Noise sensitivity and future risk of illness and mortality

Subjective Complaints and Coping Strategies of Individuals with Reported Low-Frequency Noise Perceptions

Background: Subjective everyday hindrances associated with low-frequency noise (LFN) can be high; however, there is still a lot unknown about experienced complaints. This study aims to investigate (1) subjective complaints and (2) coping strategies of individuals reporting everyday hindrances from LFN. Methods: Cognition, depressive symptoms, sleeping, fatigue, stress, and coping questionnaires were administered to participants sampled for their LFN complaints (LFN1 = 181), LFN complainants derived from a community sample (LFN2 = 239), and a comparison group without LFN complaints (CG = 410). Results: Individuals reporting LFN perceptions reported complaints in all domains and showed a higher proportion of above average symptom severity compared to the CG. Most complaints were reported by the LFN1 group, the least by the CG. However, on some sleeping, fatigue, and stress-related variables, a similar or even higher symptom severity was observed in the LFN2 group. Further, all groups used a similar combination of multiple coping strategies, although the LFN1 group scored higher on support seeking. Conclusions: There might be differences in the complaint severity between different LFN subgroups and future investigations of primary and secondary complaints are necessary. Also, more research about the use and success of coping strategies for LFN-related hindrances are needed for clear conclusions.

Dose-response associations of maternal prenatal noise exposure duration with antepartum depression status

BACKGROUND

Antepartum depression has been reported to be associated with the intensity of maternal prenatal noise exposure; however, the association between noise exposure duration and the development of antepartum depression has not been established. This study aimed to determine the total and trimester-specific association of prenatal noise exposure duration with the development of antepartum depression.

METHODS

From May 2018 to June 2021, we recruited 2,166 pregnant women from Shengjing Hospital, northeast China. We used a standardized questionnaire to assess women's prenatal noise exposure and used the Edinburgh Postnatal Depression Scale to assess pregnant women's antepartum depression during the 1st -, 2nd -, and 3rd - trimesters. We calculated a cumulative noise exposure score ranging from 0 to 3, with a higher score reflecting higher frequency and longer duration of noise exposure during pregnancy.

RESULTS

Women who were exposed to noise for ≥ 15 min per day had an increased risk of antepartum depression compared with women who were not exposed to noise during pregnancy [odds ratio (OR) = 1.83, 95%CI:1.18, 2.83]. Noise exposure in a specific trimester was associated with higher risk of depression in the same trimester and subsequent trimesters. We observed increases in antepartum depression risk with increasing cumulative noise exposure scores (P for trend < 0.05 for all). Pregnant women with the highest scores had the highest risk of antepartum depression during the first (OR = 1.30, 95%CI:1.02, 1.65), second (OR = 1.75, 95%CI:1.23, 2.50) trimesters. Women with a cumulative noise exposure score of 2 had the highest risk of antepartum depression during the third trimester (OR = 1.79, 95%CI:1.14, 2.80), as well as during the whole pregnancy (OR = 1.94, 95%CI:1.14, 3.30).

CONCLUSIONS

Maternal prenatal noise exposure duration was positively associated with antepartum depression risk in a dose-response manner. It is necessary to develop strategies by which pregnant women can avoid excessive exposure to noise to prevent antepartum depression.

Psychometric properties of an arabic translation of the short form of Weinstein noise sensitivity scale (NSS-SF) in a community sample of adolescents

BACKGROUND

The Weinstein Noise Sensitivity Scale (NSS) is widely recognized as a prominent unidimensional self-reported questionnaire to measure noise sensitivity, which is regarded as the foremost subjective factor moderating the impact of noise on perceived levels of annoyance. In this current study, we conducted an examination of the psychometric properties of a newly translated Arabic version of the short form of the scale (NSS-SF).

METHODS

A sample of 527 Lebanese adolescents participated in the study, completing the NSS-SF with measures of noise annoyance and insomnia. The total sample was randomly divided into two subsamples. Exploratory-to-Confirmatory Factor Analysis (EFA-CFA) was conducted. The normed model chi-square (χ²/df), the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values ≤ 5 for χ²/df, and ≤ 0.08 for RMSEA, and 0.90 for CFI and TLI indicate good fit of the model to the data. Composite reliability in both subsamples was assessed using McDonald's ω and Cronbach's alpha.

RESULTS

EFA results on the first split-half subsample revealed that one item (item 2) was removed because of low communality (< 0.3); the other 4 items converged on one factor, which explained 67.85% of the common variance (ω = 0.84 and α = 0.84). CFA was conducted on the second half-split subsample in adults according to the model obtained on the first split-half subsample; the fit indices were acceptable as follows: χ2/df = 5.07/2 = 2.54, p < .001, RMSEA = 0.076 (90% CI 0.001, 0.160), SRMR = 0.021, CFI = 0.992, and TLI = 0.976 (ω = 0.84 and α = 0.84). Configural, metric, and scalar invariance was supported across gender in the total sample.

CONCLUSION

Our findings substantiate that the Arabic version of the NSS-SF is a reliable, psychometrically valid instrument for assessing noise sensitivity among Arab adolescents, thereby enhancing its overall utility and applicability within Arab countries.

The Neuroanatomy of Poststroke Subjective Sensory Hypersensitivity

BACKGROUND

Although subjective sensory hypersensitivity is prevalent after stroke, it is rarely recognized by health care providers, and its neural mechanisms are largely unknown.

OBJECTIVE

To investigate the neuroanatomy of poststroke subjective sensory hypersensitivity as well as the sensory modalities in which subjective sensory hypersensitivity can occur by conducting both a systematic literature review and a multiple case study of patients with subjective sensory hypersensitivity.

METHOD

For the systematic review, we searched three databases (Web of Science, PubMed, and Scopus) for empirical articles discussing the neuroanatomy of poststroke subjective sensory hypersensitivity in humans. We assessed the methodological quality of the included studies using the case reports critical appraisal tool and summarized the results using a qualitative synthesis. For the multiple case study, we administered a patient-friendly sensory sensitivity questionnaire to three individuals with a subacute right-hemispheric stroke and a matched control group and delineated brain lesions on a clinical brain scan.

RESULTS

Our systematic literature search resulted in four studies (describing eight stroke patients), all of which linked poststroke subjective sensory hypersensitivity to insular lesions. The results of our multiple case study indicated that all three stroke patients reported an atypically high sensitivity to different sensory modalities. These patients' lesions overlapped with the right anterior insula, the claustrum, and the Rolandic operculum.

CONCLUSION

Both our systematic literature review and our multiple case study provide preliminary evidence for a role of the insula in poststroke subjective sensory hypersensitivity and suggest that poststroke subjective sensory hypersensitivity can occur in different sensory modalities.

Low-Frequency Noise: Experiences from a Low-Frequency Noise Perceiving Population

Although low-frequency noise (LFN) is associated with various complaints, there is still much unknown about this phenomenon. This research aims to provide an extensive description of (1) LFN perceptions, (2) LFN-related complaints, and (3) the characteristics of LFN complainants. In an explorative observational cross-sectional survey study, a sample of Dutch adults reporting to experience LFN (n = 190) and a group not experiencing LFN (n = 371) completed a comprehensive questionnaire. Descriptions of LFN perceptions varied individually and were dependent on different circumstances, although some common patterns were observed. Complaints were wide-ranging and individual, with a reported high impact on daily living. Common complaints included sleeping difficulties, fatigue, or annoyance. Societal consequences were described regarding housing, work, and relationships. Attempts to stop or escape the perception were manifold but often unsuccessful. The LFN sample differed regarding sex, education level, and age from the Dutch adult population, indicating more frequent inability to work, less full-time work, and less years lived in their homes. No further differences in occupational or marital status or living circumstances were found. Although this research supports some previous findings and identifies common patterns, it also highlights the individual nature of LFN-related experiences and the heterogeneity of this group. It is advised to pay attention to the complaints of affected individuals, to inform concerned authorities, and to conduct more systematic and multidisciplinary research using standardized and validated measuring instruments.

Association of road traffic noise exposure and prevalence of coronary artery disease: A cross-sectional study in North India

Epidemiological studies have established that noise from transportation sources exceeding the safe limits elevates the risk for cardiovascular diseases. The results however have remained heterogeneous. The present study was conducted to investigate the association between road traffic noise exposure and prevalence of coronary artery disease besides sub-group analysis was performed for identifying the most susceptible population. Traffic noise exposure was measured using the L_den metric in both continuous and categorical forms. A cross-sectional study was performed and information about sociodemographic, lifestyle, and health-related factors was collected. Noise level < 60 dB(A) representing the quiet areas was used as the reference group. Univariate and multivariate logistic regressions were performed to estimate the odds for self-reported coronary artery disease concerning road traffic noise after adjusting for confounding variables. The residents living in noisy areas were found to have a 2.25 times higher risk per 5 dB(A) increment in the noise levels (95% CI = 1.38 to 3.67). Males were at a higher risk of CAD (OR = 2.61; 95% CI = 1.84 to 3.72) as compared to females (OR = 2.07; 95% CI = 1.37-3.13). The subgroup analysis revealed that being sensitive to noise, belonging to a higher age group, reporting higher stress levels, and poor sleep quality were associated with higher risk. The study also provides evidence that exposure to noise levels greater than 60 dB(A) is associated with the prevalence of coronary artery disease in adults.

Internal Consistency and Convergent Validity of the Inventory of Hyperacusis Symptoms

OBJECTIVES

The aim was to assess the internal consistency and convergent and discriminant validity of a new questionnaire for hyperacusis, the Inventory of Hyperacusis Symptoms (IHS; Greenberg & Carlos 2018), using a clinical population.

DESIGN

This was a retrospective study. Data were gathered from the records of 100 consecutive patients who sought help for tinnitus and/or hyperacusis from an audiology clinic in the United Kingdom. The average age of the patients was 55 years (SD = 13 years). Audiological measures were the pure-tone average threshold (PTA) and uncomfortable loudness levels (ULL). Questionnaires administered were: IHS, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (HQ), Insomnia Severity Index, Generalized Anxiety Disorder, and Patient Health Questionnaire-9.

RESULTS

Cronbach's alpha for the 25-item IHS questionnaire was 0.96. Neither the total IHS score nor scores for any of its five subscales were correlated with the PTA of the better or worse ear. This supports the discriminant validity of the IHS, as hyperacusis is thought to be independent of the PTA. There were moderately strong correlations between IHS total scores and scores for the HQ, Tinnitus Handicap Inventory, Generalized Anxiety Disorder, and Patient Health Questionnaire-9, with r = 0.58, 0.58, 0.61, 0.54, respectively. Thus, although IHS scores may reflect hyperacusis itself, they may also reflect the coexistence of tinnitus, anxiety, and depression. The total score on the IHS was significantly different between patients with and without hyperacusis (as diagnosed based on ULLs or HQ scores). Using the HQ score as a reference, the area under the receiver operating characteristic for the IHS was 0.80 (95% confidence interval = 0.71 to 0.89) and the cutoff point of the IHS with highest overall accuracy was 56/100. The corresponding sensitivity and specificity were 74% and 82%.

CONCLUSIONS

The IHS has good internal consistency and reasonably high convergent validity, as indicated by the relationship of IHS scores to HQ scores and ULLs, but IHS scores may also partly reflect the co-occurrence of tinnitus, anxiety, and depression. We propose an IHS cutoff score of 56 instead of 69 for diagnosing hyperacusis.

Road traffic noise, noise sensitivity, noise annoyance, psychological and physical health and mortality

BACKGROUND

Both physical and psychological health outcomes have been associated with exposure to environmental noise. Noise sensitivity could have the same moderating effect on physical and psychological health outcomes related to environmental noise exposure as on annoyance but this has been little tested.

METHODS

A cohort of 2398 men between 45 and 59 years, the longitudinal Caerphilly Collaborative Heart Disease study, was established in 1984/88 and followed into the mid-1990s. Road traffic noise maps were assessed at baseline. Psychological ill-health was measured in phase 2 in 1984/88, phase 3 (1989/93) and phase 4 (1993/7). Ischaemic heart disease was measured in clinic at baseline and through hospital records and records of deaths during follow up. We examined the longitudinal associations between road traffic noise and ischaemic heart disease morbidity and mortality using Cox Proportional Hazard Models and psychological ill-health using Logistic Regression; we also examined whether noise sensitivity and noise annoyance might moderate these associations. We also tested if noise sensitivity and noise annoyance were longitudinal predictors of ischaemic heart disease morbidity and mortality and psychological ill-health.

RESULTS

Road traffic noise was not associated with ischaemic heart disease morbidity or mortality. Neither noise sensitivity nor noise annoyance moderated the effects of road traffic noise on ischaemic heart disease morbidity or mortality. High noise sensitivity was associated with lower ischaemic heart disease mortality risk (HR = 0.74, 95%CI 0.57, 0.97). Road traffic noise was associated with Phase 4 psychological ill-health but only among those exposed to 56-60dBA (fully adjusted OR = 1.82 95%CI 1.07, 3.07). Noise sensitivity moderated the association of road traffic noise exposure with psychological ill-health. High noise sensitivity was associated longitudinally with psychological ill-health at phase 3 (OR = 1.85 95%CI 1.23, 2.78) and phase 4 (OR = 1.65 95%CI 1.09, 2.50). Noise annoyance predicted psychological ill-health at phase 4 (OR = 2.47 95%CI 1.00, 6.13).

CONCLUSIONS

Noise sensitivity is a specific predictor of psychological ill-health and may be part of a wider construct of environmental susceptibility. Noise sensitivity may increase the risk of psychological ill-health when exposed to road traffic noise. Noise annoyance may be a mediator of the effects of road traffic noise on psychological ill-health.

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.

The role of aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and medication use: results of a pooled-analysis from seven European countries

BACKGROUND

Few studies have considered aircraft noise annoyance and noise sensitivity in analyses of the health effects of aircraft noise, especially in relation to medication use. This study aims to investigate the moderating and mediating role of these two factors in the relationship between aircraft noise levels and medication use among 5860 residents of ten European airports included in the HYENA and DEBATS studies.

METHODS

Information on aircraft noise annoyance, noise sensitivity, medication use, and demographic, socio-economic and lifestyle factors was collected during a face-to-face interview at home. Medication was coded according to the Anatomical Therapeutic Chemical (ATC) classification. Outdoor aircraft noise exposure was estimated by linking the participant's home address to noise contours using Geographical Information Systems (GIS) methods. Logistic regressions with adjustment for potential confounding factors were used. In addition, Baron and Kenny's recommendations were followed to investigate the moderating and mediating effects of aircraft noise annoyance and noise sensitivity.

RESULTS

A significant association was found between aircraft noise levels at night and antihypertensive medication only in the UK (OR = 1.43, 95%CI 1.19-1.73 for a 10 dB(A)-increase in L_night). No association was found with other medications. Aircraft noise annoyance was significantly associated with the use of antihypertensive medication (OR = 1.33, 95%CI 1.14-1.56), anxiolytics (OR = 1.48, 95%CI 1.08-2.05), hypnotics and sedatives (OR = 1.60, 95%CI 1.07-2.39), and antasthmatics (OR = 1.44, 95%CI 1.07-1.96), with no difference between countries. Noise sensitivity was significantly associated with almost all medications, with the exception of the use of antasthmatics, showing an increase in ORs with the level of noise sensitivity, with differences in ORs among countries only for the use of antihypertensive medication. The results also suggested a mediating role of aircraft noise annoyance and a modifying role of both aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and medication use.

CONCLUSIONS

The present study is consistent with the results of the small number of studies available to date suggesting that both aircraft noise annoyance and noise sensitivity should be taken into account in analyses of the health effects of exposure to aircraft noise.

The role of aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and hypertension risk: Results of a pooled analysis from seven European countries

INTRODUCTION

Many studies, including the HYENA and the DEBATS studies, showed a significant association between aircraft noise exposure and the risk of hypertension. Few studies have considered aircraft noise annoyance and noise sensitivity as factors of interest, especially in relation to hypertension risk, or as mediating or modifying factors. The present study aims 1) to investigate the risk of hypertension in relation to aircraft noise annoyance or noise sensitivity; and 2) to examine the role of modifier or mediator of these two factors in the association between aircraft noise levels and the risk of hypertension.

METHODS

This study included 6,105 residents of ten European airports from the HYENA and DEBATS studies. Information on aircraft noise annoyance, noise sensitivity, and demographic, socioeconomic and lifestyle factors was collected during an interview performed at home. Participants were classified as hypertensive if they had either blood pressure levels above the WHO cut-off points or physician-diagnosed hypertension in conjunction with the use of antihypertensive medication. Outdoor aircraft noise exposure was estimated for each participant's home address. Poisson regression models with adjustment for potential confounders were used. Interactions between noise exposure and country were tested to consider possible differences between countries.

RESULTS

An increase in aircraft noise levels at night was weekly but significantly associated with an increased risk of hypertension (RR = 1.03, 95% CI 1.01-1.06 for a 10-dB(A) increase in L_night). A significant association was found between aircraft noise annoyance and hypertension risk (RR = 1.06, 95%CI 1.00-1.13 for highly annoyed people compared to those who were not highly annoyed). The risk of hypertension was slightly higher for people highly sensitive to noise compared to people with low sensitivity in the UK (RR = 1.29, 95%CI 1.05-1.59) and in France (RR = 1.11, 95%CI 0.68-1.82), but not in the other countries. The association between aircraft noise levels and the risk of hypertension was higher among highly sensitive participants (RR = 1.00, 95%CI 0.96-1.04; RR = 1.03, 95%CI 0.90-1.11; RR = 1.12, 95%CI 1.01-1.24, with a 10-dB(A) increase in L_night for low, medium, and high sensitive people respectively) or, to a lesser extent, among highly annoyed participants (RR = 1.06, 95%CI 0.95-1.18 for a 10-dB(A) increase in L_night among highly annoyed participants, and RR = 1.02, 95%CI 0.99-1.06 among those not highly annoyed).

CONCLUSIONS

The present study confirms findings in the small number of available studies to date suggesting adverse health effects associated with aircraft noise annoyance and noise sensitivity. The findings also indicate possible modifier effects of aircraft noise annoyance and noise sensitivity in the relationship between aircraft noise levels and the risk of hypertension. However, further investigations are needed to better understand this role using specific methodology and tools related to mediation analysis and causal inference.

Incidence of depression in relation to transportation noise exposure and noise annoyance in the SAPALDIA study

Prospective evidence on the risk of depression in relation to transportation noise exposure and noise annoyance is limited and mixed. We aimed to investigate the associations of long-term exposure to source-specific transportation noise and noise annoyance with incidence of depression in the SAPALDIA (Swiss cohort study on air pollution and lung and heart diseases in adults) cohort. We investigated 4,581 SAPALDIA participants without depression in the year 2001/2002. Corresponding one-year mean road, railway and aircraft day-evening-night noise (Lden) was calculated at the most exposed façade of the participants' residential floors, and transportation noise annoyance was assessed on an 11-point scale. Incident cases of depression were identified in 2010/2011, and comprised participants reporting physician diagnosis, intake of antidepressant medication or having a short form-36 mental health score < 50. We used robust Poisson regressions to estimate the mutually adjusted relative risks (RR) and 95% confidence intervals (CI) of depression, independent of traffic-related air pollution and other potential confounders. Incidence of depression was 11 cases per 1,000 person-years. In single exposure models, we observed positive but in part, statistically non-significant associations (per 10 dB) of road traffic Lden [RR: 1.06 (0.93, 1.22)] and aircraft Lden [RR: 1.19 (0.93, 1.53)], and (per 1-point difference) of noise annoyance [RR: 1.05 (1.02, 1.08)] with depression risk. In multi-exposure model, noise annoyance effect remained unchanged, with weaker effects of road traffic Lden [(RR: 1.02 (0.89, 1.17)] and aircraft Lden [(RR: 1.17 (0.90, 1.50)]. However, there were statistically significant indirect effects of road traffic Lden [(β: 0.02 (0.01, 0.03)] and aircraft Lden [β: 0.01 (0.002, 0.02)] via noise annoyance. There were no associations with railway Lden in the single and multi-exposure models [(RR_{both models}: 0.88 (0.75, 1.03)]. We made similar findings among 2,885 non-movers, where the effect modification and cumulative risks were more distinct. Noise annoyance effect in non-movers was stronger among the insufficiently active (RR: 1.09; 95%CI: 1.02, 1.17; p_interaction = 0.07) and those with daytime sleepiness [RR: 1.07 (1.02, 1.12); p_interaction = 0.008]. Cumulative risks of Lden in non-movers showed additive tendencies for the linear cumulative risk [(RR_{per 10dB of combined sources}: 1.31 (0.90, 1.91)] and the categorical cumulative risk [(RR_{triple- vs. zero-source ≥45 dB}: 2.29 (1.02, 5.14)], and remained stable to noise annoyance. Transportation noise level and noise annoyance may jointly and independently influence the risk of depression. Combined long-term exposures to noise level seems to be most detrimental, largely acting via annoyance. The moderation of noise annoyance effect by daytime sleepiness and physical activity further contribute to clarifying the involved mechanisms. More evidence is needed to confirm these findings for effective public health control of depression and noise exposure burden.

Incidence of depression in relation to transportation noise exposure and noise annoyance in the SAPALDIA study

Prospective evidence on the risk of depression in relation to transportation noise exposure and noise annoyance is limited and mixed. We aimed to investigate the associations of long-term exposure to source-specific transportation noise and noise annoyance with incidence of depression in the SAPALDIA (Swiss cohort study on air pollution and lung and heart diseases in adults) cohort. We investigated 4,581 SAPALDIA participants without depression in the year 2001/2002. Corresponding one-year mean road, railway and aircraft day-evening-night noise (Lden) was calculated at the most exposed façade of the participants' residential floors, and transportation noise annoyance was assessed on an 11-point scale. Incident cases of depression were identified in 2010/2011, and comprised participants reporting physician diagnosis, intake of antidepressant medication or having a short form-36 mental health score < 50. We used robust Poisson regressions to estimate the mutually adjusted relative risks (RR) and 95% confidence intervals (CI) of depression, independent of traffic-related air pollution and other potential confounders. Incidence of depression was 11 cases per 1,000 person-years. In single exposure models, we observed positive but in part, statistically non-significant associations (per 10 dB) of road traffic Lden [RR: 1.06 (0.93, 1.22)] and aircraft Lden [RR: 1.19 (0.93, 1.53)], and (per 1-point difference) of noise annoyance [RR: 1.05 (1.02, 1.08)] with depression risk. In multi-exposure model, noise annoyance effect remained unchanged, with weaker effects of road traffic Lden [(RR: 1.02 (0.89, 1.17)] and aircraft Lden [(RR: 1.17 (0.90, 1.50)]. However, there were statistically significant indirect effects of road traffic Lden [(β: 0.02 (0.01, 0.03)] and aircraft Lden [β: 0.01 (0.002, 0.02)] via noise annoyance. There were no associations with railway Lden in the single and multi-exposure models [(RR_{both models}: 0.88 (0.75, 1.03)]. We made similar findings among 2,885 non-movers, where the effect modification and cumulative risks were more distinct. Noise annoyance effect in non-movers was stronger among the insufficiently active (RR: 1.09; 95%CI: 1.02, 1.17; p_interaction = 0.07) and those with daytime sleepiness [RR: 1.07 (1.02, 1.12); p_interaction = 0.008]. Cumulative risks of Lden in non-movers showed additive tendencies for the linear cumulative risk [(RR_{per 10dB of combined sources}: 1.31 (0.90, 1.91)] and the categorical cumulative risk [(RR_{triple- vs. zero-source ≥45 dB}: 2.29 (1.02, 5.14)], and remained stable to noise annoyance. Transportation noise level and noise annoyance may jointly and independently influence the risk of depression. Combined long-term exposures to noise level seems to be most detrimental, largely acting via annoyance. The moderation of noise annoyance effect by daytime sleepiness and physical activity further contribute to clarifying the involved mechanisms. More evidence is needed to confirm these findings for effective public health control of depression and noise exposure burden.

Subjective sensitivity to noise and non-auditory health effects among adults in Niš, Serbia

OBJECTIVE

The aim of this study was to examine subjective sensitivity to noise of the citizens of Niš and its impact on their non-auditory health effects.

METHODS

This study was designed as a cross-sectional questionnaire survey among 908 adult residents of Niš, Serbia, of whom 387 were men (42.6%) and 521 women (57.4%). Streets with day L_eq ≥ 55 dB(A) and night L_eq ≥ 45 dB(A) were regarded as noisy and those with day L_eq ≤ 55 dB(A) and night L_eq ≤ 45 dB(A) were regarded as quiet, in accordance with WHO recommendations. Noise sensitivity was measured with the Weinstein's Noise Sensitivity Scale. Logistic regression analysis was used to assess the impact of noise sensitivity on non-auditory health effects.

RESULTS

The study showed that the values of the Weinstein's Noise Sensitivity Scale were significantly higher for those surveyed in the noisy zone. Multiple regression analysis revealed a significant impact of noise sensitivity on night-sleep duration (p = 0.04), subjective assessment of sleep quality (p < 0.01) and daily rest disruption (p < 0.001).

CONCLUSION

Based on the study results, it can be confirmed that noise sensitivity has an important role in causing non-auditory health effects among adults.

Urban Noise and Psychological Distress: A Systematic Review

Chronic exposure to urban noise is harmful for auditory perception, cardiovascular, gastrointestinal and nervous systems, while also causing psychological annoyance. Around 25% of the EU population experience a deterioration in the quality of life due to annoyance and about 5-15% suffer from sleep disorders, with many disability-adjusted life years (DALYs) lost annually. This systematic review highlights the main sources of urban noise, the relevant principal clinical disorders and the most effected countries. This review included articles published on the major databases (PubMed, Cochrane Library, Scopus), using a combination of some keywords. The online search yielded 265 references; after selection, the authors have analyzed 54 articles (5 reviews and 49 original articles). From the analysis, among the sources of exposure, we found the majority of items dealing with airports and wind turbines, followed by roads and trains; the main disorders that were investigated in different populations dealt with annoyance and sleep disorders, sometimes associated with cardiovascular symptoms. Regarding countries, studies were published from all over the world with a slight prevalence from Western Europe. Considering these fundamental health consequences, research needs to be extended in such a way as to include new sources of noise and new technologies, to ensure a health promotion system and to reduce the risk of residents being exposed.

The role of depressive symptoms within the association of long-term exposure to indoor and outdoor traffic noise and cognitive function - Results from the Heinz Nixdorf Recall study

OBJECTIVES

Traffic noise is negatively associated with cognitive function, and its perception can differ between depressed and non-depressed people. We studied the role of depressive symptoms in the association between traffic noise and cognitive function. We studied the role of depressive symptoms in the association between traffic noise and cognitive function.

METHODS

During the first follow-up examination (2006-2008) of the German Heinz Nixdorf Recall study, cognitive function (five subtests and an additive global summary score, GCS) and depressive symptoms (CES-D score) were assessed in 2745 participants (aged 50-80, 49.8% women). Mild cognitive impairment (MCI) was diagnosed according to the Petersen criteria in 380 participants. Long-term exposure to traffic noise was modeled as weighted 24-h mean (L_DEN) and night-time mean (L_NIGHT) at the façade of the baseline addresses, and was corrected for indoors (L_{DEN_IN} and L_{NIGHT_IN}). We developed multiple linear and logistic regression models adjusted for individual-level characteristics to investigate cross-sectionally the role of depressive symptoms in the association of traffic noise with cognitive function.

RESULTS

Overall, 8.6% participants had depressive symptoms. The median noise values were L_DEN 52.1 dB(A) and L_{DEN_IN} 34.7 dB(A). Associations were slightly stronger for cognitive subtests in those with severe depression (CES-D>21), i.e., per 10 dB(A) L_DEN and verbal fluency: β = -0.04 [-0.11; 0.03] for CES-D≤21 and β = -0.09 [-0.24; -0.06] for CES-D>21. Additional adjustment of the main model for CES-D did not change the association between noise and cognitive outcomes. Estimates using indoor noise exposure were generally stronger and more precise.

CONCLUSIONS

Depressed people may be more susceptible to adverse effects of noise than non-depressed. Modeled estimates of indoor noise exposure is possibly a more appropriate measure of exposure.

Multisensory environmental sensitivity in patients with chronic tinnitus

OBJECTIVE

The study aimed at investigating the sensitivity to noise and chemosensory environmental stressors as well as the relation to perceived stress, depression and anxiety in subjects with chronic tinnitus as compared to subjects without tinnitus.

METHODS

We included 75 subjects with chronic tinnitus and 75 age and sex-matched subjects without tinnitus. Standardized questionnaires assessing the level of distress and impairment of quality of life caused by tinnitus, perceived level of stress, anxiety and depression, environmental noise and chemosensory sensitivity were used. A subgroup of 27 subjects with chronic tinnitus and 20 age-matched subjects without tinnitus underwent testing of olfactory function with the Sniffin' Sticks test and testing of intranasal trigeminal function using CO2 thresholds.

RESULTS

Our data confirmed the increased environmental noise sensitivity (NSS) in patients with tinnitus. Furthermore, we observed an increased environmental chemosensory sensitivity (CSS), but no difference in measured chemosensory function. Subjects with tinnitus showed also significant higher levels of perceived stress, anxiety and depression and those symptoms partially correlated to CSS and NSS. Predictors of both NSS and CSS results were the presence / absence of tinnitus and high anxiety levels while neither stress nor depression were found as predicting variables.

CONCLUSIONS

The results suggest that chronic tinnitus is related to a multisensory environmental hypersensitivity. Anxiety seems to be a predictor of this environmental vulnerability.

Validating the Turkish version of the Weinstein noise sensitivity scale: effects of age, sex, and education level

Background/aim

Subjective noise sensitivity (SNS) is not only one of the most important predictors of perceived noise annoyance for the subjects exposed to the noise, but also strongly related with some psychological conditions and poor health perception of the subjects. Weinstein’s Noise Sensitivity Scale (WNSS) is widely used for measuring of SNS.

Materials and methods

In this study we adapted WNSS to Turkish (Tr-WNSS) and evaluated its psychometric properties and effect of age, sex and education level on SNS.

Results

The study included 105 males and 105 female subjects between 18 and 55 years of age.

Conclusion

Our data demonstrated that Tr-WNSS was a reliable, valid, and invariant scale for the Turkish population, and not affected by sex, age and education level.

A profile of noise sensitivity on the health-related quality of life among young motorcyclists

Introduction:

Motorcycle riders with noise sensitivity (NS) may suffer from degraded health-related quality of life (HRQOL) because they are exposed to acute noise levels on a daily basis.

Materials and Methods:

This study was aimed to identify the relationship between NS and HRQOL among young motorcycle riders (undergraduate university students) aged between 19 and 25 years (n = 301) through a cross-sectional questionnaire-based study, that is, Weinstein noise sensitivity scale and the World Health Organization Quality of Life. The effects of NS on HRQOL were assessed based on gender, the years of motorcycle driving experience, and noise sensitive among groups using one-way analysis of variances with an alpha value of 0.05.

Results:

The results showed no significant difference in NS between males and females. On the other hand, motorcycle driving experience for <4 years displayed a higher tendency toward NS. Moreover, a significantly (P = 0.004) decreasing trend among low, moderate, and high NS with their respective HRQOL was observed, while a high NS showed significantly (P = 0.015) lower scores on the social domain of the quality of life.

Conclusion:

The overall premise of the study has statistical significance and shows that individuals with high NS tend to have degraded HRQOL compared to individuals with low NS. Furthermore, in-depth studies are required from the other demographical background of participants to investigate the motorcyclist’s NS and HRQOL as an integral requirement for the rider’s safety and health.

Aircraft sound exposure leads to song frequency decline and elevated aggression in wild chiffchaffs

The ubiquitous anthropogenic low‐frequency noise impedes communication by masking animal signals. To overcome this communication barrier, animals may increase the frequency, amplitude and delivery rate of their acoustic signals, making them more easily heard. However, a direct impact of intermittent, high‐level aircraft noise on birds’ behaviour living close to a runway has not been studied in detail.

We recorded common chiffchaffs Phylloscopus collybita songs near two airports and nearby control areas, and we measured sound levels in their territories at Manchester Airport. The song recordings were made in between aircraft movements, when ambient sound levels were similar between airport and control populations. We also conducted playback experiments at the airport and a control population to test the salience of airport, and control population specific songs.

In contrast to the general pattern of increased song frequency in noisy areas, we show that common chiffchaffs at airports show a negative relationship between noise exposure level and song frequency.

Experimental data show that chiffchaffs living near airports also respond more aggressively to song playback.

Since the decrease in song frequency results in increased overlap with aircraft noise, these findings cannot be explained as an adaptation to improve communication. The increased levels of aggression suggest that chiffchaffs, like humans, might be affected behaviourally by extreme noise pollution. These findings should influence environmental impact assessments for airport expansions globally.

Environmental noise and sleep and mental health outcomes in a nationally representative sample of urban US adolescents

BACKGROUND

Environmental noise has been linked to negative health outcomes, like poor sleep, poor mental health, and cardiovascular disease, and likely accounts for more than 1 million disability-adjusted life years annually in Western Europe. Adolescence may be a particularly sensitive period for noise exposure due to an increased need for sleep, failure to meet sleep guidelines, and increased risk for first onset of some mental health disorders. However, the potential health effects of living in high-noise environments have not been studied in US adolescents, rarely in European adolescents, and mental health outcomes studied have not corresponded to diagnoses from the Diagnostic and Statistical Manual of Mental Disorders (DSM).

METHODS

Using a US-based nationally representative survey of urban adolescents (N = 4,508), we estimated associations of day-night average sound levels exceeding the US Environmental Protection Agency's 55 decibel limit with sleep outcomes and lifetime mental health DSM diagnoses. We implemented doubly robust targeted minimum loss-based estimation coupled with propensity score matching to account for numerous potential adolescent, household, and environmental confounders.

RESULTS

Living in a high- versus low-noise Census block group was associated with later bedtimes on weeknights (0.48 hours, 95% confidence interval [CI] = -0.15, 1.12) and weekend nights (0.65 hours, 95% CI = 0.37, 0.93), but not with total hours slept. Associations between living in a high- versus low-noise Census block group and mental disorders were mixed, with wide CIs, and not robust to sensitivity analyses.

CONCLUSIONS

We find evidence for an association between residence in a high-noise area and later bedtimes among urban adolescents but no consistent evidence of such an association with mental health disorders.

Relationship among noise exposure, sensitivity, and noise annoyance with job satisfaction and job stress in a textile industry

The purpose of this study was to investigate the relationship among noise exposure, sensitivity, and noise annoyance with job satisfaction and job stress among the workers of a textile industry. In this study, Weinstein’s Noise Sensitivity Scale, Noise Annoyance Questionnaire (recommended based on ISO 15666-2003), Health and Safety Executive (HSE) Job Stress Questionnaire, and Job Satisfaction Scale were used to determine the degree of noise sensitivity, noise annoyance, occupational stress, and job satisfaction, respectively. The results showed that there was a significant difference in the mean of job satisfaction, job stress, noise sensitivity, and noise annoyance between case and control groups. The results of multivariate analysis of covariance showed that noise exposure, noise sensitivity, and noise annoyance can justify 0.09, 0.19, and 0.06 of the variance of job stress, respectively. These variables also could justify 0.09, 0.12, and 0.05 of the variance of job satisfaction, respectively. Noise sensitivity had the greatest effect on increasing the occupational stress and job satisfaction.

Residential noise exposure and the longitudinal risk of hospitalization for depression after pregnancy: Postpartum and beyond

OBJECTIVE

Depression is a major public health concern, but the link with the built environment is unclear. We sought to determine the relationship between residential noise during pregnancy and later risk of severe depression in women.

METHODS

We analyzed a population-based cohort of 140,456 women with no documented history of mental illness who were pregnant in Montreal between 2000 and 2016. We obtained residential noise estimates (LA_{eq. 24 h}, L_den, L_night) from land use regression models, and followed the women over time for up to 18 years after pregnancy to identify subsequent hospitalizations for depression or other mental disorders. We used Cox regression to compute hazard ratios and 95% confidence intervals (CI) adjusted for maternal characteristics.

RESULTS

There were 8.0 incident hospitalizations for depression and 16.4 for other mental disorders per 10,000 person-years in women exposed to an LA_{eq. 24 h} of 60-64.9 dB(A). The incidence was lower for noise at < 55 dB(A), with 7.4 hospitalizations for depression and 13.8 for other mental disorders per 10,000 person-years. Compared with 50 dB(A), an LA_{eq. 24 h} of 60 dB(A) was associated with 1.16 times (95% CI 0.84-1.62) the risk of depression hospitalization, and 1.34 times (95% CI 1.04-1.74) the risk of other mental disorders. Associations were more prominent for L_night, with 1.32 times (95% CI 1.08-1.63) the risk of depression hospitalization at 60 dB(A) and 1.68 times the risk (95% CI 1.05-2.67) at 70 dB(A).

CONCLUSIONS

Pregnant women exposed to noise, especially nighttime noise, have a greater risk of hospitalization for depression and other mental disorders later in life. Residential noise may be a risk factor for depression after pregnancy.

Traffic noise exposure of high-rise residential buildings in urban area

Noise pollution is a major factor of environmental complaints in many cities, which has significant impacts on human health. As a dominating source of environmental noise, the impact of road traffic noise is increasing. Residents living in high-rise buildings along the main road are severely affected by traffic noise. In order to assess the noise level of urban area along the main road in Guangzhou, three buildings were selected to conduct traffic noise measurements, and the questionnaire about traffic noise impact on human being was completed. Through the questionnaire, around 70% of participants consider the traffic noise has negative effect, and about 60% of participants consider the noise has moderate or much higher impact on physical comfort. Around 65% of participants consider the noise had moderately or much higher impact on their psychological comfort. By analyzing the measured data, all of the measured noise levels in three buildings exceed the recommended limit of 55 dB (A) in the daytime and 45 dB (A) in the night for residence, and the exceeded value can be up to 16 dB (A). By comparing the fitting curve of noise level transfer function on each floor relative to the reference floor, the quadratic polynomial was selected to plot the transfer function rather than cubic polynomial.

Aviation Noise and Cardiovascular Health in the United States: a Review of the Evidence and Recommendations for Research Direction

Purpose of the Review

In the USA, there is mounting pressure on aviation operators and regulators to address concerns about community impacts of aircraft noise given increasing evidence of adverse health impacts, continuing community complaints, availability of cost-effective programs to reduce exposures to aircraft noise, and more stringent international policies. In the USA, regulation of civil aviation noise is the responsibility of the Federal Aviation Administration (FAA), which requires a "significant body of scientific support," particularly applicable to the USA, to inform health-based policy and regulatory decisions. However, there have been very few studies investigating the relationship between noise and health in the USA and limited studies across the globe characterizing the effects of aviation noise specifically on cardiovascular health. This review focuses on recent findings on the relationship between aircraft noise and cardiovascular outcomes and directions for future research.

Recent Findings

Epidemiological studies generally report statistically significant associations between aircraft noise and adverse cardiovascular outcomes, although with limited evidence within the USA. Sleep disturbance, associated with nighttime noise, has been shown to be a risk factor for cardiovascular disease given associations with inflammatory markers and metabolic changes. Given numerous cardiovascular markers, the most appropriate choices depend on the ultimate objectives of the individual studies.

Summary

Given the state of the literature, future research should leverage emerging tools to estimate aviation, railway, and road traffic noise and apply noise estimates to a range of epidemiological study designs and endpoints to inform causal interpretation and help determine potential intervention strategies.

Comparison of sensitivity and annoyance to road traffic and community noise between a South African and a Swiss population sample

In developing countries, noise annoyance and noise sensitivity are not commonly investigated. The present study aimed to assess the annoyance and sensitivity to noise in 364 adults living in informal settings in the Western Cape Province, South Africa and to compare with a similar study conducted in Switzerland. Compared to Switzerland, higher percentages of highly noise sensitive individuals (women: 35.1% vs 26.9%; men: 25% vs 20.5%) and people highly annoyed to road traffic noise (women: 20.5% vs 12.4%; men: 17.9% vs 11.1%) were observed in South Africa. While in South Africa women were more annoyed to neighborhood noise than in Switzerland (21.1% vs 9.4%), this was not the case among men (7.1% vs 7.8%). Multivariable logistic regression models showed that in both countries men tended to be less sensitive and less annoyed by noise. Corresponding associations with age and education were somewhat different between the countries, which may be explained by socioeconomic and environmental differences. This study indicates that noise exposure considerably affects people living in informal settlements, and noise should be considered when improving the housing conditions.

Aircraft Noise and Psychological Ill-Health: The Results of a Cross-Sectional Study in France

Background: The effects of aircraft noise on psychological ill-health have not been largely investigated and remain to be discussed. No study has been performed in France on the health effects of aircraft noise. Objectives: The present study aimed to investigate the relationship between aircraft noise in dB and in terms of annoyance and psychological ill-health in populations living near airports in France. Methods: A total of 1244 individuals older than 18 and living near three French airports (Paris–Charles de Gaulle, Lyon–Saint-Exupéry and Toulouse–Blagnac) were randomly selected to participate in the study. Information about their personal medical history and socioeconomic and lifestyle factors was collected by means of a face-to-face questionnaire performed at their place of residence by an interviewer. Psychological ill-health was evaluated with the 12-item version of the General Heath Questionnaire (GHQ-12). For each participant, outdoor aircraft noise exposure in dB was estimated by linking their home address to noise maps. Objective noise exposure in dB was considered to be the primary exposure of interest. Four noise indicators referring to three different periods of the day were derived and used for the statistical analyses: L_den, L_Aeq,24hr, L_{Aeq,6hr–22hr}, and L_night. Noise annoyance and noise sensitivity were the secondary risk factors of interest. Logistic regression models were used with adjustment for potential confounders. Results: The participation rate in the study was 30%. Approximately 22% of the participants were considered to have psychological ill-health according to the GHQ-12. No direct association was found between exposure to aircraft noise in dB and psychological ill-health. However, annoyance due to aircraft noise and noise sensitivity were both significantly associated with psychological ill-health. Moreover, a gradient was evidenced between annoyance and psychological ill-health, with increasing ORs from 1.79 (95% CI 1.06–3.03) for people who were not all annoyed to 4.00 (95% CI 1.67–9.55) for extremely annoyed people_.Conclusions: These findings confirm the results of previous studies, suggesting there is no direct association between aircraft noise exposure in dB and psychological ill-health, but there is a significant relationship between noise sensitivity or annoyance due to aircraft noise and psychological ill-health. This supports the hypothesis that psychological aspects, such as noise annoyance and noise sensitivity, play important roles in the association between environmental noise and adverse effects on health. However, further studies are necessary in order to better understand the links between these variables.

Sensory Sensitivity in TBI: Implications for Chronic Disability

PURPOSE OF REVIEW

This review investigates the relationship between sensory sensitivity and traumatic brain injury (TBI), and the role sensory sensitivity plays in chronic disability.

RECENT FINDINGS

TBI is a significant cause of disability with a range of physical, cognitive, and mental health consequences. Sensory sensitivities (e.g., noise and light) are among the most frequently reported, yet least outwardly recognizable symptoms following TBI. Clinicians and scientists alike have yet to identify consistent nomenclature for defining noise and light sensitivity, making it difficult to accurately and reliably assess their influence. Noise and light sensitivity can profoundly affect critical aspects of independent function including communication, productivity, socialization, cognition, sleep, and mental health. Research examining the prevalence of sensory sensitivity and evidence for the association of sensory sensitivity with TBI is inconclusive. Evidence-based interventions for sensory sensitivity, particularly following TBI, are lacking.

Associated Factors of Self-Rated Mental Health Status in Southwestern Iran: Using SCAD Regression Model in a Population-Based Study

This study aimed to investigate the association between self-rated mental health (SRMH) and current health status of an Iranian population. A cross-sectional study was conducted on 3400 individuals selected through random sampling in Shiraz, Iran between January 2014 and March 2015. Data were gathered through face-to-face interviews. Statistical analyses were performed using the SPSS 19.0, and R.3.1.2 software was used for SCAD penalized logistic regression. The mean age of the participants was 38.5 (± 14.1 years). There were significant relationships between better SRMH and younger ages (p < 0.001), and between better SRMH and better self-rated physical health (p < 0.001). Individuals with poor SRMH were more likely to have signs and symptoms of medical diseases. SRMH, a component of self-rated health, was related to a variety of health problems in our study population. Therefore, paying attention to SRMH and mental well-being could be useful in making decision about implementation of preventive measures.

Aviation Noise and Cardiovascular Health in the United States: a Review of the Evidence and Recommendations for Research Direction

PURPOSE OF THE REVIEW

In the USA, there is mounting pressure on aviation operators and regulators to address concerns about community impacts of aircraft noise given increasing evidence of adverse health impacts, continuing community complaints, availability of cost-effective programs to reduce exposures to aircraft noise, and more stringent international policies. In the USA, regulation of civil aviation noise is the responsibility of the Federal Aviation Administration (FAA), which requires a "significant body of scientific support," particularly applicable to the USA, to inform health-based policy and regulatory decisions. However, there have been very few studies investigating the relationship between noise and health in the USA and limited studies across the globe characterizing the effects of aviation noise specifically on cardiovascular health. This review focuses on recent findings on the relationship between aircraft noise and cardiovascular outcomes and directions for future research.

RECENT FINDINGS

Epidemiological studies generally report statistically significant associations between aircraft noise and adverse cardiovascular outcomes, although with limited evidence within the USA. Sleep disturbance, associated with nighttime noise, has been shown to be a risk factor for cardiovascular disease given associations with inflammatory markers and metabolic changes. Given numerous cardiovascular markers, the most appropriate choices depend on the ultimate objectives of the individual studies.

SUMMARY

Given the state of the literature, future research should leverage emerging tools to estimate aviation, railway, and road traffic noise and apply noise estimates to a range of epidemiological study designs and endpoints to inform causal interpretation and help determine potential intervention strategies.

The Adverse Effects of Environmental Noise Exposure on Oxidative Stress and Cardiovascular Risk

Epidemiological studies have provided evidence that traffic noise exposure is linked to cardiovascular diseases such as arterial hypertension, myocardial infarction, and stroke. Noise is a nonspecific stressor that activates the autonomous nervous system and endocrine signaling. According to the noise reaction model introduced by Babisch and colleagues, chronic low levels of noise can cause so-called nonauditory effects, such as disturbances of activity, sleep, and communication, which can trigger a number of emotional responses, including annoyance and subsequent stress. Chronic stress in turn is associated with cardiovascular risk factors, comprising increased blood pressure and dyslipidemia, increased blood viscosity and blood glucose, and activation of blood clotting factors, in animal models and humans. Persistent chronic noise exposure increases the risk of cardiometabolic diseases, including arterial hypertension, coronary artery disease, diabetes mellitus type 2, and stroke. Recently, we demonstrated that aircraft noise exposure during nighttime can induce endothelial dysfunction in healthy subjects and is even more pronounced in coronary artery disease patients. Importantly, impaired endothelial function was ameliorated by acute oral treatment with the antioxidant vitamin C, suggesting that excessive production of reactive oxygen species contributes to this phenomenon. More recently, we introduced a novel animal model of aircraft noise exposure characterizing the underlying molecular mechanisms leading to noise-dependent adverse oxidative stress-related effects on the vasculature. With the present review, we want to provide an overview of epidemiological, translational clinical, and preclinical noise research addressing the nonauditory, adverse effects of noise exposure with focus on oxidative stress. Antioxid. Redox Signal. 28, 873-908.

Prevalence of various environmental intolerances in a Swedish and Finnish general population

OBJECTIVE

To determine the prevalence of various environmental intolerances (EIs), using several criteria in a Swedish and a Finnish general population. Ill-health attributed to low-level environmental exposures is a commonly encountered challenge in occupational and environmental medicine.

METHODS

In population-based questionnaire surveys, the Västerbotten Environmental Health Study (Sweden) and the Österbotten Environmental Health Study (Finland), EI was inquired by one-item questions on symptom attribution to chemicals, certain buildings, or electromagnetic fields (EMFs), and difficulties tolerating sounds. The respondents were asked whether they react with central nervous system (CNS) symptoms or have a physician-diagnosed EI attributed to the corresponding exposures. Prevalence rates were determined for different age and sex groups and the Swedish and Finnish samples in general.

RESULTS

In the Swedish sample (n = 3406), 12.2% had self-reported intolerance to chemicals, 4.8% to certain buildings, 2.7% to EMFs, and 9.2% to sounds. The prevalence rates for the Finnish sample (n = 1535) were 15.2%, 7.2%, 1.6%, and 5.4%, respectively, differing statistically significantly from the Swedish. EI to chemicals and certain buildings was more prevalent in Finland, while EI to EMFs and sounds more prevalent in Sweden. The prevalence rates for EI with CNS-symptoms were lower and physician-diagnosed EIs considerably lower than self-reported EIs. Women reported EI more often than men and the young (18-39 years) to a lesser degree than middle-aged and elderly.

CONCLUSIONS

The findings reflect the heterogeneous nature of EI. The differences in EI prevalence between the countries might reflect disparities concerning which exposures people perceive harmful and focus their attention to.

Race/Ethnicity, Socioeconomic Status, Residential Segregation, and Spatial Variation in Noise Exposure in the Contiguous United States

BACKGROUND

Prior research has reported disparities in environmental exposures in the United States, but, to our knowledge, no nationwide studies have assessed inequality in noise pollution.

OBJECTIVES

We aimed to a) assess racial/ethnic and socioeconomic inequalities in noise pollution in the contiguous United States; and b) consider the modifying role of metropolitan level racial residential segregation.

METHODS

We used a geospatial sound model to estimate census block group–level median (L₅₀) nighttime and daytime noise exposure and 90th percentile (L₁₀) daytime noise exposure. Block group variables from the 2006–2010 American Community Survey (ACS) included race/ethnicity, education, income, poverty, unemployment, homeownership, and linguistic isolation. We estimated associations using polynomial terms in spatial error models adjusted for total population and population density. We also evaluated the relationship between race/ethnicity and noise, stratified by levels of metropolitan area racial residential segregation, classified using a multigroup dissimilarity index.

RESULTS

Generally, estimated nighttime and daytime noise levels were higher for census block groups with higher proportions of nonwhite and lower-socioeconomic status (SES) residents. For example, estimated nighttime noise levels in urban block groups with 75% vs. 0% black residents were 46.3 A-weighted decibels (dBA) [interquartile range (IQR): 44.3–47.8 dBA] and 42.3 dBA (IQR: 40.4–45.5 dBA), respectively. In urban block groups with 50% vs. 0% of residents living below poverty, estimated nighttime noise levels were 46.9 dBA (IQR: 44.7–48.5 dBA) and 44.0 dBA (IQR: 42.2–45.5 dBA), respectively. Block groups with the highest metropolitan area segregation had the highest estimated noise exposures, regardless of racial composition. Results were generally consistent between urban and suburban/rural census block groups, and for daytime and nighttime noise and robust to different spatial weight and neighbor definitions.

CONCLUSIONS

We found evidence of racial/ethnic and socioeconomic differences in model-based estimates of noise exposure throughout the United States. Additional research is needed to determine if differences in noise exposure may contribute to health disparities in the United States. https://doi.org/10.1289/EHP898

Noise sensitivity, rather than noise level, predicts the non-auditory effects of noise in community samples: a population-based survey

BACKGROUND

Excessive noise affects human health and interferes with daily activities. Although environmental noise may not directly cause mental illness, it may accelerate and intensify the development of latent mental disorders. Noise sensitivity (NS) is considered a moderator of non-auditory noise effects. In the present study, we aimed to assess whether NS is associated with non-auditory effects.

METHODS

We recruited a community sample of 1836 residents residing in Ulsan and Seoul, South Korea. From July to November 2015, participants were interviewed regarding their demographic characteristics, socioeconomic status, medical history, and NS. The non-auditory effects of noise were assessed using the Center of Epidemiologic Studies Depression, Insomnia Severity index, State Trait Anxiety Inventory state subscale, and Stress Response Inventory-Modified Form. Individual noise levels were recorded from noise maps. A three-model multivariate logistic regression analysis was performed to identify factors that might affect psychiatric illnesses.

RESULTS

Participants ranged in age from 19 to 91 years (mean: 47.0 ± 16.1 years), and 37.9% (n = 696) were male. Participants with high NS were more likely to have been diagnosed with diabetes and hyperlipidemia and to use psychiatric medication. The multivariable analysis indicated that even after adjusting for noise-related variables, sociodemographic factors, medical illness, and duration of residence, subjects in the high NS group were more than 2 times more likely to experience depression and insomnia and 1.9 times more likely to have anxiety, compared with those in the low NS group. Noise exposure level was not identified as an explanatory value.

CONCLUSIONS

NS increases the susceptibility and hence moderates there actions of individuals to noise. NS, rather than noise itself, is associated with an elevated susceptibility to non-auditory effects.

Public health implications of environmental noise associated with unconventional oil and gas development

Modern oil and gas development frequently occurs in close proximity to human populations and increased levels of ambient noise have been documented throughout some phases of development. Numerous studies have evaluated air and water quality degradation and human exposure pathways, but few have evaluated potential health risks and impacts from environmental noise exposure. We reviewed the scientific literature on environmental noise exposure to determine the potential concerns, if any, that noise from oil and gas development activities present to public health. Data on noise levels associated with oil and gas development are limited, but measurements can be evaluated amidst the large body of epidemiology assessing the non-auditory effects of environmental noise exposure and established public health guidelines for community noise. There are a large number of noise dependent and subjective factors that make the determination of a dose response relationship between noise and health outcomes difficult. However, the literature indicates that oil and gas activities produce noise at levels that may increase the risk of adverse health outcomes, including annoyance, sleep disturbance, and cardiovascular disease. More studies that investigate the relationships between noise exposure and human health risks from unconventional oil and gas development are warranted. Finally, policies and mitigation techniques that limit human exposure to noise from oil and gas operations should be considered to reduce health risks.

Noise sensitivity: Symptoms, health status, illness behavior and co-occurring environmental sensitivities

Epidemiological evidence on the symptomatic profile, health status and illness behavior of people with subjective sensitivity to noise is still scarce. Also, it is unknown to what extent noise sensitivity co-occurs with other environmental sensitivities such as multi-chemical sensitivity and sensitivity to electromagnetic fields (EMF). A cross-sectional study performed in the Netherlands, combining self-administered questionnaires and electronic medical records of non-specific symptoms (NSS) registered by general practitioners (GP) allowed us to explore this further. The study sample consisted of 5806 participants, drawn from 21 general practices. Among participants, 722 (12.5%) responded "absolutely agree" to the statement "I am sensitive to noise", comprising the high noise-sensitive (HNS) group. Compared to the rest of the sample, people in the HNS group reported significantly higher scores on number and duration of self-reported NSS, increased psychological distress, decreased sleep quality and general health, more negative symptom perceptions and higher prevalence of healthcare contacts, GP-registered NSS and prescriptions for antidepressants and benzodiazepines. These results remained robust after adjustment for demographic, residential and lifestyle characteristics, objectively measured nocturnal noise exposure from road-traffic and GP-registered morbidity. Co-occurrence rates with other environmental sensitivities varied between 9% and 50%. Individuals with self-declared sensitivity to noise are characterized by high prevalence of multiple NSS, poorer health status and increased illness behavior independently of noise exposure levels. Findings support the notion that different types of environmental sensitivities partly overlap.

Health effects from low-frequency noise and infrasound in the general population: Is it time to listen? A systematic review of observational studies

A systematic review of observational studies was conducted to assess the association between everyday life low-frequency noise (LFN) components, including infrasound and health effects in the general population. Literature databases Pubmed, Embase and PsycInfo and additional bibliographic sources such as reference sections of key publications and journal databases were searched for peer-reviewed studies published from 2000 to 2015. Seven studies met the inclusion criteria. Most of them examined subjective annoyance as primary outcome. The adequacy of provided information in the included papers and methodological quality of studies was also addressed. Moreover, studies were screened for meta-analysis eligibility. Some associations were observed between exposure to LFN and annoyance, sleep-related problems, concentration difficulties and headache in the adult population living in the vicinity of a range of LFN sources. However, evidence, especially in relation to chronic medical conditions, was very limited. The estimated pooled prevalence of high subjective annoyance attributed to LFN was about 10%. Epidemiological research on LFN and health effects is scarce and suffers from methodological shortcomings. Low frequency noise in the everyday environment constitutes an issue that requires more research attention, particularly for people living in the vicinity of relevant sources.

Noise and somatic symptoms: A role for personality traits?

OBJECTIVES

We investigated the role of a stress-sensitive personality on relations between noise, noise annoyance and somatic symptom reporting. First, we investigated the cross-sectional association of road traffic noise exposure and somatic symptoms, and its modification by hostility and vulnerability to stress. Second, we investigated the cross-sectional association of noise annoyance from eight sources (e.g. road traffic, aircraft, neighbours) and somatic symptoms, and it's confounding by hostility and vulnerability to stress.

METHODS

Data were obtained from LifeLines, a general population cohort from the Netherlands. Road traffic noise was estimated using the Common Noise Assessment Methods in Europe (CNOSSOS-EU) noise model. Noise annoyance, hostility, vulnerability to stress, and somatic symptoms were assessed with validated questionnaires.

RESULTS

Poisson regression models adjusted for demographic and socioeconomic variables indicated no association of noise exposure and somatic symptoms (incidence rate ratio (IRR) 1.001; 95% confidence interval (CI) 1.000-1.001; n=56,937). Interactions of noise exposure and hostility and vulnerability to stress were not statistically significant. Small positive associations were found for noise annoyance from each of the eight sources and somatic symptoms, when adjusted for demographic and socioeconomic variables (e.g. for road traffic noise annoyance IRR 1.014, 95% CI 1.011-1.018; n=6177). Additional adjustment for hostility and vulnerability to stress resulted in small decreases of the IRRs for noise annoyance from each of the eight sources, but the associations remained statistically significant.

CONCLUSIONS

Personality facets hostility and vulnerability to stress did not modify the relation between road traffic noise exposure and somatic symptom reporting, or confound relations between noise annoyance and symptoms.