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Long-term transportation noise exposure and incidence of ischaemic heart disease and stroke: a cohort study
  1. Andrei Pyko1,2,
  2. Niklas Andersson1,
  3. Charlotta Eriksson1,2,
  4. Ulf de Faire1,
  5. Tomas Lind2,
  6. Natalya Mitkovskaya3,
  7. Mikael Ögren4,
  8. Claes-Göran Östenson5,
  9. Nancy L Pedersen6,
  10. Debora Rizzuto7,
  11. Alva Käte Wallas1,
  12. Göran Pershagen1,2
  1. 1 Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  2. 2 Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
  3. 3 Department of Cardiology and Internal Medicine, Belarusian State Medical University, Minsk, Belarus
  4. 4 Department of Occupational and Environmental Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
  5. 5 Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
  6. 6 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  7. 7 Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr. Andrei Pyko, Institute of Environmental Medicine, Karolinska Institutet, Stockholm 171 77, Sweden; Andrei.pyko{at}


Background There is limited evidence from longitudinal studies on transportation noise from different sources and development of ischaemic heart disease (IHD) and stroke.

Objectives This cohort study assessed associations between exposure to noise from road traffic, railway or aircraft and incidence of IHD and stroke.

Methods In a cohort of 20 012 individuals from Stockholm County, we estimated long-term residential exposure to road traffic, railway and aircraft noise. National Patient and Cause-of-Death Registers were used to identify IHD and stroke events. Information on risk factors was obtained from questionnaires and registers. Adjusted HR for cardiovascular outcomes related to source-specific noise exposure were computed using Cox proportional hazards regression.

Results No clear or consistent associations were observed between transportation noise and incidence of IHD or stroke. However, noise exposure from road traffic and aircraft was related to IHD incidence in women, with HR of 1.11 (95% CI 1.00 to 1.22) and 1.25 (95% CI 1.09 to 1.44) per 10 dB Lden, respectively. For both sexes taken together, we observed a particularly high risk of IHD in those exposed to all three transportation noise sources at≥45 dB Lden, with a HR of 1.57 (95% CI 1.06 to 2.32), and a similar tendency for stroke (HR 1.42; 95% CI 0.87 to 2.32).

Conclusion No overall associations were observed between transportation noise exposure and incidence of IHD or stroke. However, there appeared to be an increased risk of IHD in women exposed to road traffic or aircraft noise as well as in those exposed to multiple sources of transportation noise.

  • epidemiology
  • noise
  • cardiovascular
  • transport

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  • Contributors All coauthors had substantial involvement in drafting and critical revision of the article, handling the reviewer comments as well as have approved the final version of the resubmitted manuscript. Working group of AP, CE, TL and GP was responsible for the study design, data analysis and interpretation of results.

  • Funding This project was funded by the Swedish Research Council for Health, Working Life and Welfare. The SDPP cohort was funded by the Stockholm County Council, the Swedish Research Council, the Diabetes Fund of the Swedish Diabetes Association, Novo Nordisk Scandinavia and GlaxoSmithKline. The SIXTY cohort was funded by the Stockholm County Council and the Swedish Research Council. The SALT cohort was supported by NIH grant AG‐08724. The SNAC‐K cohort was supported by the Ministry of Health and Social Affairs, Sweden and the participating County Councils, Municipalities and University Departments.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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