Night noise exposure and risk of death by suicide in adults living in metropolitan areas

Environmental pollution and extreme weather conditions: insights into the effect on mental health

Environmental pollution exposures, including air, soil, water, light, and noise pollution, are critical issues that may implicate adverse mental health outcomes. Extreme weather conditions, such as hurricanes, floods, wildfires, and droughts, may also cause long-term severe concerns. However, the knowledge about possible psychiatric disorders associated with these exposures is currently not well disseminated. In this review, we aim to summarize the current knowledge on the impact of environmental pollution and extreme weather conditions on mental health, focusing on anxiety spectrum disorders, autism spectrum disorders, schizophrenia, and depression. In air pollution studies, increased concentrations of PM2.5, NO2, and SO2 were the most strongly associated with the exacerbation of anxiety, schizophrenia, and depression symptoms. We provide an overview of the suggested underlying pathomechanisms involved. We highlight that the pathogenesis of environmental pollution-related diseases is multifactorial, including increased oxidative stress, systematic inflammation, disruption of the blood-brain barrier, and epigenetic dysregulation. Light pollution and noise pollution were correlated with an increased risk of neurodegenerative disorders, particularly Alzheimer's disease. Moreover, the impact of soil and water pollution is discussed. Such compounds as crude oil, heavy metals, natural gas, agro-chemicals (pesticides, herbicides, and fertilizers), polycyclic or polynuclear aromatic hydrocarbons (PAH), solvents, lead (Pb), and asbestos were associated with detrimental impact on mental health. Extreme weather conditions were linked to depression and anxiety spectrum disorders, namely PTSD. Several policy recommendations and awareness campaigns should be implemented, advocating for the advancement of high-quality urbanization, the mitigation of environmental pollution, and, consequently, the enhancement of residents' mental health.

Neural Mechanisms of Nonauditory Effects of Noise Exposure on Special Populations

Due to the abnormal structure and function of brain neural networks in special populations, such as children, elderly individuals, and individuals with mental disorders, noise exposure is more likely to have negative psychological and cognitive nonauditory effects on these individuals. There are unique and complex neural mechanisms underlying this phenomenon. For individuals with mental disorders, there are anomalies such as structural atrophy and decreased functional activation in brain regions involved in emotion and cognitive processing, such as the prefrontal cortex (PFC). Noise exposure can worsen these abnormalities in relevant brain regions, further damaging neural plasticity and disrupting normal connections and the transmission of information between the PFC and other brain areas by causing neurotransmitter imbalances. In the case of children, in a noisy environment, brain regions such as the left inferior frontal gyrus and PFC, which are involved in growth and development, are more susceptible to structural and functional changes, leading to neurodegenerative alterations. Furthermore, noise exposure can interrupt auditory processing neural pathways or impair inhibitory functions, thus hindering children's ability to map sound to meaning in neural processes. For elderly people, age-related shrinkage of brain regions such as the PFC, as well as deficiencies in hormone, neurotransmitter, and nutrient levels, weakens their ability to cope with noise. Currently, it is feasible to propose and apply coping strategies to improve the nonauditory effects of noise exposure on special populations based on the plasticity of the human brain.

Noise Reduction Nursing in a Noisy Ward Environment Effectively Improves the Mental and Physical Health of Patients Who Underwent Intracranial Aneurysm Embolization: A Retrospective Study

OBJECTIVE

This study aims to investigate the impact of noise reduction nursing in ward on patients who underwent intracranial aneurysm embolization.

METHODS

Between April 2020 and March 2021, Funan County People's Hospital implemented standard nursing care for patients who underwent intracranial aneurysm embolization, comprising 55 patients admitted during this period, constituting the control group. Subsequently, from April 2021 to March 2022, the hospital introduced noise reduction nursing measures in wards. A total of 65 patients admitted during this period were included in the study group. Data on noise levels, emotional states, and sleep statuses were collected from both groups. The comprehensive impact of noise reduction nursing on the mental and physical health of patients who underwent intracranial aneurysm embolization was evaluated.

RESULTS

Before propensity score matching (PSM), significant differences were observed in age and intracranial aneurysm diameter between the two groups (P < 0.05). However, following PSM, a total of 102 patients were included in the analysis, and no significant differences in baseline data were observed between the two groups (P > 0.05). The noise level in the study group's ward was significantly lower than that in the control group (P < 0.05). In addition, post-management, the study group exhibited lower Self-rating Anxiety Scale scores and total scores of Pittsburgh Sleep Quality Index compared with the control group. Moreover, the Glasgow Coma Scale score was higher in the study group, demonstrating statistical significance (P < 0.05).

CONCLUSION

The implementation of noise reduction nursing in wards effectively controls ward noise levels and improves negative mood and sleep quality among patients who underwent intracranial aneurysm embolization. These findings indicate that noise reduction nursing facilitates postoperative rehabilitation and enhances patient outcomes.

Effects of Nighttime Noise Management in Intensive Care Units on Hormone Levels and Sleep Quality in Conscious Patients

OBJECTIVE

This study aims to investigate the effects of nighttime noise management in intensive care units (ICU) on hormone levels and sleep quality in conscious patients.

METHODS

From March 2020 to March 2021, the routine noise management for conscious patients was implemented in the ICU of Wenzhou TCM Hospital of Zhejiang Chinese Medical University. During this time, 86 patients were selected as the study subjects; five patients who did not meet the inclusion criteria were excluded, and 81 patients were included in the reference group. From April 2021 to April 2022, nighttime noise management for conscious patients was conducted, during which 93 patients were selected as the research subjects; six patients who did not meet the inclusion criteria were excluded, and 87 patients were included in the observation group. The hormone indicators, Pittsburgh Sleep Quality Index (PSQI) scores, and Symptom Checklist-90 (SCL-90) scores were collected and compared.

RESULTS

After management, the observation group had significantly lower noise level and hormone indicators (P < 0.05), significantly lower PSQI score (P < 0.001) and significantly lower SCL-90 score than the reference group (P < 0.01).

CONCLUSION

Nighttime noise in the ICU has an adverse effect on conscious patients. Nighttime noise management improves the hormone levels and sleep quality of ICU patients.

Effect of Noise in the Emergency Department on Occupational Burnout and Resignation Intention of Medical Staff

OBJECTIVE

This study aims to explore the effect of noise in the emergency department on the occupational burnout and the resignation intentions of medical staff.

METHODS

This retrospective study selected 42 medical staff (group A) in the emergency department of our hospital from March 2020 to March 2021 and 39 medical staff (group B) in the rehabilitation department during the same period as research subjects. Noise levels in the daily working environment of medical staff were collected. The Maslach Burnout Inventory General Survey and Intent to Leave Scale was used to evaluate occupational burnout and resignation intention. A multivariate linear regression analysis was adopted to explore the effects of noise exposure level in the emergency department on occupational burnout and resignation intention.

RESULTS

The scores of emotional fatigue, work apathy and sense of achievement in group A were higher than those in group B (P < 0.05), among which reverse scoring was adopted for sense of accomplishment. Group A had significantly higher scores of resignation intention I, resignation intention II and resignation intention III than group B (P < 0.001). The department of group A had significantly higher noise level than that of group B (P < 0.001). The Multivariate linear regression analysis showed that noise level in the emergency department was correlated with the occupational burnout and resignation intention of medical staff (all P < 0.05).

CONCLUSIONS

The emergency department is exposed to a high noise level, which is correlated with the occupational burnout and resignation intentions of medical staff. Therefore, hospitals should give importance to noise exposure in the emergency departments and adopt positive coping strategies to reduce the effect of noise on medical staff and the resignation rate.

Noise and mental health: evidence, mechanisms, and consequences

The recognition of noise exposure as a prominent environmental determinant of public health has grown substantially. While recent years have yielded a wealth of evidence linking environmental noise exposure primarily to cardiovascular ailments, our understanding of the detrimental effects of noise on the brain and mental health outcomes remains limited. Despite being a nascent research area, an increasing body of compelling research and conclusive findings confirms that exposure to noise, particularly from sources such as traffic, can potentially impact the central nervous system. These harms of noise increase the susceptibility to mental health conditions such as depression, anxiety, suicide, and behavioral problems in children and adolescents. From a mechanistic perspective, several investigations propose direct adverse phenotypic changes in brain tissue by noise (e.g. neuroinflammation, cerebral oxidative stress), in addition to feedback signaling by remote organ damage, dysregulated immune cells, and impaired circadian rhythms, which may collectively contribute to noise-dependent impairment of mental health. This concise review linking noise exposure to mental health outcomes seeks to fill research gaps by assessing current findings from studies involving both humans and animals.

The Contribution of Environmental Science to Mental Health Research: A Scoping Review

Mental health is influenced by multiple complex and interacting genetic, psychological, social, and environmental factors. As such, developing state-of-the-art mental health knowledge requires collaboration across academic disciplines, including environmental science. To assess the current contribution of environmental science to this field, a scoping review of the literature on environmental influences on mental health (including conditions of cognitive development and decline) was conducted. The review protocol was developed in consultation with experts working across mental health and environmental science. The scoping review included 202 English-language papers, published between 2010 and 2020 (prior to the COVID-19 pandemic), on environmental themes that had not already been the subject of recent systematic reviews; 26 reviews on climate change, flooding, air pollution, and urban green space were additionally considered. Studies largely focused on populations in the USA, China, or Europe and involved limited environmental science input. Environmental science research methods are primarily focused on quantitative approaches utilising secondary datasets or field data. Mental health measurement was dominated by the use of self-report psychometric scales. Measures of environmental states or exposures were often lacking in specificity (e.g., limited to the presence or absence of an environmental state). Based on the scoping review findings and our synthesis of the recent reviews, a research agenda for environmental science's future contribution to mental health scholarship is set out. This includes recommendations to expand the geographical scope and broaden the representation of different environmental science areas, improve measurement of environmental exposure, prioritise experimental and longitudinal research designs, and giving greater consideration to variation between and within communities and the mediating pathways by which environment influences mental health. There is also considerable opportunity to increase interdisciplinarity within the field via the integration of conceptual models, the inclusion of mixed methods and qualitative approaches, as well as further consideration of the socio-political context and the environmental states that can help support good mental health. The findings were used to propose a conceptual model to parse contributions and connections between environmental science and mental health to inform future studies.

Urban precarity and youth mental health: An interpretive scoping review of emerging approaches

Circumstances of living are key to shaping emotional and affective experiences, long term health, wellbeing and opportunities. In an era characterised by rapid urbanisation across the majority of the world, there is increasing interest in the interaction between mental health and urban environments, but insufficient attention is paid to how mental health is situated in space and time. Socio-economic inequalities are prevalent in many urban environments globally, making conditions of living highly precarious for some social groups including young people. There remains a large volume of unmet mental health service needs, and young people are impacted by uncertain economic futures. The purpose of this scoping review is to develop an interdisciplinary and globally-informed understanding of the urban conditions which affect youth mental health across a range of scales, and to identify protective factors which can promote better youth mental health. We seek to broaden the scope of urban mental health research beyond the physical features of urban environments to develop an interpretive framework based on perspectives shared by young people. We illustrate how concepts from social theory can be used as an integrative framework to emphasise both young people's lived experiences and the wider cultural and political dynamics of urban mental health.

Suicide and Transportation Noise: A Prospective Cohort Study from Switzerland

BACKGROUND

Although plausible from a pathophysiological point of view, robust evidence for effects of transportation noise on mental health remains scarce. Meanwhile, psychiatric diseases are among the most prevalent noncommunicable diseases worldwide, and suicide as a mortality outcome highly connected to mental disorders presents a pressing public health issue. The aim of this study was to investigate the association between source-specific transportation noise, particulate matter (PM) air pollution, residential greenness, and suicide by means of a nationwide cohort study.

METHODS

Road traffic, railway and aircraft noise exposure as well as exposure to air pollution [PM with aerodynamic diameter ≤2.5μm (PM2.5)] and greenness [normalized difference vegetation index (NDVI)] were linked to 5.1 million adults (age 15 y and older) in the Swiss National Cohort, accounting for their address history. Mean noise exposure in 5-y periods was calculated. Individuals were followed for up to 15 y (2001-2015). Time-varying Cox regression models were applied to deaths by suicide (excluding assisted suicide). Models included all three noise sources, PM2.5, and NDVI plus individual and spatial covariates, including socioeconomic status. Effect modification by sex, age, socioeconomic indicators, and degree of urbanization was explored.

RESULTS

During the follow-up, there were 11,265 suicide deaths (10.4% poisoning, 33.3% hanging, 28.7% firearms, 14.7% falls). Road traffic and railway noise were associated with total suicides [hazard ratios: 1.040; 95% confidence interval (CI): 1.015, 1.065; and 1.022 (95% CI: 1.004, 1.041) per 10 dB day-evening-night level (Lden)], whereas for aircraft noise, a risk increase starting from 50 dB was masked by an inverse association in the very low exposure range (30-40 dB). Associations were stronger for females than males. The results were robust to adjustment for residential greenness and air pollution.

CONCLUSION

In this longitudinal, nationwide cohort study, we report a robust association between exposure to road traffic and railway noise and risk of death by suicide after adjusting for exposure to air pollution and greenness. These findings add to the growing body of evidence that mental health disorders may be related to chronic transportation noise exposure. https://doi.org/10.1289/EHP11587.

The Effect of Kitchen Ventilation Modification on Independent and Combined Associations of Cooking Fuel Type and Cooking Duration with Suicidal Ideation: A Cross-Sectional Study

Although household air pollution (HAP) is associated with an increased risk of mental disorders, evidence remains scarce for the relationship between HAP and suicidal ideation. A total of 21,381 qualified participants were enrolled on the Henan Rural Cohort Study. HAP information including cooking fuel type, cooking duration and kitchen ventilation was collected by questionnaires. Suicidal ideation was evaluated by item nine of the Patient Health Questionnaire-9 (PHQ-9). Independent and combined associations of cooking fuel type and cooking duration with suicidal ideation were explored by logistic regression models. Analyses were conducted in different kitchen ventilation groups to detect the potential effect modification. The adjusted odds ratio (OR) and 95% confidence interval (95% CI) of solid fuel users versus clean fuel users for suicidal ideation was 1.37 (1.16, 1.62), and the risk of suicidal ideation increased by 15% (95% CI: 5%, 26%) for each additional hour of the cooking duration. Participants cooking with solid fuel for long durations were related to the highest risk of suicidal ideation (OR (95% CI): 1.51 (1.22, 1.87)). However, all these associations were not observed in those cooking with mechanical ventilation. Mechanical ventilation ameliorated relationships between solid fuel use and long-duration cooking with suicidal ideation.

Noise Induced Depression-Like Behavior, Neuroinflammation and Synaptic Plasticity Impairments: The Protective Effects of Luteolin

Noise is a kind of sound that causes agitation and harms human health. Studies have shown that noise can lead to neuroinflammation, damage to synaptic plasticity and altered levels of neurotransmitters that may result in depression. The present study demonstrated that luteolin exerted antidepressant-like effects by improving neuroinflammation in a mouse model of noise-induced depression. Luteolin significantly alleviated noise-induced depression-like behavior. Notably, luteolin treatment not only remarkably ameliorated noise-induced inflammation in the hippocampus and prefrontal cortex, but also increased synapsin. Furthermore, luteolin treatment significantly increased the contents of serum 5-hydroxytryptamine and norepinephrine in noise-induced mice. In sum, luteolin exerts antidepressant effects indepression-like mice caused by noise, which can serve as a potential agent for the treatment of chronic noise-induced depression.

Cerebral consequences of environmental noise exposure

The importance of noise exposure as a major environmental determinant of public health is being increasingly recognized. While in recent years a large body evidence has emerged linking environmental noise exposure mainly to cardiovascular disease, much less is known concerning the adverse health effects of noise on the brain and associated neuropsychiatric outcomes. Despite being a relatively new area of investigation, indeed, mounting research and conclusive evidence demonstrate that exposure to noise, primarily from traffic sources, may affect the central nervous system and brain, thereby contributing to an increased risk of neuropsychiatric disorders such as stroke, dementia and cognitive decline, neurodevelopmental disorders, depression, and anxiety disorder. On a mechanistic level, a significant number of studies suggest the involvement of reactive oxygen species/oxidative stress and inflammatory pathways, among others, to fundamentally drive the adverse brain health effects of noise exposure. This in-depth review on the cerebral consequences of environmental noise exposure aims to contribute to the associated research needs by evaluating current findings from human and animal studies. From a public health perspective, these findings may also help to reinforce efforts promoting adequate mitigation strategies and preventive measures to lower the societal consequences of unhealthy environments.

The Effect of Meteorological, Pollution, and Geographic Exposures on Death by Suicide: A Scoping Review

Suicide is a significant public health concern worldwide and in the United States. Despite the far-reaching impact of suicide, risk factors are still not well understood and efforts to accurately assess risk have fallen short. Current research has highlighted how potentially modifiable environmental exposures (i.e., meteorological, pollution, and geographic exposures) can affect suicide risk. A scoping review was conducted to evaluate the strength of the historical and current literature on the environment’s effect on suicide and suicide risk. Three databases (i.e., Medline, Embase, and PsychInfo) were reviewed to identify relevant studies and two authors independently reviewed studies considering pre-determined inclusion criteria. A total of 46 meteorological studies were included as well as 23 pollution studies and 12 geographic studies. Descriptive statistics, including counts, percentages, review of studies’ sample size (minimum, maximum, median, and interquartile range), were calculated using Excel and SAS 9.4. Overall, strong evidence supports that exposure to sunlight, temperature, air pollution, pesticides, and high altitude increases suicide risk, although effect sizes range from very small to small.

Long-term effects of ambient air pollutants on suicidal ideation in China: The Henan Rural Cohort Study

BACKGROUND

The association between ambient air pollutants exposure and suicidal ideation (SI) has rarely been explored, especially in Chinese population. Therefore, we aimed to investigate the long-term effects of ambient air pollutants on SI among a Chinese rural population.

METHOD

We recruited 29997 participants from the Henan Rural Cohort study in 2016-2017. SI was evaluated by using the ninth item of the Patient Health Questionnaire-9 (PHQ-9) in the baseline survey. We adopted a satellite-based spatiotemporal model to estimate participants' exposure to particulate matters (PMs) (PM with an aerodynamic diameter ≤1 μm (PM₁), ≤2.5 μm (PM_2.5) or ≤10 μm (PM₁₀), respectively) and nitrogen dioxide (NO₂), and then calculated the 3-year average concentrations of the four pollutants. We used logistic regression models to explore the association between long-term exposure to ambient air pollutants and SI. In addition, we conducted several stratified analyses to examine effect modification of selected factors.

RESULTS

The odds ratios (95% confidence intervals [CI]) of SI in response to each 1 μg/m³ increase in PM₁, PM_2.5, PM₁₀ and NO₂ concentrations were 1.08 (1.01, 1.15), 1.10 (1.02, 1.19), 1.05 (1.01, 1.09) and 1.12 (1.04, 1.21), respectively. Individuals exposed to PM₁, PM_2.5, PM₁₀ or NO₂ concentrations in the fourth quartile had a 1.36-fold (95%CI: 1.08, 1.72), 1.69-fold (95%CI: 1.05, 2.72), 1.49-fold (95%CI: 1.09, 2.05) or 1.71-fold (95%CI: 1.15, 2.85) risks of SI, compared to the ones with corresponding air pollutants in the first quartile. Besides, the risks of SI increased with the quartiles of air pollutants (PM₁: P_trend = 0.002, PM_2.5: P_trend = 0.003, PM₁₀: P_trend = 0.010, NO₂: P_trend = 0.010). Stratified analyses suggested that males, highly educated participants, ever-drinkers and people aged range 36-64 years were more vulnerable to the adverse effects of air pollutants.

CONCLUSIONS

This study provided evidence for the long-term effects of ambient PMs and NO₂ on SI in rural Chinese adults, particularly for males, highly educated participants, ever-drinkers and people aged range 36-64 years.

A Scoping Review of Non-Occupational Exposures to Environmental Pollutants and Adult Depression, Anxiety, and Suicide

PURPOSE OF REVIEW

Despite a call for better understanding of the role of environmental pollutant influences on mental health and the tremendous public health burden of mental health, this issue receives far less attention than many other effects of pollutants. Here we summarize the body of literature on non-occupational environmental pollutant exposures and adult depression, anxiety, and suicide-in PubMed, Embase, Web of Science, and PsychINFO through the end of year 2018.

RECENT FINDINGS

One hundred twelve articles met our criteria for further review. Of these, we found 88 articles on depression, 33 on anxiety, and 22 on suicide (31 articles covered multiple outcomes). The earliest article was published in 1976, and the most frequent exposure of interest was air pollution (n = 33), followed by secondhand smoke (n = 20), metals (n = 18), noise (n = 17), and pesticides (n = 10). Other exposures studied less frequently included radiation, magnetic fields, persistent organic pollutants (POPs), volatile organic compounds, solvents, and reactive sulfur compounds. The current literature, although limited, clearly suggests many kinds of environmental exposures may be risk factors for depression, anxiety, and suicide. For several pollutants, important limitations exist with many of the studies. Gaps in the body of research include a need for more longitudinal, life-course studies, studies that can measure cumulative exposures as well as shorter-term exposures, studies that reduce the possibility of reverse causation, and mechanistic studies focused on neurotoxic exposures.