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

Author(s)

Roca-Barcelo, Aina ^[1] ; Nardocci, Adelaide ^[2] ; de Aguiar, Breno Souza ^[3] ; Ribeiro, Adeylson G. ^[2] ; Failla, Marcelo Antunes ^[3] ; Hansell, Anna L. ^[4] ; Cardoso, Maria Regina ^[5] ; Piel, Frederic B. ^{[1, 6]}

Affiliation

^[1] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, UK Small Area Hlth Stat Unit SAHSU, London - England

^[2] Univ Sao Paulo, Sch Publ Hlth, Dept Environm Hlth, Sao Paulo - Brazil

^[3] Municipal Hlth Secretariat Sao Paulo, Epidemiol & Informat Dept, Sao Paulo - Brazil

^[4] Univ Leicester, Ctr Environm Hlth & Sustainabil, Leicester, Leics - England

^[5] Univ Sao Paulo, Sch Publ Hlth, Dept Epidemiol, Sao Paulo - Brazil

^[6] Natl Inst Hlth Res, Hlth Protect Res Unit NIHR HPRU Environm Exposure, London - England

• Document type: Journal article
• Source: Environmental Health; v. 20, n. 1 MAY 13 2021.
• Web of Science Citations: 1

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 (L-dn) aircraft noise and the risk of death due to cardiovascular disease (CVD), stroke and coronary heart disease (CHD) at small-area level around Sao 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 L-dn 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 (similar to 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. (AU)

• FAPESP's process: 17/50189-3 - Using big data for small area epidemiological studies: developing a new UK-Brazil partnership
• Grantee: Maria Regina Alves Cardoso
• Support Opportunities: Regular Research Grants