Aircraft noise and cardiovascular disease hospitalization and mortality near major airports in the United Kingdom

BACKGROUND AND AIM Transport noise in Europe has an associated disease burden reported as next highest after air pollution, but most studies to date relate to road traffic noise. We quantified associations between long-term aircraft noise and cardiovascular disease hospitalizations and deaths due to all cardiovascular disease (CVD), coronary heart disease (CHD) and stroke in a population of 3.1 million living near four major English airports in 2006-15 in a small-area study. METHODS Health outcome data for 2006-10 and 2011-15 and annual average aircraft noise exposure measurements for day/evening/night time (Lden ≥ 50dB) and night time (Lnight ≥45dB) noise in 2006 and 2011 were obtained for 9,860 census output areas near London Heathrow (8,147), London Gatwick (228), Manchester (898), and Birmingham (587) airports. To overcome the issue of data sparsity, hierarchical Poisson regression models were specified, accounting for airport-specific heterogeneity and overdispersion. Additionally, spatial random effects were included, to model local correlation. Adjustment was made for potential confounders including ethnicity, deprivation, road traffic noise and NO2 at small area level. RESULTS We reported evidence of increased risk of hospital admissions for CHD per 5dB increment in Lden (1.057; 95% Credible Interval: 1.027-1.089) and Lnight (1.047; 1.018-1.076). A Heathrow-specific analysis showed evidence of elevated risk of an association between daytime noise and risk of CHD hospital admissions (1.043; 1.000-1.084) and mortality (1.083; 1.007-1.165); some evidence of an effect on mortality risk was also seen for all CVD (1.051; 0.994-1.111) and stroke (1.071; 0.951-1.206) per 5dB Lden. CONCLUSIONS Findings from our study have important implications for aircraft noise policies and evaluation of ongoing public health initiatives to reduce noise pollution around major airports in England and its impact on cardiovascular health. KEYWORDS: Aircraft noise, small area study, CVD outcomes, Bayesian hierarchical model, Poisson regression