Long-term exposure to transportation noise and risk of incident stroke: A pooled study of nine scandinavian cohorts

Nina Roswall, Andrei Pyko, Mikael Ögren, Anna Oudin, Annika Rosengren, Anton Lager, Aslak H. Poulsen, Charlotta Eriksson, David Segersson, Debora Rizzuto, Eva M. Andersson, Gunn Marit Aasvang, Gunnar Engström, Jeanette T. Jørgensen, Jenny Selander, Jesper H. Christensen, Jesse Thacher, Karin Leander, Kim Overvad, Kristina EnerothKristoffer Mattisson, Lars Barregård, Leo Stockfelt, Maria Albin, Matthias Ketzel, Mette K. Simonsen, Mårten Spanne, Ole Raaschou-Nielsen, Patrik K.E. Magnusson, Pekka Tiittanen, Peter Molnar, Petter Ljungman, Timo Lanki, Youn Hee Lim, Zorana J. Andersen, Göran Pershagen, Mette Sørensen*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review


BACKGROUND: Transportation noise is increasingly acknowledged as a cardiovascular risk factor, but the evidence base for an association with stroke is sparse. OBJECTIVE: We aimed to investigate the association between transportation noise and stroke incidence in a large Scandinavian population. METHODS: We harmonized and pooled data from nine Scandinavian cohorts (seven Swedish, two Danish), totaling 135,951 participants. We identified residential address history and estimated road, railway, and aircraft noise for all addresses. Information on stroke incidence was acquired through link-age to national patient and mortality registries. We analyzed data using Cox proportional hazards models, including socioeconomic and lifestyle con-founders, and air pollution. RESULTS: During follow-up (median = 19:5 y), 11,056 stroke cases were identified. Road traffic noise (Lden ) was associated with risk of stroke, with a hazard ratio (HR) of 1.06 [95% confidence interval (CI): 1.03, 1.08] per 10-dB higher 5-y mean time-weighted exposure in analyses adjusted for indi-vidual-and area-level socioeconomic covariates. The association was approximately linear and persisted after adjustment for air pollution [particulate matter (PM) with an aerodynamic diameter of ≤2:5 lm (PM2:5 ) and NO2 ]. Stroke was associated with moderate levels of 5-y aircraft noise exposure (40–50 vs. ≤40 dB) (HR = 1:12; 95% CI: 0.99, 1.27), but not with higher exposure (≥50 dB, HR = 0:94; 95% CI: 0.79, 1.11). Railway noise was not associated with stroke. DISCUSSION: In this pooled study, road traffic noise was associated with a higher risk of stroke. This finding supports road traffic noise as an important cardiovascular risk factor that should be included when estimating the burden of disease due to traffic noise. https://doi.org/10.1289/EHP8949.

Original languageEnglish
Article number107002
JournalEnvironmental Health Perspectives
Issue number10
Publication statusPublished - Oct 2021

Bibliographical note

Funding Information:
This work was supported by NordForsk (grant 83597). Funding for the included cohorts is shown in Table S1.

Cite this