title: Long-term exposure to road traffic noise and incident diabetes: a cohort study.
abstract: BACKGROUND
  Road traffic noise at normal urban levels can lead to stress and sleep disturbances. Both excess of stress hormones and reduction in sleep quality and duration may lead to higher risk for type 2 diabetes.
  
  
  OBJECTIVE
  We investigated whether long-term exposure to residential road traffic noise is associated with an increased risk of diabetes.
  
  
  METHODS
  In the population-based Danish Diet, Cancer and Health cohort of 57,053 people 50-64 years of age at enrollment in 1993-1997, we identified 3,869 cases of incident diabetes in a national diabetes registry between enrollment and 2006. The mean follow-up time was 9.6 years. Present and historical residential addresses from 1988 through 2006 were identified using a national register, and exposure to road traffic noise was estimated for all addresses. Associations between exposure to road traffic noise and incident diabetes were analyzed in a Cox regression model.
  
  
  RESULTS
  A 10-dB higher level of average road traffic noise at diagnosis and during the 5 years preceding diagnosis was associated with an increased risk of incident diabetes, with incidence rate ratios (IRR) of 1.08 (95% CI: 1.02, 1.14) and 1.11 (95% CI: 1.05, 1.18), respectively, after adjusting for potential confounders including age, body mass index, waist circumference, education, air pollution (nitrogen oxides), and lifestyle characteristics. After applying a stricter definition of diabetes (2,752 cases), we found IRRs of 1.11 (95% CI: 1.03, 1.19) and 1.14 (95% CI: 1.06, 1.22) per 10-dB increase in road traffic noise at diagnosis and during the 5 years preceding diagnosis, respectively.
  
  
  CONCLUSIONS
  Exposure to residential road traffic noise was associated with a higher risk of diabetes. This study provides further evidence that urban noise may adversely influence population health.
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark. mettes@cancer.dk
authors.forename: Mette
authors.initials: M
authors.lastname: Sørensen
authors.forename: Zorana J
authors.initials: ZJ
authors.lastname: Andersen
authors.forename: Rikke B
authors.initials: RB
authors.lastname: Nordsborg
authors.forename: Thomas
authors.initials: T
authors.lastname: Becker
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Ole
authors.initials: O
authors.lastname: Raaschou-Nielsen
mesh_terms: D015331:Cohort Studies; D004781:Environmental Exposure; D006801:Humans; D008875:Middle Aged; D018986:Motor Vehicles; D009622:Noise; D011795:Surveys and Questionnaires