Summary

Abstract

Environmental risk factors are increasingly being recognized as important determinants of cardiovascular disease. While the contribution of diet, exercise, and smoking are well understood, the contribution to cardiovascular disease by factors such as chemical pollutants, noise, and air pollution are not frequently acknowledged, despite the recognition that noise and air pollution together represent the two most important environmental risk factors in urbanized societies. This chapter discusses the epidemiologic evidence in support of an association between noise and air pollution with cardiovascular and metabolic disease. Recent studies also suggest that the two exposures may synergize with each other and with traditional risk factors such as hypertension and type 2 diabetes. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed for exposures well below the thresholds currently accepted as being safe. Current gaps in knowledge, effects of intervention, and their impact on cardiovascular disease, are discussed. Increased awareness of the societal burden posed by these novel risk factors and acknowledgement in traditional risk factor guidelines may intensify the efforts required for effective legislation to reduce air pollution and noise.