title: Exposure to aircraft and road traffic noise and associations with heart disease and stroke in six European countries: a cross-sectional study.
abstract: BACKGROUND
  Although a number of studies have found an association between aircraft noise and hypertension, there is a lack of evidence on associations with other cardiovascular disease. For road traffic noise, more studies are available but the extent of possible confounding by air pollution has not been established.
  
  
  METHODS
  This study used data from the Hypertension and Environmental Noise near Airports (HYENA) study. Cross-sectional associations between self-reported 'heart disease and stroke' and aircraft noise and road traffic noise were examined using data collected between 2004 and 2006 on 4712 participants (276 cases), who lived near airports in six European countries (UK, Germany, Netherlands, Sweden, Greece, Italy). Data were available to assess potential confounding by NO2 air pollution in a subsample of three countries (UK, Netherlands, Sweden).
  
  
  RESULTS
  An association between night-time average aircraft noise and 'heart disease and stroke' was found after adjustment for socio-demographic confounders for participants who had lived in the same place for ≥ 20 years (odds ratio (OR): 1.25 (95% confidence interval (CI) 1.03, 1.51) per 10 dB (A)); this association was robust to adjustment for exposure to air pollution in the subsample. 24 hour average road traffic noise exposure was associated with 'heart disease and stroke' (OR: 1.19 (95% CI 1.00, 1.41), but adjustment for air pollution in the subsample suggested this may have been due to confounding by air pollution. Statistical assessment (correlations and variance inflation factor) suggested only modest collinearity between noise and NO2 exposures.
  
  
  CONCLUSIONS
  Exposure to aircraft noise over many years may increase risks of heart disease and stroke, although more studies are needed to establish how much the risks associated with road traffic noise may be explained by air pollution.
authors.forename: Sarah
authors.initials: S
authors.lastname: Floud
authors.forename: Marta
authors.initials: M
authors.lastname: Blangiardo
authors.forename: Charlotte
authors.initials: C
authors.lastname: Clark
authors.forename: Kees
authors.initials: K
authors.lastname: de Hoogh
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Babisch
authors.forename: Danny
authors.initials: D
authors.lastname: Houthuijs
authors.forename: Wim
authors.initials: W
authors.lastname: Swart
authors.forename: Göran
authors.initials: G
authors.lastname: Pershagen
authors.forename: Klea
authors.initials: K
authors.lastname: Katsouyanni
authors.forename: Manolis
authors.initials: M
authors.lastname: Velonakis
authors.forename: Federica
authors.initials: F
authors.lastname: Vigna-Taglianti
authors.forename: Ennio
authors.initials: E
authors.lastname: Cadum
authors.affiliation: MRC-PHE Centre for Environment and Health, Imperial College London, London, UK. a.hansell@imperial.ac.uk.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Hansell
mesh_terms: D000368:Aged; D000393:Air Pollutants / Q000633:toxicity*; D000401:Aircraft; D001336:Automobiles; D002940:Circadian Rhythm; D003430:Cross-Sectional Studies; D004781:Environmental Exposure; D005060:Europe; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009585:Nitrogen Dioxide / Q000633:toxicity; D009624:Noise, Transportation / Q000009:adverse effects*; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology
chemical_list: D000393:Air Pollutants; D009585:Nitrogen Dioxide