Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden; Section for Sustainable Health, Umeå University, Sweden.
Environ Int. 2023 Aug;178:108108. doi: 10.1016/j.envint.2023.108108. Epub 2023 Jul 22.
Environmental noise is an important environmental exposure that can affect health. An association between transportation noise and breast cancer incidence has been suggested, although current evidence is limited. We investigated the pooled association between long-term exposure to transportation noise and breast cancer incidence.
Pooled data from eight Nordic cohorts provided a study population of 111,492 women. Road, railway, and aircraft noise were modelled at residential addresses. Breast cancer incidence (all, estrogen receptor (ER) positive, and ER negative) was derived from cancer registries. Hazard ratios (HR) were estimated using Cox Proportional Hazards Models, adjusting main models for sociodemographic and lifestyle variables together with long-term exposure to air pollution.
A total of 93,859 women were included in the analyses, of whom 5,875 developed breast cancer. The median (5th-95th percentile) 5-year residential road traffic noise was 54.8 (40.0-67.8) dB Lden, and among those exposed, the median railway noise was 51.0 (41.2-65.8) dB Lden. We observed a pooled HR for breast cancer (95 % confidence interval (CI)) of 1.03 (0.99-1.06) per 10 dB increase in 5-year mean exposure to road traffic noise, and 1.03 (95 % CI: 0.96-1.11) for railway noise, after adjustment for lifestyle and sociodemographic covariates. HRs remained unchanged in analyses with further adjustment for PM and attenuated when adjusted for NO (HRs from 1.02 to 1.01), in analyses using the same sample. For aircraft noise, no association was observed. The associations did not vary by ER status for any noise source. In analyses using <60 dB as a cutoff, we found HRs of 1.08 (0.99-1.18) for road traffic and 1.19 (0.95-1.49) for railway noise.
We found weak associations between road and railway noise and breast cancer risk. More high-quality prospective studies are needed, particularly among those exposed to railway and aircraft noise before conclusions regarding noise as a risk factor for breast cancer can be made.
环境噪声是一种重要的环境暴露因素，可能会影响健康。有研究表明，交通噪声与乳腺癌的发生之间存在关联，尽管目前的证据有限。我们研究了长期暴露于交通噪声与乳腺癌发病风险之间的关联。
八个北欧队列的汇总数据为我们提供了 111492 名女性的研究人群。在居住地址处对道路、铁路和飞机噪声进行建模。通过癌症登记处获取乳腺癌发病情况（所有、雌激素受体阳性和雌激素受体阴性）数据。使用 Cox 比例风险模型估计危险比（HR），主要模型调整了社会人口统计学和生活方式变量以及长期暴露于空气污染的情况。
共有 93859 名女性纳入分析，其中 5875 名女性患有乳腺癌。5 年居住道路交通噪声中位数（5 分位数-95 分位数）为 54.8（40.0-67.8）dB Lden，暴露于此环境中的女性铁路噪声中位数为 51.0（41.2-65.8）dB Lden。我们观察到，5 年平均道路交通噪声每增加 10dB，乳腺癌的汇总 HR（95%置信区间）为 1.03（0.99-1.06），铁路噪声的 HR 为 1.03（95%置信区间：0.96-1.11），调整了生活方式和社会人口统计学协变量后。在进一步调整 PM 和 NO 后（HR 从 1.02 变为 1.01），或在使用相同样本的分析中，HR 保持不变。对于飞机噪声，未观察到相关性。对于任何噪声源，相关性均不受雌激素受体状态的影响。在使用<60dB 作为截断值的分析中，我们发现道路交通噪声的 HR 为 1.08（0.99-1.18），铁路噪声的 HR 为 1.19（0.95-1.49）。
我们发现道路交通噪声和铁路噪声与乳腺癌风险之间存在微弱关联。需要更多高质量的前瞻性研究，特别是针对那些在接触铁路和飞机噪声之前的女性，以便对噪声作为乳腺癌风险因素做出结论。
