Long-Term Exposure to Transportation Noise and Risk of Incident Stroke: A Pooled Study of Nine Scandinavian Cohorts

Abstract

Background: Transportation noise is increasingly acknowledged as a cardiovascular risk factor, but the evidence base for an association with stroke is sparse. Objective: We aimed to investigate the association between transportation noise and stroke incidence in a large Scandinavian population. Methods: We harmonized and pooled data from nine Scandinavian cohorts (seven Swedish, two Danish), totaling 135,951 participants. We identified residential address history and estimated road, railway, and aircraft noise for all addresses. Information on stroke incidence was acquired through linkage to national patient and mortality registries. We analyzed data using Cox proportional hazards models, including socioeconomic and lifestyle confounders, and air pollution. Results: During follow-up ( ), 11,056 stroke cases were identified. Road traffic noise ( ) was associated with risk of stroke, with a hazard ratio (HR) of 1.06 [95% confidence interval (CI): 1.03, 1.08] per 10-dB higher 5-y mean time-weighted exposure in analyses adjusted for individual- and area-level socioeconomic covariates. The association was approximately linear and persisted after adjustment for air pollution [particulate matter (PM) with an aerodynamic diameter of ( ) and ]. Stroke was associated with moderate levels of 5-y aircraft noise exposure (40–50 vs. ) ( ; 95% CI: 0.99, 1.27), but not with higher exposure ( , ; 95% CI: 0.79, 1.11). Railway noise was not associated with stroke. Discussion: In this pooled study, road traffic noise was associated with a higher risk of stroke. This finding supports road traffic noise as an important cardiovascular risk factor that should be included when estimating the burden of disease due to traffic noise. https://doi.org/10.1289/EHP8949

Occupational noise exposure and risk of incident stroke: a pooled study of five Scandinavian cohorts

“…However, the study had only 13 ischaemic and 21 haemorrhagic exposed cases. Notably, studies on transportation noise have also found positive associations with ischaemic stroke (and not haemorrhagic stroke),21 22 37 and with pathophysiological risk factors for ischaemic stroke including subclinical atherosclerosis and impaired endothelial function 5. This suggests the involvement of noise in causing vascular damage, and may provide a pathophysiological basis to explain the higher risk of ischaemic stroke in relation to occupational noise exposure.…”

“…Road traffic noise exposure was calculated based on each participant’s address history as the equivalent continuous A-weighted sound pressure level (L Aeq ) at the most exposed facade for day (07:00–19:00 hours), evening (19:00–22:00 hours) and night (22:00–07:00 hours), and expressed as L den 22. Road traffic noise for all cohorts was modelled using the Nordic Prediction method 35.…”

“…Road traffic noise has been associated with stroke 19–22. More than 20% of the European Union population lives in areas where traffic noise levels are considered harmful to health 23.…”

Short-Term Effects of Low-Level Ambient Air NO2 on the Risk of Incident Stroke in Enshi City, China

“…Stroke is a complex multifactorial disease affected by multiple factors. According to previous studies, various factors including air pollution, transportation noise, smoking, substance abuse, and physical inactivity might be contributing factors to stroke [ 4 , 5 ]. In recent decades, emerging studies demonstrated the important role of air pollutants on stroke morbidity and mortality [ 6 , 7 , 8 ].…”

Consider the Source: Noise–Stroke Association Varies by Transportation Type

“… 6 , 7 , 8 In a recently published study in Environmental Health Perspectives , researchers assessed how exposure to transportation noise may affect stroke incidence. 9 …”