Cardiovascular effects of environmental noise: research in Sweden.

In Sweden, as in many other European countries, traffic noise is an important environmental health issue. At present, almost two million people are exposed to average noise levels exceeding the outdoor national guideline value (55 dB(A)). Despite efforts to reduce the noise burden, noise-related health effects, such as annoyance and sleep disturbances, are increasing. The scientific interest regarding more serious health effects related to the cardiovascular system is growing, and several experimental and epidemiological studies have been performed or are ongoing. Most of the studies on cardiovascular outcomes have been related to noise from road or aircraft traffic. Few studies have included railway noise. The outcomes under study include morning saliva cortisol, treatment for hypertension, self-reported hypertension, and myocardial infarction. The Swedish studies on road traffic noise support the hypothesis of an association between long-term noise exposure and cardiovascular disease. However, the magnitude of effect varies between the studies and has been shown to depend on factors such as sex, number of years at residence, and noise annoyance. Two national studies have been performed on the cardiovascular effects of aircraft noise exposure. The first one, a cross-sectional study assessing self-reported hypertension, has shown a 30% risk increase per 5 dB(A) noise increase. The second one, which to our knowledge is the first longitudinal study assessing the cumulative incidence of hypertension, found a relative risk (RR) of 1.10 (95% CI 1.01 - 1.19) per 5 dB(A) noise increase. No associations have been found between railway noise and cardiovascular diseases. The findings regarding noise-related health effects and their economic consequences should be taken into account in future noise abatement policies and community planning.