Long-term exposure to transportation noise and risk for atrial fibrillation: A Danish nationwide cohort study

Background: Epidemiological studies have linked transportation noise and cardiovascular diseases, however, atrial fibrillation (AF) has received limited attention. We aimed to investigate the association between transportation noise and AF risk. Methods: Over the period 1990–2017 we estimated road and railway noise (L_den) at the most and least exposed façades for all residential addresses across Denmark. We estimated time-weighted mean noise exposure for 3.6 million individuals age ≥35 years. Of these, 269,756 incident cases of AF were identified with a mean follow-up of 13.0 years. Analyses were conducted using Cox proportional hazards models with adjustment for individual and area-level sociodemographic covariates and long-term residential air pollution. Results: A 10 dB higher 10-year mean road traffic noise at the most and least exposed façades were associated with incidence rate ratios (IRR) and 95% confidence intervals (CI) for AF of 1.006 (1.001–1.011) and 1.013 (1.007–1.019), respectively. After further adjustment for PM_2.5, the IRRs (CIs) were 1.000 (0.995–1.005) and 1.007 (1.000–1.013), respectively. For railway noise, the IRRs per 10 dB increase in 10-year mean exposure were 1.017 (1.007–1.026) and 1.035 (1.021–1.050) for the most and least exposed façades, respectively, and were slightly attenuated when adjusted for PM_2.5. Aircraft noise between 55 and 60 dB and ≥60 dB were associated with IRRs of 1.055 (0.996–1.116) and 1.036 (0.931–1.154), respectively, when compared to <45 dB. Conclusion: Transportation noise seems to be associated with a small increase in AF risk, especially for exposure at the least exposed façade.