Indoor and outdoor road traffic noise and incident diabetes mellitus: Results from a longitudinal German cohort study

Simone Ohlwein; Frauke Hennig; Sarah Lucht; Clara Matthiessen; Noreen Pundt; Susanne Moebus; Karl-Heinz Jöckel; Barbara Hoffmann

doi:10.1097/EE9.0000000000000037

Indoor and outdoor road traffic noise and incident diabetes mellitus: Results from a longitudinal German cohort study

Environ Epidemiol. 2019 Feb 12;3(1):e037. doi: 10.1097/EE9.0000000000000037. eCollection 2019 Feb.

Authors

Simone Ohlwein¹, Frauke Hennig¹, Sarah Lucht¹, Clara Matthiessen¹, Noreen Pundt², Susanne Moebus², Karl-Heinz Jöckel³, Barbara Hoffmann¹

Affiliations

¹ Institute for Occupational, Social and Environmental Medicine, Medical Faculty, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany.
² Centre of Urban Epidemiology, Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
³ Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.

Abstract

Road traffic noise affects a large number of people in urbanized areas. Recent epidemiological evidence indicates that environmental noise exposure may not only be associated with cardiovascular but also with cardio-metabolic outcomes. This prospective cohort study investigated the effect of outdoor and indoor residential road traffic noise on incident type 2 diabetes mellitus (T2DM).

Methods: We used data from 3,396 participants of age 45-75 years of the Heinz Nixdorf Recall study being non-diabetic at baseline (2000-2003). T2DM was defined via blood glucose level, incident intake of an anti-diabetic drug during follow-up or self-reported physician diagnosis at follow-up examination (2005-2008). Weighted 24-h (L_den) and night-time (L_night) mean road traffic noise was assessed according to the European Union directive 2002/49/EC. Road traffic noise exposure indoors was modeled taking into account the participants' room orientation, ventilation behavior and window insulation (n = 2,697). We applied Poisson regression analyses to estimate relative risks (RRs) of incident T2DM, adjusting for demographic characteristics, lifestyle factors, and air pollution exposure (NO₂ or PM_2.5).

Results: A 10-dB(A) increase in outdoor road traffic noise (L_den) was associated with an RR of 1.09 (95% confidence interval, 0.96-1.24) for T2DM in the fully adjusted model. Models including PM_2.5 or NO₂ yielded RRs of 1.09 (0.96-1.24) and 1.11 (0.97-1.27), respectively. In analyses with road traffic noise (L_den) exposure indoors, we observed similar RRs with smaller confidence intervals (1.11 [1.01-1.21]).

Conclusions: Our analyses suggest that long-term exposure to indoor and outdoor road traffic noise may increase the risk of developing T2DM, independent of air pollution exposure.