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

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Exposure to Road Traffic Noise and Incidence of Acute Myocardial Infarction and Congestive Heart Failure: A Population-Based Cohort Study in Toronto, Canada.
Environmental Health Perspectives ( IF 10.1 ) Pub Date : 2020-8-12 , DOI: 10.1289/ehp5809
Li Bai ₁ , Saeha Shin ₂ , Tor H Oiamo ₃ , Richard T Burnett ₄ , Scott Weichenthal _{5,

6} , Michael Jerrett ₇ , Jeffrey C Kwong _{1,

2,

8,

9} , Ray Copes _{1,

8} , Alexander Kopp ₁ , Hong Chen _{1,

2,

4,

8}

Affiliation

Abstract

Background:

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

Objectives:

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

Methods:

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

Results:

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

Conclusion:

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

中文翻译：

道路交通噪声的暴露以及急性心肌梗塞和充血性心力衰竭的发病率：加拿大多伦多一项基于人群的队列研究。

摘要

背景：

交通相关的噪音与主要心血管事件（例如急性心肌梗塞（AMI）和充血性心力衰竭（CHF））的发生率之间的流行病学证据尚无定论，尤其是在北美。

目标：

我们评估了长期暴露于道路交通噪声与AMI和CHF发生率之间的关联。

方法：

我们的研究人群包括 $approximately 1 million$ 从2001年到2015年居住在加拿大多伦多的30至100岁的人群，他们在基线时没有AMI（称为AMI队列）或CHF（CHF队列）。使用经过验证的算法从卫生管理数据库确定结果。使用传播模型分别将24小时内（LAeq24）和夜间（LAeqNight）的年平均噪声水平估计为A加权等效声压级，并在此期间将其分配给参与者的年度六位数邮政编码地址跟进。我们使用随机效应Cox比例风险模型对个体和人口普查级协变量（包括与交通有关的空气）进行了调整，从而计算了与LAeq24和LAeqNight相关的AMI和CHF事件的AMI和CHF的危险比（HRs）和95％置信区间（CIs）。污染物[例如，

结果：

在随访期间，发生了37,441例AMI事件和95,138瑞郎事件。LAeq24中的每个四分位数范围变化都与发生AMI的风险增加相关（ $H R equals 1.07$ ; 95％CI：1.06、1.08）和CHF（ $H R equals 1.07$ ; 95％CI：1.06、1.09）。同样，LAeqNight与事件AMI（ $H R equals 1.07$ ; 95％CI：1.05、1.08）和CHF（ $H R equals 1.06$ ; 95％CI：1.05、1.07）。这些结果对各种敏感性分析均很可靠，并且在控制了长期暴露于UFP和二氧化氮后仍保持较高的水平。我们发现噪声与AMI和CHF的发生率之间存在近乎线性的关系，而没有阈值的证据。