz A, Manson JE, Peters JL. Long-term aircraft noise exposure and risk of hypertension in postmenopausal women. ENVIRONMENTAL RESEARCH 2023; 218:115037. [PMID: 36502895 PMCID: PMC9845139 DOI: 10.1016/j.envres.2022.115037] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 11/21/2022] [Accepted: 12/08/2022] [Indexed: 05/28/2023]
Abstract
BACKGROUND Studies of the association between aircraft noise and hypertension are complicated by inadequate control for potential confounders and a lack of longitudinal assessments, and existing evidence is inconclusive. OBJECTIVES We evaluated the association between long-term aircraft noise exposure and risk of hypertension among post-menopausal women in the Women's Health Initiative Clinical Trials, an ongoing prospective U.S. COHORT METHODS Day-night average (DNL) and night equivalent sound levels (Lnight) were modeled for 90 U.S. airports from 1995 to 2010 in 5-year intervals using the Aviation Environmental Design Tool and linked to participant geocoded addresses from 1993 to 2010. Participants with modeled exposures ≥45 A-weighted decibels (dB [A]) were considered exposed, and those outside of 45 dB(A) who also did not live in close proximity to unmodeled airports were considered unexposed. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mmHg or inventoried/self-reported antihypertensive medication use. Using time-varying Cox proportional hazards models, we estimated hazard ratios (HRs) for incident hypertension when exposed to DNL or Lnight ≥45 versus <45 dB(A), controlling for sociodemographic, behavioral, and environmental/contextual factors. RESULTS/DISCUSSION There were 18,783 participants with non-missing DNL exposure and 14,443 with non-missing Lnight exposure at risk of hypertension. In adjusted models, DNL and Lnight ≥45 db(A) were associated with HRs of 1.00 (95% confidence interval [CI]: 0.93, 1.08) and 1.06 (95%CI: 0.91, 1.24), respectively. There was no evidence supporting a positive exposure-response relationship, and findings were robust in sensitivity analyses. Indications of elevated risk were seen among certain subgroups, such as those living in areas with lower population density (HRinteraction: 0.84; 95%CI: 0.72, 0.98) or nitrogen dioxide concentrations (HRinteraction: 0.82; 95%CI: 0.71, 0.95), which may indicate lower ambient/road traffic noise. Our findings do not suggest a relationship between aircraft noise and incident hypertension among older women in the U.S., though associations in lower ambient noise settings merit further investigation.
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Affiliation(s)
- Daniel D Nguyen
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gregory A Wellenius
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Jonathan I Levy
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Jessica H Leibler
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Stephanie T Grady
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthew P Fox
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA; Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Jason M Collins
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melissa N Eliot
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Andrew Malwitz
- Volpe National Transportation Systems Center, U.S. Department of Transportation, Cambridge, MA, USA
| | - JoAnn E Manson
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Junenette L Peters
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA.
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7
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Liu C, Li W, Chen X, Liu M, Zuo L, Chen L, Chen H, Xu W, Hao G. Dose-response association between transportation noise exposure and type 2 diabetes: A systematic review and meta-analysis of prospective cohort studies. Diabetes Metab Res Rev 2023; 39:e3595. [PMID: 36408740 DOI: 10.1002/dmrr.3595] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/19/2022] [Accepted: 10/28/2022] [Indexed: 11/22/2022]
Abstract
AIMS To examine the longitudinal association between transportation noise exposure (road traffic, aircraft, and railway noise) and T2D in a meta-analysis. MATERIALS AND METHODS We systematically searched PubMed, Embase, Scopus, Cochrane, and Web of Science published up to February 2022. The GRADE approach was used to evaluate the study quality, and the pooled effect estimate was calculated by the fixed-effects model or the random-effects model. RESULTS We included 10 prospective studies with a total of 4,994,171 participants and 417,332 T2D cases in the meta-analysis. According to the Navigation guide, 8 studies out of 10 were rated as having a probably high or high risk of bias. For road noise, the pooled relative risk (RR) per 10 dB higher Lden for developing T2D was 1.06 (95% CI:1.03, 1.09) with high heterogeneity (I2 = 90.1%, p < 0.001). Similar associations were also observed in aircraft and railway noise: the pooled RR were separately were: 1.01 (1.00, 1.01) and 1.02 (1.01, 1.03) separately. A 'dose-response' analysis found a similar linear association between road noise exposure and the risk of T2D. CONCLUSIONS An overall 6% increase in the risk of T2D per 10 dB increase in road exposure was observed. Further studies are needed to confirm our findings, especially for aircraft and railway noise, and to identify the mechanisms involved.
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Affiliation(s)
- Chengzhi Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Wenxin Li
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xia Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Mingliang Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Lei Zuo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Li Chen
- Georgia Prevention Institute, Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Haiyan Chen
- Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Wenbin Xu
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Guang Hao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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8
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Pyko A, Roswall N, Ögren M, Oudin A, Rosengren A, Eriksson C, Segersson D, Rizzuto D, Andersson EM, Aasvang GM, Engström G, Gudjonsdottir H, Jørgensen JT, Selander J, Christensen JH, Brandt J, Leander K, Overvad K, Eneroth K, Mattisson K, Barregard L, Stockfelt L, Albin M, Simonsen MK, Tiittanen P, Molnar P, Ljungman P, Solvang Jensen S, Gustafsson S, Lanki T, Lim YH, Andersen ZJ, Sørensen M, Pershagen G. Long-Term Exposure to Transportation Noise and Ischemic Heart Disease: A Pooled Analysis of Nine Scandinavian Cohorts. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:17003. [PMID: 36607286 PMCID: PMC9819217 DOI: 10.1289/ehp10745] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 12/09/2022] [Accepted: 12/09/2022] [Indexed: 05/25/2023]
Abstract
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.
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Affiliation(s)
- Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Nina Roswall
- Danish Cancer Society Research Centre, Copenhagen, Denmark
| | - Mikael Ögren
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Oudin
- Planetary Health, Lund University, Lund, Sweden
- Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Annika Rosengren
- Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Charlotta Eriksson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - David Segersson
- Swedish Meteorological and Hydrological Institute, Norrköping, Sweden
- Department of Environmental Science, Stockholm University, Stockholm, Sweden
| | - Debora Rizzuto
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Eva M. Andersson
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Gunn Marit Aasvang
- Department of Environmental Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Gunnar Engström
- Department of Clinical Science, Lund University, Malmö, Sweden
| | - Hrafnhildur Gudjonsdottir
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Jenny Selander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- iClimate – Interdisciplinary Centre for Climate Change, Aarhus University, Roskilde, Denmark
| | - Karin Leander
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kim Overvad
- Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | | | - Kristoffer Mattisson
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Lars Barregard
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Leo Stockfelt
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Maria Albin
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Mette K. Simonsen
- Department of Neurology, The Parker Institute, Frederiksberg Hospital, Capital Region, Frederiksberg, Denmark
| | - Pekka Tiittanen
- Department of Health Security, Finnish Institute for Health and Welfare (THL), Kuopio, Finland
| | - Peter Molnar
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | | | | | - Timo Lanki
- Department of Health Security, Finnish Institute for Health and Welfare (THL), Kuopio, Finland
- School of Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio, Finland
| | - Youn-Hee Lim
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Zorana J. Andersen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mette Sørensen
- Danish Cancer Society Research Centre, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
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9
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Oh HY, Yoo JE. The Association between Duration of Noise Exposure in the Workplace and Glucose Metabolism Status: Evidence from the Korea National Health and Nutrition Examination Survey. Korean J Fam Med 2022; 43:396-402. [PMID: 36444125 PMCID: PMC9708854 DOI: 10.4082/kjfm.21.0180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/28/2021] [Accepted: 10/11/2021] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND This study aimed to evaluate the association between the duration of workplace noise exposure and glucose metabolism status in a nationally representative Korean sample. METHODS This cross-sectional study included 3,534 participants aged ≥40 years without tinnitus or hearing loss from the Korea National Health and Nutrition Examination Survey (2018). The primary exposure was noise in the workplace and its duration. We divided the noise exposure group into four groups according to the duration of noise exposure (<3 years, 3-10 years, 10-20 years, and ≥20 years). The primary outcomes were fasting blood sugar (FBS), hemoglobin A1c (HbA1c), and pre-diabetes and diabetes diagnosed using FBS. Logistic and linear regression analyses were used to test the association between noise exposure and glycemic status. RESULTS After adjustment, HbA1c levels were significantly higher in the noise exposure than in the non-noise exposure group. HbA1c levels were significantly higher in those exposed to occupational noise for more than 20 years than in others. In the subgroup analysis among those who had been exposed to noise for >20 years, the non-aerobic physical activity group had significantly higher HbA1c levels than the physical activity group. Furthermore, among those who had been exposed to noise for >20 years, the without hearing protection group had significantly higher HbA1c levels than those using hearing protection. CONCLUSION The association between noise exposure and the prevalence of diabetes is unclear. However, our study clearly suggests that there is a relationship between elevated HbA1c levels and workplace noise exposure and that a long period of workplace noise exposure, no physical activity, and not wearing a hearing protection device could increase the risk of diabetes.
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Affiliation(s)
- Hye Yeong Oh
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
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10
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Zaman M, Muslim M, Jehangir A. Environmental noise-induced cardiovascular, metabolic and mental health disorders: a brief review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:76485-76500. [PMID: 35931843 DOI: 10.1007/s11356-022-22351-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/28/2022] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- Muzafar Zaman
- Department of Environmental Science, University of Kashmir, Hazratbal, Srinagar, 190006, Jammu and Kashmir, India
| | - Mohammad Muslim
- Department of Environmental Science, University of Kashmir, Hazratbal, Srinagar, 190006, Jammu and Kashmir, India
| | - Arshid Jehangir
- Department of Environmental Science, University of Kashmir, Hazratbal, Srinagar, 190006, Jammu and Kashmir, India.
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11
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Zuo L, Chen X, Liu M, Chen L, Xu W, Chen H, Dong S, Wei Y, Li L, Peng S, Hao G. Road Traffic Noise, Obesity, and the Risk of Incident Type 2 Diabetes: A Cohort Study in UK Biobank. Int J Public Health 2022; 67:1605256. [PMID: 36312318 PMCID: PMC9596764 DOI: 10.3389/ijph.2022.1605256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 09/26/2022] [Indexed: 08/03/2023] Open
Abstract
Objectives: To assess the association of road traffic noise exposure with Type 2 Diabetes (T2D) risk, and to explore the potential moderation effect of obesity. Methods: A total of 305,969 participants from the UK Biobank Cohort - an open access cohort of 500,000 participants recruited in the United Kingdom (UK) between 2006 and 2010 - were included in the study. A Cox proportional hazard model was fitted to assess the association between road traffic noise exposure and T2D. Results: A total of 19,303 participants were diagnosed with T2D during the 11.9-year median follow-up period. For every 10 dB increase in road traffic noise, there was a 4% increase in T2D risk (HR = 1.04, 95%CI: 1.01, 1.07). Besides, a significant positive interaction was observed between obesity and road traffic noise (P interaction <0.001) for the risk of T2D. The association of road traffic noise with T2D was stronger in overweight and obese participants (HR = 1.04, 95% CI: 1.01-1.08), but not significant among lean ones (HR = 0.96, 95% CI: 0.86-1.07). Conclusion: Our study observed a longitudinal association of road traffic noise exposure with T2D risk, which was stronger among overweight and obese individuals than the lean ones.
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Affiliation(s)
- Lei Zuo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xia Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Mingliang Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Li Chen
- Department of Medicine, Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Wenbin Xu
- School of Environmental Science and Engineering, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Haiyan Chen
- Department of Parasitic Disease and Endemic Disease Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou, China
| | - Shan Dong
- Guangzhou First People’s Hospital, The Second Affiliated Hospital of South China University of Technology, Guangzhou, China
| | - Yuan Wei
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
| | - Liangming Li
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
- School of Sport and Health Sciences, Guangzhou Sport University, Guangzhou, China
| | - Shuang Peng
- Key Laboratory of Sports Technique, Tactics and Physical Function of General Administration of Sport of China, Scientific Research Center, Guangzhou Sport University, Guangzhou, China
- School of Sport and Health Sciences, Guangzhou Sport University, Guangzhou, China
| | - Guang Hao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
- Guangdong Key Laboratory of Environmental Exposure and Health, Jinan University, Guangzhou, China
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12
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Vincens N, Persson Waye K. Railway noise and diabetes among residents living close to the railways in Västra Götaland, Sweden: Cross-sectional mediation analysis on obesity indicators. ENVIRONMENTAL RESEARCH 2022; 212:113477. [PMID: 35588775 DOI: 10.1016/j.envres.2022.113477] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/06/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
Railway noise is expected to increase in Europe and Sweden as well, following recommendations for a more sustainable transportation mode. This forecasted increase might lead to higher level of noise exposure, higher population exposure and potentially increased night-time exposure. Evidence supports an effect of transportation noise on several health outcomes, including metabolic conditions such as diabetes. However, few studies were directed to railway noise; present studies on railway noise and diabetes so far show ambiguous results while some studies report an association between railway noise and obesity. The aim of this study is to investigate the relationship between railway noise and diabetes prevalence and to assess whether obesity might be a mediator in this association. The study population (N = 5381) was randomly selected from residents living within 1 km of a trafficked railway in Västra Götaland, Sweden. Survey data was combined with modelled exposures and health register data (ICD10 codes for diabetes). The study uses a cross sectional design, logistic regression analysis and a counterfactual mediation analysis. We found an increase in the prevalence of diabetes associated with the exposure to railway noise: OR = 1.33 per 10 dB increase Lden (95% CI 1.09-1.63) accounting for sociodemographic and lifestyle factors. BMI and waist circumference partially mediate the association between railway noise and diabetes. This is the first study to report an association between railway noise and diabetes in Sweden. BMI and waist circumference seem to be a potential mediators in this association. Still, future studies should further explore the mechanisms from noise to diabetes, considering different pathways in relation to obesity but also exploring other potential mediators.
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Affiliation(s)
- Natalia Vincens
- Sound Environment and Health, Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
| | - Kerstin Persson Waye
- Sound Environment and Health, Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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13
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Gui SY, Wu KJ, Sun Y, Chen YN, Liang HR, Liu W, Lu Y, Hu CY. Traffic noise and adiposity: a systematic review and meta-analysis of epidemiological studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:55707-55727. [PMID: 35320480 DOI: 10.1007/s11356-022-19056-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Traffic noise has attracted much attention as a significant and intractable public health threat. This study was designed as a systematical review to explore the association of traffic noise with different indicators of obesity, thus providing updated quantitative estimates for the pooled effect estimates of the existing literature. We conducted an extensive search for epidemiological studies that investigated the association of traffic noise with obesity in three electronic databases till February 23, 2021. We used random-effects meta-analysis to calculate the summary effect estimates for each 10-dB(A) increase in noise and compared the highest with the lowest category of noise in relation to seven obesity indicators. Meanwhile, we assessed the risk of bias and the overall quality of the evidence of each study as well as the level of evidence for each exposure-outcome pair. The initial search identified 30 studies, 13 of which were ultimately included. The meta-analysis for the highest versus the lowest category of noise exposure was generally associated with higher waist circumfluence (WC) ranging from 0.326 cm (95% confidence interval (CI) = 0.078, 0.574) to 0.705 cm (95% CI = 0.071, 1.340) and higher odds of central obesity ranging from 1.055 (95% CI = 1.000, 1.109) to 1.167 (95% CI = 1.037, 1.298). When the continuous exposure (each 10 dB(A) increase in noise) was introduced, similar results were found. This study indicated positive associations of traffic noise with WC and central obesity. However, in consideration of some limitations, there is an urgent need for future studies to increase the sample size, discriminate the etiological differences in different noise and obesity indicators, and thoroughly consider socioeconomic status.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Ke-Jia Wu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yue Sun
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, China
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yue-Nan Chen
- Department of Clinical Pharmacy, School of Pharmacy, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Huan-Ru Liang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Wen Liu
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yao Lu
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, China.
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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14
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Bayo Jimenez MT, Frenis K, Hahad O, Steven S, Cohen G, Cuadrado A, Münzel T, Daiber A. Protective actions of nuclear factor erythroid 2-related factor 2 (NRF2) and downstream pathways against environmental stressors. Free Radic Biol Med 2022; 187:72-91. [PMID: 35613665 DOI: 10.1016/j.freeradbiomed.2022.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/23/2022] [Accepted: 05/19/2022] [Indexed: 12/14/2022]
Abstract
Environmental risk factors, including noise, air pollution, chemical agents, ultraviolet radiation (UVR) and mental stress have a considerable impact on human health. Oxidative stress and inflammation are key players in molecular pathomechanisms of environmental pollution and risk factors. In this review, we delineate the impact of environmental risk factors and the protective actions of the nuclear factor erythroid 2-related factor 2 (NRF2) in connection to oxidative stress and inflammation. We focus on well-established studies that demonstrate the protective actions of NRF2 and its downstream pathways against different environmental stressors. State-of-the-art mechanistic considerations on NRF2 signaling are discussed in detail, e.g. classical concepts like KEAP1 oxidation/electrophilic modification, NRF2 ubiquitination and degradation. Specific focus is also laid on NRF2-dependent heme oxygenase-1 induction with detailed presentation of the protective down-stream pathways of heme oxygenase-1, including interaction with BACH1 system. The significant impact of all environmental stressors on the circadian rhythm and the interactions of NRF2 with the circadian clock will also be considered here. A broad range of NRF2 activators is discussed in relation to environmental stressor-induced health side effects, thereby suggesting promising new mitigation strategies (e.g. by nutraceuticals) to fight the negative effects of the environment on our health.
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Affiliation(s)
- Maria Teresa Bayo Jimenez
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Katie Frenis
- Department of Hematology and Oncology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Leibniz Insitute for Resilience Research (LIR), Mainz, Germany
| | - Sebastian Steven
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Guy Cohen
- The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, 86910, Israel; Ben Gurion University of the Negev, Eilat Campus, Eilat, 8855630, Israel
| | - Antonio Cuadrado
- Departamento de Bioquímica, Facultad de Medicina, Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Investigación Sanitaria La Paz (IdiPaz), Instituto de Investigaciones Biomédicas 'Alberto Sols' UAM-CSIC, Universidad Autónoma de Madrid, Madrid, Spain
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Andreas Daiber
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
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15
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Kheirandish A, Mehrparvar A, Abou-Bakre A, Zare Sakhvidi MJ. Association between long-term occupational noise exposure and obesity. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:20176-20185. [PMID: 34729714 DOI: 10.1007/s11356-021-17299-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 10/27/2021] [Indexed: 06/13/2023]
Abstract
Noise exposure has been linked to several health outcomes including obesity. This cross-sectional study examined the association between occupational noise exposure and body mass index as a measure of general obesity in 913 textile workers (totally from nine factories) in Yazd city, Iran, from winter to summer of 2018. The sound pressure level (dBA) at each working station was measured by a calibrated sound level meter. The long-term noise exposure score of each worker (as dBA.year) was calculated by multiplying the working history in each unit to its corresponding noise level. Models were adjusted for personal, behavioral, environmental, and family history factors. In total, 81.05% (n = 740) of the participants were exposed to noise levels higher than 85 dBA. The direct association was found for the fully adjusted model (β = 0.002; 95% CI: 0.001: 0.004). For the model with past year noise exposure, a 10.6% increase in odds was observed for each 5 dBA increase in noise exposure (95% CI: 1.005: 1.216). We found a 0.1% increase in the odds of being overweight in mixed-gender analysis (95% CI: 1.001:1.002) for each 5 dBA.year in the fully adjusted model. Occupational noise exposure should be regarded as a risk factor for cardiometabolic outcomes in industrial workers.
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Affiliation(s)
- AhmadAli Kheirandish
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amirhooshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abdellah Abou-Bakre
- Department of Mathematics, Faculty of Sciences and Technics, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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16
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Liang X, Tang X, Liu M, Liang X, Chen L, Chen X, Zuo L, Ren Y, Hao G. Associations of self-reported residential noise exposure with obesity and hypertension in children and adolescents. Front Pediatr 2022; 10:902868. [PMID: 36034553 PMCID: PMC9411713 DOI: 10.3389/fped.2022.902868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Epidemiologic evidence linking environmental noise to obesity and hypertension remains scarce, especially in children, and the results remain inconclusive. This study aims to examine the cross-sectional associations of self-reported residential noise exposure with obesity and hypertension in children and adolescents. METHODS As an ongoing study, a representative sample of the children aged 6-9 years in Chongqing were selected in 2014. In 2019, self-reported residential noise (answer categories: "very quiet," "moderately quiet," "slightly quiet," and "not at all quiet") data were collected, and 3,412 participants with completed data were included in the analyses. RESULTS Participants living in a quieter area had a significantly lower risk of obesity than those living in a noisy area (very quiet: OR = 0.50, 95%CI: 0.29-0.88, P = 0.015; moderately quiet: OR = 0.61, 95%CI: 0.36-1.02, P = 0.059). Similar associations were observed for abdominal obesity, although did not reach statistical significance. Consistently, residential noise exposure was significantly associated with body mass index (BMI) and waist-to-height ratio. Self-reported residential noise exposure was positively associated with systolic blood pressure (β = -1.808; 95%CI = -3.495, -0.110; P = 0.037). When sleep quality, study stress, BMI, and vegetable/fruits consumption were further adjusted, all effect estimates decreased, and no statistical association was observed between noise exposure and blood pressure. Furthermore, we found that the mediating effects of obesity on the associations of self-reported residential noise exposure with hypertension were 6.8% (% of total effect mediated = 0.068, 95%CI: -2.58, 3.99), although did not reach statistical significance. CONCLUSIONS Self-reported residential noise exposure was associated with a higher risk of obesity or abdominal obesity. Also, self-reported residential noise exposure was positively associated with hypertension, and obesity may partially mediate this association, but did not reach statistical significance.
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Affiliation(s)
- Xiaohua Liang
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Xian Tang
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Mingliang Liu
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Xiaoyue Liang
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Li Chen
- Department of Medicine, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA, United States
| | - Xia Chen
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Lei Zuo
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
| | - Yanling Ren
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Guang Hao
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China
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Michaud D, Sivakumaran K, Ritonja J, Waseem H, AlShenaiber L, Morgan E, Ahmadi S, Denning A, Morgan R. Impact of Noise Exposure on Risk of Developing Stress-Related Metabolic Effects: A Systematic Review and Meta-Analysis. Noise Health 2022; 24:215-230. [PMID: 36537446 PMCID: PMC10088431 DOI: 10.4103/nah.nah_21_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background Exposure to noise can increase biological stress reactions, which may increase adverse health effects, including metabolic disorders; however, the certainty in the association between exposure to noise and metabolic outcomes has not been widely explored. The objective of this review is to evaluate the evidence between noise exposures and metabolic effects. Materials and Methods A systematic review of English and comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases between January 1, 1980 and December 29, 2021 was performed. Risk of Bias of Nonrandomized Studies of Exposures was used to assess risk of bias of individual studies and certainty of the body of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results Fifty-six primary studies reporting on cortisol, cholesterol levels, waist circumference, glucose levels, and adrenaline and/or noradrenaline were identified. Although meta-analyses suggested that there may be an increase in waist circumference and adrenaline with increased noise exposure, the certainty in the evidence is very low. Overall, the certainty in the evidence of an effect of increased noise on all the outcomes were low to very low due to concerns with risk of bias, inconsistency across exposure sources, populations, and studies, and imprecision in the estimates of effects. Conclusions The certainty of the evidence of increased noise on metabolic effects was low to very low, which likely reflects the inability to compare across the totality of the evidence for each outcome. The findings from this review may be used to inform policies involving noise reduction and mitigation strategies, and to direct further research in areas that currently have limited evidence available.
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Thacher JD, Poulsen AH, Hvidtfeldt UA, Raaschou-Nielsen O, Brandt J, Geels C, Khan J, Münzel T, Sørensen M. Long-Term Exposure to Transportation Noise and Risk for Type 2 Diabetes in a Nationwide Cohort Study from Denmark. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:127003. [PMID: 34855467 PMCID: PMC8638828 DOI: 10.1289/ehp9146] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
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 ≤2.5μm 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. https://doi.org/10.1289/EHP9146.
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Affiliation(s)
- Jesse D. Thacher
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Aslak H. Poulsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ulla A. Hvidtfeldt
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ole Raaschou-Nielsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jibran Khan
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Danish Big Data Centre for Environment and Health, Aarhus University, Roskilde, Denmark
| | - Thomas Münzel
- Center for Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mette Sørensen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
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Sørensen M, Poulsen AH, Thacher J, Hvidtfeldt UA, Ketzel M, Geels C, Jensen SS, Valencia VH, Raaschou-Nielsen O. Transportation noise and risk for colorectal cancer: a nationwide study covering Denmark. Cancer Causes Control 2021; 32:1447-1455. [PMID: 34467460 DOI: 10.1007/s10552-021-01492-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 08/23/2021] [Indexed: 12/09/2022]
Abstract
PURPOSE Few studies have suggested that traffic noise is a risk factor for cancer, but evidence is inconclusive. We aimed to investigate whether road traffic and railway noise are associated with risk of colorectal cancer. METHODS We obtained address history for all 3.5 million people above 40 years of age and living in Denmark for the period 1990-2017 and estimated road traffic and railway noise (Lden) at the most and least exposed facades of all addresses as well as air pollution (PM2.5). During follow-up (2000-2017), 35,881 persons developed colon cancer and 19,755 developed rectal cancer. Information on individual and area-level demographic and socioeconomic variables was collected from Danish registries. We analyzed data using Cox proportional hazards models, including traffic noise as time-varying 10-year average exposure. RESULTS Exposure to road traffic noise at the most exposed façade was associated with an incidence rate ratio and 95% confidence interval for proximal colon cancer of 1.018 (0.999-1.038) per 10 dB higher noise. We observed no associations for road traffic noise at the least exposed façade or for railway noise in relation to proximal colon cancer. Also, we found no association between road traffic or railway noise and risk for distal colon cancer or rectal cancer. CONCLUSION Traffic noise did not seem associated with higher risk for colorectal cancer, although the suggestion of a slightly higher risk of proximal colon cancer following exposure to road traffic noise warrants further research.
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Affiliation(s)
- Mette Sørensen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark. .,Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.
| | - Aslak Harbo Poulsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Jesse Thacher
- Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Ulla Arthur Hvidtfeldt
- Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark.,Global Centre for Clean Air Research (GCARE), University of Surrey, Guildford, UK
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | | | - Victor H Valencia
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Ole Raaschou-Nielsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.,Department of Environmental Science, Aarhus University, Roskilde, Denmark
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Abstract
Epidemiological studies have found that transportation noise increases the risk of cardiovascular morbidity and mortality, with high-quality evidence for ischaemic heart disease. According to the WHO, ≥1.6 million healthy life-years are lost annually from traffic-related noise in Western Europe. Traffic noise at night causes fragmentation and shortening of sleep, elevation of stress hormone levels, and increased oxidative stress in the vasculature and the brain. These factors can promote vascular dysfunction, inflammation and hypertension, thereby elevating the risk of cardiovascular disease. In this Review, we focus on the indirect, non-auditory cardiovascular health effects of transportation noise. We provide an updated overview of epidemiological research on the effects of transportation noise on cardiovascular risk factors and disease, discuss the mechanistic insights from the latest clinical and experimental studies, and propose new risk markers to address noise-induced cardiovascular effects in the general population. We also explain, in detail, the potential effects of noise on alterations of gene networks, epigenetic pathways, gut microbiota, circadian rhythm, signal transduction along the neuronal-cardiovascular axis, oxidative stress, inflammation and metabolism. Lastly, we describe current and future noise-mitigation strategies and evaluate the status of the existing evidence on noise as a cardiovascular risk factor.
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Dias FAM, Caiaffa WT, Costa DADS, Xavier CC, Proietti FA, Friche AADL. Noise annoyance, sociodemographic and health patterns, and neighborhood perceptions in a Brazilian metropolis: BH Health Study. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210038. [PMID: 34231828 DOI: 10.1590/1980-549720210038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/14/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The present study aims to analyze the association of noise annoyance with individual and sociodemographic factors and self-perception of the neighborhood in an urban center. METHODS Data were collected through a population-based cross-sectional study held in two of the nine health districts in the city of Belo Horizonte, Minas Gerais, Brazil, from 2008 to 2009. The study included 3,934 individuals of both genders, aged 18 years and older. The response variable was the self-perception of noise, investigated by the question: "In your neighborhood, does the noise bother you?" The explanatory variables were grouped into the following domains: sociodemographic, social determinants, self-rated health, and self-reported diseases. RESULTS The prevalence of noise annoyance was 47% for women and 39.8% for men. For both genders, noise annoyance was independently associated with bad traffic and the presence of loud music, discussions, and late-night parties. CONCLUSION Gender differences were identified in the association of noise annoyance with sociodemographic characteristics and self-reported morbidity. Traffic and social customs were the main sources of noise in the regions under study.
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Affiliation(s)
- Fernanda Abalen Martins Dias
- School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Belo Horizonte Urban Health Observatory - Belo Horizonte (MG), Brazil.,Pontifícia Universidade Católica de Minas Gerais - Belo Horizonte (MG), Brazil
| | - Waleska Teixeira Caiaffa
- School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Belo Horizonte Urban Health Observatory - Belo Horizonte (MG), Brazil
| | | | - César Coelho Xavier
- Belo Horizonte Urban Health Observatory - Belo Horizonte (MG), Brazil.,School of Health and Human Ecology - Vespasiano (MG), Brazil
| | - Fernando Augusto Proietti
- Belo Horizonte Urban Health Observatory - Belo Horizonte (MG), Brazil.,René Rachou Research Center, Oswaldo Cruz Foundation - Belo Horizonte (MG), Brazil
| | - Amélia Augusta de Lima Friche
- School of Medicine, Universidade Federal de Minas Gerais - Belo Horizonte (MG), Brazil.,Belo Horizonte Urban Health Observatory - Belo Horizonte (MG), Brazil
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22
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Occupational Noise Exposure and Diabetes Risk. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2021; 2021:1804616. [PMID: 33828593 PMCID: PMC8004364 DOI: 10.1155/2021/1804616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/13/2020] [Accepted: 03/04/2021] [Indexed: 11/24/2022]
Abstract
Introduction Noise is one of the most common worldwide environmental pollutants, especially in occupational fields. As a stressor, it affects not only the ear but also the entire body. Its physiological and psychological impacts have been well established in many conditions such as cardiovascular diseases. However, there is a dearth of evidence regarding diabetes risk related to noises. Aim To evaluate the relationship between occupational exposure to noise and the risk of developing diabetes. Methods This is a cross-sectional analytical study enrolling two groups of 151 workers each. The first group (noise exposed group: EG) included the employees of a Tunisian power plant, who worked during the day shift and had a permanent position. The second group (unexposed to noise group: NEG) included workers assigned to two academic institutions, who were randomly selected in the Occupational Medicine Department of the Farhat Hached University Hospital in Sousse, during periodical fitness to work visits. Both populations (exposed and unexposed) were matched by age and gender. Data collection was based on a preestablished questionnaire, a physical examination, a biological assessment, and a sonometric study. Results The mean equivalent continuous sound level was 89 dB for the EG and 44.6 dB for the NEG. Diabetes was diagnosed in 24 workers from EG (15.9%) and 14 workers from NEG (9.3%), with no statistically significant difference (p=0.08). After multiple binary logistic regression, including variables of interest, noise did not appear to be associated with diabetes. Conclusion Our results did not reveal a higher risk of developing diabetes in workers exposed to noise. Further studies assessing both level and duration of noise exposure are needed before any definitive conclusion.
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Wang H, Sun D, Wang B, Gao D, Zhou Y, Wang N, Zhu B. Association between noise exposure and diabetes: meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:36085-36090. [PMID: 32623682 DOI: 10.1007/s11356-020-09826-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 06/19/2020] [Indexed: 06/11/2023]
Abstract
Diabetes is one of the typical chronic diseases, and its incidence is related to many environmental factors. At present, there is no radical cure for diabetes, so the prevention of diabetes is particularly important. In order to effectively prevent the occurrence of diabetes, it is necessary to understand the conditions leading to the occurrence of diabetes. Current studies have shown that long-term exposure to noise will increase the risk of diabetes. Literature was retrieved from Pubmed and Web of Science. The relationship between noise exposure and diabetes published in the past 10 years was retrieved from the literature. Two researchers screened the literatures and extracted the data according to the inclusion and exclusion criteria. Endnote software was used to manage the literature, and NOS (Newcastle-Ottawa Scale) scale was used to evaluate the quality of the included literatures. Random effects meta-analysis was used to comprehensively evaluate the noise exposure of diabetic patients, and stata13.1 was used for data analysis. After adherence to strict inclusion and exclusion criteria, eight studies on the association between noise and diabetes were selected, including five cohort studies and three cross-sectional studies, with a total of 514,570 participants and 23,708 diabetics. The results showed that exposure to noise increased the risk of developing diabetes (OR = 1.08; 95% CI = 1.03 ~ 1.12). From the analysis of these selected articles, it can be seen that there is a positive correlation between noise and the occurrence of diabetes. As a result, it is necessary to strengthen routine blood tests for people who have been exposed to noise for a long time, especially those who have to be exposed to noise due to their occupations.
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Affiliation(s)
- Huimin Wang
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, No.87, Dingjiaqiao Campus, Zhongyangmen Street, Gulou District, Nanjing, 210009, Jiangsu, China
| | - Dawei Sun
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, No.87, Dingjiaqiao Campus, Zhongyangmen Street, Gulou District, Nanjing, 210009, Jiangsu, China
| | - Boshen Wang
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, No.87, Dingjiaqiao Campus, Zhongyangmen Street, Gulou District, Nanjing, 210009, Jiangsu, China
| | - Dengfeng Gao
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, No.87, Dingjiaqiao Campus, Zhongyangmen Street, Gulou District, Nanjing, 210009, Jiangsu, China
| | - Yanhua Zhou
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, No.87, Dingjiaqiao Campus, Zhongyangmen Street, Gulou District, Nanjing, 210009, Jiangsu, China
| | - Ning Wang
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, No.87, Dingjiaqiao Campus, Zhongyangmen Street, Gulou District, Nanjing, 210009, Jiangsu, China
| | - Baoli Zhu
- Key Laboratory of Environmental Medicine Engineering of Ministry of Education, School of Public Health, Southeast University, No.87, Dingjiaqiao Campus, Zhongyangmen Street, Gulou District, Nanjing, 210009, Jiangsu, China.
- Institute of Occupational Disease Prevention, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu Province, China.
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Schmidt S. Subchronic Noise and Metabolism: Rodent Model Identifies Potential Mechanistic Links. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:34004. [PMID: 32167799 PMCID: PMC7137916 DOI: 10.1289/ehp6304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 09/30/2019] [Indexed: 06/10/2023]
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Liao J, Chen X, Xu S, Li Y, Zhang B, Cao Z, Zhang Y, Liang S, Hu K, Xia W. Effect of residential exposure to green space on maternal blood glucose levels, impaired glucose tolerance, and gestational diabetes mellitus. ENVIRONMENTAL RESEARCH 2019; 176:108526. [PMID: 31202042 DOI: 10.1016/j.envres.2019.108526] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/30/2019] [Accepted: 06/05/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND Residential surrounding green spaces can affect human health. However, limited studies have examined their impacts on maternal blood glucose homeostasis outcomes. OBJECTIVE We examined the associations of residential exposure to green space with maternal blood glucose levels, gestational impaired glucose tolerance (IGT), and gestational diabetes mellitus (GDM). METHODS Pregnant women were recruited from a prospective birth cohort between October 2012 and September 2015. Exposure to green space was calculated as the mean value of the normalized difference vegetation index (NDVI) within a 300-m circular buffer area surrounding each residence. Maternal glucose was measured between 24 and 28 weeks of gestation, and gestational IGT and GDM were diagnosed using valid methods. We estimated the associations of residential NDVI with maternal glucose levels using multiple linear regression models with adjustment for age, education, BMI, passive smoking during pregnancy, parity, season of conception, income, and urbancity. We estimated the relative risks of residential NDVI with IGT and GDM using a generalized estimating equation model with modified Poisson regression. The mediation effects of residential exposure to air pollution and maternal physical activity were assessed using causal mediation analysis. RESULTS Of 6807 pregnant women, 751 (11.3%) and 604 (8.8%) were diagnosed with IGT and GDM, respectively. One SD increment of residential NDVI was associated with a decrease of 0.06 mmol/L (95% CI: -0.07, -0.05), 0.09 mmol/L (95% CI: -0.13, -0.05), and 0.06 mmol/L (95% CI: -0.09, -0.03) in maternal fasting glucose levels, 1-h glucose levels, and 2-h glucose levels, respectively, as well as reduced risks of incident IGT (RR: 0.92, 95% CI: 0.86, 0.99) and GDM (RR: 0.85, 95% CI: 0.79, 0.92). The association between residential NDVI and maternal fasting glucose levels was partly mediated by maternal exposure to PM2.5. CONCLUSION Living with higher levels of green space was significantly associated with decreased maternal glucose levels and attenuated risks of incident maternal IGT and GDM. Our findings provide evidence linking green space to better maternal glucose outcomes. More studies are needed to further explore the maternal and child health benefits related to our findings.
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Affiliation(s)
- Jiaqiang Liao
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Xinmei Chen
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Yuanyuan Li
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Bin Zhang
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, People's Republic of China
| | - Zhongqiang Cao
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, People's Republic of China
| | - Yiming Zhang
- Women and Children Medical and Healthcare Center of Wuhan, Wuhan, Hubei, People's Republic of China
| | - Shengwen Liang
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province, 430000, China
| | - Ke Hu
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province, 430000, China
| | - Wei Xia
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, And State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China.
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Hu CS, Tkebuchava T. E-noise: An increasingly relevant health risk. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2019; 17:311-314. [PMID: 31362866 DOI: 10.1016/j.joim.2019.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/25/2019] [Indexed: 12/15/2022]
Abstract
This article briefly reviews and discusses the current status of major non-communicable diseases (mNCDs), definition of e-noise, its possible link as a risk factor for cardiovascular diseases and other mNCDs, and proposes possible mechanisms and hypotheses on that link, and how to control e-noise in the future. E-noise is defined as signal from electronic products and instruments that emit radiation and electromagnetic fields. It includes not only the acoustic but also non-acoustic noise. Just like road traffic and aircraft noises, e-noise may not only lead to hearing loss and health problems such as fatigue, stress, irritability, headache, and insomnia, but may also endanger cardiovascular health and result in hypertension, ischemic heart disease (myocardial infarction), arrhythmia (atrial fibrillation) and stroke; brain and metabolic problems such as obesity and diabetes; mental and cognitive impairment; as well as changing of humans' long-evolved cortisol and circadian rhythms after long-term exposure. Even short-term exposure to excessive e-noise may lead to heightened stress responses and low quality of life. In conclusion, e-noise is a potential danger in our world, and further studies are needed of its effects on mechanisms of aging, disease, and human health.
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Affiliation(s)
- Chun-Song Hu
- Jiangxi Academy of Medical Science, Hospital of Nanchang University, Nanchang University, Nanchang 330006, Jiangxi Province, China.
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Münzel T, Schmidt FP, Steven S, Herzog J, Daiber A, Sørensen M. Environmental Noise and the Cardiovascular System. J Am Coll Cardiol 2019; 71:688-697. [PMID: 29420965 DOI: 10.1016/j.jacc.2017.12.015] [Citation(s) in RCA: 222] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 12/12/2017] [Accepted: 12/15/2017] [Indexed: 01/13/2023]
Abstract
Noise has been found associated with annoyance, stress, sleep disturbance, and impaired cognitive performance. Furthermore, epidemiological studies have found that environmental noise is associated with an increased incidence of arterial hypertension, myocardial infarction, heart failure, and stroke. Observational and translational studies indicate that especially nighttime noise increases levels of stress hormones and vascular oxidative stress, which may lead to endothelial dysfunction and arterial hypertension. Novel experimental studies found aircraft noise to be associated with oxidative stress-induced vascular damage, mediated by activation of the NADPH oxidase, uncoupling of endothelial nitric oxide synthase, and vascular infiltration with inflammatory cells. Transcriptome analysis of aortic tissues from animals exposed to aircraft noise revealed changes in the expression of genes responsible for the regulation of vascular function, vascular remodeling, and cell death. This review focuses on the mechanisms and the epidemiology of noise-induced cardiovascular diseases and provides novel insight into the mechanisms underlying noise-induced vascular damage.
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Affiliation(s)
- Thomas Münzel
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany.
| | - Frank P Schmidt
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany
| | - Sebastian Steven
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany
| | - Johannes Herzog
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany
| | - Andreas Daiber
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
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Huang YK, Hanneke R, Jones RM. Bibliometric analysis of cardiometabolic disorders studies involving NO 2, PM 2.5 and noise exposure. BMC Public Health 2019; 19:877. [PMID: 31272504 PMCID: PMC6610906 DOI: 10.1186/s12889-019-7195-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 06/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study uses bibliometric analysis to describe the state of research about the association of NO2, PM2.5 and noise exposures - three traffic-related pollutants - with cardiometabolic disorders. METHODS We retrieved references published 1994-2017 from Scopus and classified references with respect to exposure, health outcome and study design using index keywords. Temporal trend, top cited references, used index keywords and the number of hypothesis testing and non-hypothesis testing study design for each group were identified. RESULTS Results show PM2.5 is the most frequently studied exposure (47%), followed by both NO2 and PM2.5 exposure (29%). Only 3% of references considered multiple exposures between NO2 and/or PM2.5 and noise, and these were published after 2008. While we observed a growing trend in studies with NO2 and/or PM2.5 and noise and diabetes in the last decade, there is a diminishing trend in studies with noise and diabetes. Different patterns of study designs were found through H/NH ratio, the number of references classified as having a hypothesis (H)-testing design relative to the number of references classified as having a non-hypothesis (NH)-testing design. Studies with NO2 and/or PM2.5 exposure are more likely to have a H-testing design, while those with noise exposure are more likely to have a NH-testing design, such as cross-sectional study design. CONCLUSIONS We conclude with three themes about research trends. First, the study of simultaneous exposures to multiple pollutants is a current trend, and likely to continue. Second, the association between traffic-related pollutants and diabetes and metabolic symptoms is an area for growth in research. Third, the transition to the use of H-testing study designs to explore associations between noise and cardiometabolic outcomes may be supported by improved understanding of the mechanism of action, and/or improvements to the accuracy and precision of air pollution and noise exposure assessments for environmental health research.
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Affiliation(s)
- Yu-Kai Huang
- School of Public Health, University of Illinois at Chicago, Chicago, USA
| | - Rosie Hanneke
- Library of the Health Sciences, University of Illinois at Chicago, Chicago, USA
| | - Rachael M Jones
- School of Public Health, University of Illinois at Chicago, Chicago, USA.
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Tobollik M, Hintzsche M, Wothge J, Myck T, Plass D. Burden of Disease Due to Traffic Noise in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132304. [PMID: 31261828 PMCID: PMC6651346 DOI: 10.3390/ijerph16132304] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 01/09/2023]
Abstract
Traffic noise is nearly ubiquitous and thus can affect the health of many people. Using the German noise mapping data according to the Directive 2002/49/EC of 2017 and exposure-response functions for ischemic heart disease, noise annoyance and sleep disturbance assessed by the World Health Organization's Environmental Noise Guidelines for the European Region the burden of disease due to traffic noise is quantified. The burden of disease is expressed in disability-adjusted life years (DALYs) and its components. The highest burden was found for road traffic noise, with 75,896 DALYs when only considering moderate evidence. When including all available evidence, 176,888 DALYs can be attributable to road traffic noise. The burden due to aircraft and railway noise is lower because fewer people are exposed. Comparing the burden by health outcomes, the biggest share is due to ischemic heart disease (90%) in regard to aircraft noise, however, the lowest evidence was expressed for the association between traffic noise and ischemic heart disease. Therefore, the results should be interpreted with caution. Using alternative input parameters (e.g., exposure data) can lead to a much higher burden. Nevertheless, environmental noise is an important risk factor which leads to considerable loss of healthy life years.
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Affiliation(s)
- Myriam Tobollik
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, 14195 Berlin, Germany.
- Department of Environment and Health, School of Public Health, Bielefeld University, Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany.
| | - Matthias Hintzsche
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Platz 1, 06844 Dessau-Roßlau, Germany.
| | - Jördis Wothge
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Platz 1, 06844 Dessau-Roßlau, Germany.
| | - Thomas Myck
- German Environment Agency, Section Noise Abatement of Industrial Plants and Products, Noise Impact, Wörlitzer Platz 1, 06844 Dessau-Roßlau, Germany.
| | - Dietrich Plass
- German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, 14195 Berlin, Germany.
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Dendup T, Astell-Burt T, Feng X. Residential self-selection, perceived built environment and type 2 diabetes incidence: A longitudinal analysis of 36,224 middle to older age adults. Health Place 2019; 58:102154. [PMID: 31234122 DOI: 10.1016/j.healthplace.2019.102154] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 06/05/2019] [Accepted: 06/12/2019] [Indexed: 11/29/2022]
Abstract
Much of the existing studies on the built environment and type 2 diabetes are cross-sectional and prone to residential self-selection bias. Using multilevel logistic regression analysis of 36,224 participants from a longitudinal study, we examined whether perceived built environment characteristics are associated with type 2 diabetes. We found that the odds of diabetes incidence varied geographically. Those who reported that there were no local amenities and reported day- and night-time crime rates made walking unsafe in the neighbourhood had higher odds of developing incident type 2 diabetes. These associations persisted after accounting for some predictors of residential self-selection. More longitudinal studies are needed to corroborate the findings. Changing the features of the residential built environment may be an important point of intervention for type 2 diabetes prevention.
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Affiliation(s)
- Tashi Dendup
- Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia.
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales Australia; School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China.
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab, School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia; Menzies Centre for Health Policy, University of Sydney, Sydney, New South Wales Australia.
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Jørgensen JT, Bräuner EV, Backalarz C, Laursen JE, Pedersen TH, Jensen SS, Ketzel M, Hertel O, Lophaven SN, Simonsen MK, Andersen ZJ. Long-Term Exposure to Road Traffic Noise and Incidence of Diabetes in the Danish Nurse Cohort. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:57006. [PMID: 31084449 PMCID: PMC6791549 DOI: 10.1289/ehp4389] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND Evidence on the association between road traffic noise and diabetes risk is sparse and inconsistent with respect to how confounding by air pollution was treated. OBJECTIVES In this study, we aimed to examine whether long-term exposure to road traffic noise over 25 years is associated with incidence of diabetes, independent of air pollution. METHODS A total of 28,731 female nurses from the Danish Nurse cohort ([Formula: see text] at recruitment in 1993 or 1999) were linked to the Danish National Diabetes Register with information on incidence of diabetes from 1995 until 2013. The annual mean weighted levels of 24-h average road traffic noise ([Formula: see text]) at nurses' residences from 1970 until 2013 were estimated with the Nord2000 method and annual mean levels of particulate matter (PM) with diameter [Formula: see text] and [Formula: see text] ([Formula: see text] and [Formula: see text]), nitrogen dioxide ([Formula: see text]), and nitrogen oxide ([Formula: see text]) with the Danish AirGIS modeling system. Cox proportional hazards regression models were used to examine the association between residential [Formula: see text] in four different exposure windows (1-, 5-, 10-, and 25-years) and the incidence of diabetes, adjusted for lifestyle factors and air pollutants. RESULTS Of 23,762 nurses free of diabetes at the cohort baseline, 1,158 developed diabetes during a mean follow-up of 15.2 years. We found weak positive associations between 5-y mean exposure to [Formula: see text] (per [Formula: see text] increase) and diabetes incidence in a crude model [hazard ratio (HR): 1.07; 95% confidence interval (CI): 0.99, 1.12], which attenuated in a model adjusted for lifestyle factors (HR:1.04; 95% CI: 0.97, 1.12), and reached unity after additional adjustment for [Formula: see text] (HR: 0.99; 0.91, 1.08). In analyses by level of urbanization, we found a positive association between noise and diabetes in urban areas (HR:1.27; 95% CI: 0.98, 1.63) that was unchanged after adjusting for [Formula: see text] (HR: 1.25; 95% CI: 0.97, 1.62), but we found no apparent association in provincial (HR: 1.02; 95% CI: 0.88, 1.18) or rural areas (HR: 0.97; 95% CI: 0.87, 1.08). CONCLUSION In the nationwide cohort of Danish nurses 44 years of age and older, we found no association between long-term exposure to road traffic noise and diabetes incidence after adjustment for [Formula: see text] but found suggestive evidence of an association limited to urban areas. https://doi.org/10.1289/EHP4389.
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Affiliation(s)
| | - Elvira Vaclavik Bräuner
- Juliane Marie Center, Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark
| | | | | | | | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Søren Nyman Lophaven
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Mette Kildevæld Simonsen
- Diakonissestiftelsen, Frederiksberg, Denmark
- Research Unit for Dietary Studies, The Parker Institute Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Nykøbing F Hospital, Centre for Epidemiological Research, Nykøbing F, Denmark
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Cramer J, Therming Jørgensen J, Sørensen M, Backalarz C, Laursen JE, Ketzel M, Hertel O, Jensen SS, Simonsen MK, Bräuner EV, Andersen ZJ. Road traffic noise and markers of adiposity in the Danish Nurse Cohort: A cross-sectional study. ENVIRONMENTAL RESEARCH 2019; 172:502-510. [PMID: 30852453 DOI: 10.1016/j.envres.2019.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/27/2019] [Accepted: 03/01/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Studies have suggested that traffic noise is associated with markers of obesity. We investigated the association of exposure to road traffic noise with body mass index (BMI) and waist circumference in the Danish Nurse Cohort. METHODS We used data on 15,501 female nurses (aged >44 years) from the nationwide Danish Nurse Cohort who, in 1999, reported information on self-measured height, weight, and waist circumference, together with information on socioeconomic status, lifestyle, work and health. Road traffic noise at the most exposed façade of the residence was estimated using Nord2000 as the annual mean of a weighted 24-h average (Lden). We used multiple linear regression models to examine associations of road traffic noise levels in 1999 (1-year mean) with BMI and waist circumference, adjusting for potential confounders, and evaluated effect modification by degree of urbanization, air pollution levels, night shift work, job strain, sedative use, sleep aid use, and family history of obesity. RESULTS We did not observe associations between road traffic noise (per 10 dB increase in the 1-year mean Lden) and BMI (kg/m2) (β: 0.00; 95% confidence interval (CI): -0.07, 0.07) or waist circumference (cm) (β: -0.09; 95% CI: -0.31, 0.31) in the fully adjusted model. We found significant effect modification of job strain and degree of urbanization on the associations between Lden and both BMI and waist circumference. Job strained nurses were associated with a 0.41 BMI-point increase, (95% CI: 0.06, 0.76) and a 1.00 cm increase in waist circumference (95% CI: 0.00, 2.00). Nurses living in urban areas had a statistically significant positive association of Lden with BMI (β: 0.26; 95% CI: 0.11, 0.42), whilst no association was found for nurses living in suburban and rural areas. CONCLUSION Our results suggest that road traffic noise exposure in nurses with particular susceptibilities, such as those with job strain, or living in urban areas, may lead to increased BMI, a marker of adiposity.
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Affiliation(s)
- Johannah Cramer
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Jeanette Therming Jørgensen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - Mette Sørensen
- Danish Cancer Society, Strandboulevarden 49, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark.
| | | | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark; Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, University of Surrey, Guildford GU2 7XH, United Kingdom.
| | - Ole Hertel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark.
| | | | - Mette Kildevæld Simonsen
- Diakonissestiftelsen and Parker Institute, Frederiksberg Hospital, Peter Bangsvej 1, 2000 Frederiksberg, Denmark.
| | - Elvira Vaclavik Bräuner
- Juliane Marie Center, Department of Growth and Reproduction, Capital Region of Denmark, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Zorana Jovanovic Andersen
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark; Centre for Epidemiological Research, Nykøbing F Hospital, Ejegodvej 63, 4800 Nykøbing F, Denmark.
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Poulsen AH, Raaschou-Nielsen O, Peña A, Hahmann AN, Nordsborg RB, Ketzel M, Brandt J, Sørensen M. Long-Term Exposure to Wind Turbine Noise and Risk for Myocardial Infarction and Stroke: A Nationwide Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:37004. [PMID: 30864814 PMCID: PMC6768320 DOI: 10.1289/ehp3340] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 01/30/2019] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Noise from wind turbines (WTs) is reported as more annoying than traffic noise at similar levels, raising concerns as to whether WT noise (WTN) increases risk for cardiovascular disease, as observed for traffic noise. OBJECTIVES We aimed to investigate whether long-term exposure to WTN increases risk of myocardial infarction (MI) and stroke. METHODS We identified all Danish dwellings within a radius 20 times the height of the closest WT and 25% of the dwellings within [Formula: see text] the height of the closest WT. Using data on WT type and simulated hourly wind at each WT, we estimated hourly outdoor and low frequency (LF) indoor WTN for each dwelling and derived 1-y and 5-y running nighttime averages. We used hospital and mortality registries to identify all incident cases of MI ([Formula: see text]) and stroke ([Formula: see text]) among all adults age 25-85 y ([Formula: see text]), who lived in one of these dwellings for [Formula: see text] over the period 1982-2013. We used Poisson regression to estimate incidence rate ratios (IRRs) adjusted for individual- and area-level covariates. RESULTS IRRs for MI in association with 5-y nighttime outdoor WTN [Formula: see text] (vs. [Formula: see text]) dB(A) and indoor LF WTN [Formula: see text] (vs. [Formula: see text]) dB(A) were 1.21 [95% confidence interval (CI): 0.91, 1.62; 47 exposed cases] and 1.29 (95% CI: 0.73, 2.28; 12 exposed cases), respectively. IRRs for intermediate categories of outdoor WTN [24-30, 30-36, and [Formula: see text] vs. [Formula: see text]] were slightly above the null and of similar size: 1.08 (95% CI: 1.04, 1.12), 1.07 (95% CI: 1.00, 1.12), and 1.06 (95% CI: 0.93, 1.22), respectively. For stroke, IRRs for the second and third outdoor exposure groups were similar to those for MI, but near or below the null for higher exposures. CONCLUSIONS We did not find convincing evidence of associations between WTN and MI or stroke. https://doi.org/10.1289/EHP3340.
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Affiliation(s)
- Aslak Harbo Poulsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ole Raaschou-Nielsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Alfredo Peña
- DTU Wind Energy, Technical University of Denmark, Roskilde, Denmark
| | | | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
- Global Center for Clean Air Research (GCARE), University of Surrey, United Kingdom
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Mette Sørensen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
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Indoor and outdoor road traffic noise and incident diabetes mellitus: Results from a longitudinal German cohort study. Environ Epidemiol 2019; 3:e037. [PMID: 33778334 PMCID: PMC7952109 DOI: 10.1097/ee9.0000000000000037] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/10/2018] [Indexed: 12/24/2022] Open
Abstract
Supplemental Digital Content is available in the text. Road traffic noise affects a large number of people in urbanized areas. Recent epidemiological evidence indicates that environmental noise exposure may not only be associated with cardiovascular but also with cardio-metabolic outcomes. This prospective cohort study investigated the effect of outdoor and indoor residential road traffic noise on incident type 2 diabetes mellitus (T2DM).
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Wallas A, Ekström S, Bergström A, Eriksson C, Gruzieva O, Sjöström M, Pyko A, Ögren M, Bottai M, Pershagen G. Traffic noise exposure in relation to adverse birth outcomes and body mass between birth and adolescence. ENVIRONMENTAL RESEARCH 2019; 169:362-367. [PMID: 30513507 DOI: 10.1016/j.envres.2018.11.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND There is growing evidence that traffic noise exposure is associated with adiposity among adults but data in children are limited. OBJECTIVE This longitudinal study examined whether pre- and postnatal noise exposure is associated with body mass index (BMI) between birth and adolescence or with adverse birth outcomes. METHODS The study was conducted using data from the BAMSE birth cohort, which included 4089 children born in Stockholm County, Sweden. Data on BMI from birth to adolescence were collected via questionnaires, clinical examinations and health care records. A national register provided information on birth outcomes. Road traffic noise levels at the most exposed façade were estimated for all residences of the children during follow-up, as well as of their mothers during pregnancy, and time-weighted average exposure was calculated for different time windows. Maternal occupational noise exposure was obtained from a job-exposure-matrix. Logistic- and quantile regression models were used to estimate associations between noise exposure and health outcomes. RESULTS We found residential road traffic noise exposure to be associated with increases in BMI from school age to adolescence, but not at earlier ages. In the age groups 8-11 years and 12-16 years the BMI increments were 0.11 kg/m2 per 10 dB Lden (95% CI 0.08-0.13) and 0.20 kg/m2 per 10 dB Lden (95% CI 0.17-0.22), respectively. Maternal noise exposure during pregnancy was generally unrelated to adverse birth outcomes and BMI from birth to adolescence in the children, however, traffic noise exposure was associated with a decreased risk of preterm birth CONCLUSION: Residential road traffic noise exposure was associated with BMI increases from school age to adolescence, but not at earlier ages. Maternal occupational noise exposure or exposure from road traffic during pregnancy were not consistently related to birth outcomes or BMI from birth to adolescence.
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Affiliation(s)
- Alva Wallas
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Charlotta Eriksson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Olena Gruzieva
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Mattias Sjöström
- Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Andrei Pyko
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Mikael Ögren
- Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Matteo Bottai
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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Persson Waye K, Smith MG, Hussain-Alkhateeb L, Koopman A, Ögren M, Peris E, Waddington D, Woodcock J, Sharp C, Janssen S. Assessing the exposure-response relationship of sleep disturbance and vibration in field and laboratory settings. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 245:558-567. [PMID: 30469126 DOI: 10.1016/j.envpol.2018.09.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 08/01/2018] [Accepted: 09/17/2018] [Indexed: 06/09/2023]
Abstract
Exposure to nocturnal freight train vibrations may impact sleep, but exposure-response relationships are lacking. The European project CargoVibes evaluated sleep disturbance both in the field and in the laboratory and provides unique data, as measures of response and exposure metrics are comparable. This paper therefore provides data on exposure-response relationships of vibration and sleep disturbance and compares the relationships evaluated in the laboratory and the field. Two field studies (one in Poland and one in the Netherlands) with 233 valid respondents in total, and three laboratory studies in Sweden with a total of 59 subjects over 350 person-nights were performed. The odds ratios (OR) of sleep disturbance were analyzed in relation to nighttime vibration exposure by ordinal logit regression, adjusting for moderating factors common for the studies. Outcome specific fractions were calculated for eleven sleep outcomes and supported comparability between the field and laboratory settings. Vibration exposure was significantly associated with sleep disturbance, OR = 3.51 (95% confidence interval 2.6-4.73) denoting a three and a half times increase in the odds of sleep disturbance with one unit increased 8 h nighttime log10 Root Mean Square vibration. The results suggest no significant difference between field and laboratory settings OR = 1.37 (0.59-3.19). However, odds of sleep disturbance were higher in the Netherlands as compared to Sweden, indicating unexplained differences between study populations or countries, possibly related to cultural and contextual differences and uncertainties in exposure assessments. Future studies should be carefully designed to record explanatory factors in the field and enhance ecological validity in the laboratory. Nevertheless, the presented combined data set provides a first set of exposure response relationships for vibration-induced sleep disturbance, which are useful when considering public health outcomes among exposed populations.
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Affiliation(s)
- Kerstin Persson Waye
- Department of Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Michael G Smith
- Department of Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Laith Hussain-Alkhateeb
- Department of Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Mikael Ögren
- Department of Occupational and Environmental Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Eulalia Peris
- School of Computing, Science & Engineering, The University of Salford, Salford, United Kingdom
| | - David Waddington
- School of Computing, Science & Engineering, The University of Salford, Salford, United Kingdom
| | - James Woodcock
- School of Computing, Science & Engineering, The University of Salford, Salford, United Kingdom
| | | | - Sabine Janssen
- The TNO (Netherlands Organisation for Applied Scientific Research), The Hague, the Netherlands
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Poulsen AH, Raaschou-Nielsen O, Peña A, Hahmann AN, Nordsborg RB, Ketzel M, Brandt J, Sørensen M. Long-term exposure to wind turbine noise and redemption of antihypertensive medication: A nationwide cohort study. ENVIRONMENT INTERNATIONAL 2018; 121:207-215. [PMID: 30216773 DOI: 10.1016/j.envint.2018.08.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 08/23/2018] [Accepted: 08/24/2018] [Indexed: 05/21/2023]
Abstract
Noise from wind turbines (WTs) has been reported more annoying than traffic noise at similar levels, and concerns have been raised about whether WT noise (WTN) can increase risk for cardiovascular disease. We aimed to investigate if long-term exposure to WTN increases risk for hypertension, estimated as redemption of prescriptions for antihypertensive drugs. We identified all Danish dwellings within a radius of 20 WT heights from a WT and 25% randomly selected dwellings within 20-40 WT heights radius. Using data on WT type and hourly wind conditions at each WT, we estimated hourly outdoor (10-10,000 Hz) and low frequency (LF: 10-160 Hz) indoor WTN for all dwellings, and aggregated it as long-term nighttime running means. From nationwide registries, we identified 535,675 persons age 25-85 years living in these dwellings for >1 year from 1996 to 2013, of whom 83,729 fulfilled our case definition of redeeming ≥2 prescriptions and ≥180 defined daily doses of antihypertensive drugs within a year. Data were analyzed using Poisson regression according to categories of WTN exposure and adjustment for individual and area-level covariates. We found no associations between 5-year mean exposure to WTN during night and redemption of antihypertensives, with hazard ratios (HR) of 0.91 (95% confidence intervals (CI): 0.78-1.06) for outdoor WTN ≥ 42 dB(A) and of 1.06 (CI: 0.83-1.35) for indoor LF WTN ≥ 15 dB(A) when compared to the reference WTN levels (<24 dB(A) and <5 dB(A), respectively). The lack of association was consistent across sub-populations of people living on farms, far from major roads and with high validity of the noise estimate. For people younger than 65 years we found HRs of 0.81 (95% CI: 0.67-0.98) and 0.94 (95% CI: 0.68-1.30) for outdoor WTN ≥ 42 dB(A) and indoor WTN ≥ 15 dB(A), respectively, whereas for people above 65 years the corresponding HRs were 1.17 (95% CI: 0.90-1.52) and 1.28 (95% CI: 0.87-1.88). In conclusion, the present study does not support an association between WTN and redemption of antihypertensive medication.
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Affiliation(s)
- Aslak Harbo Poulsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
| | - Ole Raaschou-Nielsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Alfredo Peña
- DTU Wind Energy, Technical University of Denmark, Roskilde, Denmark
| | - Andrea N Hahmann
- DTU Wind Energy, Technical University of Denmark, Roskilde, Denmark
| | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Mette Sørensen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
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Foraster M, Eze IC, Vienneau D, Schaffner E, Jeong A, Héritier H, Rudzik F, Thiesse L, Pieren R, Brink M, Cajochen C, Wunderli JM, Röösli M, Probst-Hensch N. Long-term exposure to transportation noise and its association with adiposity markers and development of obesity. ENVIRONMENT INTERNATIONAL 2018; 121:879-889. [PMID: 30347370 DOI: 10.1016/j.envint.2018.09.057] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 09/05/2018] [Accepted: 09/30/2018] [Indexed: 05/21/2023]
Abstract
The contribution of different transportation noise sources to metabolic disorders such as obesity remains understudied. We evaluated the associations of long-term exposure to road, railway and aircraft noise with measures of obesity and its subphenotypes using cross-sectional and longitudinal designs. We assessed 3796 participants from the population-based Swiss Cohort Study on Air Pollution and Lung and Heart Diseases (SAPALDIA), who attended the visits in 2001 (SAP2) and 2010/2011 (SAP3) and who were aged 29-72 at SAP2. At SAP2 we measured body mass index (BMI, kg/m2). At SAP3 we measured BMI, waist circumference (centimetres) and Kyle body Fat Index (%) and derived overweight, central and general obesity. Longitudinally for BMI, we derived change in BMI, incidence of overweight and obesity and a 3-category outcome combining the latter two. We assigned source-specific 5-year mean noise levels before visits and during follow-up at the most exposed dwelling façade (Lden, dB), using Swiss noise models for 2001 and 2011 and participants' residential history. Models were adjusted for relevant confounders, including traffic-related air pollution. Exposure to road traffic noise was significantly associated with all adiposity subphenotypes, cross-sectionally (at SAP3) [e.g. beta (95% CI) per 10 dB, BMI: 0.39 (0.18; 0.59); waist circumference: 0.93 (0.37; 1.50)], and with increased risk of obesity, longitudinally (e.g. RR = 1.25, 95% CI: 1.04; 1.51, per 10 dB in 5-year mean). Railway noise was significantly related to increased risk of overweight. In cross-sectional analyses, we further identified a stronger association between road traffic noise and BMI among participants with cardiovascular disease and an association between railway noise and BMI among participants reporting bad sleep. Associations were independent of the other noise sources, air pollution and robust to all adjustment sets. No associations were observed for aircraft noise. Long-term exposure to transportation noise, particularly road traffic noise, may increase the risk of obesity and could constitute a pathway towards cardiometabolic and other diseases.
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Affiliation(s)
- Maria Foraster
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Barcelona Institute for Global Health (ISGlobal), University Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBEREsp), Spain; Blanquerna School of Health Science, Universitat Ramon Llull, Barcelona, Spain.
| | - Ikenna C Eze
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Ayoung Jeong
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Harris Héritier
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Franziska Rudzik
- Center for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Laurie Thiesse
- Center for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Reto Pieren
- Empa, Laboratory for Acoustics/Noise Control, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Mark Brink
- Federal Office for the Environment, Bern, Switzerland
| | - Christian Cajochen
- Center for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Jean-Marc Wunderli
- Empa, Laboratory for Acoustics/Noise Control, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
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39
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Early maternal perceived stress and children's BMI: longitudinal impact and influencing factors. BMC Public Health 2018; 18:1211. [PMID: 30376822 PMCID: PMC6208039 DOI: 10.1186/s12889-018-6110-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Maternal perceived stress has been discussed to contribute to the development of childhood overweight. Our aim was to investigate the longitudinal relationship of early maternal perceived stress and BMI z-scores in preschool children (≤ five years). METHODS A longitudinal analysis was conducted in 498 mother-child pairs of the German prospective birth cohort LINA with information on maternal perceived stress during pregnancy, one and two years after birth. BMI z-scores were based on annual measurements of children's weight/height and calculated based on WHO reference data. General estimation equations were applied to evaluate the impact of maternal stress on children's longitudinal BMI z-scores. Potential stressors contributing to the perceived stress of the mother were assessed by linear regression models. Using mediation analyses we evaluated the relationship between stressors, maternal perceived stress, and children's BMI z-score development. RESULTS Postnatal maternal stress during the first year after birth had a positive longitudinal relationship with children's BMI z-scores up to the age of five years. Gender-stratified analyses revealed that only girls showed this positive association while boy's BMI z-scores were unaffected by maternal stress. We identified three neighborhood strains and two socio-demographic factors, which contributed to the maternal perceived stress level. Stressors themselves did not directly affect girl's BMI z-scores but rather mediated their effect through the perceived stress level. CONCLUSIONS While different stressors contribute to maternal stress, the perceived stress level - rather than the stressors themselves - is strongly positively associated with BMI z-score development in girls.
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Tamura K, Elbel B, Chaix B, Regan SD, Al-Ajlouni YA, Athens JK, Meline J, Duncan DT. Residential and GPS-Defined Activity Space Neighborhood Noise Complaints, Body Mass Index and Blood Pressure Among Low-Income Housing Residents in New York City. J Community Health 2018; 42:974-982. [PMID: 28386706 DOI: 10.1007/s10900-017-0344-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Little is known about how neighborhood noise influences cardiovascular disease (CVD) risk among low-income populations. The aim of this study was to investigate associations between neighborhood noise complaints and body mass index (BMI) and blood pressure (BP) among low-income housing residents in New York City (NYC), including the use of global positioning system (GPS) data. Data came from the NYC Low-Income Housing, Neighborhoods and Health Study in 2014, including objectively measured BMI and BP data (N = 102, Black = 69%), and 1 week of GPS data. Noise reports from "NYC 311" were used to create a noise complaints density (unit: 1000 reports/km2) around participants' home and GPS-defined activity space neighborhoods. In fully-adjusted models, we examined associations of noise complaints density with BMI (kg/m2), and systolic and diastolic BP (mmHg), controlling for individual- and neighborhood-level socio-demographics. We found inverse relationships between home noise density and BMI (B = -2.7 [kg/m2], p = 0.009), and systolic BP (B = -5.3 mmHg, p = 0.008) in the fully-adjusted models, and diastolic BP (B = -3.9 mmHg, p = 0.013) in age-adjusted models. Using GPS-defined activity space neighborhoods, we observed inverse associations between noise density and systolic BP (B = -10.3 mmHg, p = 0.019) in fully-adjusted models and diastolic BP (B = -7.5 mmHg, p = 0.016) in age-adjusted model, but not with BMI. The inverse associations between neighborhood noise and CVD risk factors were unexpected. Further investigation is needed to determine if these results are affected by unobserved confounding (e.g., variations in walkability). Examining how noise could be related to CVD risk could inform effective neighborhood intervention programs for CVD risk reduction.
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Affiliation(s)
- Kosuke Tamura
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA.
| | - Brian Elbel
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA.,Wagner Graduate School of Public Service, New York University, New York, NY, USA
| | - Basile Chaix
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France.,Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Seann D Regan
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
| | - Yazan A Al-Ajlouni
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
| | - Jessica K Athens
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
| | - Julie Meline
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France.,Inserm, UMR_S 1136, Pierre Louis Institute of Epidemiology and Public Health, Paris, France
| | - Dustin T Duncan
- Department of Population Health, New York University School of Medicine, 227 East 30th Street, 6th Floor, New York, NY, 10016, USA
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41
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Zare Sakhvidi MJ, Zare Sakhvidi F, Mehrparvar AH, Foraster M, Dadvand P. Association between noise exposure and diabetes: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2018; 166:647-657. [PMID: 30006240 DOI: 10.1016/j.envres.2018.05.011] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 05/08/2018] [Accepted: 05/10/2018] [Indexed: 05/17/2023]
Abstract
BACKGROUND The prevalence of diabetes is on rise worldwide and environmental factors are being increasingly recognized to be involved in this rise. An emerging body of evidence has evaluated the impact of long-term exposure to noise on diabetes mellitus, highlighting the need to synthesize this evidence. OBJECTIVES To systematically review and conduct meta-analysis of the available evidence on the association between long-term exposure to transport and occupational noise exposure and diabetes mellitus. METHODS Selected databases were searched for available evidence published till September 13th, 2017 following MOOSE guidelines. The quality of articles was assessed using the Newcastle-Ottawa Scale. Random effects meta-analysis was applied to abstract combined estimates for diabetes mellitus per 5 dB increase in noise exposure. We evaluated the heterogeneity applying Cochran's Q test and quantified it using I2 statistic. Meta-regressions were conducted to identify sources of heterogeneity. Publication bias was evaluated using funnel plot and Egger's test. RESULTS Fifteen studies met our inclusion criteria of which nine including five prospective cohorts, two cross-sectional and two case-control studies with a total number of 444460 adult participants and 17430 diabetes mellitus cases included in meta-analyses. We observed a 6% (95% confidence interval (CI): 3%, 9%) increase in the risk of diabetes mellitus per 5 dB increase in noise exposure regardless of its source. Source-specific analyses were suggestive for stronger associations for air traffic noise (combined odds ratio: 1.17; 95% CI: 1.06, 1.29 per 5 dB increase in exposure) flowed by road traffic noise (combined odds ratio: 1.07; 95% CI: 1.02, 1.12). We observed some indications of publication bias; however the findings were robust after trim and fill test. Meta-regression analyses showed that the adjustment in general, and not specifically related to air pollution, could predict the between-study heterogeneity in reported associations. CONCLUSIONS The results indicate an increased risk of diabetes mellitus associated with noise exposure, mainly related to air and road traffic.
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Affiliation(s)
- Mohammad Javad Zare Sakhvidi
- Department of Occupational Health, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran; Occupational Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fariba Zare Sakhvidi
- Department of Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amir Houshang Mehrparvar
- Industrial Diseases Research Center, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Maria Foraster
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Payam Dadvand
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain; Pompeu Fabra University, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain.
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42
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An R, Wang J, Ashrafi SA, Yang Y, Guan C. Chronic Noise Exposure and Adiposity: A Systematic Review and Meta-analysis. Am J Prev Med 2018; 55:403-411. [PMID: 30122217 DOI: 10.1016/j.amepre.2018.04.040] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 03/28/2018] [Accepted: 04/13/2018] [Indexed: 12/12/2022]
Abstract
CONTEXT Noise is a key environmental stressor affecting millions of people worldwide on a daily basis. Chronic exposure to noise may elevate the risk of adiposity through sleep deprivation and heightened stress level. EVIDENCE ACQUISITION A literature search was conducted in the PubMed, Web of Science, and Cochrane Library for articles published until February 20, 2018, that assessed the relationship between noise and adiposity. A standardized data extraction form was used to collect methodologic and outcome variables from each included study. EVIDENCE SYNTHESIS Eleven studies were identified, among which seven reported a positive association between chronic exposure to noise and adiposity. Compared with their counterparts exposed to a lower noise level, adults chronically exposed to a noise level above 55-60 dBA were associated with a higher waist circumference by 7.5 mm per year (95% CI=3.6, 11.4, I2=0.0%). An increase in chronic exposure to noise by 10 dBA was found to be associated with a higher waist circumference by 7.0 mm per year (95% CI=2.5, 11.6, I2=93.9%) in the random effect model but not the inverse variance heterogeneity model. Chronic noise exposure was not found to be associated with BMI. CONCLUSIONS Noise tends to be positively associated with waist circumference but not BMI in adults, but current evidence remains limited. Future studies should assess the impact of noise on adiposity in alternative settings and across population subgroups and geographic areas, examine different sources of noise, and elucidate the biomedical and psychosocial pathways linking noise to adiposity.
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Affiliation(s)
- Ruopeng An
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois.
| | - Junjie Wang
- Department of Kinesiology, Dalian University of Technology, Dalian, Liaoning, China
| | | | - Yan Yang
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Chenghua Guan
- School of Economics and Resource Management, Beijing Normal University, Beijing, China
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43
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Poulsen AH, Raaschou-Nielsen O, Peña A, Hahmann AN, Nordsborg RB, Ketzel M, Brandt J, Sørensen M. Long-term exposure to wind turbine noise at night and risk for diabetes: A nationwide cohort study. ENVIRONMENTAL RESEARCH 2018; 165:40-45. [PMID: 29665463 DOI: 10.1016/j.envres.2018.03.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/23/2018] [Accepted: 03/26/2018] [Indexed: 05/25/2023]
Abstract
Focus on renewable energy sources and reduced unit costs has led to increased number of wind turbines (WTs). WT noise (WTN) is reported to be highly annoying at levels from 30 to 35 dB and up, whereas for traffic noise people report to be highly annoyed from 40 to 45 dB and up. This has raised concerns as to whether WTN may increase risk for major diseases, as exposure to traffic noise has consistently been associated with increased risk of cardiovascular disease and diabetes. We identified all Danish dwellings within a radius of 20 WT heights and 25% of all dwellings within 20-40 WT heights from a WT. Using detailed data on WT type and hourly wind data at each WT position and height, we estimated hourly outdoor and low frequency indoor WTN for all dwellings, aggregated as nighttime 1- and 5-year running means. Using nationwide registries, we identified a study population of 614,731 persons living in these dwellings in the period from 1996 to 2012, of whom 25,148 developed diabetes. Data were analysed using Poisson regression with adjustment for individual and area-levels covariates. We found no associations between long-term exposure to WTN during night and diabetes risk, with incidence rate ratios (IRRs) of 0.90 (95% confidence intervals (CI): 0.79-1.02) and 0.92 (95% CI: 0.68-1.24) for 5-year mean nighttime outdoor WTN of 36-42 and ≥ 42 dB, respectively, compared to < 24 dB. For 5-year mean nighttime indoor low frequency WTN of 10-15 and ≥ 15 dB we found IRRs of 0.90 (0.78-1.04) and 0.74 (95% CI: 0.41-1.34), respectively, when compared to and < 5 dB. The lack of association was consistent across strata of sex, distance to major road, validity of noise estimate and WT height. The present study does not support an association between nighttime WTN and higher risk of diabetes. However, there were only few cases in the highest exposure groups and findings need reproduction.
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Affiliation(s)
- Aslak Harbo Poulsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark.
| | - Ole Raaschou-Nielsen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Alfredo Peña
- DTU Wind Energy, Technical University of Denmark, Roskilde, Denmark
| | - Andrea N Hahmann
- DTU Wind Energy, Technical University of Denmark, Roskilde, Denmark
| | | | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Mette Sørensen
- Diet, Genes and Environment, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Natural Science and Environment, Roskilde University, Roskilde, Denmark
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Matthiessen C, Lucht S, Hennig F, Ohlwein S, Jakobs H, Jöckel KH, Moebus S, Hoffmann B. Long-term exposure to airborne particulate matter and NO 2 and prevalent and incident metabolic syndrome - Results from the Heinz Nixdorf Recall Study. ENVIRONMENT INTERNATIONAL 2018; 116:74-82. [PMID: 29653402 DOI: 10.1016/j.envint.2018.02.035] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/20/2018] [Accepted: 02/20/2018] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Recently, epidemiological studies have found a link between air pollution (AP) and individual components of the metabolic syndrome (MetS), a condition predisposing to cardiometabolic diseases. However, very few studies have explored a possible association between air pollution and MetS. OBJECTIVE We analyzed the effects of long-term exposure to airborne particulate matter and NO2 on prevalence and incidence of MetS. METHODS We used data of the population-based prospective Heinz Nixdorf Recall study (baseline 2000-2003) to investigate the association(s) between AP exposure and MetS prevalence at baseline (n = 4457) and MetS incidence at first follow-up visit (n = 3074; average follow-up: 5.1 years). Mean annual exposure to size-fractioned particulate matter (PM10, PM2.5, PMcoarse, and PM2.5abs) and nitrogen dioxide (NO2) was assessed using a land use regression model. MetS was defined as central obesity plus two out of four additional risk factors (i.e., elevated triglycerides, reduced high-density lipoprotein cholesterol, elevated blood pressure or elevated plasma glucose). We estimated odds ratios (ORs) of MetS prevalence and incidence per interquartile range (IQR) of exposure, adjusting for demographic and lifestyle variables. RESULTS We observed a MetS prevalence of 20.7% (n = 922) and an incidence of 9.7% (n = 299). NO2 was positively associated with MetS prevalence, with an OR increase per IQR of 1.12 (95%-CI 1.02-1.24, IQR = 6.1 μg/m3). PM10 and PM2.5 were both borderline positively associated with MetS incidence, with ORs of 1.14 (95%-CI 0.99-1.32, IQR = 2.1 μg/m3) and 1.19 (95%-CI 0.98-1.44, IQR = 1.5 μg/m3) per IQR, respectively. CONCLUSION In summary, we found a weak positive association between air pollution and MetS. The strongest and most consistent effects were observed between NO2 and prevalent MetS.
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Affiliation(s)
- Clara Matthiessen
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
| | - Sarah Lucht
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Frauke Hennig
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Simone Ohlwein
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Hermann Jakobs
- Rhenish Institute for Environmental Research, University of Cologne, Cologne, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Susanne Moebus
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Barbara Hoffmann
- Institute of Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
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45
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Eze IC, Foraster M, Schaffner E, Vienneau D, Héritier H, Rudzik F, Thiesse L, Pieren R, Imboden M, von Eckardstein A, Schindler C, Brink M, Cajochen C, Wunderli JM, Röösli M, Probst-Hensch N. Long-term exposure to transportation noise and air pollution in relation to incident diabetes in the SAPALDIA study. Int J Epidemiol 2018; 46:1115-1125. [PMID: 28338949 PMCID: PMC5837207 DOI: 10.1093/ije/dyx020] [Citation(s) in RCA: 94] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 12/13/2022] Open
Abstract
Background Epidemiological studies have inconsistently linked transportation noise and air pollution (AP) with diabetes risk. Most studies have considered single noise sources and/or AP, but none has investigated their mutually independent contributions to diabetes risk. Methods We investigated 2631 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), without diabetes in 2002 and without change of residence between 2002 and 2011. Using questionnaire and biomarker data, incident diabetes cases were identified in 2011. Noise and AP exposures in 2001 were assigned to participants’ residences (annual average road, railway or aircraft noise level during day-evening-night (Lden), total night number of noise events, intermittency ratio (temporal variation as proportion of event-based noise level over total noise level) and nitrogen dioxide (NO2) levels. We applied mixed Poisson regression to estimate the relative risk (RR) of diabetes and their 95% confidence intervals (CI) in mutually-adjusted models. Results Diabetes incidence was 4.2%. Median [interquartile range (IQR)] road, railway, aircraft noise and NO2 were 54 (10) dB, 32 (11) dB, 30 (12) dB and 21 (15) μg/m3, respectively. Lden road and aircraft were associated with incident diabetes (respective RR: 1.35; 95% CI: 1.02–1.78 and 1.86; 95% CI: 0.96–3.59 per IQR) independently of Lden railway and NO2 (which were not associated with diabetes risk) in mutually adjusted models. We observed stronger effects of Lden road among participants reporting poor sleep quality or sleeping with open windows. Conclusions Transportation noise may be more relevant than AP in the development of diabetes, potentially acting through noise-induced sleep disturbances.
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Affiliation(s)
- Ikenna C Eze
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Maria Foraster
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Danielle Vienneau
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Harris Héritier
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Franziska Rudzik
- Center for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Laurie Thiesse
- Center for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Reto Pieren
- Empa, Laboratory for Acoustics/Noise Control, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | | | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Mark Brink
- Federal Office for the Environment, Bern, Switzerland
| | - Christian Cajochen
- Center for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
| | - Jean-Marc Wunderli
- Empa, Laboratory for Acoustics/Noise Control, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Martin Röösli
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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46
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Cai Y, Hansell AL, Blangiardo M, Burton PR, de Hoogh K, Doiron D, Fortier I, Gulliver J, Hveem K, Mbatchou S, Morley DW, Stolk RP, Zijlema WL, Elliott P, Hodgson S. Long-term exposure to road traffic noise, ambient air pollution, and cardiovascular risk factors in the HUNT and lifelines cohorts. Eur Heart J 2018; 38:2290-2296. [PMID: 28575405 DOI: 10.1093/eurheartj/ehx263] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 04/28/2017] [Indexed: 01/27/2023] Open
Abstract
Aims Blood biochemistry may provide information on associations between road traffic noise, air pollution, and cardiovascular disease risk. We evaluated this in two large European cohorts (HUNT3, Lifelines). Methods and results Road traffic noise exposure was modelled for 2009 using a simplified version of the Common Noise Assessment Methods in Europe (CNOSSOS-EU). Annual ambient air pollution (PM10, NO2) at residence was estimated for 2007 using a Land Use Regression model. The statistical platform DataSHIELD was used to pool data from 144 082 participants aged ≥20 years to enable individual-level analysis. Generalized linear models were fitted to assess cross-sectional associations between pollutants and high-sensitivity C-reactive protein (hsCRP), blood lipids and for (Lifelines only) fasting blood glucose, for samples taken during recruitment in 2006-2013. Pooling both cohorts, an inter-quartile range (IQR) higher day-time noise (5.1 dB(A)) was associated with 1.1% [95% confidence interval (95% CI: 0.02-2.2%)] higher hsCRP, 0.7% (95% CI: 0.3-1.1%) higher triglycerides, and 0.5% (95% CI: 0.3-0.7%) higher high-density lipoprotein (HDL); only the association with HDL was robust to adjustment for air pollution. An IQR higher PM10 (2.0 µg/m3) or NO2 (7.4 µg/m3) was associated with higher triglycerides (1.9%, 95% CI: 1.5-2.4% and 2.2%, 95% CI: 1.6-2.7%), independent of adjustment for noise. Additionally for NO2, a significant association with hsCRP (1.9%, 95% CI: 0.5-3.3%) was seen. In Lifelines, an IQR higher noise (4.2 dB(A)) and PM10 (2.4 µg/m3) was associated with 0.2% (95% CI: 0.1-0.3%) and 0.6% (95% CI: 0.4-0.7%) higher fasting glucose respectively, with both remaining robust to adjustment for air/noise pollution. Conclusion Long-term exposures to road traffic noise and ambient air pollution were associated with blood biochemistry, providing a possible link between road traffic noise/air pollution and cardio-metabolic disease risk.
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Affiliation(s)
- Yutong Cai
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK
| | - Anna L Hansell
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK.,Directorate of Public Health and Primary Care, Imperial College Healthcare NHS Trust, London, UK
| | - Marta Blangiardo
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK
| | - Paul R Burton
- Data to Knowledge (D2K) Research Group, University of Bristol, Oakfield Grove, Bristol BS8 2BN, UK.,Maelstrom Research Program, Public Population Project in Genomics and Society (P G), 740 Dr Penfield Avenue, Suite 5104, H3A 0G1, Montreal, Canada
| | | | - Kees de Hoogh
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK.,Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Dany Doiron
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051 Basel, Switzerland.,University of Basel, Petersplatz 1, 4003 Basel, Switzerland.,Child Health and Human Development Program, Research Institute of the McGill University Health Centre, McGill University, 2155 Guy St, H3H 2L9 Montreal, Canada
| | - Isabel Fortier
- Maelstrom Research Program, Public Population Project in Genomics and Society (P G), 740 Dr Penfield Avenue, Suite 5104, H3A 0G1, Montreal, Canada.,Child Health and Human Development Program, Research Institute of the McGill University Health Centre, McGill University, 2155 Guy St, H3H 2L9 Montreal, Canada
| | - John Gulliver
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK
| | - Kristian Hveem
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Forskningsvegen 2, 7600 Levanger, Trondheim, Norway
| | - Stéphane Mbatchou
- Child Health and Human Development Program, Research Institute of the McGill University Health Centre, McGill University, 2155 Guy St, H3H 2L9 Montreal, Canada
| | - David W Morley
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK
| | - Ronald P Stolk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
| | - Wilma L Zijlema
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands.,Barcelona Institute for Global Health (ISGlobal), Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK
| | - Susan Hodgson
- Department of Epidemiology and Biostatistics, MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, W2 1PG, London, UK
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47
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Münzel T, Sørensen M, Schmidt F, Schmidt E, Steven S, Kröller-Schön S, Daiber A. The Adverse Effects of Environmental Noise Exposure on Oxidative Stress and Cardiovascular Risk. Antioxid Redox Signal 2018; 28:873-908. [PMID: 29350061 PMCID: PMC5898791 DOI: 10.1089/ars.2017.7118] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 11/11/2017] [Accepted: 11/14/2017] [Indexed: 12/29/2022]
Abstract
Epidemiological studies have provided evidence that traffic noise exposure is linked to cardiovascular diseases such as arterial hypertension, myocardial infarction, and stroke. Noise is a nonspecific stressor that activates the autonomous nervous system and endocrine signaling. According to the noise reaction model introduced by Babisch and colleagues, chronic low levels of noise can cause so-called nonauditory effects, such as disturbances of activity, sleep, and communication, which can trigger a number of emotional responses, including annoyance and subsequent stress. Chronic stress in turn is associated with cardiovascular risk factors, comprising increased blood pressure and dyslipidemia, increased blood viscosity and blood glucose, and activation of blood clotting factors, in animal models and humans. Persistent chronic noise exposure increases the risk of cardiometabolic diseases, including arterial hypertension, coronary artery disease, diabetes mellitus type 2, and stroke. Recently, we demonstrated that aircraft noise exposure during nighttime can induce endothelial dysfunction in healthy subjects and is even more pronounced in coronary artery disease patients. Importantly, impaired endothelial function was ameliorated by acute oral treatment with the antioxidant vitamin C, suggesting that excessive production of reactive oxygen species contributes to this phenomenon. More recently, we introduced a novel animal model of aircraft noise exposure characterizing the underlying molecular mechanisms leading to noise-dependent adverse oxidative stress-related effects on the vasculature. With the present review, we want to provide an overview of epidemiological, translational clinical, and preclinical noise research addressing the nonauditory, adverse effects of noise exposure with focus on oxidative stress. Antioxid. Redox Signal. 28, 873-908.
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Affiliation(s)
- Thomas Münzel
- The Center for Cardiology, Cardiology 1, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Frank Schmidt
- The Center for Cardiology, Cardiology 1, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Erwin Schmidt
- Institute for Molecular Genetics, Johannes Gutenberg University, Mainz, Germany
| | - Sebastian Steven
- The Center for Cardiology, Cardiology 1, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Swenja Kröller-Schön
- The Center for Cardiology, Cardiology 1, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Andreas Daiber
- The Center for Cardiology, Cardiology 1, Johannes Gutenberg University Medical Center, Mainz, Germany
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48
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Münzel T, Sørensen M, Gori T, Schmidt FP, Rao X, Brook J, Chen LC, Brook RD, Rajagopalan S. Environmental stressors and cardio-metabolic disease: part I-epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies. Eur Heart J 2018; 38:550-556. [PMID: 27460892 DOI: 10.1093/eurheartj/ehw269] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 06/02/2016] [Indexed: 11/14/2022] Open
Abstract
Traffic noise and air pollution together represent the two most important environmental risk factors in urbanized societies. The first of this two-part review discusses the epidemiologic evidence in support of the existence of an association between these risk factors with cardiovascular and metabolic disease. While independent effects of these risk factors have now clearly been shown, recent studies also suggest that the two exposures may interact with each other and with traditional risk factors such as hypertension and type 2 diabetes. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed for exposures well below the thresholds currently accepted as being safe. Current gaps in knowledge, effects of intervention and their impact on cardiovascular disease, will be discussed in the last section of this review. Increased awareness of the societal burden posed by these novel risk factors and acknowledgement in traditional risk factor guidelines may intensify the efforts required for effective legislation to reduce air pollution and noise.
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Affiliation(s)
- Thomas Münzel
- Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Tommaso Gori
- Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Frank P Schmidt
- Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany
| | - Xiaoquan Rao
- Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, MD, USA
| | - Jeffrey Brook
- Air Quality Research Division, Environment and Climate Change Canada, Toronto, Canada
| | - Lung Chi Chen
- Department of Environmental Medicine, New York University, New York, USA
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, USA
| | - Sanjay Rajagopalan
- Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, MD, USA
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49
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Kempen EV, Casas M, Pershagen G, Foraster M. WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cardiovascular and Metabolic Effects: A Summary. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E379. [PMID: 29470452 PMCID: PMC5858448 DOI: 10.3390/ijerph15020379] [Citation(s) in RCA: 279] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/02/2018] [Accepted: 02/10/2018] [Indexed: 01/08/2023]
Abstract
To update the current state of evidence and assess its quality, we conducted a systematic review on the effects of environmental noise exposure on the cardio-metabolic systems as input for the new WHO environmental noise guidelines for the European Region. We identified 600 references relating to studies on effects of noise from road, rail and air traffic, and wind turbines on the cardio-metabolic system, published between January 2000 and August 2015. Only 61 studies, investigating different end points, included information enabling estimation of exposure response relationships. These studies were used for meta-analyses, and assessments of the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A majority of the studies concerned traffic noise and hypertension, but most were cross-sectional and suffering from a high risk of bias. The most comprehensive evidence was available for road traffic noise and Ischeamic Heart Diseases (IHD). Combining the results of 7 longitudinal studies revealed a Relative Risk (RR) of 1.08 (95% CI: 1.01-1.15) per 10 dB (LDEN) for the association between road traffic noise and the incidence of IHD. We rated the quality of this evidence as high. Only a few studies reported on the association between transportation noise and stroke, diabetes, and/or obesity. The quality of evidence for these associations was rated from moderate to very low, depending on transportation noise source and outcome. For a comprehensive assessment of the impact of noise exposure on the cardiovascular and metabolic system, we need more and better quality evidence, primarily based on longitudinal studies.
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Affiliation(s)
- Elise van Kempen
- Dutch National Institute for Public Health and the Environment (RIVM), Centre for Sustainability, Environment and Health, P.O.-Box 1, 3729BA Bilthoven, The Netherlands.
| | - Maribel Casas
- Barcelona Institute for Global Health (ISGlobal), 08036 Barcelona, Spain.
| | - Göran Pershagen
- Institute of Environmental Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden.
| | - Maria Foraster
- Barcelona Institute for Global Health (ISGlobal), 08036 Barcelona, Spain.
- Swiss Tropical and Public Health Institute, University of Basel, 4002 Basel, Switzerland.
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50
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den Braver NR, Lakerveld J, Rutters F, Schoonmade LJ, Brug J, Beulens JWJ. Built environmental characteristics and diabetes: a systematic review and meta-analysis. BMC Med 2018; 16:12. [PMID: 29382337 PMCID: PMC5791730 DOI: 10.1186/s12916-017-0997-z] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/15/2017] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The built environment influences behaviour, like physical activity, diet and sleep, which affects the risk of type 2 diabetes mellitus (T2DM). This study systematically reviewed and meta-analysed evidence on the association between built environmental characteristics related to lifestyle behaviour and T2DM risk/prevalence, worldwide. METHODS We systematically searched PubMed, EMBASE.com and Web of Science from their inception to 6 June 2017. Studies were included with adult populations (>18 years), T2DM or glycaemic markers as outcomes, and physical activity and/or food environment and/or residential noise as independent variables. We excluded studies of specific subsamples of the population, that focused on built environmental characteristics that directly affect the cardiovascular system, that performed prediction analyses and that do not report original research. Data appraisal and extraction were based on published reports (PROSPERO-ID: CRD42016035663). RESULTS From 11,279 studies, 109 were eligible and 40 were meta-analysed. Living in an urban residence was associated with higher T2DM risk/prevalence (n = 19, odds ratio (OR) = 1.40; 95% CI, 1.2-1.6; I2 = 83%) compared to living in a rural residence. Higher neighbourhood walkability was associated with lower T2DM risk/prevalence (n = 8, OR = 0.79; 95% CI, 0.7-0.9; I2 = 92%) and more green space tended to be associated with lower T2DM risk/prevalence (n = 6, OR = 0.90; 95% CI, 0.8-1.0; I2 = 95%). No convincing evidence was found of an association between food environment with T2DM risk/prevalence. CONCLUSIONS An important strength of the study was the comprehensive overview of the literature, but our study was limited by the conclusion of mainly cross-sectional studies. In addition to other positive consequences of walkability and access to green space, these environmental characteristics may also contribute to T2DM prevention. These results may be relevant for infrastructure planning.
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Affiliation(s)
- N R den Braver
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands.
| | - J Lakerveld
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands
| | - F Rutters
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands
| | | | - J Brug
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands.,Amsterdam School for Communication Research, University of Amsterdam, Amsterdam, The Netherlands
| | - J W J Beulens
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, De Boelelaan 1089a, 1081HV, Amsterdam, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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