Long-term exposure to transportation noise has been examined as a potential environmental factor in cardiovascular disease, but updated exposure-response relationships remain limited. In a systematic review and exposure–response analysis published in the Journal of Exposure Science and Environmental Epidemiology, associations between transportation noise sources and cardiovascular outcomes were evaluated using both conventional and Burden of Proof (BoP) modeling approaches.

A systematic search identified cohort and case-control studies conducted in general populations that assessed long-term exposure to road traffic, railway, and aircraft noise in relation to myocardial infarction (MI), ischemic heart disease (IHD), stroke, and ischemic stroke. Exposure-response functions were derived using natural cubic splines and BoP risk functions.

A total of 26 studies were included. Road traffic noise was associated with a 1% increase in combined stroke incidence and mortality (relative risk [RR]=1.01; 95% confidence interval [CI]: 1.00-1.02; p=0.04), with a higher estimate under the BoP framework (RR=1.05; 95% uncertainty interval [UI]: 1.03-1.07). Railway noise was associated with a 1% increase in myocardial infarction outcomes (RR=1.01; 95% CI: 1.01-1.01; p<0.0001), increasing to 16% under the BoP model (RR=1.16; 95% UI: 1.07-1.26). Of 12 exposure-outcome pairs, five showed no evidence of association and four showed weak evidence.

These findings indicate heterogeneous and generally modest associations between transportation noise exposure and cardiovascular outcomes across different sources and modeling approaches.