title: Road traffic noise is associated with increased cardiovascular morbidity and mortality and all-cause mortality in London.
abstract: OBJECTIVE
  Road traffic noise has been associated with hypertension but evidence for the long-term effects on hospital admissions and mortality is limited. We examined the effects of long-term exposure to road traffic noise on hospital admissions and mortality in the general population.
  
  
  RESULTS
  The study population consisted of 8.6 million inhabitants of London, one of Europe's largest cities. We assessed small-area-level associations of day- (7:00-22:59) and nighttime (23:00-06:59) road traffic noise with cardiovascular hospital admissions and all-cause and cardiovascular mortality in all adults (≥25 years) and elderly (≥75 years) through Poisson regression models. We adjusted models for age, sex, area-level socioeconomic deprivation, ethnicity, smoking, air pollution, and neighbourhood spatial structure. Median daytime exposure to road traffic noise was 55.6 dB. Daytime road traffic noise increased the risk of hospital admission for stroke with relative risk (RR) 1.05 [95% confidence interval (CI): 1.02-1.09] in adults, and 1.09 (95% CI: 1.04-1.14) in the elderly in areas >60 vs. <55 dB. Nighttime noise was associated with stroke admissions only among the elderly. Daytime noise was significantly associated with all-cause mortality in adults [RR 1.04 (95% CI: 1.00-1.07) in areas >60 vs. <55 dB]. Positive but non-significant associations were seen with mortality for cardiovascular and ischaemic heart disease, and stroke. Results were similar for the elderly.
  
  
  CONCLUSIONS
  Long-term exposure to road traffic noise was associated with small increased risks of all-cause mortality and cardiovascular mortality and morbidity in the general population, particularly for stroke in the elderly.
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Tavistock Place 15-17, London WC1H 9SH, UK jaana.halonen@ttl.fi.
authors.forename: Jaana I
authors.initials: JI
authors.lastname: Halonen
authors.affiliation: UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK Imperial College Healthcare NHS Trust, London, UK.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Hansell
authors.affiliation: UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK.
authors.forename: John
authors.initials: J
authors.lastname: Gulliver
authors.affiliation: UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK.
authors.forename: David
authors.initials: D
authors.lastname: Morley
authors.affiliation: UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK.
authors.forename: Marta
authors.initials: M
authors.lastname: Blangiardo
authors.affiliation: UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK.
authors.forename: Daniela
authors.initials: D
authors.lastname: Fecht
authors.affiliation: UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College, London W2 1PG, UK.
authors.forename: Mireille B
authors.initials: MB
authors.lastname: Toledano
authors.affiliation: MRC-PHE Centre for Environment and Health, King's College London, Franklin-Wilkins Building, Waterloo SE1 9NH, UK.
authors.forename: Sean D
authors.initials: SD
authors.lastname: Beevers
authors.affiliation: MRC-PHE Centre for Environment and Health, King's College London, Franklin-Wilkins Building, Waterloo SE1 9NH, UK.
authors.forename: Hugh Ross
authors.initials: HR
authors.lastname: Anderson
authors.affiliation: MRC-PHE Centre for Environment and Health, King's College London, Franklin-Wilkins Building, Waterloo SE1 9NH, UK.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Kelly
authors.affiliation: Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, Tavistock Place 15-17, London WC1H 9SH, UK MRC-PHE Centre for Environment and Health, King's College London, Franklin-Wilkins Building, Waterloo SE1 9NH, UK.
authors.forename: Cathryn
authors.initials: C
authors.lastname: Tonne
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009624:Noise, Transportation / Q000009:adverse effects*; D011379:Prognosis
keywords: Cardiovascular; Epidemiology; Hospital admission; Mortality; Traffic noise