Associations of exposure to transportation noise with sleep and cardiometabolic health: exploration of pathways

Transportation noise is known to increase the risk for multiple cardiometabolic diseases. However, the complex relationship between different noise sources, sleep, metabolic and cardiovascular risk factors is still not well understood. To study how chronic noise exposure contributes to the development of cardiometabolic disease, data from the cross-sectional COmPLETE-Health Study were used, which includes a comprehensive cardiometabolic assessment and accelerometer-based behavioral monitoring from 527 healthy Swiss adults aged 20-89 years. Road traffic, aircraft and railway noise were modelled at the participants' home addresses, followed by a measurement based model validation. For each noise source, the following conceptual model was tested using Structural Equation Modelling (SEM): Noise was assumed to affect the two latent constructs metabolic risk (defined by waist-to-hip ratio and HDL-cholesterol) and cardiovascular risk (defined by systolic blood pressure and pulse wave velocity) directly, as well as indirectly via sleep efficiency. The SEM showed very good fit of the conceptual models. Road traffic noise had a significant, small-medium sized direct link with cardiovascular risk (β = 0.16, 95 %CI: 0.01, 0.31), while negligible associations with sleep efficiency or metabolic risk were observed. Conversely, railway noise was mainly associated with lower sleep efficiency (β = -0.15, 95 %CI: -0.23, -0.06) and increased metabolic risk (β = 0.14, 95 %CI: -0.05, 0.32), with only a negligible association with cardiovascular risk. The inclusion of physical activity did not change results, suggesting that associations of noise with cardiometabolic health are robust to the additional consideration of physical activity. These insights are important to inform effective measures to protect populations from harmful transportation noise exposure.