Abstract

Background:

Transportation noise is increasingly acknowledged as a cardiovascular risk factor, but the evidence base for an association with stroke is sparse.

Objective:

We aimed to investigate the association between transportation noise and stroke incidence in a large Scandinavian population.

Methods:

We harmonized and pooled data from nine Scandinavian cohorts (seven Swedish, two Danish), totaling 135,951 participants. We identified residential address history and estimated road, railway, and aircraft noise for all addresses. Information on stroke incidence was acquired through linkage to national patient and mortality registries. We analyzed data using Cox proportional hazards models, including socioeconomic and lifestyle confounders, and air pollution.

Results:

During follow-up ($\text{median}=19.5\mathrm{y}$), 11,056 stroke cases were identified. Road traffic noise (${\mathrm{L}}_{\text{den}}$) was associated with risk of stroke, with a hazard ratio (HR) of 1.06 [95% confidence interval (CI): 1.03, 1.08] per 10-dB higher 5-y mean time-weighted exposure in analyses adjusted for individual- and area-level socioeconomic covariates. The association was approximately linear and persisted after adjustment for air pollution [particulate matter (PM) with an aerodynamic diameter of $\le 2.5\mathrm{\mu }\mathrm{m}$ (${\mathrm{PM}}_{2.5}$) and ${\mathrm{NO}}_2$]. Stroke was associated with moderate levels of 5-y aircraft noise exposure (40–50 vs. $\le 40\text{\hspace{0.17em}dB}$) ($\text{HR}=1.12$; 95% CI: 0.99, 1.27), but not with higher exposure ($\ge 50\text{\hspace{0.17em}dB}$, $\text{HR}=0.94$; 95% CI: 0.79, 1.11). Railway noise was not associated with stroke.

Discussion:

In this pooled study, road traffic noise was associated with a higher risk of stroke. This finding supports road traffic noise as an important cardiovascular risk factor that should be included when estimating the burden of disease due to traffic noise. https://doi.org/10.1289/EHP8949

中文翻译：

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长期接触交通噪音和中风风险：九个斯堪的纳维亚队列的汇总研究

摘要

背景：

交通噪音越来越被认为是心血管危险因素，但与中风相关的证据基础很少。

客观的：

我们旨在调查运输噪音与斯堪的纳维亚大型人群中风发病率之间的关联。

方法：

我们协调并汇总了来自九个斯堪的纳维亚队列（七个瑞典，两个丹麦）的数据，总共有 135,951 名参与者。我们确定了所有地址的住宅地址历史和估计的公路、铁路和飞机噪音。中风发病率信息是通过与国家患者和死亡率登记处的联系获得的。我们使用 Cox 比例风险模型分析了数据，包括社会经济和生活方式混杂因素以及空气污染。

结果：

随访期间（$\text{中位数}=19.5\mathrm{是}$)，确定了 11,056 例中风病例。道路交通噪音（${\mathrm{升}}_{\text{书房}}$) 与卒中风险相关，在针对个体和个体调整的分析中，风险比 (HR) 为 1.06 [95% 置信区间 (CI)：1.03, 1.08] 每 10 分贝高 5 年平均时间加权暴露地区层面的社会经济协变量。在调整空气污染 [空气动力学直径为$\le 2.5\mathrm{\mu }\mathrm{米}$ (${\mathrm{下午}}_{2.5}$） 和 ${\mathrm{不}}_2$]。中风与中等水平的 5 年飞机噪音暴露有关（40-50 对$\le 40\text{\hspace{0.17em}D b}$) ($\text{人力资源}=1.12$; 95% CI: 0.99, 1.27)，但不是更高的暴露 ($\ge 50\text{\hspace{0.17em}D b}$, $\text{人力资源}=0.94$; 95% 置信区间：0.79, 1.11)。铁路噪音与中风无关。

讨论：

在这项汇总研究中，道路交通噪音与较高的中风风险相关。这一发现支持道路交通噪声作为重要的心血管危险因素，在估计交通噪声引起的疾病负担时应包括在内。https://doi.org/10.1289/EHP8949