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Background: Noise has been related to several cardiovascular diseases (CVDs) such as coronary heart disease and to their risk factors such as hypertension, but associations with stroke remain under-researched, even if CVD likely share similar pathophysiologic mechanisms.Aim: The objective of the study was to examine the association between long-term residential exposure to total environmental noise and stroke incidence in Montreal, Canada.Materials and Methods: We created an open cohort of adults aged ≥45years, free of stroke before entering the cohort for the years 2000 to 2014 with health administrative data. Residential total environmental noise levels were estimated with land use regression (LUR) models. Incident stroke was based on hospital admissions. Cox hazard models with age as the time axis and time-varying exposures were used to estimate associations, which were adjusted for material deprivation, year, nitrogen dioxide, stratified for sex, and indirectly adjusted for smoking.Results: There were 9,072,492 person-years of follow-up with 47% men; 26,741 developed stroke (21,402 ischemic; 4947 hemorrhagic; 392 had both). LUR total noise level acoustic equivalent for 24 hours (LAeq24h) ranged 44 to 79 dBA. The adjusted hazard ratio (HR) for stroke (all types), for a 10-dBA increase in LAeq24h, was 1.06 [95% confidence interval (CI): 1.03-1.09]. The LAeq24h was associated with ischemic (HR per 10 dBA: 1.08; 95% CI: 1.04-1.12) but not hemorrhagic stroke (HR per 10 dBA: 0.97; 95% CI: 0.90-1.04).Conclusion: The results suggest that total environmental noise is associated with incident stroke, which is consistent with studies on transportation noise and other CVD. [ABSTRACT FROM AUTHOR]

Background Since public transit infrastructure affects road traffic volumes and influences transportation mode choice, which in turn impacts health, it is important to estimate the alteration of the health burden linked with transit policies. Objective We quantified the variation in health benefits and burden between a business as usual (BAU) and a public transit (PT) scenarios in 2031 (with 8 and 19 new subway and train stations) for the greater Montreal region. Method Using mode choice and traffic assignment models, we predicted the transportation mode choice and traffic assignment on the road network. Subsequently, we estimated the distance travelled in each municipality by mode, the minutes spent in active transportation, as well as traffic emissions. Thereafter we estimated the health burden attributed to air pollution and road traumas and the gains associated with active transportation for both the BAU and PT scenarios. Results We predicted a slight decrease of overall trips and kilometers travelled by car as well as an increase of active transportation for the PT in 2031 vs the BAU. Our analysis shows that new infrastructure will reduce the overall burden of transportation by 2.5 DALYs per 100,000 persons. This decrease is caused by the reduction of road traumas occurring in the inner suburbs and central Montreal region as well as gains in active transportation in the inner suburbs. Conclusion Based on the results of our study, transportation planned public transit projects for Montreal are unlikely to reduce drastically the burden of disease attributable to road vehicles and infrastructures in the Montreal region. The impact of the planned transportation infrastructures seems to be very low and localized mainly in the areas where new public transit stations are planned. [ABSTRACT FROM AUTHOR]

Effects of air pollutants are related to oxidative stress which is also linked to the pathogenesis of dementia including Alzheimer's and related diseases. We assessed associations between exposure to air pollutants and the onset of dementia; the association with the distance between residence and major roads was also assessed for the island of Montreal. We created an open cohort of adults aged 65 years and older starting in 2000 and ending in 2012 in the province of Québec, Canada using linked medico-administrative databases. New cases of dementia were defined based on a validated algorithm. Annual residential levels of nitrogen dioxide (NO 2) and fine particles (PM 2.5) at residential levels were estimated for each year of follow up using estimates based on satellite images and ground air monitoring data. Hazard ratios (HRs) were assessed with Extended (time dependent exposure) Cox models with age as the time axis and stratified for sex, for the annual exposure level at each residential address. Models were adjusted for the calendar year, area-wide social and material deprivation indexes and for NO 2 or PM 2.5 ; they were also indirectly adjusted for smoking. 1,807,133 persons (13,242,270 person-years) were followed and 199,826 developed dementia. From models (adjusted for calendar year, social and material deprivation indexes), HRs for an interquartile range (IQR) increase in time-varying exposure to NO 2 (IQR 13.26 ppb), PM 2.5 (IQR 3.90 μg/m³), and distance to major roads (IQR 150 m, in Montreal only), were 1.005 (CI 95% 0.994–1.017), 1.016 (CI 95% 1.003–1.028) and 0.969 (CI 95% 0.958–0.980), respectively. Results suggest that the onset of dementia may be related to residential exposure to PM 2.5 , NO 2 , and distance to major roads. • We studied dementia onset and residential exposure to air pollutants. • We used a cohort based on administrative health data in Quebec, Canada, 2000–2012. • Residential exposure to PM2.5, NO2 was based on satellite images and monitoring data. • PM2.5, NO2, distances to major roads (Montreal) were associated with dementia onset. [ABSTRACT FROM AUTHOR]

We compared numbers of trips and distances by transport mode, air pollution and health impacts of a Business As Usual (BAU) and an Ideal scenario with urban densification and reductions in car share (76%–62% in suburbs; 55%–34% in urban areas) for the Greater Montreal (Canada) for 2061. We estimated the population in 87 municipalities using a demographic model and population projections. Year 2031 (Y2031) trips (from mode choice modeling) and distances were used to estimate those of Y2061. Emissions of nitrogen dioxide (NO2) and carbon dioxide (CO2) were estimated and NO2 used with dispersion modeling to estimate concentrations. Walking and Public Transit (PT) use and corresponding distances walked in Y2061 were >70% higher for the Ideal scenario vs the BAU, while car share and distances were <40% lower. NO2 levels were slightly lower in the Ideal scenario vs the BAU, but always higher in the urban core. Health impacts, summarized with disability adjusted life years (DALY), differed between urban and suburb areas but globally, the Ideal scenario reduced the impacts of the Y2061 BAU by 33% DALY. Percentages of car and PT trips were similar for the Y2031 and Y2061 BAU but kms travelled by car, CO2 and NO2 increased, due to increased populations. Drastic measures to decrease car share appear necessary to substantially reduce impacts of transportation. • We modelled 2061 densification, telework & decrease car share (~15%) impacts. • Walking & Public Transit use were >25% higher for this scenario in Y2061. • NO2 was slightly lower in the Y2061 scenario but always higher in the urban core. • Greater decrease in DALY was noted in suburb areas (Globally Y2061 scenario > -30%). • Drastic car share reduction & densification are necessary to greatly reduce impacts. [ABSTRACT FROM AUTHOR]