Road-traffic noise exposure and coronary atherosclerosis in the Swedish CArdioPulmonary bioImage Study (SCAPIS)

Abstract

Background: Road-traffic noise may influence the development of cardiovascular events such as stroke and myocardial infarction, but etiological mechanisms remain unclear. This study aimed to assess the relationship between long-term road-traffic noise exposure and coronary atherosclerosis in Sweden.

Methods: In the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort, including 30,154 subjects aged 50-65 years, recruited between 2013 and 2018, coronary atherosclerosis was measured based on computer tomography (CT) scans as coronary artery calcium score, segment involvement score (SIS), and non-calcified plaques (NCP) at enrollment. Based on modified Nordic model, road-traffic noise exposure was modeled for 2000, 2013, and 2018 with interpolation for intermediate years. We investigated the association between time-weighted long-term exposure to road-traffic noise (L_den) and the prevalence of atherosclerosis using ordinal logistic regression models adjusting for potential socioeconomic, behavioral, and environmental confounders, including air pollution.

Results: No clear associations were found between road-traffic noise and coronary atherosclerosis. The odds ratio for coronary artery calcium score was 1.00 (95% confidence interval [CI] = 0.96, 1.04), SIS 0.99 (0.96, 1.03), and NCP 0.98 (0.90, 1.03) per interquartile range (9.4 dB L_den) for road-traffic noise exposure during 10 years before enrollment. No consistent associations were observed in site-specific analyses or using shorter exposure periods. Furthermore, exposure-response analyses revealed no clear trends, and there were no strong interactions between road-traffic noise and cardiovascular risk factors in relation to the atherosclerosis markers.

Conclusions: Long-term exposure to road-traffic noise was not linked to coronary atherosclerosis or calcification in relatively healthy, middle-aged populations in Sweden.

Keywords: atherosclerosis; cardiovascular disease; noise; road traffic noise.

Figure 1.

Site-specific associations between mean road-traffic noise exposure for the 10 years preceding the enrollment and atherosclerosis, including CACS, SIS, and NCP.

Figure 2.

Restricted cubic splines with three degrees of freedom for exposure to road-traffic noise (dBL_den), in the main covariate model, with 95% confidence bands.

Figure 3.

Odds ratio and 95% CI for atherosclerosis in relation to exposure to road-traffic noise per IQR increase during 10 years before the enrollment according to strata of potential effect modifiers. Analyses based on separate models with interaction terms between road-traffic noise and each potential modifier, adjusted for age, sex (men/women), educational level (low/medium/high), marital status (single/married), area-level socioeconomic status, smoking status, physical activity, and alcohol consumption.