Residential exposure to traffic-borne pollution as a risk factor for acute cardiocerebrovascular events: a population-based retrospective cohort study in a highly urbanized area

Abstract

Background Long-term exposure to traffic-borne noise and air pollution has been variably associated with incidence of acute vascular events, namely acute myocardial infarction, ischaemic stroke and haemorrhagic stroke. This study aims at exploring this association within a highly urbanized city. Methods This is a population-based retrospective dynamic cohort study including all residents aged ≥ 35 years in the municipality of Milan over the years 2011–18 (1 087 110 inhabitants). Residential exposure to road traffic noise (day-evening-night levels) and nitrogen dioxide was estimated using a noise predictive model and a land use regression model, respectively. Cox proportional hazards regression analyses were performed to assess the incidence of acute vascular events and specific outcomes in single-exposure and two-exposure models including adjustment for sociodemographic confounders, fine particulate matter and surrounding greenness. Results A total of 27 282 subjects (2.5%) had an acute vascular event. Models using nitrogen dioxide produced inconsistent results. The strongest effect was observed for noise, with an optimal cut-off for dichotomization set at 70 dBA (hazard ratio 1.025, 95% confidence interval 1.000–1.050). This association was observed specifically for ischaemic and haemorrhagic stroke. When stratifying by age group and sex, a remarkable effect was found for haemorrhagic stroke in men aged <60 years (hazard ratio 1.439, 95% confidence interval 1.156–1.792). Conclusions Living by roads with a day-evening-night noise level above 70 dBA exerts a small but tangible independent effect on the risks of both ischaemic and haemorrhagic stroke. It is urgent to propose mitigation measures against pollution and noise originating from vehicular traffic in order to reduce their impact, especially in the population younger than 60 years.

ST-Elevation Acute Myocardial Infarction in a Young Man

“…STEMI-SCAD is an important subset of STEMI, particularly among younger women, and generally brings a significantly higher frequency of left main or LAD culprit and cardiogenic shock compared to STEMI atherosclerosis [ 22 ]. Long-term exposure to air pollution and traffic noise has also been variably associated with the incidence of acute vascular events, including AMI [ 23 ]. Notably, in this case, emergency service workers did not suspect AMI, despite the symptoms, due to the young age of the patient.…”

Health position paper and redox perspectives - Disease burden by transportation noise

“…Excluding one conference report, the overall RR per 10 dB L den was 1.03 (95 % CI: 1.00; 1.05), with significant heterogeneity between the studies. More recent findings, not included in the two reviews, also indicated lower risk estimates than in the WHO review or no clear associations [ [54] , [55] , [56] , [57] , [58] ]. All but one of these studies were strictly registry-based and did not contain any information on lifestyle, e.g., smoking, increasing the risk of residual lifestyle confounding compared to the studies in the two reviews, which generally included such data.…”

“…However, it should be noted that simplified noise exposure assessment approaches were applied in the studies which found no association. In studies with less complete confounder adjustment, two studies reported an association with stroke [ 56 , 78 ], whereas three other studies did not [ 54 , 58 , 79 ].…”

Evaluating the Link between Acoustic Climate in Workplaces and Extra-auditory Disorders: the Case of School Environments

“…The noise coming from external sources is not perceived as significant since the noise generated by internal sources in the classroom often makes the disturbance caused by external sources negligible, or at least little perceived, during regular teaching activities. However, considering the literature evidence, which suggests that noise pollution from vehicular and air traffic or from industrial areas is able to determine or aggravate important pathologies such as cardiovascular diseases, diabetes, sleep disturbances and annoyance, the acoustic climate inside schools, noise attributable to sources outside the building should be excluded as much as possible by evaluating the acoustic performance of the facade, especially when the school building is located in particularly busy areas (motorway junctions, railway stations, industrial areas) [7]. In most cases, the noise coming from outside is not considered disturbing, but this does not mean that it cannot contribute to triggering stress mechanisms that can result in cardiovascular or endocrine diseases.…”