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      The Effect of Aircraft, Road, and Railway Traffic Noise on Stroke – Results of a Case–Control Study Based on Secondary Data

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          Abstract

          Aim:

          To examine the stroke risks associated with aircraft, road traffic, and railway noise exposure in a large case–control study.

          Materials and Methods:

          All people aged ≥40 years living around the Frankfurt airport that were insured by one of three large statutory health insurance funds between 2005 and 2010 were included in the study ( n = 1,026,670). Address-specific exposure to aircraft, road, and railway traffic noise was estimated for 2005. We used insurance claim data to identify 25,495 newly diagnosed cases of stroke between 2006 and 2010 and compared them with 827,601 control participants. Logistic regression analysis was used to calculate the odds ratios adjusted for age, sex, local proportion of people receiving unemployment benefits, and if available individual indicators of socioeconomic status (education, occupation).

          Results:

          For 24-h continuous aircraft noise exposure, neither increased risk estimates nor a positive linear exposure–risk relation was found. However, stroke risk was statistically significantly increased by 7% [95% confidence intervals (95%CI): 2–13%] for people who were exposed to <40 dB of 24-h continuous aircraft noise, but ≥6 events of maximum nightly sound pressure levels ≥50 dB. For road and railway traffic noise, there was a positive linear exposure–risk relation: Per 10 dB the stroke risk increased by 1.7% (95%CI: 0.3–3.2%) for road traffic noise and by 1.8% (95%CI: 0.1–3.3%) for railway traffic noise. The maximum risk increase of 7% (95%CI: 0–14%) for road traffic noise and 18% (95%CI: 2–38%) for railway traffic noise was found in the exposure category ≥65 to <70 dB.

          Conclusion:

          This large case–control study indicates that traffic noise exposure may lead to an increase in stroke risk. It furthermore suggests that maximum aircraft noise levels at night increase the stroke risk even when continuous noise exposure is low, and thus highlights the relevance of maximum noise levels for research and policies on noise protection.

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          Most cited references32

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          Cardiovascular effects of environmental noise exposure

          The role of noise as an environmental pollutant and its impact on health are being increasingly recognized. Beyond its effects on the auditory system, noise causes annoyance and disturbs sleep, and it impairs cognitive performance. Furthermore, evidence from epidemiologic studies demonstrates that environmental noise is associated with an increased incidence of arterial hypertension, myocardial infarction, and stroke. Both observational and experimental studies indicate that in particular night-time noise can cause disruptions of sleep structure, vegetative arousals (e.g. increases of blood pressure and heart rate) and increases in stress hormone levels and oxidative stress, which in turn may result in endothelial dysfunction and arterial hypertension. This review focuses on the cardiovascular consequences of environmental noise exposure and stresses the importance of noise mitigation strategies for public health.
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            Road traffic noise and stroke: a prospective cohort study.

            Epidemiological studies suggest that long-term exposure to road traffic noise increases the risk of cardiovascular disorders. The aim of this study was to investigate the relation between exposure to road traffic noise and risk for stroke, which has not been studied before. In a population-based cohort of 57,053 people, we identified 1881 cases of first-ever stroke in a national hospital register between 1993-1997 and 2006. Exposure to road traffic noise and air pollution during the same period was estimated for all cohort members from residential address history. Associations between exposure to road traffic noise and stroke incidence were analysed in a Cox regression model with stratification for gender and calendar-year and adjustment for air pollution and other potential confounders. We found an incidence rate ratio (IRR) of 1.14 for stroke [95% confidence interval (CI): 1.03-1.25] per 10 dB higher level of road traffic noise (L(den)). There was a statistically significant interaction with age (P < 0.001), with a strong association between road traffic noise and stroke among cases over 64.5 years (IRR: 1.27; 95% CI: 1.13-1.43) and no association for those under 64.5 years (IRR: 1.02; 95% CI: 0.91-1.14). Exposure to residential road traffic noise was associated with a higher risk for stroke among people older than 64.5 years of age.
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              The association between noise exposure and blood pressure and ischemic heart disease: a meta-analysis.

              It has been suggested that noise exposure is associated with blood pressure changes and ischemic heart disease risk, but epidemiologic evidence is still limited. Furthermore, most reviews investigating these relations were not carried out in a systematic way, which makes them more prone to bias. We conducted a meta-analysis of 43 epidemiologic studies published between 1970 and 1999 that investigate the relation between noise exposure (both occupational and community) and blood pressure and/or ischemic heart disease (International Classification of Diseases, Ninth Revision, codes 410-414). We studied a wide range of effects, from blood pressure changes to a myocardial infarction. With respect to the association between noise exposure and blood pressure, small blood pressure differences were evident. Our meta-analysis showed a significant association for both occupational noise exposure and air traffic noise exposure and hypertension: We estimated relative risks per 5 dB(A) noise increase of 1.14 (1.01-1.29) and 1.26 (1.14-1.39), respectively. Air traffic noise exposure was positively associated with the consultation of a general practitioner or specialist, the use of cardiovascular medicines, and angina pectoris. In cross-sectional studies, road traffic noise exposure increases the risk of myocardial infarction and total ischemic heart disease. Although we can conclude that noise exposure can contribute to the prevalence of cardiovascular disease, the evidence for a relation between noise exposure and ischemic heart disease is still inconclusive because of the limitations in exposure characterization, adjustment for important confounders, and the occurrence of publication bias.
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                Author and article information

                Journal
                Noise Health
                Noise Health
                NH
                Noise & Health
                Medknow Publications & Media Pvt Ltd (India )
                1463-1741
                1998-4030
                Jul-Aug 2018
                : 20
                : 95
                : 152-161
                Affiliations
                [1 ]Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, TU Dresden, Dresden, Germany
                [2 ]NHMRC Clinical Trials Centre, The University of Sydney, Australia
                [3 ]Institute of Social Medicine and Health Economics, Otto-von-Guericke-University Magdeburg, Germany
                [4 ]Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology – BIPS, Bremen, Germany
                [5 ]Health Sciences Bremen, University of Bremen, Germany
                Author notes
                Address for correspondence to: Ms. Anna Lene Seidler, NHMRC Clinical Trials Centre, The University of Sydney, Medical Foundation Building Level 6, 92–94 Parramatta Road, Camperdown, NSW 2050, Australia. E-mail: Lene.seidler@ 123456ctc.usyd.edu.au
                Article
                NH-20-152
                10.4103/nah.NAH_7_18
                6122263
                30136675
                ce2fd3ac-3fd6-43a3-a093-8741e32f87ed
                Copyright: © 2018 Noise & Health

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                Categories
                Original Article

                case–control study,stroke,traffic noise
                case–control study, stroke, traffic noise

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