Long-term exposure to aircraft noise and risk of incident cardiovascular disease in the Women’s Health Initiative

Abstract

Background: Aircraft noise is a persistent concern for communities surrounding airports. Studies have reported associations with cardiovascular disease (CVD), but few studies have been longitudinal or assessed multiple airports. Also, to date, no prospective cohort study investigating noise and CVD has been conducted in the United States (U.S.). We evaluated the association between long-term exposure to aircraft noise and incident CVD events among post-menopausal participants in the Women’s Health Initiative (WHI), a large ongoing U.S. prospective study. Methods: Day-night average sound levels (DNL) at 1 decibel (dB) intervals down to 45 dB were modeled for 90 U.S. airports from 1995-2015 in 5-year intervals. We used the U.S. Federal Aviation Administration’s Aviation Environmental Design Tool and linked to WHI-participant geocoded addresses. Participants were followed from 1993-2010. CVD was defined as first occurrence of coronary heart disease or stroke during follow-up. Using time-varying Cox regression, we estimated hazard ratios (HRs) and 95% confidence intervals (95% CI) for incident CVD comparing exposure to ≥45 dB versus <45 dB and ≥55 dB versus <55 dB while adjusting for participant-level demographic, behavioral and risk factors. Results: Of the 132,499 women free of CVD at baseline, 10,300 developed CVD during follow-up. Median follow-up time was 13.2 (interquartile range: 9.9-14.4) years, and 20.5% were exposed to ≥DNL 45 dB and 3.9% to ≥DNL 55 dB. We observed adjusted HRs (95% CI) of 1.04 (0.98-1.11) at DNL 45 dB and 0.95 (0.83-1.09) at DNL 55 dB. Conclusions: This is among the first U.S.-based studies investigating the longitudinal relationship between aircraft noise exposure and CVD risk using a national cohort. After adjustment, preliminary analyses indicate no consistent associations between aircraft noise exposure and incident CVD among post-menopausal women. Future work will further investigate environmental and contextual factors, explore alternative noise metrics, and analyze CVD-subtypes.