Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Environ Int. 2024 Aug;190:108842. doi: 10.1016/j.envint.2024.108842. Epub 2024 Jul 4.
Long-term exposure to road traffic noise is associated with cardiovascular disease, but the evidence on respiratory diseases is just emerging. We aimed to examine the association between long-term exposure to road traffic noise and the incidence of acute lower respiratory infections (ALRIs) in adults.
We followed 23,141 female nurses (age ≥ 44 years) from the Danish Nurse Cohort from baseline (1993 or 1999) to their first hospital contact (inpatient, outpatient, or emergency room) for ALRI, death, emigration or the end of 2015. The residential annual mean levels of road traffic noise (L) during the follow-up were estimated using the Nord2000 model. We applied time-varying Cox models to estimate the association of 3-year mean exposure to L with ALRIs incidence and piecewise analysis to estimate the threshold of L. We examined the robustness of the results by adjusting for residential exposure to air pollution, and the effect modification by attained age, socioeconomic status (SES), comorbidity, and lifestyle.
During 18.5 years of follow-up, 2,004 nurses developed ALRIs. In a linear model, we detected a statistically significant positive association between L and ALRI, with a hazard ratio (HR) of 1.11 (95 % confidence interval (CI): 1.04, 1.17) per 9.2 dB (interquartile range, IQR). We observed non-linear association with a threshold at 57 dB, above which the HR was 1.25 (95 % CI: 1.09, 1.43) per IQR. Further adjustment for PM reduced the HRs slightly to 1.21 (95 % CI: 1.04, 1.40). The associations were stronger for nurses with asthma, and in those with lowest SES.
We present novel findings in support of the association between long-term exposure to road traffic noise and ALRIs, independent of air pollution, suggesting noise as a risk factor for infectious respiratory diseases.
长期暴露于道路交通噪声与心血管疾病有关，但有关呼吸道疾病的证据才刚刚出现。我们旨在研究长期暴露于道路交通噪声与成年人急性下呼吸道感染（ALRI）发病率之间的关系。
我们对来自丹麦护士队列的 23141 名女性护士（年龄≥44 岁）进行了随访，从基线（1993 年或 1999 年）开始至她们首次因 ALRI 住院（住院、门诊或急诊）、死亡、移民或 2015 年底。使用 Nord2000 模型估计随访期间的道路交通噪声（L）的年度平均居住水平。我们应用时变 Cox 模型来估计 3 年平均暴露于 L 与 ALRI 发病率的关系，并进行分段分析以估计 L 的阈值。我们通过调整居住环境污染暴露以及通过获得的年龄、社会经济状况（SES）、合并症和生活方式来检验结果的稳健性。
在 18.5 年的随访期间，有 2004 名护士患上了 ALRI。在线性模型中，我们检测到 L 与 ALRI 之间存在统计学上显著的正相关，危险比（HR）为每 9.2dB（四分位间距，IQR）增加 1.11（95%置信区间（CI）：1.04，1.17）。我们观察到存在非线性关联，其阈值为 57dB，高于该阈值时，HR 为每 IQR 增加 1.25（95%CI：1.09，1.43）。进一步调整 PM 后，HR 略有降低至 1.21（95%CI：1.04，1.40）。对于患有哮喘的护士和 SES 最低的护士，关联更强。
我们提出了新的发现，支持长期暴露于道路交通噪声与 ALRI 之间的关联，独立于空气污染，表明噪声是传染性呼吸道疾病的一个危险因素。
