Association of Exposure to Traffic-Related Air Pollution and Noise with Ischemic Heart Disease in Elderly People Living in Tokyo Metropolitan Area, Japan

摘要

Objectives: This cross-sectional study examined the association of exposure to both traffic-related air pollution (TRAP) and noise with ischemic heart disease (IHD) morbidity in elderly people living in the Tokyo metropolitan area. Methods: Six thousand elderly people (> 65 years old in April 2014) living in roadside or residential areas of Katsushika ward, Tokyo were randomly recruited. IHD, defined as diagnosis of IHD or history of medication for IHD, was determined by a questionnaire. To assess individual levels of TRAP exposure, annual concentrations of elemental carbon (EC) in 2009 were estimated using a plume dispersion model. For participants living in roadside areas, individual levels of exposure to road traffic noise (Lden) were calculated using distance attenuation formulas. The 24-h noise level was measured at five points in residential areas. A multiple logistic model was used to estimate associations of EC or noise exposure with IHD morbidity, adjusting for potential confounders as well as mutual adjustment for EC and noise exposure. Results: A total of 2,874 participants completed the questionnaire. The estimated mean annual exposure level of EC was 0.73 ng/m3 (range: 0.217-3.29 μg/m3). The estimated mean exposure level of noise for participants living in roadside areas was 59.5 dB (range: 36.2-82.4 dB). Noise levels in residential areas were < 65 dB. The adjusted odds ratio (OR) for a 1 μg/m3 increase in EC was 1.14 (95% confidence interval [CI]: 0.83-1.52), and 1.09 (95% CI: 0.77-1.49) after additional adjustment for noise. The adjusted OR for higher noise exposure (> 70 dB) compared with lower noise exposure (< 65 dB) was 1.26 (95% CI: 0.72-2.08), and 1.10. (95% CI: 0.60-1.92) after additional adjustment for EC. Conclusions: There are independent effects of TRAP and noise on IHD morbidity among elderly people living in the Tokyo metropolitan area.