Road traffic noise, air pollution and incident cardiovascular disease: A joint analysis of the HUNT, EPIC-Oxford and UK Biobank cohorts

Yutong Cai*, Susan Hodgson, Marta Blangiardo, John Gulliver, David Morley, Daniela Fecht, Danielle Vienneau, Kees de Hoogh, Tim Key, Kristian Hveem, Paul Elliott, Anna L. Hansell

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

45 Citations (Scopus)


Background: This study aimed to investigate the effects of long-term exposure to road traffic noise and air pollution on incident cardiovascular disease (CVD) in three large cohorts: HUNT, EPIC-Oxford and UK Biobank. Methods: In pooled complete-case sample of the three cohorts from Norway and the United Kingdom (N = 355,732), 21,081 incident all CVD cases including 5259 ischemic heart disease (IHD) and 2871 cerebrovascular cases were ascertained between baseline (1993–2010) and end of follow-up (2008–2013) through medical record linkage. Annual mean 24-hour weighted road traffic noise (Lden) and air pollution (particulate matter with aerodynamic diameter ≤ 10 μm [PM10], ≤2.5 μm [PM2.5] and nitrogen dioxide [NO2]) exposure at baseline address was modelled using a simplified version of the Common Noise Assessment Methods in Europe (CNOSSOS-EU) and European-wide Land Use Regression models. Individual-level covariate data were harmonised and physically pooled across the three cohorts. Analysis was via Cox proportional hazard model with mutual adjustments for both noise and air pollution and potential confounders. Results: No significant associations were found between annual mean Lden and incident CVD, IHD or cerebrovascular disease in the overall population except that the association with incident IHD was significant among current-smokers. In the fully adjusted models including adjustment for Lden, an interquartile range (IQR) higher PM10 (4.1 μg/m3) or PM2.5 (1.4 μg/m3) was associated with a 5.8% (95%CI: 2.5%–9.3%) and 3.7% (95%CI: 0.2%–7.4%) higher risk for all incident CVD respectively. No significant associations were found between NO2 and any of the CVD outcomes. Conclusions: We found suggestive evidence of a possible association between road traffic noise and incident IHD, consistent with current literature. Long-term particulate air pollution exposure, even at concentrations below current European air quality standards, was significantly associated with incident CVD.

Original languageEnglish
Pages (from-to)191-201
Number of pages11
JournalEnvironment International
Publication statusPublished - May 2018
Externally publishedYes

Bibliographical note

Funding Information:
UK Biobank was established by the Wellcome Trust medical charity, Medical Research Council, Department of Health, Scottish Government and the Northwest Regional Development Agency. It has also had funding from the Welsh Assembly Government, British Heart Foundation and Diabetes UK.

Funding Information:
This work used the computing resources of the UK MEDical Bioinformatics partnership (UK MED-BIO) which is supported by the Medical Research Council (Grant Number MR/L01632X/1).

Funding Information:
ESCAPE project has received funding from the European Community's Seventh Framework Program (FP7/2007–2011) under grant agreement number: 211250.

Funding Information:
This work was supported by funding from the European Union Seventh Framework Programme (FP7/2007–2013) Biobank Standardisation and Harmonisation for Research Excellence in the European Union-BioSHaRE-EU (grant number 261433 ).

Funding Information:
Y.C. is supported by an MRC Early-Career Research Fellowship awarded through the MRC-PHE Centre for Environment and Health (grant number MR/M501669/1).

Funding Information:
EPIC-Oxford is funded by UK Medical Research Council (grant number MR/M012190/1) and Cancer Research UK (grant number C8221/A19170).

Funding Information:
P.E. acknowledges support from the Imperial College Healthcare NHS Trust and Imperial College London Biomedical Research Centre. P.E. and A.L.H acknowledge support from the National Institute for Health Research (NIHR) Health Protection Research Unit on the Health Effects of Environmental Hazards, and the Medical Research Council and Public Health England (MRC-PHE) Centre for Environment and Health. P.E. is a UK Dementia Research Institute (DRI) Professor, UK DRI at Imperial College London, which receives its funding from UK DRI Ltd., funded by the UK Medical Research Council, Alzheimer's Society and Alzheimer's Research UK. The views expressed are those of the authors and not necessarily those of the Department of Health, the NHS or the NIHR.

Funding Information:
The Medical Research Council - Public Health England (MRC-PHE) Centre for Environment and Health is funded by the UK Medical Research Council and Public Health England (grant number MR/L01341X/1).

Publisher Copyright:
© 2018


  • Air pollution
  • Cardiovascular disease
  • Ischemic heart disease
  • Road traffic noise
  • Stroke


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