Objectives Exposure to traffic noise and air pollution is suspected to increase susceptibility to viral infections – the main triggering factor for febrile seizures. No studies have examined these two exposures in relation to febrile seizures. We aimed to investigate whether exposure to road traffic noise and air pollution are associated with risk of febrile seizures in childhood.

Methods From our study base of 51 465 singletons from a national birth cohort, we identified 2175 cases with febrile seizures using a nationwide registry. Residential address history from conception to six years of age were found in national registers, and road traffic noise (L_den) and air pollution (NO₂) were modeled for all addresses. Analyses were done using Cox proportional hazard model with adjustment for potential confounders, including mutual exposure adjustment.

Results An interquartile range (IQR) increase in childhood exposure to road traffic noise and air pollution was associated with an 11% [incidence rate ratio (IRR) 1.11, 95% confidence interval (CI) 1.04–1.19) and 5% (IRR 1.05, 95% CI 1.02–1.07) higher risk for febrile seizures, respectively, after adjustment for potential confounders. Weaker tendencies were seen for pregnancy exposure. In models with mutual exposure adjustment, the estimates were slightly lower, with IRR of 1.08 (95% CI 1.00–1.16) and 1.03 (95% CI 0.99–1.06) per IQR increase in childhood exposure to road traffic noise and air pollution, respectively.

Conclusions This study suggests that residential exposure to road traffic noise and air pollution is associated with higher risk for febrile seizures.

Key terms air pollution; cohort study; exposure; febrile seizure; noise; traffic noise

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