Residential exposure to transportation noise and risk of incident atrial fibrillation: a pooled study of 11 prospective Nordic cohorts
Jesse D. Thacher, Nina Roswall, Mikael Ögren, Andrei Pyko, Agneta Åkesson, Anna Oudin, Annika Rosengren, Aslak Harbo Poulsen, Charlotta Eriksson, David Segersson, Debora Rizzuto, Emilie Helte, Eva M. Andersson, Gunn Marit Aasvang, Gunnar Engström, Hrafnhildur Guðjónsdóttir, Jenny Selander, Jesper Heile Christensen, Jørgen Brandt, Karin Leander, Kim Overvad, Kristoffer Mattisson, Kristina Eneroth, Lara Stucki, Lars Barregard, Leo Stockfelt, María Albin, Mette Kildevæld Simonsen, Ole Raaschou‐Nielsen, Pekka Jousilahti, Pekka Tiittanen, Petter Ljungman, Steen Solvang Jensen, Susanna Gustafsson, Tarja Yli‐Tuomi, Tom Cole‐Hunter, Timo Lanki, Youn-Hee Lim, Zorana Jovanovic Andersen, Göran Pershagen, Mette Sørensen
Abstract
Background Transportation noise has been linked with cardiometabolic outcomes, yet whether it is a risk factor for atrial fibrillation (AF) remains inconclusive. We aimed to assess whether transportation noise was associated with AF in a large, pooled Nordic cohort. Methods We pooled data from 11 Nordic cohorts, totaling 161,115 participants. Based on address history from five years before baseline until end of follow-up, road, railway, and aircraft noise was estimated at a residential level. Incident AF was ascertained via linkage to nationwide patient registries. Cox proportional hazards models were utilized to estimate associations between running 5-year time-weighted mean transportation noise (L den ) and AF after adjusting for sociodemographics, lifestyle, and air pollution. Findings We identified 18,939 incident AF cases over a median follow-up of 19.6 years. Road traffic noise was associated with AF, with a hazard ratio (HR) and 95% confidence interval (CI) of 1.02 (1.00–1.04) per 10-dB of 5-year mean time-weighted exposure, which changed to 1.03 (1.01–1.06) when implementing a 53-dB cut-off. In effect modification analyses, the association for road traffic noise and AF appeared strongest in women and overweight and obese participants. Compared to exposures ≤40 dB, aircraft noise of 40.1–50 and > 50 dB were associated with HRs of 1.04 (0.93–1.16) and 1.12 (0.98–1.27), respectively. Railway noise was not associated with AF. We found a HR of 1.19 (1.02–1.40) among people exposed to noise from road (≥45 dB), railway (>40 dB), and aircraft (>40 dB) combined. Interpretation Road traffic noise, and possibly aircraft noise, may be associated with elevated risk of AF. Funding NordForsk.