Road traffic noise and incident ischemic heart disease, myocardial infarction, and stroke: A systematic review and meta-analysis.

Abstract

Background: This systematic review aimed to estimate relative risks for incident ischemic heart disease (IHD), myocardial infarction (MI), and stroke in relation to long-term road traffic noise exposure and to evaluate exposure-response functions.

Methods: We systematically searched databases for longitudinal studies in humans on incident IHD, MI, and/or stroke, including quantitative estimates on individual exposure to residential road traffic noise based on validated models or measurements. Risk of bias was evaluated in each study based on predefined criteria. Pooled linear exposure-response functions were generated from random-effect models in meta-analyses of study-specific risk estimates. Restricted cubic spline models were used to capture potential nonlinear associations.

Results: Twenty eligible studies were identified based on more than 8.4 million individuals, mostly from Europe, including between 160,000 and 240,000 cases for each of the outcomes. Pooled relative risk estimates were 1.017 (95% confidence interval [CI]: 0.990, 1.044) for IHD, 1.029 (95% CI: 1.011, 1.048) for MI, and 1.025 (95% CI: 1.009, 1.041) for stroke per 10 dB L_den in road traffic noise exposure. Risk estimates appeared higher in combined analyses of studies with a low risk of exposure assessment bias. Restricted cubic spline analyses of these studies showed clear risk increases with exposure for all three cardiovascular outcomes.

Conclusions: The evidence indicates that long-term exposure to road traffic noise increases the incidence of IHD, including MI, and stroke. Given the abundant exposure, traffic noise is a cardiovascular risk factor of public health importance. High-quality assessment of noise exposure appears essential for the risk estimation.