Risk Associations between Vehicular Traffic Noise Exposure and Cardiovascular Diseases: A Residential Retrospective Cohort Study.

Environmental noise can induce detrimental health effects such as cardiovascular disease (CVD). The relationship between vehicular traffic noise pollution and CVD was investigated through a retrospective residential cohort study in the city of Pisa. Four exposure classes were defined for noise pollution, using noise propagation maps. The association between noise exposures and cause-specific mortality or hospitalization of the subjects of the cohort was calculated using the hazard ratio (HR) for night and day through a multiple time-dependent and sex-specific Cox regression adjusting for age, the socio-economic deprivation index, and traffic air pollution. Mortality excess for CVD and risk trends for a 1 decibel noise increment were observed among the most exposed women (mortality: HRnight class4 1.15 (1.03-1.28); Trend night 1.007 (1.002-1.012); HRday class4 1.14 (1.02-1.27); Trend day 1.008 (1.003-1.013)), particularly for ischaemic disease (mortality: Trend night 1.008 (0.999-1.017); Trend day 1.009 (0.999-1.018)) and cerebrovascular disease (mortality: HRnight class3 1.23 (1.02-1.48), HRday class3 1.24 (1.03-1.49)). Hospitalization analyses confirm mortality results. A decreased risk for hospitalization was also observed among the most exposed men (HRday class4 0.94 (0.88-1.01), particularly for ischaemic disease (HRnight class4 0.90 (0.80-1.02); HRday class4 0.86 (0.77-0.97)) and cerebrovascular disease (HRnight class4 0.89 (0.78-1.01)). Authors recommend the adoption of prevention measures aimed at mitigating noise and the activation of a monitoring of the risk profile in the Pisa population updating both the residential cohort and health data.