居住环境暴露于交通噪音与房颤发病风险：11项北欧前瞻性队列的汇总研究
Residential exposure to transportation noise and risk of incident atrial fibrillation: a pooled study of 11 prospective Nordic cohorts.
作者信息
Thacher Jesse D, Roswall Nina, Ögren Mikael, Pyko Andrei, Åkesson Agneta, Oudin Anna, Rosengren Annika, Poulsen Aslak H, Eriksson Charlotta, Segersson David, Rizzuto Debora, Helte Emilie, Andersson Eva M, Aasvang Gunn Marit, Engström Gunnar, Gudjonsdottir Hrafnhildur, Selander Jenny, Christensen Jesper H, Brandt Jørgen, Leander Karin, Overvad Kim, Mattisson Kristoffer, Eneroth Kristina, Stucki Lara, Barregard Lars, Stockfelt Leo, Albin Maria, Simonsen Mette K, Raaschou-Nielsen Ole, Jousilahti Pekka, Tiittanen Pekka, Ljungman Petter L S, Jensen Steen S, Gustafsson Susanna, Yli-Tuomi Tarja, Cole-Hunter Thomas, Lanki Timo, Lim Youn-Hee, Andersen Zorana J, Pershagen Göran, Sørensen Mette
机构信息
Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark.
出版信息
Lancet Reg Health Eur. 2024 Oct 1;46:101091. doi: 10.1016/j.lanepe.2024.101091. eCollection 2024 Nov.
BACKGROUND
Transportation noise has been linked with cardiometabolic outcomes, yet whether it is a risk factor for atrial fibrillation (AF) remains inconclusive. We aimed to assess whether transportation noise was associated with AF in a large, pooled Nordic cohort.
METHODS
We pooled data from 11 Nordic cohorts, totaling 161,115 participants. Based on address history from five years before baseline until end of follow-up, road, railway, and aircraft noise was estimated at a residential level. Incident AF was ascertained via linkage to nationwide patient registries. Cox proportional hazards models were utilized to estimate associations between running 5-year time-weighted mean transportation noise (L) and AF after adjusting for sociodemographics, lifestyle, and air pollution.
FINDINGS
We identified 18,939 incident AF cases over a median follow-up of 19.6 years. Road traffic noise was associated with AF, with a hazard ratio (HR) and 95% confidence interval (CI) of 1.02 (1.00-1.04) per 10-dB of 5-year mean time-weighted exposure, which changed to 1.03 (1.01-1.06) when implementing a 53-dB cut-off. In effect modification analyses, the association for road traffic noise and AF appeared strongest in women and overweight and obese participants. Compared to exposures ≤40 dB, aircraft noise of 40.1-50 and > 50 dB were associated with HRs of 1.04 (0.93-1.16) and 1.12 (0.98-1.27), respectively. Railway noise was not associated with AF. We found a HR of 1.19 (1.02-1.40) among people exposed to noise from road (≥45 dB), railway (>40 dB), and aircraft (>40 dB) combined.
INTERPRETATION
Road traffic noise, and possibly aircraft noise, may be associated with elevated risk of AF.
FUNDING
NordForsk.
背景
交通噪音已被证明与心脏代谢结果相关，但它是否是心房颤动（AF）的危险因素仍尚无定论。我们旨在评估在一个大型的北欧合并队列中，交通噪音是否与AF有关。
方法
我们汇总了11个北欧队列的数据，共有161,115名参与者。根据基线前五年至随访结束的地址历史，在居住层面估计道路、铁路和飞机噪音。通过与全国患者登记处的链接确定新发AF。在调整社会人口统计学、生活方式和空气污染因素后，使用Cox比例风险模型估计5年时间加权平均交通噪音（L）与AF之间的关联。
结果
在中位随访19.6年期间，我们共识别出18,939例新发AF病例。道路交通噪音与AF相关，每10分贝的5年平均时间加权暴露的风险比（HR）和95%置信区间（CI）为1.02（1.00-1.04），当采用53分贝的临界值时，该值变为1.03（1.01-1.06）。在效应修饰分析中，道路交通噪音与AF的关联在女性以及超重和肥胖参与者中似乎最为明显。与暴露水平≤40分贝相比，40.1-50分贝和>50分贝的飞机噪音的HR分别为1.04（0.93-1.16）和1.12（0.98-1.27）。铁路噪音与AF无关。我们发现，在同时暴露于道路（≥45分贝）、铁路（>40分贝）和飞机（>40分贝）噪音的人群中，HR为1.19（1.02-1.40）。
解读
道路交通噪音以及可能的飞机噪音，可能与AF风险升高有关。
资助
北欧研究理事会。
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