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Residential exposure to aircraft noise and hospital admissions for cardiovascular diseases: multi-airport retrospective study

BMJ 2013; 347 doi: (Published 08 October 2013) Cite this as: BMJ 2013;347:f5561
  1. Andrew W Correia, quantitative analyst1,
  2. Junenette L Peters, assistant professor2,
  3. Jonathan I Levy, professor2,
  4. Steven Melly, geographic information systems specialist3,
  5. Francesca Dominici, professor, associate dean of information technology4
  1. 1NMR Group, Somerville, MA, USA
  2. 2Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
  3. 3Department of Environmental Health, Harvard School of Public Health, Boston
  4. 4Department of Biostatistics, Harvard School of Public Health, Boston, MA 02115-6018, USA
  1. Correspondence to: F Dominici fdominic{at}
  • Accepted 5 September 2013


Objective To investigate whether exposure to aircraft noise increases the risk of hospitalization for cardiovascular diseases in older people (≥65 years) residing near airports.

Design Multi-airport retrospective study of approximately 6 million older people residing near airports in the United States. We superimposed contours of aircraft noise levels (in decibels, dB) for 89 airports for 2009 provided by the US Federal Aviation Administration on census block resolution population data to construct two exposure metrics applicable to zip code resolution health insurance data: population weighted noise within each zip code, and 90th centile of noise among populated census blocks within each zip code.

Setting 2218 zip codes surrounding 89 airports in the contiguous states.

Participants 6 027 363 people eligible to participate in the national medical insurance (Medicare) program (aged ≥65 years) residing near airports in 2009.

Main outcome measures Percentage increase in the hospitalization admission rate for cardiovascular disease associated with a 10 dB increase in aircraft noise, for each airport and on average across airports adjusted by individual level characteristics (age, sex, race), zip code level socioeconomic status and demographics, zip code level air pollution (fine particulate matter and ozone), and roadway density.

Results Averaged across all airports and using the 90th centile noise exposure metric, a zip code with 10 dB higher noise exposure had a 3.5% higher (95% confidence interval 0.2% to 7.0%) cardiovascular hospital admission rate, after controlling for covariates.

Conclusions Despite limitations related to potential misclassification of exposure, we found a statistically significant association between exposure to aircraft noise and risk of hospitalization for cardiovascular diseases among older people living near airports.


  • Contributors: AWC (dual first authorship) was responsible for study design, data analysis, data interpretation, and writing. JLP (dual first authorship) was responsible for writing, literature search, study design, and data interpretation. JIL contributed to the literature search, study design, data interpretation, and writing. SM contributed to data collection and data interpretation. FD (study guarantor) contributed to the study design, data analysis, data interpretation, and writing.

  • Funding: This study was supported by the Federal Aviation Administration, under FAA award No 09-C-NE-HU amendment No 004 and 10-C-NE-BU amendment No 002. The sponsor provided the noise contours, but had no role in the analysis or interpretation of data; in the writing of the reports; or in the decision to submit the article for publication. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the funder.

  • Competing interests: All authors have completed the ICMJE uniform disclosure form at (available on request from the corresponding author) and declare: no support from any commercial entities for the submitted work; no financial relationships with any commercial entities that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

  • Ethical approval: Studies using national data repositories and area level exposure data do not require ethical approval in the United States. All authors had full access to the data and take full responsibility for their integrity.

  • Data sharing: No additional data available.

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