Traffic noise and risk for diabetes and cancer Mette Sørensen Senior researcher, leader of research...

Traffic noise and risk for diabetes and cancer

Mette Sørensen

Senior researcher, leader of research group

Urban Environment

Diet, Genes and Environment

Danish Cancer Society

Traffic noise exposure

Stress and sleep disturbance

Cardiovascular diseaseHypertension

Ischemic heart diseaseStroke

Stockholm, October 2015

Mechanisms, traffic noise

Other major diseases?

Sleep disturbances• Experimental reduction in sleep duration/quality

• ↓ glucose tolerance, ↑ morning glucose• ↓ insulin levels, ↓ insulin sensitivity

• Epidemiological studies• 10 prospective studies, > 100,000 participants, 3500 diabetes cases• Reduced sleep quality and quantity increase risk of diabetes

Excess of stress hormone (cortisol)• ↓ insulin production• ↓ insulin sensitivity

Sleep disturbance, stress and diabetes


Study population

Diet, Cancer and Health cohort• Enrolment in 1993-1997

• 57,053 persons aged 50-64 years

• Copenhagen and Aarhus

• Questionnaire (diet, smoking, alcohol, education etc.)

• Weight, height and waist circumference measured

→ Central Population Registry: all residential addresses 1987-2010

→ The National Diabetes Registry: 3,869 diabetes cases


Noise exposure

SoundPLAN – the Nordic Prediction Method• Geographical coordinates for each address

• Height (floor) for each address

• Building polygons

• All road lines with > 1000 vehicles

• Traffic composition (heavy/light)

• Yearly average daily traffic

• Traffic speed

AirGIS – model for estimation of air pollutionStockholm, October 2015

Results, diabetes

Road traffic noiseLden, per 10 dB

Cases

Adjusted IRR(95% CI)

All diabetes, 5-years 3 869 1.11 (1.05-1.18)

Confirmed diabetes*, 5 years 2 752 1.14 (1.06-1.22)

*Excluded cases only included in Diabetes Registry based on blood glucose tests


Exposure-response relationship

Calculations for Denmark• 5.5 million inhabitants• The risk estimates of our study• Distribution of road traffic noise in Denmark (report Danish EPA)

• 1,400 new diabetes cases every year

How many extra diabetes cases due to road traffic noise?


Eriksson et al 2014, Stockholm Arlanda airport• 5,156 participants• Pre-diabetes: 412 (52 ≥ 50 dB)• Diabetes: 159 (26 ≥ 50 dB)• Overall no associations between airport noise and diabetes• Suggestions of association with diabetes (but not pre-diabetes) in

women (1.27 (0.94-1.71) per 5 dB increase)• No associations in men

Noise and diabetes, other studies


Stress, sleep and breast cancer


Sleep disturbanceShort sleep duration may suppress melatonin

Melatonin:• body's circadian rhythm

• anti-carcinogenicNight work associated with breast cancerSelf-reported sleep maybe associated with breast cancer

Stress - glucocorticoidsSuspected of promoting tumor growth

Study, breast cancer


• Study population, 30,000 women• Residential addresses 1987-2010 • Danish Cancer Registry -> 1,219 cases• Danish Breast Cancer Co-operative group:• Estrogen receptor: 858 positive/203 negative cases

• Adjustment: Parity, age first birth, HRT, lifestyle, SES

Results, breast cancer


Traffic noise, per 10 dB

Cases

Adjusted IRR (95% CI)

Road traffic noise, 5-years

ER positive 858 0.99 (0.89-1.10)

ER negative 203 1.23 (1.00-1.51)

Railway noise, diagnosis

ER positive 858 0.96 (0.83-1.26)

ER negative 203 1.38 (1.01-1.89)

Non-Hodgkin’s lymphoma (NHL)

• originating from lymphoid tissue• incidence rates increased since 1960• etiology largely unknown• well-established risk factor is suppression of immune system

• HIV patients• immunosuppressive drugs

Nordic age-adjusted NHL incidence rates (per 100,000)


Stress, sleep and NHL

Sleep disturbanceSleep deprivation associated with immune system impairment• sleep restriction at night after

vaccination: ↓ antibody conc. • ↑ pro-inflammatory molecules • ↓ immuno-stimulating

hormonesEpi studies indicate night-shift workers at higher NHL risk

Stress Acute and chronic stressors, e.g. exams and stressful life events• associated with impaired

immune system


NHL, design and results

Traffic noise

Cases

AdjustedOR (95% CI)

Road traffic noise, 5-y < 55 dB 1,103 1.00 55-65 dB 1,256 0.98 (0.88-1.08) ≥ 65 dB 394 1.18 (1.01-1.37)

National register-based case-control study• 2,753 cases / 4,743 controls• Adjusted for sex, age and SES


ConclusionsDIABETES• Road traffic noise associated with higher risk for diabetes • Aircraft noise possibly associated with diabetes in women; not in

men (and not with pre-diabetes)

CANCER• Road traffic AND railway noise associated with higher risk for ER-

breast cancer• Road traffic noise associated with higher risk for NHL

OVERALL CONCLUSIONAlthough more studies are needed, research suggests that traffic noise is associated with other major diseases than cardiovascular

Traffic noise and risk for diabetes and cancer Mette Sørensen Senior researcher, leader of research...

Documents

Transcript of Traffic noise and risk for diabetes and cancer Mette Sørensen Senior researcher, leader of research...