Letters Aircraft noise and health

Authors’ reply to Kolstad and colleagues

BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7464 (Published 16 December 2013) Cite this as: BMJ 2013;347:f7464
  1. Anna L Hansell, assistant director and honorary consultant12,
  2. Rebecca E Ghosh, research associate1,
  3. Paul Elliott, director1
  1. 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
  2. 2Imperial College Healthcare NHS Trust, London, UK
  1. a.hansell{at}imperial.ac.uk

Kolstad and colleagues suggest that the results of our study on aircraft noise and cardiovascular disease may reflect confounding rather than causal associations,1 2 citing largely negative results of a large Danish study of occupational noise exposure, hypertension (based on registry data),3 and stroke.4 Occupational studies are subject to the “healthy worker” bias. For example, people who are prone to ill health related to noise exposure are more likely to leave or never start working in jobs with high exposure to noise, and although the study adjusted for early leavers some residual …

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