title: Environmental stressors and cardio-metabolic disease: part I-epidemiologic evidence supporting a role for noise and air pollution and effects of mitigation strategies.
abstract: Traffic noise and air pollution together represent the two most important environmental risk factors in urbanized societies. The first of this two-part review discusses the epidemiologic evidence in support of the existence of an association between these risk factors with cardiovascular and metabolic disease. While independent effects of these risk factors have now clearly been shown, recent studies also suggest that the two exposures may interact with each other and with traditional risk factors such as hypertension and type 2 diabetes. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed for exposures well below the thresholds currently accepted as being safe. Current gaps in knowledge, effects of intervention and their impact on cardiovascular disease, will be discussed in the last section of this review. Increased awareness of the societal burden posed by these novel risk factors and acknowledgement in traditional risk factor guidelines may intensify the efforts required for effective legislation to reduce air pollution and noise.
authors.affiliation: Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Sørensen
authors.affiliation: Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.affiliation: Center for Cardiology, Cardiology I, Angiology and Intensive Care Medicine, University Medical Center Mainz and Deutsches Zentrum für Herz und Kreislauf Forschung, Standort Rhein-Main, Germany.
authors.forename: Frank P
authors.initials: FP
authors.lastname: Schmidt
authors.affiliation: Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Xiaoquan
authors.initials: X
authors.lastname: Rao
authors.affiliation: Air Quality Research Division, Environment and Climate Change Canada, Toronto, Canada.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Brook
authors.affiliation: Department of Environmental Medicine, New York University, New York, USA.
authors.forename: Lung Chi
authors.initials: LC
authors.lastname: Chen
authors.affiliation: Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, USA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Brook
authors.affiliation: Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, MD, USA.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Rajagopalan
mesh_terms: D000397:Air Pollution / Q000009:adverse effects* / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D017281:Cost of Illness; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis / Q000517:prevention & control; D005260:Female; D014943:Global Health / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000453:epidemiology / Q000209:etiology*; D008875:Middle Aged; D009624:Noise, Transportation / Q000009:adverse effects*; D012307:Risk Factors; D013312:Stress, Physiological / Q000502:physiology
keywords: Air pollution; Cardiovascular; Environmental stressors; Noise