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. 2017 Aug 1;46(4):1115-1125.
doi: 10.1093/ije/dyx020.

Long-term Exposure to Transportation Noise and Air Pollution in Relation to Incident Diabetes in the SAPALDIA Study

Free PMC article

Long-term Exposure to Transportation Noise and Air Pollution in Relation to Incident Diabetes in the SAPALDIA Study

Ikenna C Eze et al. Int J Epidemiol. .
Free PMC article


Background: Epidemiological studies have inconsistently linked transportation noise and air pollution (AP) with diabetes risk. Most studies have considered single noise sources and/or AP, but none has investigated their mutually independent contributions to diabetes risk.

Methods: We investigated 2631 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), without diabetes in 2002 and without change of residence between 2002 and 2011. Using questionnaire and biomarker data, incident diabetes cases were identified in 2011. Noise and AP exposures in 2001 were assigned to participants' residences (annual average road, railway or aircraft noise level during day-evening-night (Lden), total night number of noise events, intermittency ratio (temporal variation as proportion of event-based noise level over total noise level) and nitrogen dioxide (NO2) levels. We applied mixed Poisson regression to estimate the relative risk (RR) of diabetes and their 95% confidence intervals (CI) in mutually-adjusted models.

Results: Diabetes incidence was 4.2%. Median [interquartile range (IQR)] road, railway, aircraft noise and NO2 were 54 (10) dB, 32 (11) dB, 30 (12) dB and 21 (15) μg/m3, respectively. Lden road and aircraft were associated with incident diabetes (respective RR: 1.35; 95% CI: 1.02-1.78 and 1.86; 95% CI: 0.96-3.59 per IQR) independently of Lden railway and NO2 (which were not associated with diabetes risk) in mutually adjusted models. We observed stronger effects of Lden road among participants reporting poor sleep quality or sleeping with open windows.

Conclusions: Transportation noise may be more relevant than AP in the development of diabetes, potentially acting through noise-induced sleep disturbances.

Keywords: Noise; air pollution; diabetes mellitus; sleep; transportation.


Figure 1.
Figure 1.
Relationship between transportation noise and risk of diabetes. All effect estimates are per inter-quartile range of respective noise metric (Lden/Lday/Lnight road: 10dB; Lden/Lday aircraft: 12dB; Lden/Lday/Lnight railway: 11dB). Leq: noise level. Lden: day-evening-night noise level. All estimates are from multi-exposure models adjusted for age, sex, educational level, neighborhood socio-economic index, smoking status and pack years, consumption of alcohol, fruits and vegetables, nitrogen dioxide, physical activity, body mass index and change in body mass index. Random intercepts were applied at the level of the study areas in the all models.

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