title: Long-term aircraft noise exposure and body mass index, waist circumference, and type 2 diabetes: a prospective study.
abstract: BACKGROUND
  Long-term aircraft noise exposure may increase the risk of cardiovascular disease, but no study has investigated chronic effects on the metabolic system.
  
  
  OBJECTIVE
  The aim of this study was to investigate effects of long-term aircraft noise exposure on body mass index (BMI), waist circumference, and type 2 diabetes. Furthermore, we explored the modifying effects of sleep disturbance.
  
  
  METHODS
  This prospective cohort study of residents of Stockholm County, Sweden, followed 5,156 participants with normal baseline oral glucose tolerance tests (OGTT) for up to 10 years. Exposure to aircraft noise was estimated based on residential history. Information on outcomes and confounders was obtained from baseline and follow-up surveys and examinations, and participants who developed prediabetes or type 2 diabetes were identified by self-reported physician diagnosis or OGTT at follow-up. Adjusted associations were assessed by linear, logistic, and random-effects models.
  
  
  RESULTS
  The mean (± SD) increases in BMI and waist circumference during follow-up were 1.09 ± 1.97 kg/m2 and 4.39 ± 6.39 cm, respectively. The cumulative incidence of prediabetes and type 2 diabetes was 8% and 3%, respectively. Based on an ordinal noise variable, a 5-dB(A) increase in aircraft noise was associated with a greater increase in waist circumference of 1.51 cm (95% CI: 1.13, 1.89), fully adjusted. This association appeared particularly strong among those who did not change their home address during the study period, which may be a result of lower exposure misclassification. However, no clear associations were found for BMI or type 2 diabetes. Furthermore, sleep disturbances did not appear to modify the associations with aircraft noise.
  
  
  CONCLUSIONS
  Long-term aircraft noise exposure may be linked to metabolic outcomes, in particular increased waist circumference.
authors.affiliation: Unit of Environmental Epidemiology, Institute of Environmental Medicine, and.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Eriksson
authors.forename: Agneta
authors.initials: A
authors.lastname: Hilding
authors.forename: Andrei
authors.initials: A
authors.lastname: Pyko
authors.forename: Gösta
authors.initials: G
authors.lastname: Bluhm
authors.forename: Göran
authors.initials: G
authors.lastname: Pershagen
authors.forename: Claes-Göran
authors.initials: CG
authors.lastname: Östenson
mesh_terms: D000328:Adult; D000401:Aircraft; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009622:Noise / Q000009:adverse effects*; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology; D013548:Sweden / Q000453:epidemiology; D055105:Waist Circumference