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Volume : 44

Part : 2

Proceedings of the Institute of Acoustics

 

 

Long-term exposure to transportation noise and mortality with diabetes mellitus: a national cohort study

 

Danielle Vienneau1, Swiss Tropical and Public Health Institute & University of Basel, Basel, Switzerland

 

Benedikt Wicki, Swiss Tropical and Public Health Institute & University of Basel, Basel, Switzerland

 

Benjamin Flückiger, Swiss Tropical and Public Health Institute & University of Basel, Basel, Switzerland

 

Beat Schäffer, Empa – Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland

 

Jean Marc Wunderli, Empa – Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland

 

Martin Röösli2, Swiss Tropical and Public Health Institute & University of Basel, Basel, Switzerland

 

SUMMARY

 

Chronic exposure to transportation noise is related to cardio-metabolic diseases, including diabetes mellitus incidence. In this study, we evaluated the association between source-specific transportation noise and mortality with diabetes mellitus, finding associations with road traffic and railway noise exposure.

 

1. INTRODUCTION

 

Long-term exposure to transportation noise is related to cardio-metabolic diseases. Previous studies have shown both morbidity and mortality from specific cardiovascular diseases to be associated with these exposures [1-6]. Diabetes mellitus is an important risk factor for cardiovascular disease, but is

 

also a contributing factor for non-cardiovascular morbidity, such as blindness and kidney disease, and mortality [7]. Identified as an important health outcome in the 2018 WHO environmental noise guideline systematic reviews [4, 8], the body of evidence supporting an association between noise and diabetes mellitus incidence is also growing. This study aimed to evaluate the association between road traffic, railway and aircraft noise exposure and mortality with diabetes mellitus in a nation-wide cohort in Switzerland with high quality exposure assessment and 15 years of follow-up.

 

2. METHODS

 

Over 4.1 million adults in the Swiss National Cohort (SNC) were followed from 2001-2015. Accounting for residential history, source-specific noise calculations were performed for residential locations. Specifically, road traffic, railway and aircraft noise from Swiss-wide models for the years 2001 and 2011 were linked to individuals in the SNC, based on their residential geocode and floor of residence. Noise levels (Lden) at the maximum exposed façade per dwelling were used. The mean exposure in three 5-year periods (2001-2005, 2006-2010, 2011-2015) were calculated, with the residential location updated at the start of each period for movers.

 

ICD10 codes E11-E14 were used to identify mortality with diabetes mellitus, either as the primary definitive cause, concomitant, consecutive or initial disease. Type 1 diabetes (E10) was excluded since its pathophysiology and risk factors are not primarily related to lifestyle factors, and disease onset is typically already in early life. Multipollutant, time-varying Cox regression with age as timescale was applied to determine the mortality risk (hazard ratios, HR, and 95% confidence intervals). Models included each noise source, and were adjusted for individual and area-level covariates plus air pollution (PM2.5 or NO2 from 100 ×100 m European models [9], tested in separate models). HR and 95% confidence intervals were expressed per 10 dB Lden. HRs stratified by sex and age were also derived.

 

3. RESULTS

 

During follow-up (mean 13.4 years) over 72,000 deaths identified diabetes mellitus on death certificates. Approximately 20% identified diabetes mellitus as the primary cause of death while for 80% diabetes mellitus was a concomitant, consecutive or initial disease.

 

HR in the adjusted model (including PM2.5) were 1.06 (1.05-1.07), 1.02 (1.02-1.03) and 1.01 (0.99- 1.02) per 10 dB Lden road traffic, railway and aircraft noise, respectively. Substituting PM2.5 with NO2 did not change the associations. Associations with road traffic and railway noise were higher in males compared to females (Figure 1), and higher in younger compared to older adults (Figure 2). This pattern tended to be reversed for aircraft noise.

 

 

Figure 1: Sex-specific hazard ratios for mortality with diabetes mellitus, per 10 dB Lden for each noise source

 

 

Figure 2: Age-specific hazard ratios for mortality with diabetes mellitus (both sexes combined), per 10 dB Lden for each noise source

 

4. CONCLUSIONS

 

Using death certificates alone for outcome definition is likely to result missing diabetes mellitus diagnosis for some individuals. However, such misclassification is unlikely to be differential on noise exposure, and would lead to underestimation of the risk rather than produce spurious results. Thus, this study provides new evidence that mortality in persons with diabetes mellitus is associated with exposure to road traffic and railway noise. Interestingly the pattern of risk is similar to that for cardiovascular disease mortality, with the strongest effects seen for road traffic followed by railway noise [10]. This is also the first study on diabetes mellitus clearly demonstrating a link with railway noise exposure.

 

5. ACKNOWLEDGEMENTS

 

We thank the Federal Statistical Office (FSO) for providing mortality and census data and for the support that made the Swiss National Cohort and this study possible. This work was supported by the Swiss National Science Foundation (grant nos. 3347CO-108806, 33CS30_134273 and 33CS30_148415). The members of the Swiss National Cohort Scientific Board are Marcel Zwahlen (University of Berne), Matthias Egger (University of Berne), Viktor von Wyl (University of Zurich), Oliver Hämmig (University of Zurich), Murielle Bochud (University of Lausanne), Martin Röösli (University of Basel) and Markus Schwyn (Federal Statistical Office).

 

This work was additionally supported by the Swiss National Science Foundation grant no. 324730B_201272 for the TRANQUIL2 project.

 

6. REFERENCES

 

  1. Héritier, H., et al., Transportation noise exposure and cardiovascular mortality: a nationwide cohort study from Switzerland. Eur J Epidemiol, 2017. 32 (4): p. 307-315.

  2. Münzel, T., M. Sørensen, and A. Daiber, Transportation noise pollution and cardiovascular disease. Nature Reviews Cardiology, 2021.

  3. Saucy, A., et al., Does night-time aircraft noise trigger mortality? A case-crossover study on 24 886 cardiovascular deaths. European Heart Journal, 2021. 42(8): p. 835–843.

  4. van Kempen, E., et al., WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cardiovascular and Metabolic Effects: A Summary. Int J Environ Res Public Health, 2018. 15(2).

  5. Vienneau, D., et al., Transportation noise exposure and cardiovascular mortality: 15-years of follow-up in a nationwide prospective cohort in Switzerland. Environment International, 2022. 158: p. 106974.

  6. Vienneau, D., et al., Association between transportation noise and cardio-metabolic diseases: an update of the WHO meta-analysis, in PROCEEDINGS of the 23rd International Congress on Acoustics. 2019: Aachen, Germany.

  7. IDF, IDF Diabetes Atlas, 10th Edition. 2021, International Diabetes Federation: Brussels, Belgium.

  8. WHO, Environmental Noise Guidelines for the European Region. 2018, WHO Regional Office for Europe: Copenhagen, Denmark.

  9. de Hoogh, K., et al., Spatial PM2.5, NO2, O3 and BC models for Western Europe – Evaluation of spatiotemporal stability. Environment International, 2018. 120: p. 81-92.

  10. Tangermann, L., et al., The association of road traffic noise with problem behaviour in adolescents: A cohort study. Environmental Research, 2022. 207: p. 112645.

 

1 danielle.vienneau@swisstph.ch

2 martin.roosli@swisstph.ch