Risk of cardiovascular mortality, stroke and coronary heart mortality associated with aircraft noise around Congonhas airport, São Paulo, Brazil: a small-area study

Aina Roca-Barceló*, Adelaide Nardocci, Breno Souza de Aguiar, Adeylson G. Ribeiro, Marcelo Antunes Failla, Anna L. Hansell, Maria Regina Cardoso, Frédéric B. Piel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Background: Noise pollution is increasingly recognised as a public health hazard, yet limited evidence is available from low- and middle-income countries (LMIC), particularly for specific sources. Here, we investigated the association between day-night average (Ldn) aircraft noise and the risk of death due to cardiovascular disease (CVD), stroke and coronary heart disease (CHD) at small-area level around São Paulo‘s Congonhas airport, Brazil during the period 2011–2016. Methods: We selected 3259 census tracts across 16 districts partially or entirely exposed to ≥50 dB aircraft noise levels around the Congonhas airport, using pre-modelled 5 dB Ldn noise bands (≤50 dB to > 65 dB). We estimated the average noise exposure per census tract using area-weighting. Age, sex and calendar year-specific death counts for CVD, stroke and CHD were calculated by census tract, according to the residential address at time of death. We fitted Poisson regression models to quantify the risk associated with aircraft noise exposure, adjusting for age, sex, calendar year and area-level covariates including socioeconomic development, ethnicity, smoking and road traffic related noise and air pollution. Results: After accounting for all covariates, areas exposed to the highest levels of noise (> 65 dB) showed a relative risk (RR) for CVD and CHD of 1.06 (95% CI: 0.94; 1.20) and 1.11 (95%CI: 0.96; 1.27), respectively, compared to those exposed to reference noise levels (≤50 dB). The RR for stroke ranged between 1.05 (95%CI: 0.95;1.16) and 0.91 (95%CI: 0.78;1.11) for all the noise levels assessed. We found a statistically significant positive trend for CVD and CHD mortality risk with increasing levels of noise (p = 0.043 and p = 0.005, respectively). No significant linear trend was found for stroke. Risk estimates were generally higher after excluding road traffic density, suggesting that road traffic air and noise pollution are potentially important confounders. Conclusions: This study provides some evidence that aircraft noise is associated with increased risk of CVD and CHD mortality in a middle-income setting. More research is needed to validate these results in other LMIC settings and to further explore the influence of residual confounding and ecological bias. Remarkably, 60% of the study population living near the Congonhas airport (~ 1.5 million) were exposed to aircraft noise levels > 50 dB, well above those recommended by the WHO (45 dB), highlighting the need for public health interventions.

Original languageEnglish
Article number59
JournalEnvironmental Health: A Global Access Science Source
Volume20
Issue number1
DOIs
Publication statusPublished - Dec 2021
Externally publishedYes

Bibliographical note

Funding Information:
The authors would like to thank Professor Jules G. Slama, Departamento de Engenharia Mec?nica (DEM) , Federal University of Rio de Janeiro for sharing unpublished noise contours with us.

Funding Information:
This study was supported by a São Paulo Researchers in International Collaboration (SPRINT) grant to Fred B. Piel (2017/50189–3) funded jointly by Imperial College London and the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP). This work was also partly supported by the MRC Centre for Environment and Health, which is funded by the Medical Research Council (MRC/S019669/1, 2019–2024) and by the National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Exposures and Health, a partnership between Public Health England (PHE) and Imperial College. Infrastructure support for the Department of Epidemiology and Biostatistics was provided by the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC). Anna L. Hansell acknowledges funding from the NIHR Health Protection Research Unit in Environmental Exposures and Health, a partnership between Public Health England, the Health and Safety Executive and the University of Leicester. The views expressed are those of the authors and not necessarily those of the NIHR, Public Health England, the Health and Safety Executive or the Department of Health and Social Care.

Publisher Copyright:
© 2021, The Author(s).

Keywords

  • Aircraft noise
  • Cardiovascular disease
  • Mortality
  • Stroke

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