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 $3.56\text{\hspace{0.17em}million}$ individuals $\ge 35\text{\hspace{0.17em}years}$ 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 $\le 2.5\mathrm{\mu }\mathrm{m}$ 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 $>45\mathrm{\hspace{0.17em}dB}$ 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

中文翻译：

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丹麦全国队列研究中长期暴露于交通噪音和 2 型糖尿病风险

摘要

背景：

流行病学研究已将交通噪音与发病率和死亡率增加联系起来，尤其是心血管结局。然而，对糖尿病等代谢结果的研究是有限的，并且只关注对最响亮的住宅立面估计的噪音暴露。

目标：

我们旨在研究长期居住在最响亮和最安静的住宅外墙交通噪音的影响以及患 2 型糖尿病的风险。

方法：

在 1990 年至 2017 年期间，估计丹麦所有住宅的道路交通和铁路噪声暴露 (Lden) 最多和最少。飞机噪声估计为 5-dB 类别。十年时间加权平均噪声暴露估计为$3.56\text{\hspace{0.17em}百万}$个人$\ge 35\text{\hspace{0.17em}年}$年龄。从 2000 年到 2017 年，使用医院和处方登记处确定了 233,912 例 2 型糖尿病病例，平均随访时间为 12.9 年。我们使用 Cox 比例风险模型来调整个人和区域水平的协变量和长期住宅空气污染。还计算了人口归因分数（PAF）。

结果：

2 型糖尿病的风险比 (HRs) 和 95% 置信区间 (CIs) 与 10 年平均道路交通噪声在最多和最少暴露的外墙增加 10-dB 相关，分别为 1.05 (95% CI: 1.04 , 1.05) 和 1.09 (95% CI: 1.08, 1.10)。在随后调整细颗粒物 [颗粒物$\le 2.5\mathrm{\mu }\mathrm{米}$在空气动力学直径中]（10 年平均值），HR（CI）分别为 1.03（95% CI：1.03, 1.04）和 1.08（95% CI：1.07, 1.09）。对于铁路噪声，10 年平均暴露量每增加 10-dB 的 HR 分别为 1.03（95% CI：1.02, 1.04）和 1.02（95% CI：1.01, 1.04），对于暴露最多和最少暴露的外墙。分类模型支持道路交通噪声的线性暴露-结果关系，并在较小程度上支持铁路噪声。飞机噪音$>45\mathrm{\hspace{0.17em}D\; b}$与未暴露的人相比，患 2 型糖尿病的可能性高 1-4%。我们发现道路交通和铁路噪音分别与糖尿病病例的 8.5% 和 1.4% 的 PAF 相关。

讨论：

在全国范围的丹麦成年人队列中，长期暴露于公路、铁路和可能的飞机交通噪音与 2 型糖尿病风险增加有关。我们的研究结果表明，在估计交通噪音造成的疾病负担时，应将糖尿病包括在内。https://doi.org/10.1289/EHP9146