Objective: Myocardial infarction has been associated with both transportation noise and air pollution. We examined residential exposure to aircraft noise and mortality from myocardial infarction, taking air pollution into account.
Methods: We analyzed the Swiss National Cohort, which includes geocoded information on residence. Exposure to aircraft noise and air pollution was determined based on geospatial noise and air-pollution (PM10) models and distance to major roads. We used Cox proportional hazard models, with age as the timescale. We compared the risk of death across categories of A-weighted sound pressure levels (dB(A)) and by duration of living in exposed corridors, adjusting for PM10 levels, distance to major roads, sex, education, and socioeconomic position of the municipality.
Results: We analyzed 4.6 million persons older than 30 years who were followed from near the end of 2000 through December 2005, including 15,532 deaths from myocardial infarction (ICD-10 codes I 21, I 22). Mortality increased with increasing level and duration of aircraft noise. The adjusted hazard ratio comparing ≥60 dB(A) with <45 dB(A) was 1.3 (95% confidence interval = 0.96-1.7) overall, and 1.5 (1.0-2.2) in persons who had lived at the same place for at least 15 years. None of the other endpoints (mortality from all causes, all circulatory disease, cerebrovascular disease, stroke, and lung cancer) was associated with aircraft noise.
Conclusion: Aircraft noise was associated with mortality from myocardial infarction, with a dose-response relationship for level and duration of exposure. The association does not appear to be explained by exposure to particulate matter air pollution, education, or socioeconomic status of the municipality.
From the aInstitute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland; bInstitute for Risk Assessment Sciences, University of Utrecht, Utrecht, The Netherlands; cDepartment of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; and dUniversity of Basel, Basel, Switzerland.
Submitted 22 November 2009; accepted 22 May 2010.
Supported by the Swiss National Science Foundation to the Swiss National Cohort (grant number 3347C0-108806). The members of the Swiss National Cohort Study Group are Felix Gutzwiller (Chairman of the Executive Board) and Matthias Bopp (Zurich, Switzerland); Matthias Egger (Chairman of the Scientific Board), Adrian Spoerri, Malcolm Sturdy, and Marcel Zwahlen (Bern, Switzerland); Charlotte Braun-Fahrländer (Basel, Switzerland); Fred Paccaud (Lausanne, Switzerland); and André Rougemont (Geneva, Switzerland).
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Correspondence: Matthias Egger, Institute of Social and Preventive Medicine (ISPM), Finkenhubelweg 11, CH-3012 Bern, Switzerland. E-mail: firstname.lastname@example.org.