Centre for Environmental Health and Sustainability, University of Leicester, UK.
Noise and Public Health Group, Environmental Hazards and Emergencies Department, UK Health Security Agency (UKHSA), UK.
Environ Res. 2023 Sep 1;232:116075. doi: 10.1016/j.envres.2023.116075. Epub 2023 May 12.
Exposure to environmental noise is associated with adverse health effects, but there is potential for confounding and interaction with air pollution, particularly where both exposures arise from the same source, such as transport.
To review evidence on confounding and interaction of air pollution in relation to associations between environmental noise and cardiovascular outcomes.
Papers were identified from similar reviews published in 2013 and 2015, from the systematic reviews supporting the WHO 2018 noise guidelines, and from a literature search covering the period 2016-2022 using Medline and PubMed databases. Additional papers were identified from colleagues. Study selection was according to PECO inclusion criteria. Studies were evaluated against the WHO checklist for risk of bias.
52 publications, 36 published after 2015, were identified that assessed associations between transportation noise and cardiovascular outcomes, that also considered potential confounding (49 studies) or interaction (23 studies) by air pollution. Most, but not all studies, suggested that the associations between traffic noise and cardiovascular outcomes are independent of air pollution. NO or PM were the most commonly included air pollutants and we observed no clear differences across air pollutants in terms of the potential confounding role. Most papers did not appear to suggest an interaction between noise and air pollution. Eight studies found the largest noise effect estimates occurring within the higher noise and air pollution exposure categories, but were not often statistically significant.
Whilst air pollution does not appear to confound associations of noise and cardiovascular health, more studies on potential interactions are needed. Current methods to assess quality of evidence are not optimal when evaluating evidence on confounding or interaction.
接触环境噪声与不良健康影响有关，但存在与空气污染相互混杂和相互作用的可能性，特别是在两种暴露均来自同一来源（如交通）的情况下。
综述空气污染对环境噪声与心血管结局之间关联的混杂和交互作用的证据。
从 2013 年和 2015 年发表的类似综述、为 2018 年世卫组织噪声准则提供支持的系统综述以及 2016 年至 2022 年期间使用 Medline 和 PubMed 数据库进行的文献检索中确定了相关文献。还从同事那里确定了其他文献。根据 PECO 纳入标准进行了研究选择。根据世卫组织偏倚风险检查表评估了研究。
确定了 52 篇出版物，其中 36 篇发表于 2015 年之后，评估了交通噪声与心血管结局之间的关联，这些研究还考虑了空气污染的潜在混杂（49 项研究）或交互作用（23 项研究）。大多数（但不是全部）研究表明，交通噪声与心血管结局之间的关联独立于空气污染。NO 或 PM 是最常包含的空气污染物，我们没有观察到在潜在混杂作用方面不同空气污染物之间存在明显差异。大多数论文似乎没有表明噪声和空气污染之间存在相互作用。有 8 项研究发现噪声效应估计值最大的情况发生在噪声和空气污染暴露较高的类别中，但通常不具有统计学意义。
虽然空气污染似乎不会混杂噪声与心血管健康之间的关联，但仍需要更多关于潜在相互作用的研究。当前评估混杂或相互作用证据的方法对于评估证据的质量并不理想。
