Journal Article

Long-term exposure to road traffic noise and stroke incidence: a Danish Nurse Cohort study

Jensen, Steen Solvang, Geels, Camilla, Mehta, Amar, Amini, Heresh, Hertel, Ole, Brandt, Jørgen, Li, Shuo, Westendorp, Rudi, Christensen, Jesper H., Hoffmann, Barbara, Dehlendorff, Christian, Simonsen, Mette K., Andersen, Zorana J., So, Rina, Mortensen, Laust H., Cole-Hunter, Tom, Jørgensen, Jeanette T., Backalarz, Claus, Bräuner, Elvira V., Lim, Youn-Hee, Ketzel, Matthias, Loft, Steffen, Frohn, Lise M.

2021

Overview

Background Road traffic noise has been linked to increased risk of ischemic heart disease, yet evidence on stroke shows mixed results. We examine the association between long-term exposure to road traffic noise and incidence of stroke, overall and by subtype (ischemic or hemorrhagic), after adjustment for air pollution. Methods Twenty-five thousand six hundred and sixty female nurses from the Danish Nurse Cohort recruited in 1993 or 1999 were followed for stroke-related first-ever hospital contact until December 31st, 2014. Full residential address histories since 1970 were obtained and annual means of road traffic noise (L den [dB]) and air pollutants (particulate matter with diameter < 2.5 μm and < 10 μm [PM 2.5 and PM 10 ], nitrogen dioxide [NO 2 ], nitrogen oxides [NOx]) were determined using validated models. Time-varying Cox regression models were used to estimate hazard ratios (HR) (95% confidence intervals [CI]) for the associations of one-, three-, and 23-year running means of L den preceding stroke (all, ischemic or hemorrhagic), adjusting for stroke risk factors and air pollutants. The World Health Organization and the Danish government’s maximum exposure recommendations of 53 and 58 dB, respectively, were explored as potential L den thresholds. Results Of 25,660 nurses, 1237 developed their first stroke (1089 ischemic, 148 hemorrhagic) during 16 years mean follow-up. For associations between a 1-year mean of L den and overall stroke incidence, the estimated HR (95% CI) in the fully adjusted model was 1.06 (0.98–1.14) per 10 dB, which attenuated to 1.01 (0.93–1.09) and 1.00 (0.91–1.09) in models further adjusted for PM 2.5 or NO 2 , respectively. Associations for other exposure periods or separately for ischemic or hemorrhagic stroke were similar. There was no evidence of a threshold association between L den and stroke. Conclusions Long-term exposure to road traffic noise was suggestively positively associated with the risk of overall stroke, although not after adjusting for air pollution.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Air Pollutants - analysis / Air Pollutants - toxicity / Air pollution / Air Pollution - analysis / Air Pollution - statistics & numerical data / Background noise / Blood pressure / Cardiovascular diseases / Cohort analysis / Cohort Studies / Confidence intervals / Coronary artery disease / Denmark - epidemiology / Earth and Environmental Science / Environment / Environmental Exposure - analysis / Environmental Exposure - statistics & numerical data / Environmental Health / Environmental risk / Exposure / Female / Health aspects / Health risks / Heart diseases / Hemorrhage / Hormone replacement therapy / Humans / Hypertension / Incidence / Ischemia / Medical personnel / Nitrogen dioxide / Nitrogen oxides / NO2 / Noise / Noise levels / Noise, Transportation - adverse effects / Noise, Transportation - statistics & numerical data / Nurses / Occupational Medicine/Industrial Medicine / Particulate emissions / Particulate matter / Particulate Matter - analysis / Particulate Matter - toxicity / Photochemicals / PM10 / PM2.5 / Pollutants / Public Health / Questionnaires / Regression analysis / Regression models / Risk analysis / Risk factors / Road traffic noise / Roads & highways / Statistical analysis / Stroke / Stroke (Disease) / Stroke - epidemiology / Traffic / Traffic noise / Transportation noise