Swiss Tropical and Public Health Institute, Basel, Switzerland.
University of Basel, Basel, Switzerland.
Int J Epidemiol. 2017 Aug 1;46(4):1115-1125. doi: 10.1093/ije/dyx020.
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.
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.
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.
Transportation noise may be more relevant than AP in the development of diabetes, potentially acting through noise-induced sleep disturbances.
流行病学研究表明，交通噪声和空气污染（AP）与糖尿病风险之间存在不一致的关联。大多数研究都考虑了单一的噪声源和/或 AP，但没有研究调查它们对糖尿病风险的相互独立贡献。
我们调查了瑞士成人空气污染与肺部和心脏疾病队列研究（SAPALDIA）中的 2631 名参与者，他们在 2002 年没有糖尿病，并且在 2002 年至 2011 年期间没有居住地变更。使用问卷调查和生物标志物数据，在 2011 年确定了新发糖尿病病例。2001 年的噪声和 AP 暴露量被分配给参与者的住所（日间-傍晚-夜间的年平均道路、铁路或飞机噪声水平（Lden）、夜间噪声事件总数、间歇性比（作为事件噪声水平与总噪声水平之比的时间变化）和二氧化氮（NO2）水平。我们应用混合泊松回归来估计糖尿病的相对风险（RR）及其 95%置信区间（CI）在相互调整的模型中。
糖尿病发病率为 4.2%。中位数[四分位距（IQR）]道路、铁路、飞机噪声和 NO2 分别为 54（10）dB、32（11）dB、30（12）dB 和 21（15）μg/m3。在相互调整的模型中，Lden 道路和飞机噪声与新发糖尿病相关（分别 RR：1.35；95%CI：1.02-1.78 和 1.86；95%CI：0.96-3.59 每 IQR），而 Lden 铁路和 NO2 与糖尿病风险无关（与糖尿病风险无关）。我们观察到，在报告睡眠质量差或开着窗户睡觉的参与者中，Lden 道路的影响更强。
交通噪声可能比 AP 更与糖尿病的发生有关，可能通过噪声引起的睡眠障碍发挥作用。
