Exposure-response relationship between transportation noise and cardiovascular disease outcomes: a systematic review and meta-regression analysis.
Elia Gonzato, Tessa M I Haverkate, Susanne Breitner-Busch et al.
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In 30 seconds
This systematic review and meta-regression analysed cohort and case-control evidence on long-term road, railway, and aircraft noise exposure and cardiovascular outcomes in general populations. Twenty-six studies met the eligibility criteria. In conventional analyses, road traffic noise was associated with a 1% increase in combined stroke incidence and mortality (RR = 1.01, 95%CI: 1.00-1.02), while railway noise was associated with a 1% increase in myocardial infarction outcomes (RR = 1.01, 95%CI: 1.01-1.01). Estimates differed under the Burden of Proof framework, and evidence varied across the twelve risk-outcome pairs examined.
Key findings
- Road traffic noise was associated with a 1% increase in combined stroke incidence and mortality (RR = 1.01, 95%CI: 1.00-1.02, p-value = 0.04).
- Railway noise was associated with a 1% increase in myocardial infarction outcomes (RR = 1.01, 95%CI: 1.01-1.01, p-value < 0.0001).
- Under the Burden of Proof framework, estimates were RR = 1.05 (95%UI: 1.03-1.07) for road noise and stroke, and RR = 1.16 (95%UI: 1.07-1.26) for railway noise and myocardial infarction.
- Across twelve risk-outcome pairs, five showed no evidence of association, four showed weak evidence, and the remainder lacked credible evidence or did not meet Burden of Proof criteria.
Why it matters
Transportation noise is a potentially relevant environmental exposure in cardiovascular disease burden assessment. This review updates the evidence base and shows that estimated associations depend on the method used to derive exposure-response functions. The variation in evidence across noise sources and outcomes underscores the importance of interpreting individual risk estimates in light of their evidential strength and analytical framework.
What to keep in mind
Evidence was uneven across the twelve risk-outcome pairs: several showed no or weak association, while others lacked credible evidence or did not meet Burden of Proof criteria.