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Road traffic noise, air pollution and myocardial infarction: a prospective cohort study

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Abstract

Purpose

Both road traffic noise and air pollution have been linked to cardiovascular disease. However, there are few prospective epidemiological studies available where both road traffic noise and air pollution have been analyzed simultaneously. The aim of this study was to investigate the relation between road traffic noise, air pollution and incident myocardial infarction in both current (1-year average) and medium-term (3-year average) perspective.

Methods

This study was based on a stratified random sample of persons aged 18–80 years who answered a public health survey in Skåne, Sweden, in 2000 (n = 13,512). The same individuals received a repeated survey in 2005 and 2010. Diagnoses of myocardial infarction (MI) were obtained from medical records for both inpatient and outpatient specialized care. The endpoint was first MI during 2000–2010. Participants with prior myocardial infarction were excluded at baseline. Yearly average levels of noise (L DEN) and air pollution (NO x ) were estimated using geographic information system for residential address every year until censoring.

Results

The mean exposure levels for road traffic noise and air pollution in 2005 were L DEN 51 dB(A) and NO x 11 µg/m3, respectively. After adjustment for individual confounders (age, sex, body mass index, smoking, education, alcohol consumption, civil status, year, country of birth and physical activity), a 10-dB(A) increase in current noise exposure did not increase the incidence rate ratio (IRR) for MI, 0.99 (95 % CI 0.86–1.14). Neither did a 10-μg/m3 increase in current NO x increase the risk of MI, 1.02 (95 % CI 0.86–1.21). The IRR for MI associated with combined exposure to road traffic noise >55 dB(A) and NO x >20 µg/m3 was 1.21 (95 % CI 0.90–1.64) compared to <55 dB(A) and <20 µg/m3.

Conclusions

This study did not provide evidence for an increased risk of MI due to exposure to road traffic noise or air pollution at moderate average exposure levels.

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Acknowledgments

Financial support: Swedish Research Council for Health, Working Life and Welfare, FORTE, and Swedish Research Council (VR). We would like to thank Pernilla Fagerström at The National Board of Health and Welfare (Socialstyrelsen) for support on register data. Also many thanks to Mathias Grahn at the Clinical Research Centre, County Council of Skåne, for help with survey database management.

Authors’ contributions

All authors of this article have read and approved the final version submitted. They have also directly participated either in the planning, execution, or analysis of this study. T. B., M. A. and J. B. developed the study design. T. B. collected and managed the data from different sources. T. B. performed the statistical analysis together with M. B., who also wrote parts of the methods section. K. M. and R. R. performed the GIS modeling for noise and air pollution, respectively, and contributed to the article’s methods and discussion section. K. J. has especially contributed to the parts regarding air pollution, PG to on aspects of cardiovascular epidemiology. P-O. Ö. was responsible for the three surveys and contributed to the methods section. All authors have revised drafts and contributed to the discussion.

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Authors and Affiliations

  1. Division of Occupational and Environmental Medicine, Lund University, 221 85, Lund, Sweden

    Theo Bodin, Jonas Björk, Kristoffer Mattisson, Ralf Rittner, Kristina Jakobsson & Maria Albin

  2. Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden

    Theo Bodin, Matteo Bottai & Per Gustavsson

  3. Division of Social Medicine and Global Health, Lund University, 205 02, Malmö, Sweden

    Per-Olof Östergren

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  1. Theo Bodin
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Correspondence to Theo Bodin.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was carried out in accordance with ethical standards of the 1964 Helsinki Declaration and its later amendments and approved by the regional research ethics committee of southern Sweden.

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Bodin, T., Björk, J., Mattisson, K. et al. Road traffic noise, air pollution and myocardial infarction: a prospective cohort study. Int Arch Occup Environ Health 89, 793–802 (2016). https://doi.org/10.1007/s00420-016-1115-9

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