Peer ReviewedPostprint (published version

Agis Cherta, David

Aguilera, Inmaculada

Basagaña Flores, Xavier

Bouso, Laura

Deltell, Alexandre

Dratva, Julia

Elosua, Roberto

Foraster, María

Juvinyà, Dolors

Künzli, Nino

Rivera, Marcela

Sunyer, Jordi

English

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10th International Congress on Noise as a Public Health Problem (ICBEN) 2011, London, UK 351 Cross-sectional association between road traffic noise and  hypertension in a population-based sample in Girona, Spain  (REGICOR-AIR project) M. Foraster1,2,3,4,5, X. Basagaña1,3,5, I. Aguilera1,3,5, M. Rivera1,3,5, D. Agis1,3,5,  L. Bouso1,3,5, A. Deltell6,7, J. Dratva8,9, D. Juvinyà7, J. Sunyer1,3,4,5, R. Elosua2,3,  N. Künzli8,9  1 Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain 2 Instituto de Salud Carlos III (ISCIII), Spain 3 Hospital del Mar Research Institute (IMIM), Barcelona, Spain 4 Universitat Pompeu Fabra (UPF), Barcelona, Spain 5 CIBER Epidemiologia y Salud Pública (CIBERESP), Spain  6 GREFEMA (Grup de Recerca en Enginyeria de Fluids, Energia i Medi Ambient), Girona, Spain 7 University of Girona (UdG), Girona, Spain 8 Swiss Tropical and Public Health Institute Basel (SwissTPH), Basel, Switzerland 9 University of Basel, Switzerland INTRODUCTION  Long-term exposure to traffic-related noise may increase blood pressure levels and induce hypertension, especially at night-time (WHO 2009). The evidence for the ef-fects of road traffic noise on hypertension seems to be increasing, but some incon-sistencies are still found in the size of the effects and in the effect modifiers involved in this association (such as age or gender) (e.g. de Kluizenaar et al. 2007; Bluhm et al. 2007; Belojevic et al. 2008; Jarup et al. 2008; Barregard et al. 2009).  Besides, long-term exposure to traffic-related air pollution has been also associated with cardiovascular health (HEI 2010). There could be some interrelated biological pathways of long-term exposure to road traffic noise and air pollution leading to common cardiovascular endpoints. Therefore, traffic-related air pollution may con-found the cardiovascular effects of road traffic noise in the long-term (Foraster et al. 2011). However, to our knowledge, few studies analyzing hypertension could consid-er air pollution (de Kluizenaar et al. 2007; Jarup et al. 2008).  We evaluated the cross-sectional association between outdoor residential modeled estimates of road traffic equivalent noise levels (Lnight and L24h) and hypertension, adjusting for outdoor long-term modeled estimates of traffic-related air pollution in the city of Girona, north-eastern Spain, within the REGICOR-AIR project. We also evalu-ated the association by age groups and gender.  METHODS  We evaluated 3,480 baseline participants (35-83 years old) corresponding to the population-based HERMES cohort (years 2003-2005). Trained nurses administered questionnaires on socio-demographic and lifestyle characteristics and collected in-formation on general and cardiovascular health. They also took blood pressure measurements following the standard procedures of the project, based on the Joint National Committee VII. 10th International Congress on Noise as a Public Health Problem (ICBEN) 2011, London, UK 352 The participants‟ addresses were automatically geocoded at 2 meters from the fa-çade of the building and their precision was evaluated and corrected manually if ne-cessary. The outdoor residential road traffic equivalent noise levels for the night, 9pm-7am, (Lnight) and 24 hours (L24h), and outdoor residential long-term averages of nitrogen dioxide (NO2) concentrations were derived with a validated city-specific noise model (Environmental Noise Directive 2002/49/EC) and a land-use regression model, respectively.  Hypertension was defined as having a systolic blood pressure ≥140 mmHg or a dias-tolic blood pressure ≥90 mmHg or having hypertensive treatment. We performed mul-tivariate logistic regression for the association between hypertension and road traffic noise. The relevant confounders were selected based on literature. The list included age, gender, socio-economic variables, diet, smoking, alcohol consumption, diabe-tes, body mass index, physical activity, family history of cardiovascular disease, heart rate, hyperlipidemia and air pollution exposure. The analyses were finally adjusted for those covariates that were associated with the outcome and the exposure in the biva-riate analyses (with a p-value <0.2) and that contributed to the association in the mul-tivariate analyses (with p-value<0.05 and a change in the effect estimate for road traffic noise of more than 10 %). RESULTS  Our population had an average age of 58 years (range 35-83). The prevalence of hypertension in our population was 42 %. The percentage of the population exposed to the different noise categories (Lnight) was 13.8 % (for less than 50 dBA), 23.9 % (between 50-54 dBA), 38.6 % (between 55-59 dBA) and 23.7 % (60 dBA or more). The mean NO2 level was 26.7 µg/m3 (IQR=10.75 µg/m3). A non-significant association was found between night-time traffic-related noise and hypertension for an increase of 10 dB(A) in Lnight (OR=1.02; 95 %CI 0.86-1.20). Re-sults for the relationship between hypertension and 24h traffic-related noise were similar for an increase of 10 dB(A) in L24h (OR=1.04; 95 %CI 0.88-1.22). This associ-ation remained unchanged after adjusting for NO2. No significant associations were observed when using Lnight or L24h in categories of 5 dB and there was no clear trend in the OR with increasing noise. Results did not change in the stratified analyses by gender or age groups.  CONCLUSIONS The overall non-significant positive effect estimates are in line with some previous epidemiological studies. However, we could not confirm some of the reported signifi-cant effects observed in previous studies by gender or age groups. Further analyses will include the evaluation of coping behavior against noise and sensitivity analyses on the noise exposure assessment. Furthermore, we will also study the association between blood pressure and road traffic noise.  REFERENCES Barregard L, Bonde E, Ohrstrom E (2009). Risk of hypertension from exposure to road traffic noise in a population-based sample. Occup Environ Med 66: 410-415. Belojevic GA, Jakovljevic BD, Stojanov VJ et al. (2008). Night-time road traffic noise and arterial hypertension in an urban population. Hypertens Res 31: 775-781. Bluhm GL, Berglind N, Nordling E et al. (2007). Road traffic noise and hypertension. Occup Environ Med 64:122–126. 10th International Congress on Noise as a Public Health Problem (ICBEN) 2011, London, UK 353 Bodin T, Albin M, Ardo J et al. (2009). Road traffic noise and hypertension: results from a cross-sectional public health sur-vey in southern Sweden. Environ Health 8: 38. Chang TY, Liu CS, Bao BY (2011). Characterization of road traffic noise exposure and prevalence of hypertension in central Taiwan. Sci Total Environ 409: 1053-1057. de Kluizenaar Y, Gansevoort RT, Miedema HM et al. (2007). Hypertension and road traffic noise exposure. J. Occup Environ Med 49: 484–492. Foraster M, Deltell A, Basagaña X et al. (2011). Local determinants of road traffic noise levels versus determinants of air pollution levels in a Mediterranean city. Environ Res 111: 177-183. HEI Panel on Health Effects of Traffic-Related Air Pollution (2010). Traffic-related air pollution: a critical review of the litera-ture on emissions, exposure, and health effects. Health Effects Institute, Boston, A. Jarup L, Babisch W, Houthuijs D et al. (2008). Hypertension and exposure to noise near airports: the HYENA study. Environ Health Perspect 116: 329–333. WHO (2009). Night noise guidelines for Europe. Copenhagen: WHO, Regional Office for Europe. 

Cross-sectional association between road traffic noise and hypertension in a population-based sample in Girona, Spain (REGICOR-AIR project)

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Cross-sectional association between road traffic noise and hypertension in a population-based sample in Girona, Spain (REGICOR-AIR project)

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