The impact of aircraft noise on vascular and cardiac function in relation to noise event number: a randomized trial

Abstract

Aims: Nighttime aircraft noise exposure has been associated with increased risk of hypertension and myocardial infarction, mechanistically linked to sleep disturbance, stress, and endothelial dysfunction. It is unclear, whether the most widely used metric to determine noise exposure, equivalent continuous sound level (Leq), is an adequate indicator of the cardiovascular impact induced by different noise patterns.

Methods and results: In a randomized crossover study, we exposed 70 individuals with established cardiovascular disease or increased cardiovascular risk to two aircraft noise scenarios and one control scenario. Polygraphic recordings, echocardiography, and flow-mediated dilation (FMD) were determined for three study nights. The noise patterns consisted of 60 (Noise60) and 120 (Noise120) noise events, respectively, but with comparable Leq, corresponding to a mean value of 45 dB. Mean value of noise during control nights was 37 dB. During the control night, FMD was 10.02 ± 3.75%, compared to 7.27 ± 3.21% for Noise60 nights and 7.21 ± 3.58% for Noise120 nights (P < 0.001). Sleep quality was impaired after noise exposure in both noise scenario nights (P < 0.001). Serial echocardiographic assessment demonstrated an increase in the E/E' ratio, a measure of diastolic function, within the three exposure nights, with a ratio of 6.83 ± 2.26 for the control night, 7.21 ± 2.33 for Noise60 and 7.83 ± 3.07 for Noise120 (P = 0.043).

Conclusions: Nighttime exposure to aircraft noise with similar Leq, but different number of noise events, results in a comparable worsening of vascular function. Adverse effects of nighttime aircraft noise exposure on cardiac function (diastolic dysfunction) seemed stronger the higher number of noise events.

Keywords: Aircraft noise exposure; Cardiac function; Environmental health; Flow-mediated dilation; Sleep disturbance; Vascular function.

Graphical abstract

Figure 1

Sleep quality as reported after each study night on a 0–10 visual analogue scale with higher values indicating impaired sleep quality, depicted as scatter plots with mean ± standard deviation. P-values from a repeated measures non-parametric Friedman test with Dunn’s correction for multiple comparisons (normality test failed) for 70 participants.

Figure 2

Vascular function as assessed by means of flow-mediated dilation after each study night, depicted as scatter plots with mean ± standard deviation and P-values from a repeated measures non-parametric Friedman test with Dunn’s correction for multiple comparisons (normality test failed) for 70 participants.

Figure 3

FMD values (%) for the study nights with 60 and 120 noise events on x and y axis for 70 participants.

Figure 4

E/E′ ratio after each study night, depicted as scatter plots with mean ± standard deviation and P-values from a repeated measures non-parametric Friedman test with Dunn’s correction for multiple comparisons (normality test failed) for 63 participants (7 excluded values as not all repeated measures for Control, Noise60, and Noise120 nights were available).