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Cheng C, Messerschmidt L, Bravo I, Waldbauer M, Bhavikatti R, Schenk C, Grujic V, Model T, Kubinec R, Barceló J. A General Primer for Data Harmonization. Sci Data 2024; 11:152. [PMID: 38297013 PMCID: PMC10831085 DOI: 10.1038/s41597-024-02956-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Affiliation(s)
- Cindy Cheng
- Hochschule für Politik, Technical University of Munich, Richard-Wagner Str. 1, Munich, 80333, Bavaria, Germany.
| | - Luca Messerschmidt
- Hochschule für Politik, Technical University of Munich, Richard-Wagner Str. 1, Munich, 80333, Bavaria, Germany
| | - Isaac Bravo
- Hochschule für Politik, Technical University of Munich, Richard-Wagner Str. 1, Munich, 80333, Bavaria, Germany
| | - Marco Waldbauer
- Hochschule für Politik, Technical University of Munich, Richard-Wagner Str. 1, Munich, 80333, Bavaria, Germany
| | | | - Caress Schenk
- School of Humanities and Social Sciences, Nazarbayev University, Kabanbay Batry Ave., 53, Astana, 010000, Kazakhstan
| | - Vanja Grujic
- Faculty of Law, University of Brasilia, Campus Universitário Darcy Ribeiro Asa Norte, Brasília, 10587, Brazil
| | - Tim Model
- Delve, 2225 3rd St, San Francisco, 94107, California, USA
| | - Robert Kubinec
- Division of Social Science, New York University Abu Dhabi, Social Science Building (A5), Abu Dhabi, 129188, United Arab Emirates
| | - Joan Barceló
- Division of Social Science, New York University Abu Dhabi, Social Science Building (A5), Abu Dhabi, 129188, United Arab Emirates
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Griggs S, Pignatiello G, Motairek I, Rieke J, Howard Q, Crawford SL, Rajagopalan S, Al-Kindi S, Hickman RL. Environmental exposures and blood pressure in adolescents and adults in the T1D exchange clinic registry. J Diabetes Complications 2023; 37:108594. [PMID: 37660429 PMCID: PMC10592032 DOI: 10.1016/j.jdiacomp.2023.108594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/11/2023] [Accepted: 08/20/2023] [Indexed: 09/05/2023]
Abstract
AIMS To examine the associations between environmental determinants of health and blood pressure and whether age, sex, or race moderated the associations among 18,754 adolescents and adults from the type 1 diabetes (T1D) Exchange Clinic Registry. METHODS We used multivariable linear regression. Environmental determinants included exposure to ambient fine particulate matter (PM2.5, obtained from an integrated model), nitrogen dioxide (NO2), noise and light pollution, and the normalized difference vegetation index (NDVI, a marker of green space) at the ZIP code level of residence. RESULTS Higher exposure to PM2.5 and NO2, and lower NDVI, was associated with higher systolic and diastolic blood pressure, and higher light pollution exposure were similarly associated with higher diastolic blood pressure. These associations between environmental exposures and blood pressure remained significant after accounting for other covariates (age, sex, race/ethnicity, BMI, and T1D duration). With aging, the negative association between NDVI and blood pressure weakened. CONCLUSIONS These findings emphasize the significance of minimizing exposure to environmental pollutants, including PM2.5 and NO2, as well as ensuring access to areas with higher NDVI, to promote cardiovascular health in individuals with T1D.
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Affiliation(s)
- Stephanie Griggs
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America.
| | - Grant Pignatiello
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America; Case Western Reserve University, Frances Payne Bolton School of Nursing, United States of America.
| | - Issam Motairek
- Cardiovascular Phenomics Core, School of Medicine, Case Western Reserve University, United States of America.
| | - Jorden Rieke
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America; Case Western Reserve University, Frances Payne Bolton School of Nursing, United States of America.
| | - Quiana Howard
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America.
| | - Sybil L Crawford
- University of Massachusetts Chan Medical School, Tan Chingfen Graduate School of Nursing, Worcester, MA 01655, United States of America.
| | - Sanjay Rajagopalan
- Cardiovascular Research Institute, Case Western Reserve University, School of Medicine, United States of America.
| | - Sadeer Al-Kindi
- Center for Vascular Metabolic Disease, School of Medicine, United States of America.
| | - Ronald L Hickman
- Case Western Reserve University, Frances Payne Bolton School of Nursing, Cleveland, OH 44106, United States of America.
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Eminson K, Cai YS, Chen Y, Blackmore C, Rodgers G, Jones N, Gulliver J, Fenech B, Hansell AL. Does air pollution confound associations between environmental noise and cardiovascular outcomes? - A systematic review. ENVIRONMENTAL RESEARCH 2023; 232:116075. [PMID: 37182833 DOI: 10.1016/j.envres.2023.116075] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 04/24/2023] [Accepted: 05/05/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Exposure to environmental noise is associated with adverse health effects, but there is potential for confounding and interaction with air pollution, particularly where both exposures arise from the same source, such as transport. OBJECTIVES To review evidence on confounding and interaction of air pollution in relation to associations between environmental noise and cardiovascular outcomes. METHODS Papers were identified from similar reviews published in 2013 and 2015, from the systematic reviews supporting the WHO 2018 noise guidelines, and from a literature search covering the period 2016-2022 using Medline and PubMed databases. Additional papers were identified from colleagues. Study selection was according to PECO inclusion criteria. Studies were evaluated against the WHO checklist for risk of bias. RESULTS 52 publications, 36 published after 2015, were identified that assessed associations between transportation noise and cardiovascular outcomes, that also considered potential confounding (49 studies) or interaction (23 studies) by air pollution. Most, but not all studies, suggested that the associations between traffic noise and cardiovascular outcomes are independent of air pollution. NO2 or PM2.5 were the most commonly included air pollutants and we observed no clear differences across air pollutants in terms of the potential confounding role. Most papers did not appear to suggest an interaction between noise and air pollution. Eight studies found the largest noise effect estimates occurring within the higher noise and air pollution exposure categories, but were not often statistically significant. CONCLUSION Whilst air pollution does not appear to confound associations of noise and cardiovascular health, more studies on potential interactions are needed. Current methods to assess quality of evidence are not optimal when evaluating evidence on confounding or interaction.
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Affiliation(s)
- Katie Eminson
- Centre for Environmental Health and Sustainability, University of Leicester, UK
| | - Yutong Samuel Cai
- Centre for Environmental Health and Sustainability, University of Leicester, UK
| | - Yingxin Chen
- Centre for Environmental Health and Sustainability, University of Leicester, UK
| | - Claire Blackmore
- Centre for Environmental Health and Sustainability, University of Leicester, UK
| | - Georgia Rodgers
- Noise and Public Health Group, Environmental Hazards and Emergencies Department, UK Health Security Agency (UKHSA), UK
| | | | - John Gulliver
- Centre for Environmental Health and Sustainability, University of Leicester, UK; National Institute for Health Research (NIHR), Health Protection Research Unit (HPRU) in Environmental Exposures and Health at the University of Leicester, UK
| | - Benjamin Fenech
- Noise and Public Health Group, Environmental Hazards and Emergencies Department, UK Health Security Agency (UKHSA), UK; National Institute for Health Research (NIHR), Health Protection Research Unit (HPRU) in Environmental Exposures and Health at the University of Leicester, UK
| | - Anna L Hansell
- Centre for Environmental Health and Sustainability, University of Leicester, UK; National Institute for Health Research (NIHR), Health Protection Research Unit (HPRU) in Environmental Exposures and Health at the University of Leicester, UK.
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Rabiei H, Ramezanifar S, Hassanipour S, Gharari N. Investigating the effects of occupational and environmental noise on cardiovascular diseases: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:62012-62029. [PMID: 34562216 DOI: 10.1007/s11356-021-16540-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 09/10/2021] [Indexed: 06/13/2023]
Abstract
The present study aimed to use a meta-analysis to investigate the relationship between occupational and non-occupational noise exposure expressed in various studies with cardiovascular disease. This is a systematic review and meta-analysis study based on PRISMA checklist. In this study, the researchers searched five international databases of Medline/PubMed, Embase, Scopus, ISI/web of knowledge, and Google Scholar. Search keywords included two categories noise and noise pollution, cardiovascular disease, and hypertension. The Joanna Briggs Institute checklist was used to review and control the quality of the articles. After all screening stage 139 articles entered the final analysis. The results show that except for East African environmental studies and workplace studies in East Asia, Western Asia, and Northern Europe, there was a significant association between noise exposure and cardiovascular disease. Also, there was a significant difference between the intensity of sound and blood pressure in workers (OR = 1.28, CI 95%: 1.15-1.42, P < 0.001). Based on the results of environmental noise, there was a significant difference between ambient noise intensity and blood pressure (OR = 1.55, CI 95%: 1.53-1.57, P < 0.001). It can be concluded that it is very important to study and identify jobs or living environments with less than the recommended noise level and in addition to hearing aids that occur in over-standard exposures, such as cardiovascular disease.
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Affiliation(s)
- Hadiseh Rabiei
- Student Research Committee, Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soleiman Ramezanifar
- Student Research Committee, Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soheil Hassanipour
- Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Noradin Gharari
- Department of Occupational Health and Safety, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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D'Souza J, Weuve J, Brook RD, Evans DA, Kaufman JD, Adar SD. Long-Term Exposures to Urban Noise and Blood Pressure Levels and Control Among Older Adults. Hypertension 2021; 78:1801-1808. [PMID: 34689591 DOI: 10.1161/hypertensionaha.121.17708] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Jennifer D'Souza
- School of Public Health, University of Michigan, Ann Arbor (J.D., S.D.A.)
| | | | - Robert D Brook
- Division of Cardiovascular Diseases, Wayne State University, Detroit, MI (R.D.B.)
| | - Denis A Evans
- Rush University School of Medicine, Chicago, IL (D.A.E.)
| | - Joel D Kaufman
- School of Public Health, University of Washington, Seattle (J.D.K.)
| | - Sara D Adar
- School of Public Health, University of Michigan, Ann Arbor (J.D., S.D.A.)
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Kupcikova Z, Fecht D, Ramakrishnan R, Clark C, Cai YS. Road traffic noise and cardiovascular disease risk factors in UK Biobank. Eur Heart J 2021; 42:2072-2084. [PMID: 33733673 PMCID: PMC8169156 DOI: 10.1093/eurheartj/ehab121] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/16/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
AIMS The aim of this study was to investigate the cross-sectional associations of modelled residential road traffic noise with cardiovascular disease risk factors [systolic (SBP) and diastolic blood pressure (DBP), C-reactive protein, triglycerides, glycated haemoglobin, and self-reported hypertension] in UK Biobank. METHODS AND RESULTS The UK Biobank recruited 502 651 individuals aged 40-69 years across the UK during 2006-10. Road traffic noise (Lden and Lnight) exposure for 2009 was estimated at baseline address using a simplified version of the Common Noise Assessment Methods model. We used multivariable linear and logistic regression models, adjusting for age, sex, body mass index (BMI), smoking, alcohol intake, area- and individual-level deprivation, season of blood draw, length of time at residence, and nitrogen dioxide (main model), in an analytical sample size of over 370 000 participants. Exposure to road-traffic Lden >65 dB[A], as compared to ≤55 dB[A], was associated with 0.77% [95% confidence interval (CI) 0.60%, 0.95%], 0.49% (95% CI 0.32%, 0.65%), 0.79% (95% CI 0.11%, 1.47%), and 0.12% (95% CI -0.04%, 0.28%) higher SBP, DBP, triglycerides, and glycated haemoglobin, respectively. Removing BMI from the main model yielded significant positive associations with all five markers with elevated percent changes. The associations with SBP or DBP did not appear to be impacted by hypertension medication while a positive association with prevalent self-reported hypertension was seen in the non-medicated group who exposed to a Lden level of 60-65 dB[A] (odds ratio 1.07, 95% CI 1.00, 1.15). CONCLUSION Exposure to road traffic noise >65 dB[A], independent of nitrogen dioxide, was associated with small but adverse changes in blood pressure and cardiovascular biochemistry.
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Affiliation(s)
- Zuzana Kupcikova
- Acoustics, Ove Arup & Partners, 13 Fitzroy Street, London W1T 4BQ, UK
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Daniela Fecht
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Rema Ramakrishnan
- Nuffield Department of Women’s & Reproductive Health, Women's Centre (Level 3), John Radcliffe Hospital, University of Oxford, Oxford OX3 9DU, UK
- Deep Medicine Programme, Oxford Martin School, University of Oxford, 34 Broad St, Oxford OX1 3BD, UK
| | - Charlotte Clark
- Acoustics, Ove Arup & Partners, 13 Fitzroy Street, London W1T 4BQ, UK
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Weuve J, D’Souza J, Beck T, Evans DA, Kaufman JD, Rajan KB, de Leon CFM, Adar SD. Long-term community noise exposure in relation to dementia, cognition, and cognitive decline in older adults. Alzheimers Dement 2021; 17:525-533. [PMID: 33084241 PMCID: PMC8720224 DOI: 10.1002/alz.12191] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/31/2020] [Accepted: 08/18/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Exposure to noise might influence risk of Alzheimer's disease (AD) dementia. METHODS Participants of the Chicago Health and Aging Project (≥65 years) underwent triennial cognitive assessments. For the 5 years preceding each assessment, we estimated 5227 participants' residential level of noise from the community using a spatial prediction model, and estimated associations of noise level with prevalent mild cognitive impairment (MCI) and AD, cognitive performance, and rate of cognitive decline. RESULTS Among these participants, an increment of 10 A-weighted decibels (dBA) in noise corresponded to 36% and 29% higher odds of prevalent MCI (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.15 to 1.62) and AD (OR = 1.29, 95% CI, 1.08 to 1.55). Noise level was associated with worse global cognitive performance, principally in perceptual speed (-0.09 standard deviation per 10 dBA, 95% CI: -0.16 to -0.03), but not consistently associated with cognitive decline. DISCUSSION These results join emerging evidence suggesting that noise may influence late-life cognition and risk of dementia.
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Affiliation(s)
- Jennifer Weuve
- School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Jennifer D’Souza
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Todd Beck
- Institute for Healthy Aging, Rush University, Chicago, Illinois, USA
| | - Denis A. Evans
- Institute for Healthy Aging, Rush University, Chicago, Illinois, USA
| | - Joel D. Kaufman
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Kumar. B. Rajan
- Department of Public Health Sciences, UC Davis, Davis, California, USA
| | | | - Sara D. Adar
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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Acute cardiovascular health effects in a panel study of personal exposure to traffic-related air pollutants and noise in Toronto, Canada. Sci Rep 2020; 10:16703. [PMID: 33028877 PMCID: PMC7541521 DOI: 10.1038/s41598-020-73412-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/10/2020] [Indexed: 12/29/2022] Open
Abstract
Urban populations are often simultaneously exposed to air pollution and environmental noise, which are independently associated with cardiovascular disease. Few studies have examined acute physiologic responses to both air and noise pollution using personal exposure measures. We conducted a repeated measures panel study of air pollution and noise in 46 non-smoking adults in Toronto, Canada. Data were analyzed using linear mixed-effects models and weighted cumulative exposure modeling of recent exposure. We examined acute changes in cardiovascular health effects of personal (ultrafine particles, black carbon) and regional (PM2.5, NO2, O3, Ox) measurements of air pollution and the role of personal noise exposure as a confounder of these associations. We observed adverse changes in subclinical cardiovascular outcomes in response to both air pollution and noise, including changes in endothelial function and heart rate variability (HRV). Our findings show that personal noise exposures can confound associations for air pollutants, particularly with HRV, and that impacts of air pollution and noise on HRV occur soon after exposure. Thus, both noise and air pollution have a measurable impact on cardiovascular physiology. Noise should be considered alongside air pollution in future studies to elucidate the combined impacts of these exposures in urban environments.
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Renner RA, Groß VJ, Ernst A, Hellmich M, Erren TC. [Epidemiological Studies on the Association between Chronic Exposure to Road Traffic Noise and Blood Pressure: A Systematic Review with Meta-Analyses]. DAS GESUNDHEITSWESEN 2020; 83:384-397. [PMID: 32693422 DOI: 10.1055/a-1165-1797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM The aim of this study was to review epidemiological studies on the association between chronic exposures to road traffic noise and prevalence of arterial hypertension as well as blood pressure by using meta-analyses. METHODS A systematic literature search in the databases Medline® and Web of science™ as well as the database OpenGrey was conducted to identify suitable studies, namely epidemiological observational studies assessing objective exposures to road traffic noise at the subject's home place with analysis of their potential associations with arterial hypertension or blood pressure. Whenever possible, overall effects for the different relationships were estimated with meta-analyses. For statistical analyses R for windows was used. RESULTS A total of 31 eligible studies were identified. Meta-analyses were conducted for potential association between road traffic noise and prevalence of arterial hypertension in adults and for association with systolic and diastolic blood pressure in adults and children. There was a significant (p<0.01) increase of risk for arterial hypertension in adults when exposed to chronic road traffic noise with an increment of 7% per 5 dB(A). Overall effects for systolic blood pressure were positive but weak for children as well as adults without any statistical significance. For diastolic blood pressure there appeared to be no relationship with chronic exposure to road traffic noise in either of the two groups. CONCLUSION Considering the multiple methodological limitations of studies examined as well as the high level of heterogeneity in all random effects models, the estimated overall effects must be interpreted with caution. To examine potential associations between road traffic noise and arterial hypertension or measured blood pressure appropriately, more prospective cohort studies are necessary with precise assessments of noise exposure as well as clinical endpoints and with adjustments for relevant cofactors.
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Affiliation(s)
- René A Renner
- Institut und Poliklinik für Arbeitsmedizin, Umweltmedizin und Präventionsforschung, Universität zu Köln, Köln
| | - Valérie J Groß
- Institut und Poliklinik für Arbeitsmedizin, Umweltmedizin und Präventionsforschung, Universität zu Köln, Köln.,Institut für Medizinische Statistik und Bioinformatik, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln
| | - Angela Ernst
- Institut für Medizinische Statistik und Bioinformatik, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln
| | - Martin Hellmich
- Institut für Medizinische Statistik und Bioinformatik, Medizinische Fakultät und Uniklinik Köln, Universität zu Köln, Köln
| | - Thomas C Erren
- Institut und Poliklinik für Arbeitsmedizin, Umweltmedizin und Präventionsforschung, Universität zu Köln, Köln
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Hodgson S, Fecht D, Gulliver J, Iyathooray Daby H, Piel FB, Yip F, Strosnider H, Hansell A, Elliott P. Availability, access, analysis and dissemination of small-area data. Int J Epidemiol 2020; 49 Suppl 1:i4-i14. [PMID: 32293007 PMCID: PMC7158061 DOI: 10.1093/ije/dyz051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2019] [Indexed: 11/26/2022] Open
Abstract
In this era of 'big data', there is growing recognition of the value of environmental, health, social and demographic data for research. Open government data initiatives are growing in number and in terms of content. Remote sensing data are finding widespread use in environmental research, including in low- and middle-income settings. While our ability to study environment and health associations across countries and continents grows, data protection rules and greater patient control over the use of their data present new challenges to using health data in research. Innovative tools that circumvent the need for the physical sharing of data by supporting non-disclosive sharing of information, or that permit spatial analysis without researchers needing access to underlying patient data can be used to support analyses while protecting data confidentiality. User-friendly visualizations, allowing small-area data to be seen and understood by non-expert audiences, are revolutionizing public and researcher interactions with data. The UK Small Area Health Statistics Unit's Environment and Health Atlas for England and Wales, and the US National Environmental Public Health Tracking Network offer good examples. Open data facilitates user-generated outputs, and 'mash-ups', and user-generated inputs from social media, mobile devices and wearable tech are new data streams that will find utility in future studies, and bring novel dimensions with respect to ethical use of small-area data.
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Affiliation(s)
- Susan Hodgson
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Daniela Fecht
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - John Gulliver
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Hima Iyathooray Daby
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Frédéric B Piel
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Fuyuen Yip
- Environmental Health Tracking Section, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Heather Strosnider
- Environmental Health Tracking Section, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, USA
| | - Anna Hansell
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
| | - Paul Elliott
- MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Imperial College London, London, UK
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Farooqi ZUR, Sabir M, Latif J, Aslam Z, Ahmad HR, Ahmad I, Imran M, Ilić P. Assessment of noise pollution and its effects on human health in industrial hub of Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:2819-2828. [PMID: 31836979 DOI: 10.1007/s11356-019-07105-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 11/19/2019] [Indexed: 06/10/2023]
Abstract
Faisalabad is one of the major industrial cities of Pakistan, which may cause noise pollution to the local residents due to the development of robust industrial and transport systems. This study aimed at (i) mapping the noise pollution levels at various locations of Faisalabad city; (ii) comparing noise pollution levels in the morning, the afternoon, and the evening for each source; and (iii) assessing nonauditory effects of noise on human health. Two industries and 43 famous/busy locations of Faisalabad Sadar were selected to study noise pollution by using the sound level meter for the period of 24 h. A questionnaire-based survey was carried out near the sampling points to get a public perception about the health impacts of noise pollution. The measured equivalent sound pressure levels (SPLeq) were higher than the permissible limits at all the sampling locations during morning, afternoon, and evening hours. The maximum sound pressure level (SPLmax) was 102 dB inside the production unit in the afternoon at Mian Muhammad Siddiq Textile Loom industry. The average SPL was found at State Bank road (102 dB), Children's Hospital (101 dB), Jhang Bazar (100 dB) in the afternoon and at Punjab Medical College in the evening (97 dB). Based on the survey, 94% of respondents reported headache, 76% sleeplessness, 74% hypertension, 74% physiological stress, 64% elevated blood pressure levels, and 60% dizziness due to noise. Noise pollution is higher than the standard limits and causes auditory as well as nonauditory effects on humans. The vehicles and industrial machinery should be maintained, and sound proofing and protection equipment should be provided to the workforce in order to protect them from extreme noise levels.
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Affiliation(s)
- Zia Ur Rahman Farooqi
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Muhammad Sabir
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Junaid Latif
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan
- North West A&F University, Shaanxi Sheng, 712100, China
| | - Zubair Aslam
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Hamaad Raza Ahmad
- Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, 38040, Pakistan
| | - Iftikhar Ahmad
- Department of Environmental Sciences, COMSATS University, Islamabad, Vehari Campus, Vehari, 61100, Pakistan.
| | - Muhammad Imran
- Department of Environmental Sciences, COMSATS University, Islamabad, Vehari Campus, Vehari, 61100, Pakistan
| | - Predrag Ilić
- Institute for Protection and Ecology of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
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Morishita M, Wang L, Speth K, Zhou N, Bard RL, Li F, Brook JR, Rajagopalan S, Brook RD. Acute Blood Pressure and Cardiovascular Effects of Near-Roadway Exposures With and Without N95 Respirators. Am J Hypertens 2019; 32:1054-1065. [PMID: 31350540 PMCID: PMC7962899 DOI: 10.1093/ajh/hpz113] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/03/2019] [Accepted: 07/18/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The risk for cardiovascular events increases within hours of near-roadway exposures. We aimed to determine the traffic-related air pollution (TRAP) and biological mechanisms involved and if reducing particulate matter <2.5 µm (PM2.5) inhalation is protective. METHODS Fifty healthy-adults underwent multiple 2-hour near-roadway exposures (Tuesdays to Fridays) in Ann Arbor during 2 separate weeks (randomized to wear an N95 respirator during 1 week). Monday both weeks, participants rested 2 hours in an exam room (once wearing an N95 respirator). Brachial blood pressure, aortic hemodynamics, and heart rate variability were repeatedly measured during exposures. Endothelial function (reactive hyperemia index [RHI]) was measured post-exposures (Thursdays). Black carbon (BC), total particle count (PC), PM2.5, noise and temperature were measured throughout exposures. RESULTS PM2.5 (9.3 ± 7.7 µg/m3), BC (1.3 ± 0.6 µg/m3), PC (8,375 ± 4,930 particles/cm3) and noise (69.2 ± 4.2 dB) were higher (P values <0.01) and aortic hemodynamic parameters trended worse while near-roadway (P values<0.15 vs. exam room). Other outcomes were unchanged. Aortic hemodynamics trended towards improvements with N95 respirator usage while near-roadway (P values<0.15 vs. no-use), whereas other outcomes remained unaffected. Higher near-roadway PC and BC exposures were associated with increases in aortic augmentation pressures (P values<0.05) and trends toward lower RHI (P values <0.2). N95 respirator usage did not mitigate these adverse responses (nonsignificant pollutant-respirator interactions). Near-roadway outdoor-temperature and noise were also associated with cardiovascular changes. CONCLUSIONS Exposure to real-world combustion-derived particulates in TRAP, even at relatively low concentrations, acutely worsened aortic hemodynamics. Our mixed findings regarding the health benefits of wearing N95 respirators support that further studies are needed to validate if they adequately protect against TRAP given their growing worldwide usage.
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Affiliation(s)
- Masako Morishita
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Lu Wang
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Kelly Speth
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Nina Zhou
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert L Bard
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Fengyao Li
- Department of Family Medicine, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Jeffrey R Brook
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Sanjay Rajagopalan
- Division of Cardiovascular Medicine, Case Western Reserve Medical School, Cleveland, Ohio, USA
| | - Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Collins TW, Grineski SE, Nadybal S. Social disparities in exposure to noise at public schools in the contiguous United States. ENVIRONMENTAL RESEARCH 2019; 175:257-265. [PMID: 31146097 DOI: 10.1016/j.envres.2019.05.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 06/09/2023]
Abstract
Children are vulnerable to environmental hazards and spend significant portions of their days at school. However, just one national-level study has examined school-level environmental inequalities (in air pollution exposures), and none have examined disparate exposures to noise pollution, even though noise impacts children's health and development. We integrated data from 2014-2015 on the locations and socio-demographics of each public school in the contiguous US (n=94,432) with road and aviation transportation noise estimates. Using bivariate and multivariate statistics, we tested for disparities in road and aviation noise exposure across schools. Among the 49,697,890 children attending contiguous US public schools, we found that those attending schools most highly exposed to road noise or aviation noise were significantly more likely to be eligible for free/reduced price meals (economically deprived), and to be Hispanic, black, or Asian/Pacific Islander (API). They were less likely to be white or of another race. In multivariate generalized estimating equations (GEEs) controlling for school district effects, we found that schools with greater proportions of Hispanic, black or API students, schools with higher enrollment, and schools serving the youngest students had significantly more road noise and greater odds of aviation noise exposure. In the GEEs, a higher proportion of economically-deprived students in schools was associated with greater road noise, but not aviation noise. Overall, our analyses indicate that America's racial/ethnic minority children bear the brunt of transportation noise exposures at school, which may unequally impact their academic performance, health, and future potential.
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Affiliation(s)
- Timothy W Collins
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, United States.
| | - Sara E Grineski
- Department of Sociology, University of Utah; 380 S 1530 E, Rm. 301, Salt Lake City, UT, 84112, United States
| | - Shawna Nadybal
- Department of Geography, University of Utah; 260 Central Campus Dr., Rm. 4625, Salt Lake City, UT, 84112, United States
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Münzel T, Schmidt FP, Steven S, Herzog J, Daiber A, Sørensen M. Environmental Noise and the Cardiovascular System. J Am Coll Cardiol 2019; 71:688-697. [PMID: 29420965 DOI: 10.1016/j.jacc.2017.12.015] [Citation(s) in RCA: 222] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 12/12/2017] [Accepted: 12/15/2017] [Indexed: 01/13/2023]
Abstract
Noise has been found associated with annoyance, stress, sleep disturbance, and impaired cognitive performance. Furthermore, epidemiological studies have found that environmental noise is associated with an increased incidence of arterial hypertension, myocardial infarction, heart failure, and stroke. Observational and translational studies indicate that especially nighttime noise increases levels of stress hormones and vascular oxidative stress, which may lead to endothelial dysfunction and arterial hypertension. Novel experimental studies found aircraft noise to be associated with oxidative stress-induced vascular damage, mediated by activation of the NADPH oxidase, uncoupling of endothelial nitric oxide synthase, and vascular infiltration with inflammatory cells. Transcriptome analysis of aortic tissues from animals exposed to aircraft noise revealed changes in the expression of genes responsible for the regulation of vascular function, vascular remodeling, and cell death. This review focuses on the mechanisms and the epidemiology of noise-induced cardiovascular diseases and provides novel insight into the mechanisms underlying noise-induced vascular damage.
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Affiliation(s)
- Thomas Münzel
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany.
| | - Frank P Schmidt
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany
| | - Sebastian Steven
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany
| | - Johannes Herzog
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany
| | - Andreas Daiber
- University Medical Center Mainz Center of Cardiology, Cardiology I, Johannes Gutenberg University, Mainz, Germany
| | - Mette Sørensen
- Danish Cancer Society Research Center, Copenhagen, Denmark
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Generaal E, Timmermans EJ, Dekkers JEC, Smit JH, Penninx BWJH. Not urbanization level but socioeconomic, physical and social neighbourhood characteristics are associated with presence and severity of depressive and anxiety disorders. Psychol Med 2019; 49:149-161. [PMID: 29540253 PMCID: PMC6316373 DOI: 10.1017/s0033291718000612] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Revised: 02/13/2018] [Accepted: 02/16/2018] [Indexed: 12/02/2022]
Abstract
BACKGROUND Which neighbourhood factors most consistently impact on depression and anxiety remains unclear. This study examines whether objectively obtained socioeconomic, physical and social aspects of the neighbourhood in which persons live are associated with the presence and severity of depressive and anxiety disorders. METHODS Cross-sectional data are from the Netherlands Study of Depression and Anxiety including participants (n = 2980) with and without depressive and anxiety disorders in the past year (based on DSM-based psychiatric interviews). We also determined symptom severity of depression (Inventory of Depression Symptomatology), anxiety (Beck Anxiety Inventory) and fear (Fear Questionnaire). Neighbourhood characteristics comprised socioeconomic factors (socioeconomic status, home value, number of social security beneficiaries and percentage of immigrants), physical factors (air pollution, traffic noise and availability of green space and water) and social factors (social cohesion and safety). Multilevel regression analyses were performed with the municipality as the second level while adjusting for individual sociodemographic variables and household income. RESULTS Not urbanization grade, but rather neighbourhood socioecononomic factors (low socioeconomic status, more social security beneficiaries and more immigrants), physical factors (high levels of traffic noise) and social factors (lower social cohesion and less safety) were associated with the presence of depressive and anxiety disorders. Most of these neighbourhood characteristics were also associated with increased depressive and anxiety symptoms severity. CONCLUSION These findings suggest that it is not population density in the neighbourhood, but rather the quality of socioeconomic, physical and social neighbourhood characteristics that is associated with the presence and severity of affective disorders.
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Affiliation(s)
- Ellen Generaal
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Erik J. Timmermans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Jasper E. C. Dekkers
- Spatial Information Laboratory, Department of Spatial Economics, Faculty of Economics and Business Administration, VU University Amsterdam, Amsterdam, the Netherlands
| | - Johannes H. Smit
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - Brenda W. J. H. Penninx
- Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
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Fallah-Shorshani M, Minet L, Liu R, Plante C, Goudreau S, Oiamo T, Smargiassi A, Weichenthal S, Hatzopoulou M. Capturing the spatial variability of noise levels based on a short-term monitoring campaign and comparing noise surfaces against personal exposures collected through a panel study. ENVIRONMENTAL RESEARCH 2018; 167:662-672. [PMID: 30241005 DOI: 10.1016/j.envres.2018.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 07/25/2018] [Accepted: 08/14/2018] [Indexed: 06/08/2023]
Abstract
Environmental noise can cause important cardiovascular effects, stress and sleep disturbance. The development of appropriate methods to estimate noise exposure within a single urban area remains a challenging task, due to the presence of various transportation noise sources (road, rail, and aircraft). In this study, we developed a land-use regression (LUR) approach using a Generalized Additive Model (GAM) for LAeq (equivalent noise level) to capture the spatial variability of noise levels in Toronto, Canada. Four different model formulations were proposed based on continuous 20-min noise measurements at 92 sites and a leave one out cross-validation (LOOCV). Models where coefficients for variables considered as noise sources were forced to be positive, led to the development of more realistic exposure surfaces. Three different measures were used to assess the models; adjusted R2 (0.44-0.64), deviance (51-72%) and Akaike information criterion (AIC) (469.2-434.6). When comparing exposures derived from the four approaches to personal exposures from a panel study, we observed that all approaches performed very similarly, with values for the Fractional mean bias (FB), normalized mean square error (NMSE), and normalized absolute difference (NAD) very close to 0. Finally, we compared the noise surfaces with data collected from a previous campaign consisting of 1-week measurements at 200 fixed sites in Toronto and observed that the strongest correlations occurred between our predictions and measured noise levels along major roads and highway collectors. Our validation against long-term measurements and panel data demonstrates that manual modifications brought to the models were able to reduce bias in model predictions and achieve a wider range of exposures, comparable with measurement data.
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Affiliation(s)
| | - Laura Minet
- Civil Engineering, University of Toronto, Canada.
| | - Rick Liu
- Civil Engineering, University of Toronto, Canada.
| | - Céline Plante
- Direction régionale de santé publique du CIUSS du Centre-Sud-de-l'Île-de Montréal, Canada.
| | - Sophie Goudreau
- Direction régionale de santé publique du CIUSS du Centre-Sud-de-l'Île-de Montréal, Canada.
| | - Tor Oiamo
- Department of Geography and Environmental Studies, Faculty of Arts, Ryerson University, Canada.
| | - Audrey Smargiassi
- Department of Environmental Health and Occupational Health, School of Public Health, Universtiy of Montreal, Canada.
| | - Scott Weichenthal
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Canada.
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Brosschot JF, Verkuil B, Thayer JF. Generalized Unsafety Theory of Stress: Unsafe Environments and Conditions, and the Default Stress Response. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E464. [PMID: 29518937 PMCID: PMC5877009 DOI: 10.3390/ijerph15030464] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 02/13/2018] [Accepted: 02/27/2018] [Indexed: 12/14/2022]
Abstract
Prolonged physiological stress responses form an important risk factor for disease. According to neurobiological and evolution-theoretical insights the stress response is a default response that is always "on" but inhibited by the prefrontal cortex when safety is perceived. Based on these insights the Generalized Unsafety Theory of Stress (GUTS) states that prolonged stress responses are due to generalized and largely unconsciously perceived unsafety rather than stressors. This novel perspective necessitates a reconstruction of current stress theory, which we address in this paper. We discuss a variety of very common situations without stressors but with prolonged stress responses, that are not, or not likely to be caused by stressors, including loneliness, low social status, adult life after prenatal or early life adversity, lack of a natural environment, and less fit bodily states such as obesity or fatigue. We argue that in these situations the default stress response may be chronically disinhibited due to unconsciously perceived generalized unsafety. Also, in chronic stress situations such as work stress, the prolonged stress response may be mainly caused by perceived unsafety in stressor-free contexts. Thus, GUTS identifies and explains far more stress-related physiological activity that is responsible for disease and mortality than current stress theories.
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Affiliation(s)
- Jos F Brosschot
- Institute of Psychology, Unit Health, Medical and Neuropsychology, Leiden University, 2300 RB Leiden, The Netherlands.
| | - Bart Verkuil
- Institute of Psychology, Unit Clinical Psychology, Leiden University, 2300 RB Leiden, The Netherlands.
| | - Julian F Thayer
- Department of Psychology, The Ohio State University, Columbus, OH 43210, USA.
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Zeeb H, Hegewald J, Schubert M, Wagner M, Dröge P, Swart E, Seidler A. Traffic noise and hypertension - results from a large case-control study. ENVIRONMENTAL RESEARCH 2017; 157:110-117. [PMID: 28554004 DOI: 10.1016/j.envres.2017.05.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 05/11/2017] [Accepted: 05/15/2017] [Indexed: 05/09/2023]
Abstract
BACKGROUND Environmental traffic noise is a potential cause of hypertension. We aimed to study the association between hypertension as recorded in health insurance claims data and the exposure to three sources of traffic noise (aircraft, road and rail). METHODS This large case-control study was conducted among persons aged 40 and above in 2010 and living in the region around Frankfurt airport in Germany. Individual residential noise exposure for the index year 2005 was assessed using standard noise algorithms. Cases were all newly diagnosed cases of hypertension recorded in three large health insurances databases in the period 2006-2010. Controls had no hypertension diagnosis. Categorical and continuous analyses were conducted with binary logistic regression models adjusted for sex, age and residential area-based socioeconomic information. RESULTS The main analysis included 137,577 cases and 355,591 controls. There were no associations with any of the traffic noise sources. Odds ratios (OR) per 10dB noise increase were 0.99 (95% confidence interval: 0.98;1.01) for aircraft noise, and 1.00 (0.99;1.01) both for road and railway noise. Similarly, nighttime noise levels showed no associations with hypertension. Odds ratios were increased for the subgroup of newly diagnosed hypertension cases with a subsequent diagnosis of hypertensive heart disease: per 10dB aircraft noise there was a 13.9% OR increase (6.0% for road traffic, 5.4% for rail traffic). Increases were also noted when we analyzed cases with a longer exposure-outcome time window. CONCLUSION Our results are suggestive of an association of noise exposure with clinically more severe hypertension diagnoses, but not with uncomplicated hypertension. The absence of individual confounder data, however, adds to the risk of bias. The results contribute to evidence on traffic noise as a cardiovascular risk factor.
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Affiliation(s)
- Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz-Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany; Health Sciences Bremen, University of Bremen, Germany.
| | - Janice Hegewald
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Melanie Schubert
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Mandy Wagner
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Patrik Dröge
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - Enno Swart
- Institute of Social Medicine and Health Economics, Otto-von-Guericke-University Magdeburg, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
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Chung S, Youn S, Lee C, Jo MW, Park J, Jo SW, Lee J, Sung JH, Sim CS. Environmental Noise and Sleep Disturbance: Night-to-Night Variability of Sleep/Wake Pattern. SLEEP MEDICINE RESEARCH 2016. [DOI: 10.17241/smr.2016.00122] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
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