The authors investigated the independent and joint effects of urban noise and traffic-related air pollution on the risk of coronary heart disease (CHD) mortality. This population-based cohort study included a 5-year exposure period and a 4-year follow-up period. All residents aged 45-85 years who resided in metropolitan Vancouver during the exposure period and without known CHD at baseline were included (n velence 445,868). Individual exposures to noise and traffic-related air pollutants (NO, NO2, black carbon, PM2.5) were estimated at subjects' residences using a detailed noise prediction model and land use regression models, respectively. CHD deaths were identified from provincial death registration database. After adjusting for covariates and coexistent traffic-related air pollutants or noise, an interquartile-range (IQR) increase in residential noise was associated with 6 percent (95 percent Cl: 1-11 percent) increase in CHD mortality (IQR increase in black carbon, 4percent; 95percent-Cl: 1 - 8percent). Subjects in the highest noise decile had a 22 percent (95percent Cl: 4-43 percent) increase in CHD mortality compared with those in the lowest decile. Co-exposure to higher levels of traffic noise and black carbon was associated with a substantially greater risk of coronary mortality; relative risk for CHD in top decile of noise and top quartile of black carbon was 1.45 (95 percent-Cl 1.14-1.85). These results suggest independent effects of noise and traffic-related air pollution on CHD mortality.
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