Long-Term Road Traffic Noise, Air Pollution, and Cardiovascular Disease AIRCARD

Background: Air pollution and road traffic noise are major environmental stressors associated with cardiovascular disease (CVD). Although their independent effects are well-documented, few studies have concurrently evaluated their relative contributions—particularly in low ambient air pollution sett...

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Main Authors: Stephan P. Mayntz, MD, MPH, PhD, Roda A. Mohamed, MD, PhD, Anna Mejldal, PhD, Jens-Jakob K. Møller, PhD, Jes S. Lindholt, MD, DMSci, Axel CP. Diederichsen, MD, PhD, Lise M. Frohn, PhD, Jørgen Brandt, PhD, Matthias Ketzel, PhD, Jibran Khan, PhD, Jess Lambrechtsen, MD, PhD
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:JACC: Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772963X25002054
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author Stephan P. Mayntz, MD, MPH, PhD
Roda A. Mohamed, MD, PhD
Anna Mejldal, PhD
Jens-Jakob K. Møller, PhD
Jes S. Lindholt, MD, DMSci
Axel CP. Diederichsen, MD, PhD
Lise M. Frohn, PhD
Jørgen Brandt, PhD
Matthias Ketzel, PhD
Jibran Khan, PhD
Jess Lambrechtsen, MD, PhD
author_facet Stephan P. Mayntz, MD, MPH, PhD
Roda A. Mohamed, MD, PhD
Anna Mejldal, PhD
Jens-Jakob K. Møller, PhD
Jes S. Lindholt, MD, DMSci
Axel CP. Diederichsen, MD, PhD
Lise M. Frohn, PhD
Jørgen Brandt, PhD
Matthias Ketzel, PhD
Jibran Khan, PhD
Jess Lambrechtsen, MD, PhD
author_sort Stephan P. Mayntz, MD, MPH, PhD
collection DOAJ
description Background: Air pollution and road traffic noise are major environmental stressors associated with cardiovascular disease (CVD). Although their independent effects are well-documented, few studies have concurrently evaluated their relative contributions—particularly in low ambient air pollution settings. Objectives: The purpose of this study was to investigate the association between long-term exposure to air pollution and road traffic noise and CVD. Methods: We conducted a prospective cohort study using data from the DANCAVAS (Danish Cardiovascular Screening Trial) (2014-2018) and VIVA (Viborg vascular) (2008-2010) screening trials, including 26,723 men aged 65 to 74 years with pollution exposure data from 1979 to 2019. Residential exposure to air pollutants (particulate matter with a diameter <2.5 μm, nitrogen dioxide, warm-season ozone, sulfur dioxide, and carbon monoxide) and road traffic noise (Lden) were estimated based on residential addresses using the Danish Eulerian Hemispheric Model/Urban Background Model/Air Geographic Information System model and Nord2000. We used Cox proportional hazards models, adjusting for baseline inclusion year, individual-level lifestyle factors, family history of CVD, and socioeconomic status. Major adverse cardiovascular events was the primary outcome. Results: A 14.9 decibel increase in road traffic noise (IQR increment) was associated with a 7.5% higher risk of major adverse cardiovascular events (HR: 1.075; 95% CI: 1.026-1.128) and an 8.1% increased risk of all-cause mortality (HR: 1.081; 95% CI: 1.027-1.137). No significant associations were found between air pollutants and the primary or secondary outcomes in the pooled cohort after adjustment for confounders. Conclusions: Long-term exposure to road traffic noise was significantly associated with increased CVD and all-cause mortality. Our findings suggest that studies that do not consider noise exposure may overestimate the cardiovascular burden attributed to air pollution. (Impact of Lifetime Exposure to Air and Noise Pollution on Cardiovascular Disease and Mortality-the AIRCARD Study [AIRCARD]; NCT04353232)
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spelling doaj-art-dd0228f1402b4292b80d4b9c248fac3b2025-08-20T02:26:20ZengElsevierJACC: Advances2772-963X2025-06-014610178710.1016/j.jacadv.2025.101787Long-Term Road Traffic Noise, Air Pollution, and Cardiovascular Disease AIRCARDStephan P. Mayntz, MD, MPH, PhD0Roda A. Mohamed, MD, PhD1Anna Mejldal, PhD2Jens-Jakob K. Møller, PhD3Jes S. Lindholt, MD, DMSci4Axel CP. Diederichsen, MD, PhD5Lise M. Frohn, PhD6Jørgen Brandt, PhD7Matthias Ketzel, PhD8Jibran Khan, PhD9Jess Lambrechtsen, MD, PhD10Cardiology Research Unit, Odense University Hospital, Svendborg, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN – Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark; Address for correspondence: Dr Stephan Peronard Mayntz, Cardiology Research Unit, Odense University Hospital, Baagoes Alle 31, Svendborg 5700, Denmark.Cardiology Research Unit, Odense University Hospital, Svendborg, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN – Open Patient Data Explorative Network, Odense University Hospital, Odense, DenmarkOPEN – Open Patient Data Explorative Network, Odense University Hospital, Odense, DenmarkOPEN – Open Patient Data Explorative Network, Odense University Hospital, Odense, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, DenmarkDepartment of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Cardiology, Odense University Hospital, Odense, DenmarkDepartment of Environmental Science, Aarhus University, Roskilde, DenmarkDepartment of Environmental Science, Aarhus University, Roskilde, DenmarkDepartment of Environmental Science, Aarhus University, Roskilde, DenmarkDepartment of Environmental Science, Aarhus University, Roskilde, DenmarkCardiology Research Unit, Odense University Hospital, Svendborg, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; OPEN – Open Patient Data Explorative Network, Odense University Hospital, Odense, DenmarkBackground: Air pollution and road traffic noise are major environmental stressors associated with cardiovascular disease (CVD). Although their independent effects are well-documented, few studies have concurrently evaluated their relative contributions—particularly in low ambient air pollution settings. Objectives: The purpose of this study was to investigate the association between long-term exposure to air pollution and road traffic noise and CVD. Methods: We conducted a prospective cohort study using data from the DANCAVAS (Danish Cardiovascular Screening Trial) (2014-2018) and VIVA (Viborg vascular) (2008-2010) screening trials, including 26,723 men aged 65 to 74 years with pollution exposure data from 1979 to 2019. Residential exposure to air pollutants (particulate matter with a diameter <2.5 μm, nitrogen dioxide, warm-season ozone, sulfur dioxide, and carbon monoxide) and road traffic noise (Lden) were estimated based on residential addresses using the Danish Eulerian Hemispheric Model/Urban Background Model/Air Geographic Information System model and Nord2000. We used Cox proportional hazards models, adjusting for baseline inclusion year, individual-level lifestyle factors, family history of CVD, and socioeconomic status. Major adverse cardiovascular events was the primary outcome. Results: A 14.9 decibel increase in road traffic noise (IQR increment) was associated with a 7.5% higher risk of major adverse cardiovascular events (HR: 1.075; 95% CI: 1.026-1.128) and an 8.1% increased risk of all-cause mortality (HR: 1.081; 95% CI: 1.027-1.137). No significant associations were found between air pollutants and the primary or secondary outcomes in the pooled cohort after adjustment for confounders. Conclusions: Long-term exposure to road traffic noise was significantly associated with increased CVD and all-cause mortality. Our findings suggest that studies that do not consider noise exposure may overestimate the cardiovascular burden attributed to air pollution. (Impact of Lifetime Exposure to Air and Noise Pollution on Cardiovascular Disease and Mortality-the AIRCARD Study [AIRCARD]; NCT04353232)http://www.sciencedirect.com/science/article/pii/S2772963X25002054air pollutioncardiovascular disease riskenvironmental pollutionprospective cohort studyroad traffic noise
spellingShingle Stephan P. Mayntz, MD, MPH, PhD
Roda A. Mohamed, MD, PhD
Anna Mejldal, PhD
Jens-Jakob K. Møller, PhD
Jes S. Lindholt, MD, DMSci
Axel CP. Diederichsen, MD, PhD
Lise M. Frohn, PhD
Jørgen Brandt, PhD
Matthias Ketzel, PhD
Jibran Khan, PhD
Jess Lambrechtsen, MD, PhD
Long-Term Road Traffic Noise, Air Pollution, and Cardiovascular Disease AIRCARD
JACC: Advances
air pollution
cardiovascular disease risk
environmental pollution
prospective cohort study
road traffic noise
title Long-Term Road Traffic Noise, Air Pollution, and Cardiovascular Disease AIRCARD
title_full Long-Term Road Traffic Noise, Air Pollution, and Cardiovascular Disease AIRCARD
title_fullStr Long-Term Road Traffic Noise, Air Pollution, and Cardiovascular Disease AIRCARD
title_full_unstemmed Long-Term Road Traffic Noise, Air Pollution, and Cardiovascular Disease AIRCARD
title_short Long-Term Road Traffic Noise, Air Pollution, and Cardiovascular Disease AIRCARD
title_sort long term road traffic noise air pollution and cardiovascular disease aircard
topic air pollution
cardiovascular disease risk
environmental pollution
prospective cohort study
road traffic noise
url http://www.sciencedirect.com/science/article/pii/S2772963X25002054
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