WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Effects on Sleep

Effects of Nocturnal Aircraft Noise and Non-Acoustical Factors on Short-Term Annoyance in Primary School Children

Children are considered at higher risk for harmful noise effects due to their sensitive development phase. Here, we investigated the effects of nocturnal aircraft noise exposure on short-term annoyance assessed in the morning in 51 primary school children (8-10 years) living in the surrounding community of Cologne-Bonn Airport. Child-appropriate short-term annoyance assessments and associated non-acoustical variables were surveyed. Nocturnal aircraft noise exposure was recorded inside the children's bedrooms. Exposure-response models were calculated by using random effects logistic regression models. The present data were compared with those from a previous study near Cologne-Bonn Airport in adults using very similar methodology. Short-term annoyance reaction in children was not affected by the nocturnal aircraft noise exposure. Non-acoustical factors (e.g., the attitude that "aircraft are dangerous" or noise sensitivity), however, significantly impacted on children's short-term annoyance. In contrast to children, the probability of moderate to high annoyance in adults increased with the number of aircraft flyovers during the time in bed. It is concluded that short-term annoyance from nocturnal aircraft noise in children is mainly determined by non-acoustical factors. Unlike in adults, acoustical factors did not play a significant role.

Spatial extent of road pollution: A national analysis

Roads form vast, pervasive and growing networks across the Earth, causing negative environmental impacts that spill out into a 'road-effect zone'. Previous research has estimated the regional and global extent of these zones using arbitrary distances, ignoring the spatial distribution and distance-dependent attenuation of different forms of road environmental impact. With Great Britain as a study area, we used mapping of roads and realistic estimates of how pollution levels decay with distance to project the spatial distribution of road pollution. We found that 25% of land was less than 79 m from a road, 50% of land was less than 216 m and 75% of land was less than 527 m. Roadless areas were scarce, and confined almost exclusively to the uplands (mean elevation 391 m), with only ca 12% of land in Great Britain more than 1 km from roads and <4% of land more than 2.5 km from roads. Using light, noise, heavy metals, NO₂, and particulate matter PM_2.5 and PM₁₀ as examples, we estimate that roads have a zone of influence that extends across >70% of the land area. Potentially less than 6% of land escapes any impact, resulting in nearly ubiquitously elevated pollution levels. Generalising from this, we find that, whilst the greatest levels of road pollution are relatively localised around the busiest roads, low levels of road pollution (which may be ecologically significant) are pervasive. Our findings demonstrate the importance of incorporating greater realism into road-effect zones and considering the ubiquity of road pollution in global environmental issues. We used Great Britain as a study area, but the findings likely apply to other densely populated regions at present, and to many additional regions in the future due to the predicted rapid expansion of the global road network.

Preparation of Industrial Noise Mapping and Improvement of Environmental Quality

Environmental noise control is necessary for human health and auditory comfort conditions. In this respect, it is required that industrial noise should be kept under control and healthy living spaces should be obtained in residential areas. This paper aims to explain industrial noise control at urban and building scales. In this study, the strategic noise mapping process related to industrial activities in a line with the Environmental Noise Directive (END) was clarified. Besides this, what type of factors are effective in the industrial noise mapping process were defined, and important basic parameters, which are essential in the industrial noise mapping, were detailed. The preparation of the industrial noise mapping process was explained in detail. It was mentioned that the regions exposed to excessive noise should be defined according to the strategic noise map and improvement plans should be performed. Improvement methods that reduce excessive noise in living spaces are clarified and it was explained how the improvement of environmental quality can be acquired. In this regard, this paper gives information on industrial noise mapping and industrial noise control at the urban scale.

Space-time characterization of community noise and sound sources in Accra, Ghana

Urban noise pollution is an emerging public health concern in growing cities in sub-Saharan Africa (SSA), but the sound environment in SSA cities is understudied. We leveraged a large-scale measurement campaign to characterize the spatial and temporal patterns of measured sound levels and sound sources in Accra, Ghana. We measured sound levels and recorded audio clips at 146 representative locations, involving 7-days (136 locations) and 1-year measurements between 2019 and 2020. We calculated metrics of noise levels and intermittency and analyzed audio recordings using a pre-trained neural network to identify sources. Commercial, business, and industrial areas and areas near major roads had the highest median daily sound levels (LAeq_24hr: 69 dBA and 72 dBA) and the lowest percentage of intermittent sound; the vice-versa was found for peri urban areas. Road-transport sounds dominated the overall sound environment but mixtures of other sound sources, including animals, human speech, and outdoor music, dominated in various locations and at different times. Environmental noise levels in Accra exceeded both international and national health-based guidelines. Detailed information on the acoustical environmental quality (including sound levels and types) in Accra may guide environmental policy formulation and evaluation to improve the health of urban residents.

The impact of nocturnal road traffic noise, bedroom window orientation, and work-related stress on subjective sleep quality: results of a cross-sectional study among working women

Objective

To examine the effect of work-related stress and road noise exposure on self-rated sleep and potential additive interaction effects.

Methods

Sleep and predictor variables were surveyed within two subsamples with 2191 and 1764 working women in a cross-sectional study. Sleep was assessed using a single question on general sleep quality and four questions on specific sleep problems and subsequently dichotomized (poor sleep vs. no poor sleep). Work-related stress was operationalized by job strain and effort-reward imbalance. Nocturnal exposure to road traffic noise was assessed as (a) the orientation of the bedroom window to a quiet façade vs. a low-, medium- or high-trafficked street and (b) energy-equivalent sound pressure levels for night-time modelled at the most exposed façade (L_night). We distinguished between low (< 45 dB(A)), medium (45–50 dB(A)) and high exposure (> 50 dB(A)).

Results

Poor sleep was associated with job strain and effort-reward imbalance. The prevalence of poor sleep did not increase with increasing L_night, but bedroom window orientation showed a non-significant trend. A quiet façade had a protective effect on sleep in each L_night category. We found a non-significant trend for an additive interaction between bedroom window orientation and job strain.

Conclusion

Noise levels modelled for the most exposed façade likely overestimate the actual exposure and thus may not be a precise predictor of poor sleep. Bedroom window orientation seems more relevant. Potential additive interaction effects between bedroom window orientation and job strain should be considered when interpreting epidemiological study results on noise-induced sleep disturbances.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01696-w.

Environmental factors related to sleep latency among inpatients in rehabilitation wards according to functional independence measure cognitive scores

BACKGROUND

No study has investigated sleep-related environmental factors in patients according to their functional independence measure (FIM) cognitive scores.

AIMS

The aim of this study is to examine the associations between environmental factors such as noise and sleep latency according to the FIM cognitive scores among inpatients in rehabilitation wards.

DESIGN

This is a prospective longitudinal study.

METHODS

This study measured the sleep state using a bed-based actigraphy, environmental data from Environmental Sensor®, and medical record information of 33 inpatients in the rehabilitation wards during 2018. A linear mixed-effect model was used to analyse the associations between sleep latency and environmental factors. Participants were grouped according to high or low FIM cognitive scores.

RESULTS

The average patient age was 77.2 ± 10.9 years, and 48.5% were male. In the high FIM cognitive score group, the loudness and frequency of noise exceeding 40 dB during sleep latency were significantly associated with sleep latency. In the low FIM cognitive score group, only the noise frequency was associated with sleep latency, and intra-individual variance was larger than that of the high group.

CONCLUSION

These findings suggest that providing night care with attention to subdued noise is important, particularly for patients with low cognitive functional independence levels measured by the FIM cognitive score.

How Does a Community Respond to Changes in Aircraft Noise? A Comparison of Two Surveys Conducted 11 Years Apart in Ho Chi Minh City

There have been many arguments about findings of an increase in noise annoyance over time and a recommendation of stricter limits on aircraft noise levels to protect the health of residents around airports. It is crucial to examine if the established exposure–response relationship is suitable for designing future aircraft noise regulations. This study was focused on identifying changes in response to noise over time by comparing community responses from two surveys conducted in 2008 and 2019 at Tân Sơn Nhất (TSN) international airport. Annoyance was found to significantly reduce in 2019 compared to 2008; however, changes in sleep quality were relatively small. Unexpectedly, a gradual increase in the annoyance due to aircraft noise was not found. Results of multiple regression analysis indicated that differences in the reaction of the residents to noise in the two studies were significantly attributed to nonacoustic factors. Noise sensitivity and dissatisfaction with the living environment (e.g., inconvenience in accessing workplace) considerably affect noise annoyance, whereas noise sensitivity, age, and dissatisfaction with the green environment of living areas affect sleep quality. These findings suggest the fulfillment of desired living environment as effective measures for mitigating noise impacts on residents in the vicinity of busy airports.

Nighttime road traffic noise exposure at the least and most exposed façades and sleep medication prescription redemption-a Danish cohort study

STUDY OBJECTIVES

Traffic noise has been associated with poor sleep quality and short sleep duration. This study investigates the association between nighttime road traffic noise at the least and most exposed façades of the residence and redemption of sleep medication.

METHODS

In a cohort of 44,438 Danes, aged 50-64 at baseline (1993-1997), we identified all addresses from 1987 to 2015 from a national registry and calculated nighttime road traffic noise at the most and least exposed façades. Using Cox Proportional Hazard Models we investigated the association between residential traffic noise over 1, 5, and 10 years before redemption of the first sleep medication prescription in the Danish National Prescription Registry. During a median follow-up time of 18.5 years, 13,114 persons redeemed a prescription.

RESULTS

We found that 10-year average nighttime exposure to road traffic noise at the most exposed façade was associated with a hazard ratio (HR) of 1.05, 95% confidence interval (CI) (1.00 to 1.10) for Ln greater than 55 as compared to not more than 45 dB, which when stratified by sex was confined to men (HR 1.16, 95% CI 1.08 to 1.25). For the least exposed façade the HR for Ln >45 vs ≤35 dB was 1.00, 95% CI (0.95 to 1.05). For the most exposed façade, the overall association was strongest in smokers and physically inactive.

CONCLUSIONS

Long-term residential nighttime noise exposure at the most exposed façade may be associated with a higher likelihood of redeeming prescriptions for sleep medication, especially among men, smokers, and physically inactive.

Snoring: a source of noise pollution and sleep apnea predictor

Snoring is a highly prevalent condition associated with obstructive sleep apnea (OSA) and sleep disturbance in bed partners. Objective measurements of snoring in the community, however, are limited. The present study was designed to measure sound levels produced by self-reported habitual snorers in a single night. Snorers were excluded if they reported nocturnal gasping or had severe obesity (BMI > 35 kg/m2). Sound was measured by a monitor mounted 65 cm over the head of the bed on an overnight sleep study. Snoring was defined as sound ≥40 dB(A) during flow limited inspirations. The apnea hypopnea index (AHI) and breath-by-breath peak decibel levels were measured. Snore breaths were tallied to determine the frequency and intensity of snoring. Regression models were used to determine the relationship between objective measures of snoring and OSA (AHI ≥ 5 events/h). The area under the curve (AUC) for the receiver operating characteristic (ROC) was used to predict OSA. Snoring intensity exceeded 45 dB(A) in 66% of the 162 participants studied, with 14% surpassing the 53 dB(A) threshold for noise pollution. Snoring intensity and frequency were independent predictors of OSA. AUCs for snoring intensity and frequency were 77% and 81%, respectively, and increased to 87% and 89%, respectively, with the addition of age and sex as predictors. Snoring represents a source of noise pollution in the bedroom and constitutes an important target for mitigating sound and its adverse effects on bed partners. Precise breath-by-breath identification and quantification of snoring also offers a way to risk stratify otherwise healthy snorers for OSA.

The effects of white noise on sleep and duration in individuals living in a high noise environment in New York City

INTRODUCTION

Undisturbed sleep has been shown to be important for both health and quality of life (Medic et al. [7]). The World Health Organization estimates that nearly 25% of the population suffers from disturbed sleep due to environmental noise (Health TWECfEa, [2]). Sleep disturbance associated with elevated noise levels is particularly prevalent in metropolitan areas. Our study tested the hypothesis that white noise would improve sleep in New Yorkers complaining of sleep difficulty due to elevated sound levels.

METHODS

Ten adult participants were included in this study. All participants were recruited from a New York City based sleep clinic. Inclusion criteria was based on the presence of sleep disturbance and the reporting of high levels of environmental noise in participants' sleep location. The study was conducted using a within-subject, ABA design, with baseline, treatment phase, followed by another baseline (washout) period. Each phase lasted one-week, during which noise level and sleep were assessed. The treatment consisted of the application of a white noise device (Dohm Classic by Marpac, LLC) in the participants' bedroom. Sleep parameters were measured subjectively using the Consensus Sleep Diary (Carney et al. [15]), and objectively using a Motionlogger Actigraph.

RESULTS

Paired sample t-tests were conducted to evaluate the hypothesis that white noise improves sleep in a high noise environment. Significance was found on the variables WASO, as measured by actigraphy, t(9) = 3.438, p = 0.007 and sleep latency as measured by sleep diary, t(9) = 2.947, p = 0.016. There was a trend toward significance on the number of awakenings during the night, as measured by sleep diary, t(9) = 2.622, p = 0.028 (Holm's sequential correction of p-value required a value of <0.01 to find significance on this comparison) and sleep efficiency (actigraph), t(9) = -2.121, p = 0.063.

CONCLUSION

Our data show that white noise significantly improved sleep based on subjective and objective measurements in subjects complaining of difficulty sleeping due to high levels of environmental noise. This suggests that the application of white noise may be an effective tool in helping to improve sleep in those settings.

Noise sensitivity associated with nonrestorative sleep in Chinese adults: a cross-sectional study

Background

Nonrestorative sleep is a common sleep disorder with a prevalence ranging from 1.4 to 35%, and is associated with various psychological and physical health issues. Noise exposure and noise sensitivity have been proposed to contribute to nonrestorative sleep. This study aimed to examine the relationships among noise, noise sensitivity, nonrestorative sleep, and physiological sleep parameters in Chinese adults.

Methods

A cross-sectional household survey was conducted with randomly selected Chinese adults based on a frame stratified by geographical districts and types of quarters in Hong Kong. We administered a battery of questionnaires, including the Nonrestorative Sleep Scale, the Weinstein Noise Sensitivity Scale, the ENRICHD Social Support Instrument, the Patient Health Questionnaire, and the Perceived Stress Scale to assess nonrestorative sleep, noise sensitivity, social support, somatic symptoms and stress, respectively. Anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale while sociodemographic and lifestyle characteristics were assessed with an investigator-developed sheet. Nocturnal noise level and physiological sleep parameters were measured during nighttime for a week by noise dosimetry and actigraphy, respectively. A structured multiphase linear regression was conducted to estimate associations.

Results

A total of 500 adults (66.4% female) with an average age of 39 years completed this study. Bivariate regressions showed that age, marital status, occupation, family income, season, exercise, cola and soda consumption, social support, somatic symptoms, stress, depression, noise sensitivity, total sleep time, and awakenings were associated with nonrestorative sleep. In the multivariable analysis, family income, season, exercise, social support, somatic symptoms, stress, and depression remained associated with nonrestorative sleep. Specifically, a one-unit increase of noise sensitivity was associated with 0.08 increase in nonrestorative sleep (95% confidence interval [CI]: 0.01, 0.15, p = 0.023). Nocturnal noise was negatively associated with time in bed (b = − 1.65, 95% CI: − 2.77, − 0.52, p = 0.004), total sleep time (b = − 1.61, 95% CI: − 2.59, − 0.62, p = 0.001), and awakenings (b = − 0.16, 95% CI: − 0.30, − 0.03, p = 0.018), but was not associated with nonrestorative sleep.

Conclusions

Nonrestorative sleep was predicted by noise sensitivity in addition to family income, season, exercise, social support, somatic symptoms, stress, and depression.

Association between urban environment and mental health in Brussels, Belgium

Background

Mental health disorders appear as a growing problem in urban areas. While common mental health disorders are generally linked to demographic and socioeconomic factors, little is known about the interaction with the urban environment. With growing urbanization, more and more people are exposed to environmental stressors potentially contributing to increased stress and impairing mental health. It is therefore important to identify features of the urban environment that affect the mental health of city dwellers. The aim of this study was to define associations of combined long-term exposure to air pollution, noise, surrounding green at different scales, and building morphology with several dimensions of mental health in Brussels.

Methods

Research focuses on the inhabitants of the Brussels Capital Region older than 15 years. The epidemiological study was carried out based on the linkage of data from the national health interview surveys (2008 and 2013) and specifically developed indicators describing each participant’s surroundings in terms of air quality, noise, surrounding green, and building morphology. These data are based on the geographical coordinates of the participant’s residence and processed using Geographical Information Systems (GIS). Mental health status was approached through several validated indicators: the Symptom Checklist-90-R subscales for depressive, anxiety and sleeping disorders and the 12-Item General Health Questionnaire for general well-being. For each mental health outcome, single and multi-exposure models were performed through multivariate logistic regressions.

Results

Our results suggest that traffic-related air pollution (black carbon, NO₂, PM₁₀) exposure was positively associated with higher odds of depressive disorders. No association between green surrounding, noise, building morphology and mental health could be demonstrated.

Conclusions

These findings have important implications because most of the Brussel’s population resides in areas where particulate matters concentrations are above the World Health Organization guidelines. This suggests that policies aiming to reduce traffic related-air pollution could also reduce the burden of depressive disorders in Brussels.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10557-7.

Environmental noise in hospitals: a systematic review

Environmental noise has been growing in recent years, causing numerous health problems. Highly sensitive environments such as hospitals deserve special attention, since noise can aggravate patients' health issues and impair the performance of healthcare professionals. This work consists of a systematic review of scientific articles describing environmental noise measurements taken in hospitals between the years 2015 and 2020. The researchers started with a consultation of three databases, namely, Scopus, Web of Science, and ScienceDirect. The results indicate that for the most part, these studies are published in journals in the fields of medicine, engineering, environmental sciences, acoustics, and nursing and that most of their authors work in the fields of architecture, engineering, medicine, and nursing. These studies, which are concentrated in Europe, the Americas, and Asia, use as reference values sound levels recommended by the World Health Organization. L_eq measured in hospital environments showed daytime values ranging from 37 to 88.6 dB (A) and nighttime values of 38.7 to 68.8 dB (A). L_eq values for outdoor noise were 74.3 and 56.6 dB (A) for daytime and nighttime, respectively. The measurements were taken mainly inside hospitals, prioritizing more sensitive departments such as intensive care units. There is a potential for growth in work carried out in this area, but research should also include discussions about guidelines for improvement measures aimed at reducing noise in hospitals.

Road and railway noise and risk for breast cancer: A nationwide study covering Denmark

OBJECTIVE

Previous studies have suggested that transportation noise may increase risk for breast cancer, but existing literature is scarce and inconclusive. We aimed to investigate associations between road traffic and railway noise and risk for breast cancer across the entire Danish female population.

METHODS

For all 2.8 million residential addresses across Denmark, we modelled road and railway noise at the most and least exposed façades for the period 1990-2017. We calculated 10-year time-weighted mean noise exposure for 1.8 million women aged >35 years, of whom 66,006 developed breast cancer during follow-up from 2000 to 2017. We analysed data using Cox proportional hazards models with noise exposure included as 10-year running means and adjusted for a number of individual and area-level socioeconomic co-variates and air pollution with fine particles estimated for all addresses.

RESULTS

For exposures at the least exposed façade, we found that a 10 dB increase in 10-year time-weighted noise was associated with incidence rate ratios (IRRs) and 95% confidence intervals (CI) for breast cancer of 1.032 (1.019-1.046) for road noise and 1.023 (0.993-1.053) for railway noise. For exposures at the most exposed façade, the IRRs (95% CIs) were 1.012 (1.002-1.022) for road noise and 1.020 (1.001-1.039) for railway noise. Associations were strongest among women with human epidermal growth factor receptor 2 negative breast cancer.

CONCLUSIONS

Road traffic and railway noise were associated with higher risk for breast cancer, especially noise at the least exposed façade, which is a proxy for noise exposure during sleep.

Sleep actigraphy time-synchronized with wind turbine output

Studies have yielded inconsistent evidence for an association between long-term average wind turbine sound pressure level (SPL) and disturbed sleep. Transient changes in sleep may be more susceptible to short-term variations in wind turbine SPL throughout the sleep period time. We analyzed sleep actigraphy data (subject sleep nights=2094, males=151, females=192) in 10 min intervals time-synchronized to wind turbine supervisory control and data acquisition. Calculated indoor wind turbine SPL was considered after adjusting for turbine rotor speed and closed/open bedroom windows. Maximum calculated nightly average wind turbine SPL reached 44.7 dBA (mean=32.9, SD=6.4) outdoors, and 31.4 dBA (mean=12.5, SD=8.3) indoors. Wind turbine SPL in 10 min intervals, and nightly averages, were not statistically associated with actigraphy outcomes. However, the variability in wind turbine SPL due to changes in wind turbine operation across the sleep period time, as measured by the difference between the 10 min SPL and the nightly average SPL (∆SPL), was statistically related to awakenings (p=0.028) and motility (p=0.015) rates. These diminutive differences translate to less than 1 min of additional awake and motility time for a 5 dBA increase over a 450 min sleep period time. Overall results showed that wind turbine SPL below 45 dBA was not associated with any consequential changes in actigraphy-measured sleep. Observations based on ∆SPL provided some indication that a more sensitive assessment of sleep may be one that considers variations in wind turbine SPL throughout the sleep period time.

Transportation noise and risk of stroke: a nationwide prospective cohort study covering Denmark

BACKGROUND

Studies on transportation noise and incident stroke are few and inconclusive. We aimed to investigate associations between road-traffic and railway noise and the risk of incident stroke in the entire Danish population.

METHODS

We estimated road-traffic and railway noise (Lden) at the most and least exposed façades for all residential addresses across Denmark (2.8 million) for the period 1990-2017. Based on this, we estimated the 10-year time-weighted mean noise exposure for 3.6 million Danes aged >35 years, of whom 184 523 developed incident stroke during follow-up from 2000 to 2017. Analyses were conducted using Cox proportional-hazards models, with adjustment for various individual- and area-level demographic and socio-economic covariates collected from registries and air pollution [fine particulate matter with particles with a diameter of ≤2.5 µm (PM2.5) and nitrogen dioxide (NO2)].

RESULTS

A 10-dB increase in the 10-year mean road-traffic noise at the most exposed façade was associated with an incidence rate ratio (IRR) of 1.04 [95% confidence interval (CI): 1.03-1.05] for all strokes. For road-traffic noise at the least exposed façade, the IRR per 10 dB was 1.03 (95% CI: 1.02-1.04) for all strokes. Railway noise was not associated with a higher risk of stroke.

CONCLUSION

Road-traffic noise increased the risk of stroke. These findings add to the evidence of road-traffic noise as a cardiovascular risk factor.

Association of long-term exposure to ambient air pollution with the incidence of sleep disorders: A cohort study in China

BACKGROUND

Sleep disorders have been verified to be associated with adverse health outcomes. Recent studies have linked ambient air pollution to sleep disorders. However, evidence with large sample size and especially prospective studies is very limited.

METHODS

We used data from a prospective cohort study established from 2015 to 2018 in Ningbo, China. Participants were followed-up after baseline survey through linkage to the regional Health Information System (HIS). Sleep disorders were defined based on International Classification of Disease 10 (ICD-10). Spatial-temporal land-use regression (LUR) models were used to estimate the annual exposure to particulate matter with diameter ≤ 2.5 µm (PM_2.5), ≤ 10 µm (PM₁₀) and nitrogen dioxides (NO₂). The associations between long-term exposure to air pollutants and prevalence of sleep disorders were examined using logistic regression models, and Cox regression models for the effects of air pollution on the incidence of sleep disorders. A generalized weighted quantile sum (gWQS) regression was used in the multipollutant analysis.

RESULTS

A total of 38,775 participants were included in the final analysis. Based on baseline data, we observed significant positive associations between air pollution exposure and increased odds of prevalent sleep disorders (Odds Ratio (OR)= 1.48, 95% confidence interval (CI): 1.41-1.55 for PM_2.5; OR= 1.47,95%CI:1.38-1.57 for PM₁₀; OR= 1.38, 95%CI:1.31-1.46 for NO₂). In the longitudinal analysis, hazard ratios for incident sleep disorders associated with per interquartile range (IQR) increase in PM_2.5, PM₁₀ and NO₂ were 1.14 (1.03, 1.25), 1.13 (1.01, 1.27) and 1.13 (1.04, 1.23), respectively. A gWQS regression analysis showed significant association between air pollution mixture and incident sleep disorders (OR=1.11, 95%CI: 1.03-1.20).

CONCLUSIONS

Long-term exposure to PM_2.5, PM₁₀ and NO₂ were associated with increased risk of sleep disorders in a Chinese population. Our findings could provide evidence for a more general role in the adverse health impact of air pollution.

K-complexes are a sensitive marker of noise-related sensory processing during sleep: A pilot study

STUDY OBJECTIVES

The primary aim of this study was to examine dose-response relationships between sound pressure levels (SPLs) and K-complex occurrence probability for wind farm and road traffic noise. A secondary aim was to compare K-complex dose-responses to manually scored EEG arousals and awakenings.

METHODS

Twenty-five participants underwent polysomnography recordings and noise exposure during sleep in a laboratory. Wind farm and road traffic noise recordings of 20-sec duration were played in random order at 6 SPLs between 33 - 48 dBA during established N2 or deeper sleep. Noise periods were separated with periods of 23 dBA background noise. K-complexes were scored using a validated algorithm. K-complex occurrence probability was compared between noise types controlling for noise SPL, subjective noise sensitivity and measured hearing acuity.

RESULTS

Noise-induced K-complexes were observed in N2 sleep at SPLs as low as 33 dBA (Odds ratio, 33dBA vs 23 dBA, mean (95% confidence interval); 1.75 (1.16, 2.66)) and increased with SPL. EEG arousals and awakenings were only associated with noise above 39 dBA in N2 sleep. K-complexes were 2 times more likely to occur in response to noise than EEG arousals or awakenings. Subjective noise sensitivity and hearing acuity were associated with K-complex occurrence, but not arousal or awakening. Noise type did not detectably influence K-complexes, EEG arousals or awakening responses.

CONCLUSION

These findings support that K-complexes are a sensitive marker of sensory processing of environmental noise during sleep and that increased hearing acuity and decreased self-reported noise sensitivity increase K-complex probability.

Associations between neighbourhood street pattern, neighbourhood socioeconomic status and sleep in adults

Sleep duration is a risk factor for poor health and all-cause mortality. Evidence suggests that neighbourhood characteristics such as built environment and socioeconomic status (SES) may affect sleep duration in adults. This study examined the relationship between neighbourhood built environment (i.e., measured via the street pattern) and SES with sleep duration in adults (n = 797) from 12 neighbourhoods in Calgary (Canada). Covariate adjusted linear and multinomial logistic regression models estimated the associations between street pattern (grid, warped-grid, curvilinear), SES and sleep duration. We also tested if the interaction between street pattern and SES was associated with sleep duration. Although neighbourhood street pattern and neighbourhood SES were not independently associated with sleep, the interaction between street pattern and neighbourhood SES, was associated with mean sleep duration. Individuals living in curvilinear low SES neighbourhoods had the shortest sleep duration (6.93 h per day; 95% CI 6.68, 7.18), while those living in curvilinear high SES neighbourhoods slept the longest (7.43 h per day; 95% CI 7.29, 7.57). Neighbourhood street pattern and SES, as well as their interaction, were not associated with the odds of sleeping shorter or longer than 7 to 8 h per day. Our findings suggest that the combined effect of the neighbourhood built environment and SES is potentially important for influencing sleep duration. More research is needed to understand the complex interrelationships between the built environment, SES, and sleep.

University Students' Self-Rated Health in Relation to Perceived Acoustic Environment during the COVID-19 Home Quarantine

BACKGROUND

Online education became mandatory for many students during the Coronavirus disease 2019 (COVID-19) pandemic and blurred the distinction between settings where processes of stress and restoration used to take place. The lockdown also likely changed perceptions of the indoor acoustic environment (i.e., soundscape) and raised its importance. In the present study, we seek to understand how indoor soundscape related to university students' self-rated health in Bulgaria around the time that the country was under a state of emergency declaration caused by the COVID-19 pandemic.

METHODS

Between 17 May and 10 June 2020, we conducted a cross-sectional online survey among 323 students (median age 21 years; 31% male) from two universities in the city of Plovdiv, Bulgaria. Self-rated health (SRH) was measured with a single-item. Participants were asked how frequently they heard different types of sounds while at home and how pleasant they considered each of those sounds to be. Restorative quality of the home (the "being away" dimension of the Perceived Restorativeness Scale) was measured with a single-item. A priori confounders and effect modifiers included sociodemographics, house-related characteristics, general sensitivity to environmental influences, and mental health. Our analysis strategy involved sequential exploratory factor analysis (EFA), multivariate linear and ordinal regressions, effect modification tests, and structural equation modeling (SEM).

RESULTS

EFA supported grouping perceived sounds into three distinct factors-mechanical, human, and nature sounds. Regression analyses revealed that greater exposure to mechanical sounds was consistently associated with worse SRH, whereas no significant associations were found for human and nature sounds. In SEM, exposure to mechanical sounds related to lower restorative quality of the home, and then to poorer SRH, whereas nature sounds correlated with higher restorative quality, and in turn with better SRH.

CONCLUSIONS

These findings suggest a role of positive indoor soundscape and restorative quality for promoting self-rated health in times of social distancing.

University Students' Self-Rated Health in Relation to Perceived Acoustic Environment during the COVID-19 Home Quarantine

BACKGROUND

Online education became mandatory for many students during the Coronavirus disease 2019 (COVID-19) pandemic and blurred the distinction between settings where processes of stress and restoration used to take place. The lockdown also likely changed perceptions of the indoor acoustic environment (i.e., soundscape) and raised its importance. In the present study, we seek to understand how indoor soundscape related to university students' self-rated health in Bulgaria around the time that the country was under a state of emergency declaration caused by the COVID-19 pandemic.

METHODS

Between 17 May and 10 June 2020, we conducted a cross-sectional online survey among 323 students (median age 21 years; 31% male) from two universities in the city of Plovdiv, Bulgaria. Self-rated health (SRH) was measured with a single-item. Participants were asked how frequently they heard different types of sounds while at home and how pleasant they considered each of those sounds to be. Restorative quality of the home (the "being away" dimension of the Perceived Restorativeness Scale) was measured with a single-item. A priori confounders and effect modifiers included sociodemographics, house-related characteristics, general sensitivity to environmental influences, and mental health. Our analysis strategy involved sequential exploratory factor analysis (EFA), multivariate linear and ordinal regressions, effect modification tests, and structural equation modeling (SEM).

RESULTS

EFA supported grouping perceived sounds into three distinct factors-mechanical, human, and nature sounds. Regression analyses revealed that greater exposure to mechanical sounds was consistently associated with worse SRH, whereas no significant associations were found for human and nature sounds. In SEM, exposure to mechanical sounds related to lower restorative quality of the home, and then to poorer SRH, whereas nature sounds correlated with higher restorative quality, and in turn with better SRH.

CONCLUSIONS

These findings suggest a role of positive indoor soundscape and restorative quality for promoting self-rated health in times of social distancing.

Exposure to the road traffic noise in an urban complex in Greece: the quantification of healthy life years lost due to noise-induced annoyance and noise-induced sleep disturbances

In the recent years, the environmental noise is a global issue of great concern. Especially, it is considered to be one of the most deleterious environmental risk factors for the human health and well-being in urban areas. In this study, we focus on the major source of the transportation noise in the modern-day urbanized societies, which is the road traffic noise. The study was performed in the urban complex in Thessaloniki-Neapoli in Greece, and the estimation of the road traffic noise levels was based on the CoRTN (Calculation of Road Traffic Noise) prediction method. In addition, we estimated the EBD (environmental burden of disease), in terms of DALYs (disability-adjusted life years), due to the annoyance and sleep disturbances associated with the exposure to road traffic noise. The estimation of the EBD was based on the strategic noise mapping in Thessaloniki-Neapoli as well as on the guidance document produced by the WHO (World Health Organization) for the quantitative assessment on the humans' health consequences of the environmental noise. Above all, the results revealed the magnitude of the health damage caused by the transportation noise.

[Estimation of Health Risk Posed by Road Traffic Noise in Japan Based on the Environmental Noise Guidelines for the European Region]

OBJECTIVES

Traffic noise exposure is associated with adverse health effects such as environmental sleep disorder, ischaemic heart disease (IHD), stroke and diabetes. The health risks posed by traffic noise were estimated to be quite high in European countries. However, in Japan, no estimation has ever been conducted. In the present study, we estimated the health risk posed by road traffic noise in Japan.

METHODS

We estimated the risks of environmental sleep disorder (high sleep disturbance) and IHD caused by road traffic noise in Japan as of 2015 on the basis of existing noise-exposure estimates, vital statistics of deaths, and patient survey with exposure-response relationships proposed by the Environmental Noise Guidelines for the European Region issued in 2018. We employed old information on noise exposure in 1994 because it is the only information currently available in Japan. We also estimated the health risks of noise exposure levels that were equivalent to the Japanese environmental quality standards.

RESULTS

The estimated numbers of patients with environmental sleep disorder and IHD caused by road traffic noise were approximately 1,200,000 and 9,000, respectively. The estimated number of mortalities from IHD was approximately 1,700. The noise exposure level equivalent to the Japanese noise standards caused a lifetime mortality rate of more than 10^-2, which was extremely high as an environmental health risk.

CONCLUSIONS

As in European countries, road traffic noise was one of the most important environmental risk factors in Japan. However, the current Japanese noise standards are insufficient for the protection of public health.

Framework to manage railway noise exposure in Brazil based on field measurements and strategic noise mapping at the local level

Rail freight transport has grown worldwide and in Brazil as well, which increases people's exposure to railway noise. A promising tool to manage it is Strategic Noise Mapping (SNM), which has advanced around the world favoring a common and more accurate calculation method that requires more accurate measurements. This paper presents a framework to manage railway noise exposure in Brazil based on a case study carried out in the city with the longest stretches of railway tracks in urban areas. Background noise due to road traffic and train pass-by noise levels were measured for knowledge of noise sources and SNM calibration. Background noise predicted by the CNOSSOS-EU (Road) method reached an accuracy within ±2 dB(A) and was overestimated by the NMPB-96 method. The combination with railway noise using the SRM II and ISO 9613 calculation methods maintained the aforementioned accuracy, while the current best fit CNOSSOS-EU (Railway and Industry) configuration for the study area overestimated it. Although the study area is a quiet suburb, a quarter of its population is exposed to road traffic noise levels above those recommended by WHO, and more than 40% are affected by rail noise that is 5 dB(A) or higher than the background noise. The elimination of level crossings (LC) and the need to sound the train horn is more cost-effective than noise barriers. Therefore, the strategy to manage exposure to rail noise in Brazil should involve altering residential zoning of non-built-up areas next to the railways to repurpose them for other land uses and/or establish acoustic performance criteria for new buildings; federal government investing in reducing the number of LC or railway variants; and railway operators investing in the creation of an emission database for noise control at the source.

A Short Form of the Chinese Version of the Weinstein Noise Sensitivity Scale through Optimal Test Assembly

This study developed a short form of the traditional Chinese version of the Weinstein Noise Sensitivity Scale (WNSS) through optimal test assembly (OTA). A total of 1069 Chinese adults (64.8% female) completed the territory-wide cross-sectional study. We first removed Items 12 and 5 which had negative factor loading and gender-related differential item functioning (DIF), respectively. The optimal length was then determined as the minimal one that reasonably resembled the reliability and validity of the scale without DIF items. OTA identified an 8-item WNSS (WNSS-8) which retained 67.2% of the test information of the original 21-item scale and had a Cronbach's alpha of 0.83. It also showed significant correlations of 0.272 and -0.115 with the neuroticism and extraversion scales of Chinese NEO-Five Factor Inventory, respectively. Adequate model fit of the WNSS-8 was demonstrated by the confirmatory factor analysis. The Chinese WNSS-8 can be used to assess noise sensitivity without compromising reliability and validity.

A Psychoacoustic Approach to Building Knowledge about Human Response to Noise of Unmanned Aerial Vehicles

We are on the cusp of a revolution in the aviation sector, driven by the significant progress in electric power and battery technologies, and autonomous systems. Several industry leaders and governmental agencies are currently investigating the use of Unmanned Aerial Vehicles (UAVs), or "drones" as commonly known, for an ever-growing number of applications-from blue light services to parcel delivery and urban mobility. Undoubtedly, the operation of UAVs will lead to noise exposure, which has the potential to become a significant public health issue. This paper first describes the main acoustic and operational characteristics of UAVs, as an unconventional noise source compared to conventional civil aircraft. Gaps in the literature and the regulations on the noise metrics and acceptable noise levels are identified and discussed. The state-of-the-art evidence on human response to aircraft and other environmental noise sources is reviewed and its application for UAVs discussed. A methodological framework is proposed for building psychoacoustic knowledge, to inform systems and operations development to limit the noise impact on communities.

Rest-activity rhythms in emerging adults: implications for cardiometabolic health

Emerging adulthood (18-25 years) represents a window of opportunity to modify the trajectory of cardiometabolic disease risk into older adulthood. Not known is the extent to which rest-activity rhythms (RAR) may be related to biomarkers of cardiometabolic health in this population. In this cross-sectional, observational study, 52 healthy emerging adults wore wrist accelerometers (14 consecutive days; 24 h/day) for assessment of nonparametric RAR metrics, including interdaily stability (IS; day-to-day RAR consistency), intradaily variability (IV; within-day RAR fragmentation), and relative amplitude (RA; robustness of RAR), as well as autocorrelation (correlation of rest/activity levels at 24-h lag-times). Cardiometabolic biomarkers, including body mass index (BMI), body fat percentage, blood pressure (BP), fasting lipids, glucose, and C-reactive protein (CRP) were assessed. Additional measures including physical activity, sleep duration, and habitual caffeine and alcohol consumption were also evaluated. A series of multivariable regression models of cardiometabolic biomarkers were used to quantify associations with RAR metrics. On average, participants were 20 ± 1 years of age (21 males, 31 females), non-obese, and non-hypertensive. All were nonsmokers and free of major diseases or conditions. In separate models, which adjusted for sex, BMI, moderate-vigorous physical activity, sleep duration, caffeine, and alcohol consumption, IS was inversely associated with total cholesterol (p ≤ 0.01) and non-HDL cholesterol (p < .05), IV was positively associated with CRP (p < .05), and autocorrelation was inversely associated with total cholesterol (p < .05) and CRP (p < .05). Conversely, associations between RA and cardiometabolic biomarkers were nonsignificant after adjustment for BMI, alcohol, and caffeine consumption. In conclusion, RAR metrics, namely, a higher IS, lower IV, and higher autocorrelation, emerged as novel biomarkers associated with more favorable indices of cardiometabolic health in this sample of apparently healthy emerging adults.

Self-rated health status in relation to aircraft noise exposure, noise annoyance or noise sensitivity: the results of a cross-sectional study in France

BACKGROUND

Noise is a major public health issue because of its negative impacts on health, including annoyance, sleep disturbance, cardiovascular diseases and altered cognitive performance among children. Self-rated health status (SRHS) can be considered as a reliable indicator of quality of life, morbidity and mortality but few studies have considered SRHS in relation to aircraft noise exposure. The present study aims to investigate the association between this exposure and SRHS of people living near airports in France, and to consider the mediating or moderating role of aircraft noise annoyance and noise sensitivity in this association.

METHODS

This cross-sectional study included 1242 participants older than 18 and living near three major French airports. Information on their SRHS, aircraft noise annoyance, noise sensitivity and demographic, socioeconomic and lifestyle factors was collected during a face-to-face interview performed at home. Outdoor aircraft noise levels were estimated for each participant's home address using noise maps. Logistic regressions with adjustment for potential confounders were used. The moderating and mediating effects of aircraft noise annoyance and noise sensitivity were investigated following Baron and Kenny's recommendations.

RESULTS

A significant association was shown between aircraft noise levels and a fair/poor SRHS, only in men (OR=1.55, 95%CI 1.01-2.39, for a 10 dB(A)-increase in L_den). This relationship was higher in men highly sensitive to noise (OR=3.26, 95%CI 1.19-8.88, for a 10 dB(A)-increase in L_den). Noise sensitivity was associated with a fair/poor SRHS significantly in women (OR=1.74, 95%CI 1.12-2.68) and at the borderline of significance in men (OR=1.68, 95% CI 0.94-3.00), whereas aircraft noise annoyance was associated with a fair/poor SRHS only in men (OR=1.81, 95%CI 1.00-3.27).

CONCLUSION

The present study confirms findings in the small number of available studies to date suggesting a positive association between aircraft noise levels and a fair/poor SRHS. These results also support the hypothesis that noise sensitivity would moderate this association. However, a mediating effect of annoyance cannot be excluded.

Defining pathways to healthy sustainable urban development

Goals and pathways to achieve sustainable urban development have multiple interlinkages with human health and wellbeing. However, these interlinkages have not been examined in depth in recent discussions on urban sustainability and global urban science. This paper fills that gap by elaborating in detail the multiple links between urban sustainability and human health and by mapping research gaps at the interface of health and urban sustainability sciences. As researchers from a broad range of disciplines, we aimed to: 1) define the process of urbanization, highlighting distinctions from related concepts to support improved conceptual rigour in health research; 2) review the evidence linking health with urbanization, urbanicity, and cities and identify cross-cutting issues; and 3) highlight new research approaches needed to study complex urban systems and their links with health. This novel, comprehensive knowledge synthesis addresses issue of interest across multiple disciplines. Our review of concepts of urban development should be of particular value to researchers and practitioners in the health sciences, while our review of the links between urban environments and health should be of particular interest to those outside of public health. We identify specific actions to promote health through sustainable urban development that leaves no one behind, including: integrated planning; evidence-informed policy-making; and monitoring the implementation of policies. We also highlight the critical role of effective governance and equity-driven planning in progress towards sustainable, healthy, and just urban development.

Associations and effect modification between transportation noise, self-reported response to noise and the wider determinants of health: A narrative synthesis of the literature

Noise and health guidance to date have focused on the direct links between noise and health outcomes such as annoyance, sleep disturbance, cardiovascular and metabolic disease, and cognitive impairment in schoolchildren. However, noise is a psychosocial stressor, and there are individual studies showing that exposure to noise or the self-reported responses to noise may affect health through interactions with the wider determinants of health and well-being including physical activity, use of green spaces and social interactions. Despite this emerging evidence concerning potential impacts of noise on the wider determinants of health, literature in the field remains dispersed and unsynthesised. This study seeks to synthetize evidence on different relationships between transportation noise, self-reported responses to noise and the wider determinants of health using a systematic review methodology. The search was conducted in Medline, PsycINFO, PubMed, and Scopus on articles published from 2000 to 2017. This led to the review of 76 papers which satisfied the inclusion criteria. Despite strong heterogeneity in the studies' methodologies and indicators used, there is some evidence that noise exposure and responses to noise such as annoyance and disturbance are associated with people's lifestyle, recreational activities as well as the local economy of the neighbourhood. On the other hand, there are some wider determinants of health, mainly those related to the built and natural environment, which modify the relationship between noise exposure and self-reported responses to noise. In particular, greenness, having access to quiet areas, and covering noise sources either visually or acoustically with natural features seems to decrease people's negative responses to noise. Results indicate that transportation noise has the potential to affect health through various pathways, and a holistic approach is needed to capture all the effects.

Association between residential greenness and sleep quality in Chinese rural population

BACKGROUND

Epidemiological studies on the association of residential greenness with sleep quality are limited in China.

OBJECTIVE

This study aims to investigate the association of long-term exposure to residential greenness with sleep quality in rural China.

METHODS

In our study, 27,654 rural residents were selected from 4 counties of Henan Province by a multi-stage stratified cluster sampling method. Participants' sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI), two satellite-derived vegetation indexes, were used to assess the level of residential greenness. Long-term greenness exposure was defined as the averages of NDVI and EVI during the three years prior to the baseline survey. The relationship between sleep quality and greenness was assessed using the mixed-effect linear regression models.

RESULTS

Among 27,654 rural residents, the mean age was 55.89 years (standard deviation, SD = 12.22) and 60.18% of them were female. In the crude model, the PSQI score decreased with per interquartile range (IQR) increase in EVI and NDVI [ΔPSQI score (95% confidence interval, 95%CI): -0.073 (-0.115, -0.030) and -0.047 (-0.089, -0.002)]. After controlling potential confounders, ΔPSQI scores and 95%CIs were -0.055 (-0.095, -0.012) and -0.090 (-0.151, -0.025) associated with per IQR increment in EVI and NDVI. The results of stratified analyses showed the effect of residential greenness on sleep was stronger among males and individuals with higher household income and educational attainment than females and those with lower household income and educational attainment. Moreover, the modification effect of air pollution was observed in the greenness-sleep association.

CONCLUSIONS

Our study indicated that higher residential greenness was significantly associated with better sleep quality in Chinese rural population, which highlights the significant effect of green space on human health.

Estimating the health benefits associated with a speed limit reduction to thirty kilometres per hour: A health impact assessment of noise and road traffic crashes for the Swiss city of Lausanne

Reductions of speed limits for road traffic are effective in reducing casualties, and are also increasingly promoted as an effective way to reduce noise exposure. The aim of this study was to estimate the health benefits of the implementation of 30 km/h speed limits in the city of Lausanne (136'077 inhabitants) under different scenarios addressing exposure to noise and road crashes. The study followed a standard methodology for quantitative health impact assessments to derive the number of attributable cases in relation to relevant outcomes. We compared a reference scenario (without any 30 km/h speed limits) to the current situation with partial speed limits and additional scenarios with further implementation of 30 km/h speed limits, including a whole city scenario. Compared to the reference scenario, noise reduction due to the current speed limit situation was estimated to annually prevent 1 cardiovascular death, 72 hospital admissions from cardiovascular disease, 17 incident diabetes cases, 1'127 individuals being highly annoyed and 918 individuals reporting sleep disturbances from noise. Health benefits from a reduction in road traffic crashes were less pronounced (1 severe injury and 4 minor injuries). The whole city speed reduction scenario more than doubled the annual benefits, and was the only scenario that contributed to a reduction in mortality from road traffic crashes (one death per two years). Implementing 30 km/h speed limits in a city yields health benefits due to reduction in road traffic crashes and noise exposure. We found that the benefit from noise reduction was more relevant than safety benefits.

Development of a new night-time noise index: Integration of neurophysiological theory and epidemiological findings

Background:

The effects of environmental noise on sleep are of great interest to public health. Numerous studies have been conducted to investigate these effects; however, these previous studies applied existing sound-level statistics that were not based on neurophysiology.

Aims:

This study aimed to develop a new night-time noise index based on neurophysiology and epidemiology.

Methods:

First, we derived a formula for predicting the noise effects on sleep based on a neurophysiological model of brainstem sleep regulation, where awakening was associated with greater electrical potentials in the brainstem. Second, we investigated the noise effects on sleep using the results of an epidemiological study conducted in the vicinity of the Kadena military airfield in Okinawa, Japan. Thirty volunteers participated in the study. Vibrations of whole-body movements were recorded using sheet-shaped sleep monitors for 26 consecutive nights. The onset of motility, which was defined by monitor vibrations, was used to index awakening reactions.

Results:

Our statistical model could properly predict the fluctuating risk of motility onset. The new index, which is the mean of the sound level above 60 dB, can be successfully used, irrespective of the duration of noise exposure. Additionally, it out-performed existing event-related noise indices.

Conclusions:

We derived a new night-time noise index for evaluating the noise effects on sleep. To our knowledge, this is the first study to explain the noise effects on sleep with the consideration of neurophysiology and epidemiology.

A systematic review and meta-analysis of wind turbine noise effects on sleep using validated objective and subjective sleep assessments

Little is known about the potential impacts of wind turbine noise (WTN) on sleep. Previous research is limited to cross-sectional studies reporting anecdotal impacts on sleep using inconsistent sleep metrics. This meta-analysis sought to comprehensively review studies evaluating the impact of WTN using widely accepted and validated objective and subjective sleep assessments. Search terms included: "wind farm noise", "wind turbine noise", "wind turbine sound", "wind turbine noise exposure" AND "sleep". Only original articles published in English published after the year 2000 and reporting sleep outcomes in the presence of WTN using polysomnography, actigraphy or psychometrically validated sleep questionnaires were included. Uniform outcomes of the retrieved studies were meta-analysed to examine WTN effects on objective and subjective sleep outcomes. Nine studies were eligible for review and five studies were meta-analysed. Meta-analyses (Hedges' g; 95% confidence interval [CI]) revealed no significant differences in objective sleep onset latency (0.03, 95%  CI -0.34 to 0.41), total sleep time (-0.05, 95%  CI -0.77 to 0.67), sleep efficiency (-0.25, 95%  CI -0.71 to 0.22) or wake after sleep onset (1.25, 95%  CI -2.00 to 4.50) in the presence versus absence of WTN (all p > .05). Subjective sleep estimates were not meta-analysed because measurement outcomes were not sufficiently uniform for comparisons between studies. This systematic review and meta-analysis suggests that WTN does not significantly impact key indicators of objective sleep. Cautious interpretation remains warranted given variable measurement methodologies, WTN interventions, limited sample sizes, and cross-sectional study designs, where cause-and-effect relationships are uncertain. Well-controlled experimental studies using ecologically valid WTN, objective and psychometrically validated sleep assessments are needed to provide conclusive evidence regarding WTN impacts on sleep.

Dynamic Evaluation of Traffic Noise through Standard and Multifractal Models

Traffic microsimulation models use the movement of individual driver-vehicle-units (DVUs) and their interactions, which allows a detailed estimation of the traffic noise using Common Noise Assessment Methods (CNOSSOS). The Dynamic Traffic Noise Assessment (DTNA) methodology is applied to real traffic situations, then compared to on-field noise levels from measurement campaigns. This makes it possible to determine the influence of certain local traffic factors on the evaluation of noise. The pattern of distribution of vehicles along the avenue is related to the logic of traffic light control. The analysis of the inter-cycles noise variability during the simulation and measurement time shows no influence from local factors on the prediction of the dynamic traffic noise assessment tool based on CNOSSOS. A multifractal approach of acoustic waves propagation and the source behaviors in the traffic area are implemented. The novelty of the approach also comes from the multifractal model’s freedom which allows the simulation, through the fractality degree, of various behaviors of the acoustic waves. The mathematical backbone of the model is developed on Cayley–Klein-type absolute geometries, implying harmonic mappings between the usual space and the Lobacevsky plane in a Poincaré metric. The isomorphism of two groups of SL(2R) type showcases joint invariant functions that allow associations of pulsations–velocities manifolds type.

A Conceptual Model of the Healthy Acoustic Environment: Elements, Framework, and Definition

Noise has been proved to be a risk factor of physiological and psychological health. Therefore, creating a high-quality acoustic environment for people is particularly important. The aims of this study are to explore the basic elements, propose a conceptual framework, and identify the definition of a healthy acoustic environment. Through the method of grounded theory, 75 respondents participated in interviews. The results revealed that (1) "sound sources and acoustic environment," "people's demands," "criteria and standards of a healthy acoustic environment," "matching process," "secondary fitting process," "context," and "acoustic environment quality" are the basic elements of a healthy acoustic environment; (2) "matching process" and "secondary fitting process" connect all the other categories and reflect the processes by which a healthy acoustic environment is judged; (3) based on the associations revealed in the framework, a healthy acoustic environment is defined as a supportive acoustic environment that can match people's physiological, psychological, and behavioral demands in context, and that also fits the criteria and standards. The proposal of a conceptual model for a healthy acoustic environment can provide a new perspective on designing and establishing a high-quality acoustic environment required by people in the near future.

With Corona Outbreak: Nature Started Hitting the Reset Button Globally

Considering the potential threat and the contagious nature of the Covid-19 pandemic, lockdowns have been implemented worldwide to stop the spread of this novel virus. The coronavirus pandemic has hit the world severely, representing the most severe threat to human health in more than a century. The environment from local to global scales has witnessed apparent positive and negative impacts. Global lockdowns have drastically altered the patterns of energy demand and have caused an economic downturn but at the same time, have provided an upside-cleaner global environment. Such immense unintended advantages offer opportunities for unprecedented insights into the dynamics of our natural and built environments that can lead to viable paths for the conservation and perpetuation of the recovered environments and through sensible policies and practices that can help to create new recovery pathways. Knowledge gained from the studies suggests that a substantial relationship exists between the contingency measures and environmental health. Here in this review, the authors discussed the impact of coronavirus pandemic on human life, healthcare organizations, and the environment. The parallels between the Covid-19 and other diseases are mentioned. Finally, the impact of Covid-19 on society and the global environment has also been highlighted.

Noise as a sleep aid: A systematic review

White noise is purported to mask disruptive noises in the bedroom environment and be a non-pharmacological approach for promoting sleep and improving sleep quality. We conducted a systematic review of all studies examining the relationships between continuous white noise or similar broadband noise and sleep (PROSPERO 2020: CRD42020148736). Animal studies and studies using intermittent white noise to disrupt sleep or enhance slow wave activity were excluded. Two reviewers independently screened titles and abstracts of articles from three databases and assessed risk of bias for the 38 included articles. The primary outcomes described sleep onset latency, sleep fragmentation, sleep quality, and sleep and wake duration. There was heterogeneity in noise characteristics, sleep measurement methodology, adherence to the intervention, control group conditions or interventions, and presence of simultaneous experimental interventions. There was perhaps resultantly variability in research findings, with the extremes being that continuous noise improves or disrupts sleep. Following the GRADE criteria, the quality of evidence for continuous noise improving sleep was very low, which contradicts its widespread use. Additional research with objective sleep measures and detailed descriptions of noise exposure is needed before promoting continuous noise as a sleep aid, especially since it may also negatively affect sleep and hearing.

Traffic Noise and Mental Health: A Systematic Review and Meta-Analysis

Recent evidence suggests that traffic noise may negatively impact mental health. However, existing systematic reviews provide an incomplete overview of the effects of all traffic noise sources on mental health. We conducted a systematic literature search and summarized the evidence for road, railway, or aircraft noise-related risks of depression, anxiety, cognitive decline, and dementia among adults. We included 31 studies (26 on depression and/or anxiety disorders, 5 on dementia). The meta-analysis of five aircraft noise studies found that depression risk increased significantly by 12% per 10 dB L_DEN (Effect Size = 1.12, 95% CI 1.02–1.23). The meta-analyses of road (11 studies) and railway traffic noise (3 studies) indicated 2–3% (not statistically significant) increases in depression risk per 10 dB L_DEN. Results for road traffic noise related anxiety were similar. We did not find enough studies to meta-analyze anxiety and railway or aircraft noise, and dementia/ cognitive impairment and any traffic noise. In conclusion, aircraft noise exposure increases the risk for depression. Otherwise, we did not detect statistically significant risk increases due to road and railway traffic noise or for anxiety. More research on the association of cognitive disorders and traffic noise is required. Public policies to reduce environmental traffic noise might not only increase wellness (by reducing noise-induced annoyance), but might contribute to the prevention of depression and anxiety disorders.

Sleep in Isolated, Confined, and Extreme (ICE): A Review on the Different Factors Affecting Human Sleep in ICE

The recently renewed focus on the human exploration of outer space has boosted the interest toward a variety of questions regarding health of astronauts and cosmonauts. Among the others, sleep has traditionally been considered a central issue. To extend the research chances, human sleep alterations have been investigated in several analog environments, called ICEs (Isolated, Confined, and Extreme). ICEs share different features with the spaceflight itself and have been implemented in natural facilities and artificial simulations. The current paper presents a systematic review of research findings on sleep disturbances in ICEs. We looked for evidence from studies run in polar settings (mostly Antarctica) during space missions, Head-Down Bed-Rest protocols, simulations, and in a few ICE-resembling settings such as caves and submarines. Even though research has shown that sleep can be widely affected in ICEs, mostly evidencing general and non-specific changes in REM and SWS sleep, results show a very blurred picture, often with contradictory findings. The variable coexistence of the many factors characterizing the ICE environments (such as isolation and confinement, microgravity, circadian disentrainment, hypoxia, noise levels, and radiations) does not provide a clear indication of what role is played by each factor per se or in association one with each other in determining the pattern observed, and how. Most importantly, a number of methodological limitations contribute immensely to the unclear pattern of results reported in the literature. Among them, small sample sizes, small effect sizes, and large variability among experimental conditions, protocols, and measurements make it difficult to draw hints about whether sleep alterations in ICEs do exist due to the specific environmental characteristics, and which of them plays a major role. More systematic and cross-settings research is needed to address the mechanisms underlying the sleep alterations in ICE environments and possibly develop appropriate countermeasures to be used during long-term space missions.

Long-term residential road traffic noise and mortality in a Danish cohort

Transportation noise is a growing public health concern worldwide and epidemiological evidence has linked road traffic noise with mortality. However, incongruent effect estimates have been reported between incidence and mortality studies. Therefore, the present study aimed to investigate whether long-term exposure to residential road traffic noise at the most and least exposed façades was associated with all-cause, cardiovascular disease (CVD), ischemic heart disease (IHD), stroke, respiratory, or cancer mortality in a Danish cohort study. In a cohort of 52,758 individuals from Copenhagen and Aarhus, we estimated road traffic noise at the most and least exposed façades, as well as ambient air pollution, at all present and historical residential addresses from 1987 to 2016. Using the Danish cause of death register we identified cause-specific mortality. Analyses were conducted using Cox proportional hazards models. Ten-year time-weighted mean road traffic noise exposure at the most exposed façade was associated with an 8% higher risk for all-cause mortality per interquartile range (IQR; 10.4 dB) higher exposure level (95% CI: 1.05-1.11). Higher risks were also observed for CVD (HR = 1.13, 95% CI: 1.06-1.19) and stroke (HR = 1.11, 95% CI: 0.99-1.25) mortality. Road traffic noise at the least exposed façade (per IQR; 8.4 dB) was associated with CVD (HR = 1.09, 95% CI: 1.03-1.15), IHD (HR = 1.10, 95% CI: 1.01-1.21) and stroke (HR = 1.06, 95% CI: 0.95-1.19) mortality. Results were robust to adjustment for PM_2.5 and NO₂. In conclusion, this study adds to the body of evidence linking exposure to road traffic noise with higher risk of mortality.

[Adverse health effects due to environmental noise exposure in urban areas]

Environmental noise is a great burden for the population in Germany, especially in urban areas. People are often exposed not only to one but several noise sources. Long-term exposure to environmental noise can have several and severe adverse effects on human health, such as noise annoyance, sleep disturbances, ischaemic heart disease and depression. Additional burdens arise from multiple exposure to particulate matter or air pollutants. The current article describes the relevant adverse health effects due to long-term environmental noise exposure, discusses the challenges of environmental noise in urban areas different and introduces measures and instruments to abate environmental noise.

Acoustics for Supportive and Healthy Buildings: Emerging Themes on Indoor Soundscape Research

The focus of the building industry and research is shifting from delivering satisfactory spaces to going beyond what is merely acceptable with a wave of new research and practice dedicated to exploring how the built environment can support task performance and enhance people’s health and well-being. The present study addresses the role of acoustics in this paradigm shift. Indoor soundscape research has recently emerged as an approach that brings a perceptual perspective on building and room acoustics in order to shape built environments that “sound good” according to building occupants’ preference and needs. This paper establishes an initial discussion over some of the open questions in this field of research that is still in an embryonic stage. A thematic analysis of structured interviews with a panel of experts offered a range of perspectives on the characterization, management, and design of indoor soundscapes and health-related outcomes. The discussion pointed out the importance of both perceptual and multisensory research and integrated participatory design practices to enable a holistic view regarding the complex building–user interrelations and the design of just cities. Soundscape methodologies tailored to the peculiarities of indoor soundscapes can help to measure and predict the human perceptual response to the acoustic stimuli in context, thus reducing the risk of mismatches between expected and real building experiences. This perceptual perspective is expected to widen the scientific evidence for the negative and positive impacts of the acoustic environment on human health, well-being, and quality of life. This will support prioritizing the role of acoustics in building design and challenge many current design practices that are based on a noise control approach.

[Combined effects of different environmental factors on health: air pollution, temperature, green spaces, pollen, and noise]

Environmental factors affect the health and wellbeing of urban residents. However, they do not act individually on humans, but instead show potential synergistic or antagonistic effects. Questions that arise from this are: How does a combination of air pollutants with other environmental factors impact health? How well are these associations evidenced? What methods can we use to look at them? In this article, methodical approaches regarding the effects of a combination of various environmental factors are first described. Environmental factors are then examined, which together with different air pollutants, have an impact on human health such as ambient temperature, noise, and pollen as well as the effect of green spaces. Physical activity and nutrition are addressed regarding the attenuation of health effects from air pollution.While there is often clear evidence of health effects of single environmental stressors, there are still open questions in terms of their interaction. The research methods required for this still need to be further developed. The interrelationship between the different environmental factors make it clear that (intervention) measures for reducing single indicators are also interlinked. Regarding traffic, switching from passive to active transport (e.g., due to safe cycle paths and other measures) leads to less air pollutants, smaller increases in temperature in the long term, and at the same time improved health of the individual. As a result, sensible planning of the built environment has great potential to reduce environmental stressors and improve people's health and wellbeing.

Environmental, Health and Sociodemographic Determinants Related to Common Mental Disorders in Adults: A Spanish Country-Wide Population-Based Study (2006-2017)

Common mental disorders (CMD) represent a serious, growing public health concern, especially in women. The aims of this study were to report the prevalence of CMD among the adult population in Spain, to analyze the time trends from 2006 to 2017 and to explore the associations between CMD and gender, in relation to the perceived environmental and sociodemographic problems and clinical factors. A nationwide cross-sectional study was conducted including 48,505 participants aged 16 to 64 years old who had participated in the Spanish National Health Surveys in 2006, 2011/2012 and 2017. A logistic regression analysis was performed to identify the variables associated with CMD by gender. The prevalence of CMD was 20.4% in 2006, 20.8% in 2011/2012 and 16.9% in 2017 (p = 0.36). In women, the probability of having a CMD was higher in widowed or separated/divorced compared with single individuals and as the perception of distressing noise levels from outside the home increased. The probability of CMD was lower as the level of education increased in men. Foreigners and those with limitations due to health problems, chronic conditions and worse perceived health were more likely to suffer from a CMD in both women and men.

Night-time Noise Levels and Patients’ Sleep Experiences in a Medical Assessment Unit in Northern England

Background:

Hospital in-patients need sleep so that restorative process and healing can take place. However, over one third of in-patients experience sleep disturbance, often caused by noise. This can compromise patients’ perceptions of care quality and cause physical and psychological ill health.

Aims:

To assess 1) in-patients sleep quality, quantity, reported sources of sleep disturbance and their suggestions for improvement 2) objectively measure decibel levels recorded at night.

Methods:

This descriptive study conducted in a Medical Assessment Unit used multi-methods; a semi-structured ‘sleep experience’ questionnaire administered to a purposive sample of in-patients; recording of night-time noise levels, on 52 consecutive nights, using two calibrated Casella sound level meters.

Results:

Patient ratings of ‘in-hospital’ sleep quantity (3.25; 2.72 SD) and quality (2.91; 2.56 SD) was poorer compared to ‘home’ sleep quantity (5.07; 2.81 SD) and quality (5.52; 2.79 SD). The difference in sleep quality (p<0.001) and quantity (p<0.001) ratings whilst in hospital, compared to at home, was statistically significant. Care processes, noise from other patients and the built environment were common sources of sleep disturbance. Participants’ suggestions for improvement were similar to interventions identified in current research. The constant noise level ranged from 38-57 decibels (equivalent to an office environment), whilst peak levels reached a maximum of 116 decibels, (equivalent to banging a car door one metre away).

Conclusion:

The self-rated patient sleep experience was significantly poorer in hospital, compared to home. Noise at night contributed to sleep disturbance. Decibel levels were equivalent to those reported in other international studies. Data informed the development of a ‘Sleep Smart’ toolkit designed to improve the in-patient sleep experience.

On the feasibility of measuring physiologic and self-reported sleep disturbance by aircraft noise on a national scale: A pilot study around Atlanta airport

Aircraft noise can disturb sleep and impair recuperation. Research is needed to develop exposure-response relationships that are representative of noise-exposed communities and can be used to inform noise mitigation policy in the United States. For a national field study on physiologic response to aircraft noise during sleep to be feasible, an inexpensive yet sound study methodology is needed. In the pilot study presented here, the methodology of using electrocardiography and actigraphy to monitor sleep was implemented around Atlanta Hartsfield-Jackson International Airport (ATL). The primary objective was to evaluate the quality and quantity of data that could be obtained with the following study approaches: recruiting participants by postal questionnaire, shipping them the physiologic and noise measurement equipment, and the unattended setup of the equipment and recording of data by the participants themselves. The secondary objective was to compare objective and subjective measures of sleep and health between groups exposed to different levels of nocturnal aircraft noise. We mailed 4080 questionnaires containing items on sleep, health and noise disturbance to residences around ATL that were exposed to at least 35 dB L_night aircraft noise. From 407 questionnaire respondents, 34 participants completed five nights of unattended sleep measurements. Data of sufficient quality and quantity to investigate the effects of aircraft noise on sleep were obtained. Self-reported awakenings increased as a function of the highest maximum aircraft noise level occurring during the sleep period. Event-related physiologic awakenings increased as a function of the maximum noise level of individual aircraft noise events, although this effect was of only borderline statistical significance (p = 0.057) likely due to the low sample size of this pilot study. The approach used in the presented pilot study has been demonstrated to be feasible for the purpose of the larger-scale study among a representative population around multiple airports in the future.

Road Traffic Noise Exposure and Filled Prescriptions for Antihypertensive Medication: A Danish Cohort Study

BACKGROUND

Epidemiological research on effects of transportation noise on incident hypertension is inconsistent.

OBJECTIVES

We aimed to investigate whether residential road traffic noise increases the risk for hypertension.

METHODS

In a population-based cohort of 57,053 individuals 50-64 years of age at enrollment, we identified 21,241 individuals who fulfilled our case definition of filling ≥2 prescriptions and ≥180 defined daily doses of antihypertensive drugs (AHTs) within a year, during a mean follow-up time of 14.0 y. Residential addresses from 1987 to 2016 were obtained from national registers, and road traffic noise at the most exposed façade as well as the least exposed façade was modeled for all addresses. Analyses were conducted using Cox proportional hazards models.

RESULTS

We found no associations between the 10-y mean exposure to road traffic noise and filled prescriptions for AHTs, with incidence rate ratios (IRRs) of 0.999 [95% confidence intervals (CI): 0.980, 1.019)] per 10-dB increase in road traffic noise at the most exposed façade and of 1.001 (95% CI: 0.977, 1.026) at the least exposed façade. Interaction analyses suggested an association with road traffic noise at the least exposed façade among subpopulations of current smokers and obese individuals.

CONCLUSION

The present study does not support an association between road traffic noise and filled prescriptions for AHTs. https://doi.org/10.1289/EHP6273.

Effect of parking lanes on assessing the impact of road traffic noise on building façades

The use of strategic noise maps as a means for estimating population exposure to environmental noise and defining action plans to mitigate its effects on human health has become a reality since the publication of the European Noise Directive. In this context, it is known that some differences can be found between the values obtained for sound indicators through simulation and measurements due to different causes. One of these factors is the presence of elements in urban environments not currently considered in calculation methods but certainly present in validation measurements. This paper presents an assessment of the acoustic shielding effect due to parked vehicles on urban streets using computational methods. First of all, a process of validation of the software model by means of different simulation methods and in situ measurements was carried out. Then, a study was developed varying different variables related to urban planning and noise modelling, as well as considering different typologies of real streets according to a categorisation method. Broadband results show that this shielding effect can be significant in common configurations in urban environments, even to receiver heights of 4 m considered as a reference in strategic noise maps. The magnitude of this effect varied depending on the distances between the building façade, parked vehicles and sound sources, as well as the receiver height. Differences up to 4 dBA in sound levels were found in several configurations between situations without and with cars parked at 4 m, although in some specific cases it reached up to 8 dBA. Therefore, results of this study indicated that parking lane shielding effect should be considered in calculations and validation measurements for strategic noise maps in order to obtain an adequate estimation of population exposure to road traffic noise.