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As part of two large heart surveys, associations between traffic noise exposure and cardiovascular risk factors were studied. The Caerphilly sample (small town, total sample) consisted of 2512 men aged 45 to 59 years and the Speedwell sample (suburb of a major city, random sample) of 2030 men of same age group. Both studies have a prospective design; cross-sectional results are presented here. Acoustic measurements were carried out in both areas. Among the possible risk factors for ischaemic heart disease studied were blood pressure, blood coagulation, blood lipids and other biochemical factors. Statistically significant noise effects were detected for systolic blood pressure, total cholesterol, HDL cholesterol, total triglycerides, blood viscosity, platelet count and glucose level, although not all of these were consistent with noise being a risk factor for heart disease. In a subsample, the additional influence of work noise as determined by noise dosimetry was studied in 255 men, taking the use of ear protection into account. The associations between traffic noise and risk factors were more pronounced in men who also were exposed to high work noise levels.