Inmetropolitan areas, roadtraffic isamajor contributor toambient air pollution and thedominant source of community
noise. The authors investigated the independent and joint influences of community noise and traffic-related air pollution
on risk of coronary heart disease (CHD) mortality in a population-based cohort study with a 5-year exposure period
(January 1994–December 1998) and a 4-year follow-up period (January 1999–December 2002). Individualswhowere
45–85 years of age and resided in metropolitan Vancouver, Canada, during the exposure period and did not have
known CHD at baseline were included (n ¼ 445,868). Individual exposures to community noise and traffic-related air
pollutants, including black carbon, particulate matter less than or equal to 2.5 lm in aerodynamic diameter, nitrogen
dioxide, and nitric oxide, were estimated at each person’s residence using a noise prediction model and land-use
regression models, respectively. CHD deaths were identified from the provincial death registration database. After
adjustment for potential confounders, including traffic-related air pollutants or noise, elevations in noise and black
carbon equal to the interquartile ranges were associated with 6% (95% confidence interval: 1, 11) and 4% (95%
confidence interval: 1, 8) increases, respectively, in CHD mortality. Subjects in the highest noise decile had a 22%
(95%confidence interval: 4, 43) increase inCHDmortality compared with persons in the lowest decile. These findings
suggest that there are independent effects of traffic-related noise and air pollution on CHD mortality.