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Background:

Associations between long-term exposure to air pollution and road traffic noise have been established for ischemic heart disease, but findings have been mixed for atrial fibrillation (AF).

Objectives:

The goal of the study was to examine associations of long-term exposure to road traffic noise and air pollution with AF.

Methods:

Time-varying Cox regression models were used to estimate associations of 1-, 3-, and 23-y mean road traffic noise and air pollution exposures with AF incidence in 23,528 women enrolled in the Danish Nurse Cohort (age $>44\mathrm{y}$ at baseline in 1993 or 1999). AF diagnoses were ascertained via the Danish National Patient Register. Annual mean weighted 24-h average road traffic noise levels (${\mathrm{L}}_{\text{den}}$) at the nurses’ residences, since 1970, were estimated using the Nord2000 model, and annual mean levels of particulate matter with a diameter $<2.5\mathrm{\mu }\mathrm{m}$ (${\mathrm{PM}}_{2.5}$) and nitrogen dioxide (${\mathrm{NO}}_2$) were estimated using the DEHM/UBM/AirGIS model.

Results:

Of 23,528 nurses with no prior AF diagnosis at the cohort baseline, 1,522 developed AF during follow-up. In a fully adjusted model (including ${\mathrm{PM}}_{2.5}$), the estimated risk of AF was 18% higher [hazard ratio (HR); 95% confidence interval (CI): 1.18; 1.02, 1.36] in nurses with residential 3-y mean ${\mathrm{L}}_{\text{den}}$ levels $>58\text{\hspace{0.17em}dB}$ vs. $<48\text{\hspace{0.17em}dB}$, with similar findings for 1-y mean exposures. A $3.9\text{-}{\mathrm{\mu }\mathrm{g}/\mathrm{m}}^3$ increase in 3-y mean ${\mathrm{PM}}_{2.5}$ was associated with incident AF before and after adjustment for concurrent exposure to road traffic noise (HR 1.09; 95% CI: 1.00, 1.20 and 1.08; 95% CI: 0.97, 1.19, respectively). Associations with 1-y mean ${\mathrm{PM}}_{2.5}$ exposures were positive but closer to the null and not significant. Associations with ${\mathrm{NO}}_2$ were null for all time periods before and after adjustment for road traffic noise and inverse when adjusted for concurrent ${\mathrm{PM}}_{2.5}$.

Conclusion:

Our analysis of prospective data from a cohort of Danish female nurses followed for up to 14 y provided suggestive evidence of independent associations between incident AF and 1- and 3-y exposures to road traffic noise and ${\mathrm{PM}}_{2.5}$. https://doi.org/10.1289/EHP8090