Mayntz Stephan P, Mohamed Roda A, Mejldal Anna, Møller Jens-Jakob K, Lindholt Jes S, Diederichsen Axel Cp, Frohn Lise M, Brandt Jørgen, Ketzel Matthias, Khan Jibran, Lambrechtsen Jess
Cardiology Research Unit, Odense University Hospital, Svendborg, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.
Cardiology Research Unit, Odense University Hospital, Svendborg, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.
JACC Adv. 2025 May 21;4(6 Pt 1):101787. doi: 10.1016/j.jacadv.2025.101787.
Air pollution and road traffic noise are major environmental stressors associated with cardiovascular disease (CVD). Although their independent effects are well-documented, few studies have concurrently evaluated their relative contributions-particularly in low ambient air pollution settings.
The purpose of this study was to investigate the association between long-term exposure to air pollution and road traffic noise and CVD.
We conducted a prospective cohort study using data from the DANCAVAS (Danish Cardiovascular Screening Trial) (2014-2018) and VIVA (Viborg vascular) (2008-2010) screening trials, including 26,723 men aged 65 to 74 years with pollution exposure data from 1979 to 2019. Residential exposure to air pollutants (particulate matter with a diameter <2.5 μm, nitrogen dioxide, warm-season ozone, sulfur dioxide, and carbon monoxide) and road traffic noise (L) were estimated based on residential addresses using the Danish Eulerian Hemispheric Model/Urban Background Model/Air Geographic Information System model and Nord2000. We used Cox proportional hazards models, adjusting for baseline inclusion year, individual-level lifestyle factors, family history of CVD, and socioeconomic status. Major adverse cardiovascular events was the primary outcome.
A 14.9 decibel increase in road traffic noise (IQR increment) was associated with a 7.5% higher risk of major adverse cardiovascular events (HR: 1.075; 95% CI: 1.026-1.128) and an 8.1% increased risk of all-cause mortality (HR: 1.081; 95% CI: 1.027-1.137). No significant associations were found between air pollutants and the primary or secondary outcomes in the pooled cohort after adjustment for confounders.
Long-term exposure to road traffic noise was significantly associated with increased CVD and all-cause mortality. Our findings suggest that studies that do not consider noise exposure may overestimate the cardiovascular burden attributed to air pollution. (Impact of Lifetime Exposure to Air and Noise Pollution on Cardiovascular Disease and Mortality-the AIRCARD Study [AIRCARD]; NCT04353232).
空气污染和道路交通噪音是与心血管疾病（CVD）相关的主要环境压力源。尽管它们的独立影响已有充分记录，但很少有研究同时评估它们的相对贡献——尤其是在低环境空气污染环境中。
本研究的目的是调查长期暴露于空气污染和道路交通噪音与心血管疾病之间的关联。
我们使用丹麦心血管筛查试验（DANCAVAS）（2014 - 2018年）和维堡血管研究（VIVA）（2008 - 2010年）筛查试验的数据进行了一项前瞻性队列研究，纳入了26723名年龄在65至74岁之间的男性，其污染暴露数据涵盖1979年至2019年。根据居住地址，使用丹麦欧拉半球模型/城市背景模型/航空地理信息系统模型和Nord2000估算住宅暴露于空气污染物（直径<2.5μm的颗粒物、二氧化氮、暖季臭氧、二氧化硫和一氧化碳）和道路交通噪音（L）的情况。我们使用Cox比例风险模型，对基线纳入年份、个体水平的生活方式因素、心血管疾病家族史和社会经济地位进行了调整。主要不良心血管事件是主要结局。
道路交通噪音增加14.9分贝（四分位间距增量）与主要不良心血管事件风险升高7.5%（风险比：1.075；95%置信区间：1.026 - 1.128）以及全因死亡率风险升高8.1%（风险比：1.081；95%置信区间：1.027 - 1.137）相关。在对混杂因素进行调整后，在合并队列中未发现空气污染物与主要或次要结局之间存在显著关联。
长期暴露于道路交通噪音与心血管疾病增加和全因死亡率显著相关。我们的研究结果表明，未考虑噪音暴露的研究可能高估了空气污染所致的心血管负担。（终生暴露于空气和噪音污染对心血管疾病和死亡率的影响——AIRCARD研究[AIRCARD]；临床试验注册号：NCT04353232）
