title: Road traffic noise, air pollution and myocardial infarction: a prospective cohort study.
abstract: OBJECTIVE
  Both road traffic noise and air pollution have been linked to cardiovascular disease. However, there are few prospective epidemiological studies available where both road traffic noise and air pollution have been analyzed simultaneously. The aim of this study was to investigate the relation between road traffic noise, air pollution and incident myocardial infarction in both current (1-year average) and medium-term (3-year average) perspective.
  
  
  METHODS
  This study was based on a stratified random sample of persons aged 18-80 years who answered a public health survey in Skåne, Sweden, in 2000 (n = 13,512). The same individuals received a repeated survey in 2005 and 2010. Diagnoses of myocardial infarction (MI) were obtained from medical records for both inpatient and outpatient specialized care. The endpoint was first MI during 2000-2010. Participants with prior myocardial infarction were excluded at baseline. Yearly average levels of noise (L DEN) and air pollution (NO x ) were estimated using geographic information system for residential address every year until censoring.
  
  
  RESULTS
  The mean exposure levels for road traffic noise and air pollution in 2005 were L DEN 51 dB(A) and NO x 11 µg/m(3), respectively. After adjustment for individual confounders (age, sex, body mass index, smoking, education, alcohol consumption, civil status, year, country of birth and physical activity), a 10-dB(A) increase in current noise exposure did not increase the incidence rate ratio (IRR) for MI, 0.99 (95 % CI 0.86-1.14). Neither did a 10-μg/m(3) increase in current NO x increase the risk of MI, 1.02 (95 % CI 0.86-1.21). The IRR for MI associated with combined exposure to road traffic noise >55 dB(A) and NO x >20 µg/m(3) was 1.21 (95 % CI 0.90-1.64) compared to <55 dB(A) and <20 µg/m(3).
  
  
  CONCLUSIONS
  This study did not provide evidence for an increased risk of MI due to exposure to road traffic noise or air pollution at moderate average exposure levels.
authors: Division of Occupational and Environmental Medicine, Lund University, 221 85, Lund, Sweden. theo.bodin@ki.se.|Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden. theo.bodin@ki.se.
authors: Theo
authors: T
authors: Bodin
authors: Division of Occupational and Environmental Medicine, Lund University, 221 85, Lund, Sweden.
authors: Jonas
authors: J
authors: Björk
authors: Division of Occupational and Environmental Medicine, Lund University, 221 85, Lund, Sweden.
authors: Kristoffer
authors: K
authors: Mattisson
authors: Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors: Matteo
authors: M
authors: Bottai
authors: Division of Occupational and Environmental Medicine, Lund University, 221 85, Lund, Sweden.
authors: Ralf
authors: R
authors: Rittner
authors: Institute of Environmental Medicine, Karolinska Institutet, 171 77, Stockholm, Sweden.
authors: Per
authors: P
authors: Gustavsson
authors: Division of Occupational and Environmental Medicine, Lund University, 221 85, Lund, Sweden.
authors: Kristina
authors: K
authors: Jakobsson
authors: Division of Social Medicine and Global Health, Lund University, 205 02, Malmö, Sweden.
authors: Per-Olof
authors: PO
authors: Östergren
authors: Division of Occupational and Environmental Medicine, Lund University, 221 85, Lund, Sweden.
authors: Maria
authors: M
authors: Albin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000397:Air Pollution / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology*; D009624:Noise, Transportation / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D055815:Young Adult
keywords: Air pollution; Ischemic heart disease; Myocardial infarction; Road traffic noise; Traffic noise