Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Barcelona Institute for Global Health, Barcelona, Spain.
Environ Int. 2022 Jan;158:106974. doi: 10.1016/j.envint.2021.106974. Epub 2021 Nov 11.
Death from cardiovascular diseases (CVD) has been associated with transportation noise. This nationwide cohort, with state-of-the-art exposure assessment, evaluates these associations by noise source.
Road traffic, railway and aircraft noise for 2001 and 2011 were linked to 4.1 million adults in the Swiss National Cohort, accounting for address history. Mean noise exposure in 5-year periods was calculated. Time-varying Cox regression models, with age as timescale, were applied to all and cause-specific cardiovascular causes of death. Models included all three noise sources plus PM, adjusted for individual and spatial covariates. Nighttime noise events for all sources combined (expressed as intermittency ratio or number of events) were considered in sensitivity analyses. Absolute excess risk was calculated by multiplying deaths/100,000 person-years by the excess risk (hazard ratio-1) within each age/sex group.
During a 15-year follow-up, there were 277,506 CVD and 34,200 myocardial infarction (MI) deaths. Associations (hazard ratio; 95%-CIs) for road traffic, railway and aircraft noise and CVD mortality were 1.029 (1.024-1.034), 1.013 (1.010-1.017), and 1.003 (0.996-1.010) per 10 dB L, respectively. Associations for MI mortality were a respective 1.043 (1.029-1.058), 1.020 (1.010-1.030) and 1.040 (1.020-1.060) per 10 dB L. Blood pressure-related, ischemic heart disease, and all stroke mortality were significantly associated with road traffic and railway noise, while ischemic stroke mortality was associated with aircraft noise. Associations were mostly linear, often starting below 40 dB L for road traffic and railway noise. Higher levels of noise intermittency were also independently associated with each outcome. While the absolute number of deaths attributed to noise increased with age, the hazard ratios declined with age. Relative and absolute risk was higher in males compared to females.
Independent of air pollution, transportation noise exposure is associated with all and cause-specific CVD mortality, with effects starting below current guideline limits.
心血管疾病（CVD）导致的死亡与交通噪声有关。本研究采用最新的暴露评估方法，基于全国性队列研究，从噪声源的角度评估了这些关联。
将道路交通、铁路和航空噪声与瑞士国家队列中的 410 万成年人相关联，记录他们的地址变更历史。计算每个 5 年期间的平均噪声暴露量。采用年龄为时间刻度的时变 Cox 回归模型，对所有心血管疾病死亡原因和特定原因进行分析。模型纳入了三种噪声源以及 PM，同时还调整了个体和空间协变量。敏感性分析中还考虑了所有三种噪声源的夜间噪声事件（用间歇性比或事件数表示）。根据每个年龄/性别组内的超额风险（风险比-1），计算每 10 万人年的绝对超额风险（超额风险乘以死亡人数）。
在 15 年的随访期间，共有 277506 例 CVD 和 34200 例心肌梗死（MI）死亡。道路交通、铁路和航空噪声与 CVD 死亡率之间的关联（风险比；95%-CI）分别为 1.029（1.024-1.034）、1.013（1.010-1.017）和 1.003（0.996-1.010）/10dB L。MI 死亡率的关联分别为 1.043（1.029-1.058）、1.020（1.010-1.030）和 1.040（1.020-1.060）/10dB L。与血压相关的、缺血性心脏病和所有卒中死亡率与道路交通和铁路噪声显著相关，而缺血性卒中死亡率与航空噪声相关。这些关联通常是线性的，道路交通和铁路噪声的关联往往在 40dB L 以下开始出现。噪声间歇性的更高水平也与每种结局独立相关。虽然归因于噪声的死亡人数随年龄增加而增加，但风险比随年龄下降。与女性相比，男性的相对和绝对风险更高。
在不考虑空气污染的情况下，交通噪声暴露与所有心血管疾病和特定病因的死亡率相关，其影响在当前指南限值以下开始出现。
