Transportation noise and cardiovascular health: an Umbrella+ review

A significant number of studies have shown an association between transportation noise and cardiovascular diseases. With this Umbrella+ review, we aimed to provide a comprehensive overview of the literature on the relation between transportation noise and various cardiovascular health outcomes such as ischaemic heart disease, stroke, heart failure, blood pressure and hypertension, as well as cardiovascular mortality. Following the Umbrella+ approach, we first identified the newest review of high quality and then original high-quality studies published thereafter. Further, by including the latest studies we performed a meta-analysis to derive up-to-date exposure-response functions for each noise source (road traffic, railway and aircraft) separately. We found that compared to road traffic noise, less research was available for railway and aircraft noise. Regarding road traffic noise, we identified a significantly increased risk for multiple cardiovascular health outcomes. For example, the pooled effect estimate for cardiovascular mortality was 1.05 (95% CI: 1.02-1.07) per 10dB(A) increase in noise, for the incidence of ischaemic heart disease it was 1.04 (95% CI: 1.02-1.06) and for stroke incidence 1.05 (95% CI: 1.01-1.08) per 10dB(A) increase in noise. This work will be used to quantify the burden of disease from transportation noise for the general population in Europe.