Long-term exposure to aircraft noise and cardiovascular disease hospitalization and mortality near major airports in the UK, 2006–2015 – A small area study

The environmental disease burden from transport noise in Europe is considered second only to air pollution, but the majority of epidemiological studies relate to road noise. We examined associations between annual average day-evening-night (Lden) and night-time (Lnight) aircraft noise in 2006 and 2011 and cardiovascular disease (CVD) hospitalization and mortality. We used a small area design covering a population of 3.1 million living near London Heathrow, Gatwick, Birmingham and Manchester international airports in 2006–2015. Statistical analysis used Bayesian Poisson regression in linear and categorical analyses. We observed strong evidence of associations between aircraft noise and hospital admissions; for coronary heart disease admissions near London Heathrow, we found an increased risk of 0.44 % (95 % CrI 0.16 %, 0.73 %) and for all-CVD admissions near other airports an increased risk of 0.34 % (95 % CrI 0.04 %, 0.64 %) per 5 dB Lden for noise levels above 50 dB Lden (the cut-off level for available data). However, results were not fully consistent across airports and no associations were seen with stroke hospitalisation and mortality, nor with CVD or CHD mortality. Associations were smaller and less clear than our previous Heathrow study of similar design during 2001–5. Differences over time are likely to relate to changes in population, therefore population confounder structure, over time, as well as reductions in population aircraft noise exposure. Given the increasing evidence base showing associations between noise and cardiovascular disease, we recommend use of large cohorts with better control of confounding at individual-level to provide quantification of exposure–response relationships.