Abstract
Introduction: Evidence for an association between cardiovascular diseases (CVD) and transportation noise is growing. While the bulk of studies published to date consider noise sources separately, the typical noise metrics do not inform about the peaking characteristics of the noise source. Our study focuses on the association of the three major transportation noise sources – aircraft, railway and road – along with a novel noise metric termed intermittency ratio (IR, % contribution of individual events in the total noise level from all sources above a certain threshold) with CVD mortality in Switzerland. Methods: In the SiRENE project, we modeled a Swiss-wide noise exposure database for each building at each floor and façade. We geographically linked participants of the Swiss National Cohort (SNC) to the noise database. Noise exposure was assigned to 4.54 mil adult participants of the SNC for the period 2000 to 2008. We selected the maximum Lden values by source and total IR at the floor of residence. The association between noise exposure and heart failure (HF) and myocardial infarction (MI) was investigated by cox regression in multipollutant models adjusted for potential confounders and NO2 exposure. Results: 172025 cases of CVD as primary cause of death were reported, from which 9.4% and 12% died of heart failure and myocardial infarction. Hazard ratios (95% CI) per 10dB(A) increase of exposure for HF were 1.02 (1.01-1.04), 1.06 (1.04-1.08) and 1.06 (1.03-1.08) for Lden-rail, Lden-road, and Lden-air, while for MI they were 1.01 (0.99-1.02), 1.04 (1.02-1.06) 1.02 (1.00-1.04), and 1.01 (1.00-1.02) for Lden-rail, Lden-road, Lden-air and IR. Conclusion: Our study demonstrates the impact of all major transportation noise sources on CVD mortality. For MI, the degree of intermittency was found to be relevant in addition to Lden. This finding is relevant for protection policy of various noise sources with different characteristics.
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