Authors’ reply to Corbin, Moore, and CoeberghBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6795 (Published 19 November 2013) Cite this as: BMJ 2013;347:f6795
- Anna L Hansell, assistant director and honorary consultant12,
- John Gulliver, lecturer in environmental science1,
- Sean Beevers, senior lecturer in air quality modelling3,
- Paul Elliott, director1
- 1UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London W2 1PG, UK
- 2Imperial College Healthcare NHS Trust, London, UK
- 3Environmental Research Group, MRC-PHE Centre for Environment and Health, King’s College London, UK
In our recent paper on aircraft noise and cardiovascular disease near Heathrow airport we concluded, “As well as the possibility of causal associations, alternative explanations such as residual confounding . . . should be considered.”1 Responses to our paper put forward possible candidates.2 3 4
Corbin suggests that ultrafine particulate air pollution (PM0.1) from aircraft could be a possible explanation for our findings.2 Although increased concentrations of such particles have been found near the runway during take-off,5 we are unaware of data showing that this is the case in well mixed air up to tens of kilometres away from the airport. PM0.1 particles are not a regulated pollutant in the UK, so there are no readily available data to investigate this.
Moore questions our choice of confounders.3 We adjusted for age, sex, area level ethnicity, and lung cancer (as proxy for smoking), but information on hypertension, cholesterol, and family history are not currently available within routine datasets at small area scale. Also, care would be needed in adjusting for hypertension if raised blood pressure lies on the causal pathway between aircraft noise and cardiovascular disease.
Coebergh raises the possibility that our findings reflect occupational hazards related to Heathrow.4 We think this is unlikely—stroke and coronary heart disease are most common in older people who are less likely to be still working.
Our paper concluded that “Further work to understand better the possible health effects of aircraft noise is needed,” and these rapid responses support this notion.
Cite this as: BMJ 2013;347:f6795
Competing interests: We received financial support for the submitted work from the UK Small Area Health Statistics Unit (Public Health England) as part of the MRC-PHE Centre for Environment and Health, funded also by the UK Medical Research Council; financial support from the European Network for Noise and Health (ENNAH), EU FP7 grant 226442; PE was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial College Healthcare NHS Trust and Imperial College London; PE is an NIHR senior investigator; ALH declares consultancy fees from AECOM as part of a Defra report on health effects of environmental noise; ALH is a member of Greenpeace but has not received money from the organisation or been involved in campaigns.
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