Table 2. Exposure parameters and endpoints of included studies.
|
First author, publication year (additional associated publications) |
Exposure metrics |
Categorical or continuous exposure reporting*1 (range) |
Effect estimates, endpoint data collection |
Confounders considered |
Value |
95% confidence interval |
| Correia et al., 2013 (18) | LDN*2 | per 10 dB (≥ 45 – 71.59 dB) |
RR, ICD-coded hospital admissions for stroke | Age, sex, ethnicity | 1.039*3 | [0.995; 1.084]*3 |
| Evrard et al., 2015 (19) | LDENAEI*2 | per 10 dB (≥ 42.0 – 46.1 dB) |
MRR, ICD-coded stroke mortality rate | Adjusted on municipal level for sex, age, population density, lung cancer mortality, and a deprivation index*4 | 1.08*4 | [0.97; 1.21]*4 |
| Frerichs et al.,1980 (20– 22) | LDay (17.5 hours)*2 | 45 – 50 dB | SMR, ICD-coded cerebrovascular deaths | Age, sex, ethnicity | 1.06*5 | [0.86; 1.29]*5 |
| 90 dB | 0.92*5 | [0.71; 1.17]*5 | ||||
| Gan et al., 2012 (23) | LDEN*2 | not exposed | RR, ICD-coded stroke mortality | Age, sex, neighborhood, socioeconomic status, and comorbidity (diabetes, COPD, hypertensive heart disease) | 1.00*3 | [1.00; 1.00]*3 |
| 0.01 – 21.3 dB | 1.30*3 | [1.11; 1.53]*3 | ||||
| 21.4 – 35.2 dB | 1.29*3 | [1.10; 1.51]*3 | ||||
| 35.3 – 44.4 dB | 1.07*3 | [0.90; 1.26]*3 | ||||
| 44.5 – 71.0 dB | 1.16*3 | [0.98; 1.36]*3 | ||||
| Hansell et al., 2013 (4) | LDay (7–23 hrs)*2 | ≤ 51 dB | RR, ICD-coded hospital admissions for stroke | Age, sex, ethnicity, deprivation (Carstairs index), lung cancer (ecological variables) | 1.00 | [1.00; 1.00] |
| >51 – 54 dB | 1.03 | [0.98; 1.09] | ||||
| >54 – 57 dB | 1.04 | [0.98; 1.12] | ||||
| >57 – 60 dB | 1.04 | [0.95; 1.14] | ||||
| >60 – 63 dB | 1.10 | [0.96; 1.25] | ||||
| >63 dB | 1.24 | [1.08; 1.43] | ||||
| LNight (23–7 hrs)*2 | ≤ 50 dB | 1.00*4 | [1.00; 1.00]*4 | |||
| >50–55 dB | 0.99*4 | [0.92; 1.07]*4 | ||||
| >55 dB | 1.29*4 | [1.14; 1.46]*4 | ||||
| Héritier et al., 2017 (2, 5) | LDEN*2 | per 10 dB (≥ 30 dB) | HR, ICD-coded stroke mortality | Sex, neighborhood index of socioeconomic status, marital status, education level, first language, nationality, and NO2 exposure | 1.013 | [0.993; 1.033] |
| Floud et al., 2013 (HYENA study: [3, 24–31, e14]) |
LAeq, 16 hours*2 | per 10 dB (<35 – 76 db) | OR, self-reporting of a physician’s stroke diagnosis | Age, sex, ethnicity, education level, body mass index; additionally assessed but not included in the final regression (≤ 10% change in exposure coefficient): alcohol consumption, exercise, smoking | 1.08 | [0.82; 1.41] |
| LNight*2 | per 10 dB (<30 – 70 db) | 1.18 | [0.89; 1.56] | |||
| Seidler et al., 2016 (NORAH study: [32, 33]) |
LDEN*2 | <40 db | ICD-10-coded hospital diagnosis of stroke | Age, sex, education level, job title (if available) and local proportion of persons receiving unemployment benefits | 1.0*3 | [1.00; 1.00]*3 |
| ≥ 40 to <45 db | 1.04*3 | [1.01; 1.08]*3 | ||||
| ≥ 45 to <50 db | 0.99*3 | [0.96; 1.03]*3 | ||||
| ≥ 50 to <55 db | 1.03*3 | [0.98; 1.08]*3 | ||||
| ≥ 55 to <60 db | 0.99*3 | [0.93; 1.06]*3 | ||||
| ≥ 60 dB | 0.86*3 | [0.76; 0.97]*3 | ||||
| Wiens. 1995 (34) | Annoyance | Little, moderately annoyed | POR, self-reporting of a physician’s stroke diagnosis | None | 0.94*4 | [0.44; 2.04]*4 |
| Rather, very annoyed | 0.66*4 | [0.66; 1.49]*4 |
*1 All aircraft noise information is based on calculated exterior noise levels which were established using noise maps. Personalized interior noise measurements were not included in any of the studies.
*2 L Aeq : A-weighted average of an energy-equivalent continuous sound level over a period of time (A-weighting: in noise research typically the A filter is used which adjusts for deep and high frequencies, as these are perceived as less loud);
L Day : L Aeq for the day (usually 7:00 am – 7:00 pm) for all day periods of a year; L Night : L Aeq for the night (usually from 11:00 pm – 7:00 am) for all night periods of a year; L DN : all 24 h L Aeq periods of a year with additional 10 dB for nighttime noise annoyance (usually from 11:00 pm – 7:00 am) ; L DEN : all 24h L Aeq periods of a year with additional 5 dB for the evening hours (8:00 pm – 10.00 pm or 7:00 pm – 11:00 pm) and additional 10 dB for nighttime hours (10:00 pm – 6:00 am or from 11:00 pm 7:00 am) ; L DEN AEI: see L DEN , but in addition weighted average exposure on municipal level
*3 Additional data from correspondence with study authors
*4 Data extraction of cerebrovascular events, but these data were not suitable for meta-analysis
*5 Self-calculated as described by Ulm, 1990 (e15)
COPD: chronic obstructive pulmonary disease; HR: hazard ratio; ICD: International Classification of Diseases and Related Health Problems; MRR: mortality rate ratio; OR: odds ratio, POR: prevalence odds ratio; RR: risk ratio, SMR: standardized mortality ratio