1. Cardiovascular and metabolic effects of long-term exposure to traffic noise
Göran Pershagen
Institute of Environmental Medicine, Karolinska Institutet
Center for Occupational and Environmental Medicine, Stockholm County Council
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2. Sympathetic nervous system
Potential biological mechanisms behind non-auditory health effects induced by environmental noise exposure
Short-term exposure
Long-term exposure
Stress response:
Sympathetic nervous system
Endocrine system
Annoyance
Sleep disturbances
Chronic stress
Hemodynamic and metabolic effects:
Pulse rate ↑
Blood pressure ↑
Cortisol production ↑
Release of free fatty acids ↑
Mobilization of glucose
Hypertension
Myocardial
infarction
Stroke
Overweight
Diabetes
Type 2

3. Cushing’s syndrome (hypercortisolemia)
Hypercholesterolemia
Rapid weight gain
Abdominal obesity
Moodiness, irritability, or depression
Muscle and bone weakness
Memory and attention dysfunction
Osteoporosis
Diabetes mellitus
Hypertension
Immune suppression
Sleep disturbances

4. Systematic Review on Cardiovascular and Metabolic Effects of Environmental Noise
Elise van Kempen
National Institute of Public Health and the Environment, Utrecht, Netherlands
Maribel Casas
Center for Research in Environmental Epidemiology, Barcelona, Spain
Göran Pershagen
Karolinska Institutet, Stockholm, Sweden
Maria Foraster
Swiss Tropical and Public Health Institute, Basel, Switzerland

5. Systematic Review on Cardiovascular and Metabolic Effects of Environmental Noise
Data collection > 500 references
Quantitative assessment 57 studies
Quality rating Modified GRADE

6. Relative risk (RR) of hypertension following exposure to noise from different sources in combined analyses of several studies
Noise source
Number of studies and design*
RR per 10 dB (95%CI)
Participants (cases)
Air traffic
9 CS
1.05 (0.95 – 1.17)
60,121 (9,488)
1 CO
1.00 (0.77 – 1.30)
4,721 (1,346)
Road traffic
26 CS
1.06 (1.02 – 1.09)
156,802 (18,690)
0.97 ( )
45,271 (3,145)
Rail traffic
5 CS
1.05 (0.88 – 1.26)
15,850 (2,059)
0.96 (0.88 – 1.04)
Wind turbine
3 CS -
1,856 (NR)
*CS=cross-sectional, CO=cohort, CC=case-control, ECO=ecological
van Kempen et al. 2017

7. Relative risk (RR) of ischemic heart disease following exposure to noise from different sources in combined analyses of several studies
Noise source
Outcome
Number of studies and design*
RR per 10 dB (95%CI)
Participants (cases)
Air traffic
Prevalence
2 CS
1.07 (0.94 – 1.23)
14,098 (340)
Incidence
2 ECO
1.09 (1.04 – 1.15)
9,619,082 (158,975)
Mortality
2 ECO, 1 CO
1.05 (1.01 – 1.09)
8,477,956 (41,598)
Road traffic
7 CS
1.24 (1.08 – 1.42)
25,682 (1,614)
1 ECO, 4 CC, 3 CO
1.08 ( )
330,054 (7,451)
1 CC, 2 CO
1.05 (0.97 – 1.13)
532,268 (6,884)
Rail traffic
4 CS
1.18 (0.82 – 1.68)
13,241 (283)
Wind turbine
3 CS -
1,856 (NR)
*CS=cross-sectional, CO=cohort, CC=case-control, ECO=ecological
van Kempen et al. 2017

8. ---- 95% confidence interval ---- linear relation
Relative risk (RR) for ischemic heart disease following exposure to road traffic noise in combined analysis of several studies
cubic spline
% confidence interval
---- linear relation
van Kempen et al. 2017
Göran Pershagen

9. Waist circumference (cm)
Increase in BMI and waist circumference in relation to exposure to aircraft noise near Stockholm Arlanda
Average increase during 8-10 years of observation
BMI kg/m2
Waist circumference cm
Aircraft noise exposure (Lden)
BMI (kg/m2)
Waist circumference (cm)
β (95% CI)
≥ 50 dB(A)
0.5 (-0.15 – 0.25)
1.34 (0.52 – 2.16)
Per 5 dB(A)
0.04 (-0.05 – 0.13)
1.51 (1.13 – 1.89)
Model adjusted for sex, age, family history of diabetes, physical activity, tobacco use and psychological distress as well as for individual and area-based socioeconomic status.
Eriksson et al. 2014

10. Waist circumference increase in relation to noise from road traffic and aircraft in Stockholm County
Pyko et al. 2017
2 januari 2019
Göran Pershagen

11. Relative risk (RR) for central obesity in relation to exposure to noise from road traffic, railways and/or aircraft
ptrend < 0.01
We observed a clear exposure-response association between the number of traffic noise sources ≥45 dB and risk of central obesity (Figure 3). The OR increased from 1.25 (95% CI ) among those exposed to one source only to 1.95 (95% CI ) among those exposed to all three traffic noise sources.
RR (95% CI)
Pyko et al. 2015

12. Conclusions
Several studies have documented an association between long-term exposure to traffic noise and cardiovascular disease
An increasing number of studies suggest that such exposure may also lead to metabolic diseases
It appears that current environmental noise guidelines do not fully protect against serious adverse health effects