Risk of cardiovascular mortality, stroke and coronary heart mortality associated with aircraft noise around Congonhas airport, São Paulo, Brazil: a small-area study.
Risk of cardiovascular mortality, stroke and coronary heart mortality associated with aircraft noise around Congonhas airport, São Paulo, Brazil: a small-area study.
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DOI：
10.1186/s12940-021-00746-7
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发表时间：
2021-05-13
期刊：
影响因子：
--
通讯作者：
Piel FB
中科院分区：
文献类型：
--
作者：
Roca-Barceló A;Nardocci A;de Aguiar BS;Ribeiro AG;Failla MA;Hansell AL;Cardoso MR;Piel FB
噪音污染越来越被认为是一种公共健康危害，但来自低收入和中等收入国家（LMIC）的证据有限，特别是针对特定来源。在这里，我们调查了2011-2016年期间巴西圣保罗孔戈尼亚斯机场周围小区域昼夜平均（Ldn）飞机噪音与心血管疾病（CVD）、中风和冠心病（CHD）死亡风险之间的关系。我们在孔戈尼亚斯机场周围部分或全部暴露于≥50 dB飞机噪声水平的16个区中选择了3259个普查区域，使用预先建模的5 dB Ldn噪声频段（≤50 dB至> 65 dB）。我们使用面积加权法估计了每个人口普查区的平均噪声暴露。根据死亡时的居住地址，通过人口普查区域计算年龄、性别和日历年特定的心血管疾病、中风和冠心病死亡计数。我们拟合泊松回归模型来量化与飞机噪音暴露相关的风险，调整年龄，性别，日历年和地区水平协变量，包括社会经济发展，种族，吸烟和道路交通相关的噪音和空气污染。考虑所有协变量后，暴露于最高水平噪声（> 65 dB）的地区与暴露于参考噪声水平（≤50 dB）的地区相比，CVD和CHD的相对危险度（RR）分别为1.06（95%CI：0.94; 1.20）和1.11（95%CI：0.96; 1.27）。对于所有评估的噪声水平，卒中的RR范围为1.05（95%CI：0.95;1.16）至0.91（95%CI：0.78;1.11）。我们发现，随着噪声水平的增加，CVD和CHD死亡风险呈统计学显著的正趋势（分别为p = 0.043和p = 0.005）。卒中无显著线性趋势。排除道路交通密度后，风险估计值普遍较高，这表明道路交通空气和噪音污染是潜在的重要混杂因素。这项研究提供了一些证据表明，在中等收入环境中，飞机噪音与心血管疾病和冠心病死亡率的风险增加有关。需要更多的研究来验证这些结果在其他LMIC设置，并进一步探讨剩余混杂和生态偏见的影响。值得注意的是，居住在孔戈尼亚斯机场附近的研究人群中有60%（约150万人）暴露于> 50 dB的飞机噪音水平，远高于WHO推荐的水平（45 dB），这突出了公共卫生干预的必要性。在线版本包含补充材料，可通过10.1186/s12940-021-00746-7获得。
Noise pollution is increasingly recognised as a public health hazard, yet limited evidence is available from low- and middle-income countries (LMIC), particularly for specific sources. Here, we investigated the association between day-night average (Ldn) aircraft noise and the risk of death due to cardiovascular disease (CVD), stroke and coronary heart disease (CHD) at small-area level around São Paulo‘s Congonhas airport, Brazil during the period 2011–2016. We selected 3259 census tracts across 16 districts partially or entirely exposed to ≥50 dB aircraft noise levels around the Congonhas airport, using pre-modelled 5 dB Ldn noise bands (≤50 dB to > 65 dB). We estimated the average noise exposure per census tract using area-weighting. Age, sex and calendar year-specific death counts for CVD, stroke and CHD were calculated by census tract, according to the residential address at time of death. We fitted Poisson regression models to quantify the risk associated with aircraft noise exposure, adjusting for age, sex, calendar year and area-level covariates including socioeconomic development, ethnicity, smoking and road traffic related noise and air pollution. After accounting for all covariates, areas exposed to the highest levels of noise (> 65 dB) showed a relative risk (RR) for CVD and CHD of 1.06 (95% CI: 0.94; 1.20) and 1.11 (95%CI: 0.96; 1.27), respectively, compared to those exposed to reference noise levels (≤50 dB). The RR for stroke ranged between 1.05 (95%CI: 0.95;1.16) and 0.91 (95%CI: 0.78;1.11) for all the noise levels assessed. We found a statistically significant positive trend for CVD and CHD mortality risk with increasing levels of noise (p = 0.043 and p = 0.005, respectively). No significant linear trend was found for stroke. Risk estimates were generally higher after excluding road traffic density, suggesting that road traffic air and noise pollution are potentially important confounders. This study provides some evidence that aircraft noise is associated with increased risk of CVD and CHD mortality in a middle-income setting. More research is needed to validate these results in other LMIC settings and to further explore the influence of residual confounding and ecological bias. Remarkably, 60% of the study population living near the Congonhas airport (~ 1.5 million) were exposed to aircraft noise levels > 50 dB, well above those recommended by the WHO (45 dB), highlighting the need for public health interventions. The online version contains supplementary material available at 10.1186/s12940-021-00746-7.
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影响因子：
9.3
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