PDF(Pubmed)
Abstract：
BACKGROUND: Long-term exposure to transportation noise is related to cardio-metabolic diseases, with more recent evidence also showing associations with diabetes mellitus (DM) incidence. This study aimed to evaluate the association between transportation noise and DM mortality within the Swiss National Cohort.
METHODS: During 15 years of follow-up (2001-2015; 4.14 million adults), over 72,000 DM deaths were accrued. Source-specific noise was calculated at residential locations, considering moving history. Multi-exposure, time-varying Cox regression was used to derive hazard ratios (HR, and 95%-confidence intervals). Models included road traffic, railway and aircraft noise, air pollution, and individual and area-level covariates including socio-economic position. Analyses included exposure-response modelling, effect modification, and a subset analysis around airports. The main findings were integrated into meta-analyses with published studies on mortality and incidence (separately and combined).
RESULTS: HRs were 1.06 (1.05, 1.07), 1.02 (1.01, 1.03) and 1.01 (0.99, 1.02) per 10 dB day evening-night level (Lden) road traffic, railway and aircraft noise, respectively (adjusted model, including NO2). Splines suggested a threshold for road traffic noise (~ 46 dB Lden, well below the 53 dB Lden WHO guideline level), but not railway noise. Substituting for PM2.5, or including deaths with type 1 DM hardly changed the associations. HRs were higher for males compared to females, and in younger compared to older adults. Focusing only on type 1 DM showed an independent association with road traffic noise. Meta-analysis was only possible for road traffic noise in relation to mortality (1.08 [0.99, 1.18] per 10 dB, n = 4), with the point estimate broadly similar to that for incidence (1.07 [1.05, 1.09] per 10 dB, n = 10). Combining incidence and mortality studies indicated positive associations for each source, strongest for road traffic noise (1.07 [1.05, 1.08], 1.02 [1.01, 1.03], and 1.02 [1.00, 1.03] per 10 dB road traffic [n = 14], railway [n = 5] and aircraft noise [n = 5], respectively).
CONCLUSIONS: This study provides new evidence that transportation noise is associated with diabetes mortality. With the growing evidence and large disease burden, DM should be viewed as an important outcome in the noise and health discussion.
METHODS: During 15 years of follow-up (2001-2015; 4.14 million adults), over 72,000 DM deaths were accrued. Source-specific noise was calculated at residential locations, considering moving history. Multi-exposure, time-varying Cox regression was used to derive hazard ratios (HR, and 95%-confidence intervals). Models included road traffic, railway and aircraft noise, air pollution, and individual and area-level covariates including socio-economic position. Analyses included exposure-response modelling, effect modification, and a subset analysis around airports. The main findings were integrated into meta-analyses with published studies on mortality and incidence (separately and combined).
RESULTS: HRs were 1.06 (1.05, 1.07), 1.02 (1.01, 1.03) and 1.01 (0.99, 1.02) per 10 dB day evening-night level (Lden) road traffic, railway and aircraft noise, respectively (adjusted model, including NO2). Splines suggested a threshold for road traffic noise (~ 46 dB Lden, well below the 53 dB Lden WHO guideline level), but not railway noise. Substituting for PM2.5, or including deaths with type 1 DM hardly changed the associations. HRs were higher for males compared to females, and in younger compared to older adults. Focusing only on type 1 DM showed an independent association with road traffic noise. Meta-analysis was only possible for road traffic noise in relation to mortality (1.08 [0.99, 1.18] per 10 dB, n = 4), with the point estimate broadly similar to that for incidence (1.07 [1.05, 1.09] per 10 dB, n = 10). Combining incidence and mortality studies indicated positive associations for each source, strongest for road traffic noise (1.07 [1.05, 1.08], 1.02 [1.01, 1.03], and 1.02 [1.00, 1.03] per 10 dB road traffic [n = 14], railway [n = 5] and aircraft noise [n = 5], respectively).
CONCLUSIONS: This study provides new evidence that transportation noise is associated with diabetes mortality. With the growing evidence and large disease burden, DM should be viewed as an important outcome in the noise and health discussion.
摘要：
背景：长期暴露于运输噪声与心脏代谢疾病有关，最近的证据也显示与糖尿病（DM）发病率有关。这项研究旨在评估瑞士国家队列中交通噪声与DM死亡率之间的关系。
方法：在15年的随访中（2001-2015年；414万成年人），累计超过72,000DM死亡。在住宅位置计算了特定源的噪声，考虑到移动的历史。多次曝光，时变Cox回归用于推导风险比(HR，和95%-置信区间)。模型包括道路交通，铁路和飞机噪音，空气污染,以及个人和地区一级的协变量，包括社会经济地位。分析包括暴露反应建模，效果修饰，和机场周围的子集分析。主要研究结果与已发表的关于死亡率和发病率的研究（单独和合并）整合到荟萃分析中。
结果：HR为1.06（1.05，1.07），1.02（1.01，1.03）和1.01（0.99，1.02）每10分贝的昼夜水平（Lden）道路交通，铁路和飞机噪音，分别(调整后的模型，包括NO2)。样条建议道路交通噪声的阈值(~46dBLden，远低于53dBLdenWHO指南水平)，但不是铁路噪音。替代PM2.5或包括1型DM死亡几乎没有改变相关性。男性的HR高于女性，与老年人相比，年轻人更年轻。仅关注1型DM显示出与道路交通噪声的独立关联。Meta分析仅适用于道路交通噪声与死亡率的关系（1.08[0.99,1.18]每10dB，n=4),点估计与发病率大致相似(每10分贝1.07[1.05，1.09]，n=10)。结合发病率和死亡率研究表明，每种来源都有正相关关系，道路交通噪声最强(1.07[1.05，1.08]，1.02[1.01,1.03],和1.02[1.00，1.03]每10分贝道路交通[n=14]，铁路[n=5]和飞机噪音[n=5]，分别)。
结论：这项研究提供了交通噪音与糖尿病死亡率相关的新证据。随着越来越多的证据和巨大的疾病负担，DM应被视为噪声和健康讨论中的重要结果。
方法：在15年的随访中（2001-2015年；414万成年人），累计超过72,000DM死亡。在住宅位置计算了特定源的噪声，考虑到移动的历史。多次曝光，时变Cox回归用于推导风险比(HR，和95%-置信区间)。模型包括道路交通，铁路和飞机噪音，空气污染,以及个人和地区一级的协变量，包括社会经济地位。分析包括暴露反应建模，效果修饰，和机场周围的子集分析。主要研究结果与已发表的关于死亡率和发病率的研究（单独和合并）整合到荟萃分析中。
结果：HR为1.06（1.05，1.07），1.02（1.01，1.03）和1.01（0.99，1.02）每10分贝的昼夜水平（Lden）道路交通，铁路和飞机噪音，分别(调整后的模型，包括NO2)。样条建议道路交通噪声的阈值(~46dBLden，远低于53dBLdenWHO指南水平)，但不是铁路噪音。替代PM2.5或包括1型DM死亡几乎没有改变相关性。男性的HR高于女性，与老年人相比，年轻人更年轻。仅关注1型DM显示出与道路交通噪声的独立关联。Meta分析仅适用于道路交通噪声与死亡率的关系（1.08[0.99,1.18]每10dB，n=4),点估计与发病率大致相似(每10分贝1.07[1.05，1.09]，n=10)。结合发病率和死亡率研究表明，每种来源都有正相关关系，道路交通噪声最强(1.07[1.05，1.08]，1.02[1.01,1.03],和1.02[1.00，1.03]每10分贝道路交通[n=14]，铁路[n=5]和飞机噪音[n=5]，分别)。
结论：这项研究提供了交通噪音与糖尿病死亡率相关的新证据。随着越来越多的证据和巨大的疾病负担，DM应被视为噪声和健康讨论中的重要结果。
