Environmental burden of disease in Europe: assessing nine risk factors in six countries

CD36-mediated ROS/PI3K/AKT signaling pathway exacerbates cognitive impairment in APP/PS1 mice after noise exposure

There is an association between noise exposure and cognitive impairment, and noise may have a more severe impact on patients with Alzheimer's disease (AD) and mild cognitive impairment; however, the mechanisms need further investigation. This study used the classic AD animal model APP/PS1 mice to simulate the AD population, and C57BL/6J mice to simulate the normal population. We compared their cognitive abilities after noise exposure, analyzed changes in Cluster of Differentiation (CD) between the two types of mice using transcriptomics, identified the differential CD molecule: CD36 in APP/PS1 after noise exposure, and used its pharmacological inhibitor to intervene to explore the mechanism by which CD36 affects APP/PS1 cognitive abilities. Our study shows that noise exposure has a more severe impact on the cognitive abilities of APP/PS1 mice, and that the expression trends of differentiation cluster molecules differ significantly between C57BL/6J and APP/PS1 mice. Transcriptomic analysis showed that the expression of CD36 in the hippocampus of APP/PS1 mice increased by 2.45-fold after noise exposure (p < 0.001). Meanwhile, Western Blot results from the hippocampus and entorhinal cortex indicated that CD36 protein levels increased by approximately 1.5-fold (p < 0.001) and 1.3-fold (p < 0.05) respectively, after noise exposure in APP/PS1 mice. The changes in CD36 expression elevated oxidative stress levels in the hippocampus and entorhinal cortex, leading to a decrease in PI3K/AKT phosphorylation, which in turn increased M1-type microglia and A1-type astrocytes while reducing the numbers of M2-type microglia and A2-type astrocytes. This increased neuroinflammation in the hippocampus and entorhinal cortex, causing synaptic and neuronal damage in APP/PS1 mice, ultimately exacerbating cognitive impairment. These findings may provide new insights into the relationship between noise exposure and cognitive impairment, especially given the different expression trends of CD molecules in the two types of mice, which warrants further research.

Association between residential noise exposure and burnout among healthcare workers in Taiwan: a cross-sectional study

Few studies have explored the association between residential noise exposure and burnout. In this study, we investigated the association between residential noise exposure and burnout prevalence among 5416 health-care workers in Taiwan from 2012 to 2017. Burnout was evaluated using the Mandarin version of the Copenhagen Burnout Inventory by considering both continuous and binary measures. We applied ordinary Kriging models to calculate the annual average residential noise exposure at an individual level. Multivariable linear regression models and logistic regression models were employed. Restricted cubic splines were used to explore dose-response relationships. The median age of the health-care workers was 31.5 years. In the multivariable linear regression models, exposure to residential noise (per 1 dBA) was associated with increases in personal burnout and work-related burnout scores by 1.59 ± 0.25 and 1.38 ± 0.20, respectively. In the multivariable logistic regression models, the adjusted odds ratios were 1.24 (95% confidence interval [CI]: 1.16, 1.32) for personal burnout and 1.19 (95% CI: 1.13, 1.26) for work-related burnout per 1-dBA increase in residential noise exposure. Linear dose-response associations of burnout with residential noise level were detected. Our findings suggest that exposure to residential noise may increase the risk of burnout among health-care workers.

Informing the public about chemical mixtures in the local environment: Currently applied indicators in the Netherlands and ways forward

The current use of chemicals puts pressure on human and ecological health. Based on the Aarhus Convention, citizens have the right to have access to information on substances in their local environment. Providing this information is a major challenge, especially considering complex mixtures, as the current substance-by-substance risk assessment may not adequately address the risk of co-exposure to multiple substances. Here, we provide an overview of the currently available indicators in the Netherlands to explore current scientific possibilities to indicate the impacts of complex chemical mixtures in the environment on human health and ecology at the local scale. This is limited to impact estimates on freshwater species for 701 substances, impact estimates of four metals on soil organisms, and impacts on human health for particulate matter (PM10) and nitrogen dioxide (NO2) in air. The main limiting factors in developing and expanding these indicators to cover more compartments and substances are the availability of emission and concentration data of substances and dose-response relationships at the population (human health) or community (ecology) level. As ways forward, we propose; 1) developing cumulative assessment groups (CAGs) for substances on the European Pollutant Transfer and Release Register and Water Framework Directive substance lists, to enable the development of mixture indicators based on mixture risk assessment and concentration addition principles; 2) to gain insight into local mixtures by also applying these CAGs to emission data, which is available for soil and air for more substances than concentrations data; 3) the application of analytical non-target screening methods as well as effect-based methods for whole-mixture assessment.

Noise barriers as a mitigation measure for highway traffic noise: Empirical evidence from three study cases

Noise barriers are path interventions between noise sources and human receivers used mainly along road corridors to improve the acoustic environment for affected residents. Despite their widespread use, the impact of these interventions on community perception is still insufficiently investigated. This paper presents findings from a longitudinal study evaluating the efficacy of noise barriers in three residential areas alongside highways, compared to a reference case in a relatively quiet area. Noise exposure was objectively quantified via acoustic measurements and noise modelling, while socio-acoustic surveys measured the residents' subjective response in terms of noise annoyance as well as other aspects of quality of life. While noise exposure (Lday) decreased on average by 4.4-11.7 dBA at near-barrier points, direct reductions in pre to post-intervention noise annoyance were observed only in one case. Additionally, only in this particular case were the appraisals of the acoustic environment restored to a condition similar to low-level noise emissions (reference case). Contextual factors potentially downgrading the interventions' effectiveness are discussed, such as the history of complaints and coping, mistrust towards road authorities, high expectations, and the impacts of the COVID-19 pandemic. While noise exposure reductions did not directly lead to noise annoyance decreases, an ordinal regression pooling all cases revealed that larger reductions in noise exposure were associated with a higher likelihood of residents reporting decreased traffic noise annoyance in the post-survey. No evidence was found regarding noise barriers' impact on the subjective assessment of other aspects of quality of life, such as health complaints, concentration disturbance, and sleep quality.

Chemical exposome and children health: Identification of dose-response relationships from meta-analyses and epidemiological studies

BACKGROUND

Health impact assessment studies quantifying the impact of the chemical exposome on children's health generally consider a small fraction of the exposome. Synthetizing available dose-response relationships is an essential step to fill this gap. We reviewed the literature for dose-response relationships relating the chemical exposome with children health.

METHOD

We focused on 78 substance-outcome pairs for which the level of evidence had previously been classified as 'likely' or 'very likely'. We searched for dose-response relationships for these pairs from meta-analyses and, if none was available, from single epidemiological studies, from which we conducted meta-analyses whenever possible.

RESULTS

We identified dose-response relationships for 50 of the 78 prioritized substance-outcome pairs (64%). Dose-response relationships stemmed from meta-analyses for 21 pairs, from de novo meta-analyses for 1 pair and single studies for 28 pairs. Dose-response relationships were available for tobacco (fetal and infant death, congenital heart defects, birth outcomes, orofacial clefts, respiratory health), lead (asthma, cognition, delayed puberty onset and iron deficiency anaemia), polychlorobiphenyls (PCBs) (cognition, respiratory infections and birth outcomes), bisphenol A (cognition), hexachlorobenzene (HCB) (respiratory health), Polybrominated diphenyl ethers (neurodevelopment), DDT (hypospadias, cryptorchidism, miscarriage), pesticides (neurodevelopment), methylmercury (cognition), PFAS (immune system, birth weight, behavior, miscarriage), arsenic (cognition, birth weight, death, respiratory health), cadmium (cognition, birth weight), manganese (behavior), sodium (blood pressure) and thallium (birth weight). For 28 of the 78 substance-outcome pairs (36%), no dose-response relationship was available from epidemiological studies in children.

CONCLUSIONS

We identified dose-response relationships for 50 substance-outcome pairs, corresponding to 20 chemicals and 17 health outcomes. These can be used to perform more comprehensive quantitative health impact assessment of the exposome on child health. We also identified 28 substance-outcome pairs corresponding to 'likely' or 'very likely' effects for which research generating dose-response functions in children would be relevant.

The burden of disease due to dietary exposure to acrylamide in Italy: A risk assessment-based approach

The aim of this study was to assess Italian consumers' risk of cancer and burden of disease due to dietary exposure to acrylamide. Our model considered six age groups such as infants, toddlers, other children, adolescents, adults, and the elderly, and the consumption of 31 food items. Using a risk-assessment-based approach, we first characterized the risk of neoplastic effects using the margin of exposure method. Then the risk of kidney, endometrial, breast, ovarian cancer, and total cancer was estimated using adjusted cancer slope factors while the burden of disease was quantified using Disability-adjusted Life Years (DALYs). The highest risk for females was related to breast cancer while the lowest was for kidney cancer. We found a comparable risk of total cancer among Italian males and females, estimated at around 1.59 to 3.57 cases per 100,000 individuals annually with the burden ranging between 12.3 - 25.4 and 11.4 - 24.1 DALYs respectively. Our findings provide insights on the multifaceted impact of acrylamide on public health by offering detailed insights into age-specific exposure levels, diverse cancer risks, and the dietary burden of disease related to acrylamide. Targeted interventions and policies can be developed towards mitigating the health risks associated with acrylamide exposure.

Multi-Scenario Validation and Assessment of a Particulate Matter Sensor Monitor Optimized by Machine Learning Methods

OBJECTIVE

The aim was to evaluate and optimize the performance of sensor monitors in measuring PM2.5 and PM10 under typical emission scenarios both indoors and outdoors.

METHOD

Parallel measurements and comparisons of PM2.5 and PM10 were carried out between sensor monitors and standard instruments in typical indoor (2 months) and outdoor environments (1 year) in Shanghai, respectively. The optimized validation model was determined by comparing six machining learning models, adjusting for meteorological and related factors. The intra- and inter-device variation, measurement accuracy, and stability of sensor monitors were calculated and compared before and after validation.

RESULTS

Indoor particles were measured in a range of 0.8-370.7 μg/m3 and 1.9-465.2 μg/m3 for PM2.5 and PM10, respectively, while the outdoor ones were in the ranges of 1.0-211.0 μg/m3 and 0.0-493.0 μg/m3, correspondingly. Compared to machine learning models including multivariate linear model (ML), K-nearest neighbor model (KNN), support vector machine model (SVM), decision tree model (DT), and neural network model (MLP), the random forest (RF) model showed the best validation after adjusting for temperature, relative humidity (RH), PM2.5/PM10 ratios, and measurement time lengths (months) for both PM2.5 and PM10, in indoor (R2: 0.97 and 0.91, root-mean-square error (RMSE) of 1.91 μg/m3 and 4.56 μg/m3, respectively) and outdoor environments (R2: 0.90 and 0.80, RMSE of 5.61 μg/m3 and 17.54 μg/m3, respectively), respectively.

CONCLUSIONS

Sensor monitors could provide reliable measurements of PM2.5 and PM10 with high accuracy and acceptable inter and intra-device consistency under typical indoor and outdoor scenarios after validation by RF model. Adjusting for both climate factors and the ratio of PM2.5/PM10 could improve the validation performance.

Effect of ambient ozone pollution on disease burden globally: A systematic analysis for the global burden of disease study 2019

BACKGROUND

Exposure to ambient ozone pollution causes health loss and even death, and both are the main risk factors for the disease burden worldwide. We comprehensively evaluated the ozone pollution-related disease burden.

METHODS

First, numbers and age-standardized rates of deaths and disability-adjusted life years (DALYs) were assessed globally and by sub-types in 2019. Furthermore, the temporal trend of the disease burden was explored by the linear regression model from 1990 to 2019. The cluster analysis was used to evaluate the changing pattern of related disease burden across Global Burden of Disease Study (GBD) regions. Finally, the age-period-cohort (APC) model and the Bayesian age-period-cohort (BAPC) model were used to predict the future disease burden in the next 25 years.

RESULT

Exposure to ozone pollution contributed to 365,222 deaths and 6,210,145 DALYs globally in 2019, which accounted for 0.65 % of deaths globally and 0.24 % of DALYs globally. The disease burden was consistently increasing with age. Males were high-risk populations and low-middle socio-demographic index (SDI) regions were high-risk areas. The disease burden of ozone pollution varied considerably across the GBD regions and the countries. In 2019, the number of deaths and DALYs cases increased by 76.11 % and 56.37 %, respectively compared to those in 1990. The predicted results showed that the number of deaths cases and DALYs cases for both genders would still increase from 2020 to 2044.

CONCLUSION

In conclusion, ambient ozone pollution has threatened public health globally. More proactive and effective strategic measures should be developed after considering global-specific circumstances.

Mortality burden of cardiovascular disease attributable to ambient PM2.5 exposure in Portugal, 2011 to 2021

BACKGROUND

Exposure to high levels of environmental air pollution causes several health outcomes and has been associated with increased mortality, premature mortality, and morbidity. Ambient exposure to PM2.5 is currently considered the leading environmental risk factor globally. A causal relationship between exposure to PM2.5 and the contribution of this exposure to cardiovascular morbidity and mortality was already demonstrated by the American Heart Association.

METHODS

To estimate the burden of mortality attributable to environmental risk factors, a comparative risk assessment was performed, considering a "top-down" approach. This approach uses an existing estimate of mortality of the disease endpoint by all causes as a starting point. A population attributable fraction was calculated for the exposure to PM2.5the overall burden of IHD and stroke was multiplied by the PAF to determine the burden attributable to this risk factor. The avoidable burden was calculated using the potential impact fraction (PIF) and considering the WHO-AQG 2021 as an alternative scenario.

RESULTS

Between 2011 and 2021, the ambient exposure to PM2.5 resulted in a total of 288,862.7 IHD YLL and a total of 420,432.3 stroke YLL in Portugal. This study found a decreasing trend in the mortality burden attributable to PM2.5 exposure, for both males and females and different age-groups. For different regions of Portugal, the same trend was observed in the last years. The mortality burden attributable to long-term exposure to PM2.5 was mainly concentrated in Lisbon Metropolitan Area, North and Centre. Changes in the exposure limits to the WHO recommended value of exposure (WHO-AQG 2021) have a reduction in the mortality burden due to IHD and stroke attributable to PM2.5 exposure, in Portugal.

CONCLUSION

Between 2011 and 2021, approximately 22% and 23% of IHD and stroke deaths were attributable to PM2.5 exposure. Nevertheless, the mortality burden attributable to cardiovascular diseases has been decreasing in last years in Portugal. Our findings provide evidence of the impact of air pollution on human health, which are crucial for decision-making, at the national and regional level.

The impact of co-exposure to air and noise pollution on the incidence of metabolic syndrome from a health checkup cohort

Previous studies have found associations between the incidence of metabolic syndrome (MetS) and exposure to air pollution or road traffic noise. However, investigations on environmental co-exposures are limited. This study aimed to investigate the association between co-exposure to air pollution and road traffic noise and MetS and its subcomponents. Participants living in Taipei City who underwent at least two health checkups between 2010 and 2016 were included in the study. Data were sourced from the MJ Health database, a longitudinal, large-scale cohort in Taiwan. The monthly traffic noise exposure (Lden and Lnight) was computed using a dynamic noise map. Monthly fine particulate data at one kilometer resolution were computed from satellite imagery data. Cox proportional hazards regression models with month as the underlying time scale were used to estimate hazard ratios (HRs) for the impact of PM2.5 and road traffic noise exposure on the risk of developing MetS or its subcomponents. Data from 10,773 participants were included. We found significant positive associations between incident MetS and PM2.5 (HR: 1.88; 95% CI 1.67, 2.12), Lden (HR: 1.10; 95% CI 1.06, 1.15), and Lnight (HR: 1.07; 95% CI 1.02, 1.13) in single exposure models. Results further showed significant associations with an elevated risk of incident MetS in co-exposure models, with HRs of 1.91 (95% CI 1.69, 2.16) and 1.11 (95% CI 1.06, 1.16) for co-exposure to PM2.5 and Lden, and 1.90 (95% CI 1.68, 2.14) and 1.08 (95% CI 1.02, 1.13) for co-exposure to PM2.5 and Lnight. The HRs for the co-exposure models were higher than those for models with only a single exposure. This study provides evidence that PM2.5 and noise exposure may elevate the risk of incident MetS and its components in both single and co-exposure models. Therefore, preventive approaches to mitigate the risk of MetS and its subcomponents should consider reducing exposure to PM2.5 and noise pollution.

Long-term exposure to transportation noise in relation to global cognitive decline and cognitive impairment: Results from a Swedish longitudinal cohort

BACKGROUND AND AIMS

Transportation noise is an environmental exposure with mounting evidence of adverse health effects. Besides the increased risk of cardiovascular and metabolic diseases, recent studies suggest that long-term noise exposure might accelerate cognitive decline in older age. We examined the association between transportation noise and cognitive function in a cohort of older adults.

METHODS

The present study is based on 2594 dementia-free participants aged 60 + years from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K). Global cognition score and CIND (cognitive impairment, no dementia) were assessed with a comprehensive neuropsychological battery at baseline and up to 16 years. Residential transportation noise resulting from road traffic, railway, and aircraft were estimated at the most exposed façade and the time-weighted average exposure was assessed. Linear mixed-effect models were used to assess the effect of long-term traffic noise exposure on the rate of change in global cognition score. Hazard ratios (HRs) and 95 % confidence intervals (CIs) of CIND by transportation noise exposure were obtained with Cox proportional hazard models.

RESULTS

Global cognition score decreased at an average rate of -0.041 (95 %CI -0.043, -0.039) per year. Aircraft noise was associated with a 0.007 (per 10 dB Lden; 95 %CI -0.012, -0.001) faster annual rate of decline. Global cognition score seems to be not affected by road traffic and railway noise. During the follow-up, 422 (21 %) participants developed CIND. A 10-dB Lden difference in exposure to aircraft and railway noise was associated with a 16 % (HR 1.16, 95 %CI 0.91, 1.49) and 26 % (HR 1.26, 95 %CI 1.01, 1.56) increased hazard of CIND in the multi-pollutant model, respectively. No association was found for road traffic (HR 1.00, 95 %CI 0.83, 1.21).

CONCLUSIONS

Transportation noise was linked to cognitive impairment and faster cognitive decline among older adults. Future studies are warranted to confirm our results.

Urban noise assessment in hospitals: measurements and mapping in the context of the city of Sorocaba, Brazil

Noise pollution has become a public health problem in several countries worldwide. Noise maps are tools used in many cities, mainly on the European continent. In other regions, they are used in smaller areas, and few studies focus on hospital areas, considered noise-sensitive zones. In this context, this study aimed to perform sound measurements and noise maps for the day and night periods in the surroundings of three hospitals in Sorocaba, Brazil. Sound measurements occurred around the three hospitals based on NBR 10151 and ISO 1996 standards. The noise maps were drawn up using a calculation model based on ISO 9613-2. Results showed that the sound measurement points around the hospitals had levels above those recommended by the Brazilian standard for sensitive areas (LAeq 50 and 45 dB for day and night, respectively). The acoustic maps showed high sound levels on all faces of the hospital buildings, both during the day and at night. The worst scenario concerned the vicinity of the roads with the highest flow and speed of vehicles. We concluded that three different hospitals in the city have high sound levels in their surroundings above the recommended for sensitive areas.

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.

Random effect generalized linear model-based predictive modelling of traffic noise

Noise pollution is one of the negative consequences of growth and development in cities. Traffic noise pollution due to traffic growth is the main aspect that worsens city quality of life. Therefore, research around the world is being conducted to manage and reduce traffic noise. A number of traffic noise prediction models have been proposed employing fixed effect modelling approach considering each observation as independent; however, observations may have spatial and temporal correlations and unobserved heterogeneity. Random effect models overcome these problems. This study attempts to develop a random effect generalized linear model (REGLM) along with a machine learning random forest (RF) model to validate the results, concerning the parameters related to road, traffic and environmental conditions. Models were developed based on the experimental quantities in Delhi in year 2022-2023. Both the models performed comparably well in terms of coefficient of determination. Random forest models with R2= 0.75, whereas random effect generalized linear model had an R2= 0.70. REGLM model has the ability to quantify the effects of explanatory variables over traffic noise pollution and will be more helpful in prioritizing of resources and chalking out control strategies.

The effects of noise exposure on hippocampal cognition in C57BL/6 mice via transcriptomics

BACKGROUND

Noise is an important environmental stressor in the industrialized world and has received increasing attention in recent years. Although epidemiological research has extensively demonstrated the relationship between noise and cognitive impairment, the specific molecular mechanisms and targets remain to be fully explored and understood.

METHODS

To address this issue, 5-month-old C57BL/6 mice were divided into two groups, with one group exposed to white noise at 98 dB. The effects of noise on cognition in mice were investigated through molecular biology and behavioral experiments. Subsequently, transcriptomic sequencing of the hippocampus in both groups of mice was performed and enrichment analysis of differentially expressed genes (DEGs) was conducted using KEGG and GO databases. Furthermore, LASSO analysis was used to further narrow down the relevant DEGs, followed by enrichment analysis of these genes using KEGG and GO databases. The DEGs were further validated by rt-qPCR.

RESULTS

Following noise exposure, the hippocampus levels of inflammation-related factors increased, the phosphorylation of Tau protein increased, the postsynaptic density protein decreased, the number of Nissl bodies decreased, and cell shrinkage in the hippocampus increased. Moreover, the behavioral experiments manifest characteristics indicative of a decline in cognitive.A total of 472 DEGs were identified through transcriptomic analysis, and seven relevant genes were screened by the LASSO algorithm, which were further validated by PCR to confirm their consistency with the omics results.

CONCLUSION

In conclusion, noise exposure affects cognitive function in mice through multiple pathways, and the omics results provide new evidence for the cognitive impairment induced by noise exposure.

The burden of disease attributable to indoor air pollutants in China from 2000 to 2017

BACKGROUND

High-level exposure to indoor air pollutants (IAPs) and their corresponding adverse health effects have become a public concern in China in the past 10 years. However, neither national nor provincial level burden of disease attributable to multiple IAPs has been reported for China. This is the first study to estimate and rank the annual burden of disease and the financial costs attributable to targeted residential IAPs at the national and provincial level in China from 2000 to 2017.

METHODS

We first did a systematic review and meta-analysis of 117 articles from 37 231 articles identified in major databases, and obtained exposure-response relationships for the candidate IAPs. The exposure levels to these IAPs were then collected by another systematic review of 1864 articles selected from 52 351 articles. After the systematic review, ten IAPs with significant and robust exposure-response relationships and sufficient exposure data were finally targeted: PM2·5, nitrogen dioxide, sulphur dioxide, ozone, carbon monoxide, radon, formaldehyde, benzene, toluene, and p-dichlorobenzene. The annual exposure levels in residences were then evaluated in all 31 provinces in mainland China continuously from 2000 to 2017, using the spatiotemporal Gaussian process regression model to analyse indoor originating IAPs, and the infiltration factor method to analyse outdoor originating IAPs. The disability-adjusted life-years (DALYs) attributable to the targeted IAPs were estimated at both national and provincial levels in China, using the population attributable fraction method. Financial costs were estimated by an adapted human capital approach.

FINDINGS

From 2000 to 2017, annual DALYs attributable to the ten IAPs in mainland China decreased from 4620 (95% CI 4070-5040) to 3700 (3210-4090) per 100 000. Nevertheless, in 2017, IAPs still ranked third among all risk factors, and their DALYs and financial costs accounted for 14·1% (95% CI 12·3-15·6) of total DALYs and 3·45% (3·01-3·82) of the gross domestic product. Specifically, the rank of ten targeted IAPs in order of their contribution to DALYs in 2017 was PM2·5, carbon monoxide, radon, benzene, nitrogen dioxide, ozone, sulphur dioxide, formaldehyde, toluene, and p-dichlorobenzene. The DALYs attributable to IAPs were 9·50% higher than those attributable to outdoor air pollution in 2017. For the leading IAP, PM2·5, the DALYs attributable to indoor origins are 18·3% higher than those of outdoor origins.

INTERPRETATION

DALYs attributed to IAPs in China have decreased by 20·0% over the past two decades. Even so, they are still much higher than those in the USA and European countries. This study can provide a basis for determining which IAPs to target in various indoor air quality standards and for estimating the health and economic benefits of various indoor air quality control approaches, which will help to reduce the adverse health effects of IAPs in China.

FUNDING

The National Key Research and Development Program of China and the National Natural Science Foundation of China.

Food processing contaminants: Dietary exposure to 3-MCPD and glycidol and associated burden of disease for Italian consumers

In this study we assessed Italian consumers' dietary exposure to 3-MCPD and glycidol followed by risk characterization, potential cancer risk and the associated burden of disease. Consumption data was retrieved from the most recent Italian Food Consumption Survey (2017-2020), while contamination data was obtained from the European Food Safety Authority. The level of risk due to exposure to 3-MCPD was negligible, below the tolerable daily intake (TDI), except for high consumption of infant formulas. For infants, the intake level was higher than the TDI (139-141% of TDI), indicating a potential health risk. Exposure to glycidol indicated a health concern for infants, toddlers, other children, and adolescents consuming infant formulas, plain cakes, chocolate spreads, processed cereals, biscuits, rusks, and cookies (margin of exposure (MOE) < 25,000). The risk of cancer due to exposure to glycidol was estimated and the overall health impact was quantified in Disability-Adjusted Life Years (DALYs). The risk of cancer due to chronic dietary exposure to glycidol was estimated at 0.08-0.52 cancer cases/year/100,000 individuals depending on the life stage and dietary habits in Italy. The burden of disease quantified in DALYs varied from 0.7 to 5.37 DALYs/year/100,000 individuals. It is crucial to continuously gather consumption and occurrence data for glycidol over time to track patterns, assess potential health risks, identify exposure sources, and develop effective countermeasures, as long-term exposure to chemical contaminants can lead to an increased risk for human health. This data is critical for protecting public health and reducing the likelihood of cancer and other health issues related to glycidol exposure.

Does air pollution confound associations between environmental noise and cardiovascular outcomes? - A systematic review

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.

Spatial assessment of the attributable burden of disease due to transportation noise in England

BACKGROUND

Noise pollution from transportation is one of the leading contributors to the environmental disease burden in Europe. We provide a novel assessment of spatial variations of these health impacts within a country, using England as an example.

METHODS

We estimated the burden of annoyance (highly annoyed), sleep disturbance (highly sleep disturbed), ischemic heart disease (IHD), stroke, and diabetes attributable to long-term transportation noise exposures in England for the adult population in 2018 down to local authority level (average adult population: 136,000). To derive estimates, we combined literature-informed exposure-response relationships, with population data on noise exposures, disease, and mortalities. Long-term average noise exposures from road, rail and aircraft were sourced from strategic noise mapping, with a lower exposure threshold of 50 dB (decibels) Lden and Lnight.

RESULTS

40 %, 4.5 % and 4.8 % of adults in England were exposed to road, rail, and aircraft noise exceeding 50 dB Lden. We estimated close to a hundred thousand (∼97,000) disability adjusted life years (DALY) lost due to road-traffic, ∼13,000 from railway, and ∼ 17,000 from aircraft noise. This excludes some noise-outcome pairs as there were too few studies available to provide robust exposure-response estimates. Annoyance and sleep disturbance accounted for the majority of the DALYs, followed by strokes, IHD, and diabetes. London, the South East, and North West regions had the greatest number of road-traffic DALYs lost, while 63 % of all aircraft noise DALYs were found in London. The strategic noise mapping did not include all roads, which may still have significant traffic flows. In sensitivity analyses using modelled noise from all roads in London, the DALYs were 1.1x to 2.2x higher.

CONCLUSION

Transportation noise exposures contribute to a significant and unequal environmental disease burden in England. Omitting minor roads from the noise exposure modelling leads to underestimation of the disease burden.

Indoor air quality guidelines from across the world: An appraisal considering energy saving, health, productivity, and comfort

Buildings are constructed and operated to satisfy human needs and improve quality of life. Good indoor air quality (IAQ) and thermal comfort are prerequisites for human health and well-being. For their provision, buildings often rely on heating, ventilation, and air conditioning (HVAC) systems, which may lead to higher energy consumption. This directly impacts energy efficiency goals and the linked climate change considerations. The balance between energy use, optimum IAQ and thermal comfort calls for scientifically solid and well-established limit values for exposures experienced by building occupants in indoor spaces, including homes, schools, and offices. The present paper aims to appraise limit values for selected indoor pollutants reported in the scientific literature, and to present how they are handled in international and national guidelines and standards. The pollutants include carbon dioxide (CO2), formaldehyde (CH2O), particulate matter (PM), nitrogen dioxide (NO2), carbon monoxide (CO), and radon (Rn). Furthermore, acknowledging the particularly strong impact on energy use from HVAC, ventilation, indoor temperature (T), and relative humidity (RH) are also included, as they relate to both thermal comfort and the possibilities to avoid moisture related problems, such as mould growth and proliferation of house dust mites. Examples of national regulations for these parameters are presented, both in relation to human requirements in buildings and considering aspects related to energy saving. The work is based on the Indoor Environmental Quality (IEQ) guidelines database, which spans across countries and institutions, and aids in taking steps in the direction towards a more uniform guidance for values of indoor parameters. The database is coordinated by the Scientific and Technical Committee (STC) 34, as part of ISIAQ, the International Society of Indoor Air Quality and Climate.

Noise and Air Pollution as Risk Factors for Hypertension: Part I-Epidemiology

Traffic noise and air pollution are 2 major environmental health risk factors in urbanized societies that often occur together. Despite cooccurrence in urban settings, noise and air pollution have generally been studied independently, with many studies reporting a consistent effect on blood pressure for individual exposures. In the present reviews, we will discuss the epidemiology of air pollution and noise effects on arterial hypertension and cardiovascular disease (part I) and the underlying pathophysiology (part II). Both environmental stressors have been found to cause endothelial dysfunction, oxidative stress, vascular inflammation, circadian dysfunction, and activation of the autonomic nervous system, thereby facilitating the development of hypertension. We also discuss the effects of interventions, current gaps in knowledge, and future research tasks. From a societal and policy perspective, the health effects of both air pollution and traffic noise are observed well below the current guideline recommendations. To this end, an important goal for the future is to increase the acceptance of environmental risk factors as important modifiable cardiovascular risk factors, given their substantial impact on the burden of cardiovascular disease.

Traffic noise in the bedroom in association with markers of obesity: a cross-sectional study and mediation analysis of the respiratory health in Northern Europe cohort

BACKGROUND

Previous research suggests an association between road traffic noise and obesity, but current evidence is inconclusive. The aim of this study was to assess the association between nocturnal noise exposure and markers of obesity and to assess whether sleep disturbance might be a mediator in this association.

METHODS

We applied data from the Respiratory Health in Northern Europe (RHINE) cohort. We used self-measured waist circumference (WC) and body mass index (BMI) as outcome values. Noise exposure was assessed as perceived traffic noise in the bedroom and/or the bedroom window's location towards the street. We applied adjusted linear, and logistic regression models, evaluated effect modifications and conducted mediation analysis.

RESULTS

Based on fully adjusted models we found that women, who reported very high traffic noise levels in bedroom, had 1.30 (95% CI 0.24-2.37) kg/m² higher BMI and 3.30 (95% CI 0.39-6.20) cm higher WC compared to women, who reported no traffic noise in the bedroom. Women who reported higher exposure to road traffic noise had statistically significant higher odds of being overweight and have abdominal obesity with OR varying from 1.15 to 1.26 compared to women, who reported no traffic noise in the bedroom. For men, the associations were rather opposite, although mostly statistically insignificant. Furthermore, men, who reported much or very much traffic noise in the bedroom, had a statistically significantly lower risk of abdominal obesity. Sleep disturbance fully or partially mediated the association between noise in bedroom and obesity markers among women.

CONCLUSION

Our results suggest that self-reported traffic noise in the bedroom may be associated to being overweight or obese trough sleep disturbance among women, but associations were inconclusive among men.

Assessment of health risk and burden of disease induced by exposure to benzene, toluene, ethylbenzene, and xylene in the outdoor air in Tehran, Iran

The health risk and burden of disease induced by exposure to benzene, toluene, ethylbenzene, and xylene (BTEX) in the outdoor air in Tehran, 2019 were assessed based on the data of five fixed stations with weekly BTEX measurements. The non-carcinogenic risk, carcinogenic risk, and disease burden from exposure to BTEX compounds were determined by hazard index (HI), incremental lifetime cancer risk (ILCR), and disability-adjusted life year (DALY), respectively. The average annual concentrations of benzene, toluene, ethylbenzene, and xylene in the outdoor air in Tehran were 6.59, 21.62, 4.68, and 20.88 μg/m³, respectively. The lowest seasonal BTEX concentrations were observed in spring and the highest ones occurred in summer. The HI values of BTEX in the outdoor air in Tehran by district ranged from 0.34 to 0.58 (less than one). The average ILCR values of benzene and ethylbenzene were 5.37 × 10^-5 and 1.23 × 10^-5, respectively (in the range of probable increased cancer risk). The DALYs, death, DALY rate (per 100,000 people) and death rate (per 100,000 people) induced by BTEX exposure in the outdoor air in Tehran were determined to be 180.21, 3.51, 2.07, and 0.04, respectively. The five highest attributable DALY rates in Tehran by district were observed in the districts 10 (2.60), 11 (2.43), 17 (2.41), 20 (2.32), and 9 (2.32), respectively. The corrective measures such as controlling road traffic and improving the quality of vehicles and gasoline in Tehran could reduce the burden of disease from BTEX along with the health effects of other outdoor air pollutants.

Burden of disease due to transportation noise in the Nordic countries

BACKGROUND

Environmental noise is of increasing concern for public health. Quantification of associated health impacts is important for regulation and preventive strategies.

AIM

To estimate the burden of disease (BoD) due to road traffic and railway noise in four Nordic countries and their capitals, in terms of DALYs (Disability-Adjusted Life Years), using comparable input data across countries.

METHOD

Road traffic and railway noise exposure were obtained from the noise mapping conducted according to the Environmental Noise Directive (END) as well as nationwide noise exposure assessments for Denmark and Norway. Noise annoyance, sleep disturbance and ischaemic heart disease were included as the main health outcomes, using exposure-response functions from the WHO, 2018 systematic review. Additional analyses included stroke and type 2 diabetes. Country-specific DALY rates from the Global Burden of Disease (GBD) study were used as health input data.

RESULTS

Comparable exposure data were not available on a national level for the Nordic countries, only for capital cities. The DALY rates for the capitals ranged from 329 to 485 DALYs/100,000 for road traffic noise and 44 to 146 DALY/100,000 for railway noise. Moreover, the DALY estimates for road traffic noise increased with up to 17% upon inclusion of stroke and diabetes. DALY estimates based on nationwide noise data were 51 and 133% higher than the END-based estimates, for Norway and Denmark, respectively.

CONCLUSION

Further harmonization of noise exposure data is required for between-country comparisons. Moreover, nationwide noise models indicate that DALY estimates based on END considerably underestimate national BoD due to transportation noise. The health-related burden of traffic noise was comparable to that of air pollution, an established risk factor for disease in the GBD framework. Inclusion of environmental noise as a risk factor in the GBD is strongly encouraged.

How to use human biomonitoring in chemical risk assessment: Methodological aspects, recommendations, and lessons learned from HBM4EU

One of the aims of the European Human Biomonitoring Initiative, HBM4EU, was to provide examples of and good practices for the effective use of human biomonitoring (HBM) data in human health risk assessment (RA). The need for such information is pressing, as previous research has indicated that regulatory risk assessors generally lack knowledge and experience of the use of HBM data in RA. By recognising this gap in expertise, as well as the added value of incorporating HBM data into RA, this paper aims to support the integration of HBM into regulatory RA. Based on the work of the HBM4EU, we provide examples of different approaches to including HBM in RA and in estimations of the environmental burden of disease (EBoD), the benefits and pitfalls involved, information on the important methodological aspects to consider, and recommendations on how to overcome obstacles. The examples are derived from RAs or EBoD estimations made under the HBM4EU for the following HBM4EU priority substances: acrylamide, o-toluidine of the aniline family, aprotic solvents, arsenic, bisphenols, cadmium, diisocyanates, flame retardants, hexavalent chromium [Cr(VI)], lead, mercury, mixture of per-/poly-fluorinated compounds, mixture of pesticides, mixture of phthalates, mycotoxins, polycyclic aromatic hydrocarbons (PAHs), and the UV-filter benzophenone-3. Although the RA and EBoD work presented here is not intended to have direct regulatory implications, the results can be useful for raising awareness of possibly needed policy actions, as newly generated HBM data from HBM4EU on the current exposure of the EU population has been used in many RAs and EBoD estimations.

Suicide and Transportation Noise: A Prospective Cohort Study from Switzerland

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSION

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

The association between road traffic noise and type 2 diabetes: a systematic review and meta-analysis of cohort studies

The association between road traffic noise and type 2 diabetes (T2DM) was inconsistent. To address this, we have synthesized available cohort studies about their association by meta-analysis. PubMed, Web of Science, EBSCO, Cochrane Library, EMBASE, and Scopus databases were searched up to July 2022. The Quality-effect model (QE) was used to incorporate the results of included studies. The possibility of publication bias was assessed by the Doi plots and Luis Furuya-Kanamori index. Sensitivity analyses included leave-one-out meta-analysis, subgroup meta-analysis, and meta-regressions. The Recommendations for Assessment, Development, and Evaluation (GRADE) guidelines were conducted to evaluate the overall quality of evidence. Eight cohort studies with 4,989,846 participants and 416,799 diabetes cases were included. Based on the fully adjusted models from 8 cohort studies (10 estimates; Lden range ≈ 15-98.5 dB(A)), we found "high" evidence of RR per 10 dB(A) = 1.07 (1.05, 1.10), high heterogeneity (I2 = 0.91%, p < 0.001), and high publication bias (LKF index = 4.55). Sensitivity analyses showed stable model results, and the GRADE assessment suggested the current overall quality of evidence is high. Comprehensive evidence from cohort studies supports that increasing exposure to road traffic noise may be associated with higher risk of T2DM.

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.

Experimental investigation on the enhancement of plenum window noise reduction using solid scatterers

The sound transmission across plenum windows installed with rigid non-resonant cylindrical scatterer arrays was investigated in detail using scale-down model measurements carried out inside a fully anechoic chamber. The arrays have manifested to some extent the acoustical behaviors of virtual sonic crystals. The maximum cross section blockage ratio was 0.6. The effects of plenum window gap, array configuration, and scatterer diameter on the sound transmission characteristics were also examined. Results indicate that the window cavity longitudinal modes and the gap modes control the sound transmission characteristics at low frequencies. The upper bound of this frequency range increases with decreasing gap width. Within this frequency range, the scatterers have negligible effect on the sound transmission. At higher frequencies, the array configurations with scatterer(s) attached to the window walls result in stronger sound reduction. There are relatively higher sound transmission loss improvements around the frequencies where a full bandgap is observed. There are wide bandgaps in various lattice directions, and the present results suggest that they play a role in the broadband improvement of sound reduction.

Health impact assessments of shipping and port-sourced air pollution on a global scale: A scoping literature review

BACKGROUND

Globalisation has led to international trade expand rapidly. Seaborne transport moves 80% of traded goods across the globe, producing around 3% of greenhouse gases and other hazardous pollutants, such as PM, NO_x and SO_x, known to be harmful to health.

METHODS

A scoping literature review was conducted reviewing peer-reviewed studies on health impact assessments (HIA) of global shipping and port-sourced air pollution. For review inclusion, studies had to (1) use a HIA methodology; (2) quantify the air pollution concentration attributable to at least one shipping or port activity scenario; (3) assess at least one health outcome (i.e. epidemiological measure or monetization); (4) quantify the attributable health burden of the respective scenario.

RESULTS

Thirty-two studies were included, studying predominantly European Sea shipping/ port-sourced emissions with health impacts for global or respective European populations. Also, Global, Asian, North American and Australian Sea shipping/ port-sourced emissions were studied, with attributable health impacts for global or respective populations. The health outcome predominantly studied was mortality (all-cause, cause-specific, loss in life expectancy, years of life lost (YLLs)), but also morbidity (disease cases, hospital admissions, years lived with disability (YLDs)), disability-adjusted life-years (DALYs), restricted activity days and work loss days. The highest air pollution concentrations were identified along major shipping routes and ports, and the strongest health impacts occurred among respective riparian populations. Globally, ∼265,000 premature deaths were projected for 2020 (∼0.5% of global mortality) attributable to global shipping-sourced emissions. Emission control scenarios studied were predominantly sulphur fuel content caps and NO_x emission reduction scenarios, consisting of technological interventions, cleaner fuels or fuel switches, and were assessed as effective in reducing shipping-sourced emissions, and hence, health burdens.

CONCLUSIONS

Our review positions maritime transport an important source of air pollution and health risk factor, which needs more research and policy attention and rigorous emission control efforts, as shipping-sourced emissions are projected to increase with increases in global trade and shipping volumes.

Rationale and Design of a Study to Test the Effect of Personal Protective Aids on Hypertension and Diabetes in People Living With High Levels of Air Pollution-Study Protocol

BACKGROUND

Air pollution is the largest environmental cause of disease and premature death in the world today, disproportionally affecting low- and middle-income countries (LMIC) such as India. Studies have shown that exposure to particulate matter <2.5 μm (PM_2.5) can contribute to cardiovascular disease and increase mortality. We hypothesise that the use of personal protective aids (home indoor air purifiers/N95 masks) can decrease systolic blood pressure (SBP) in people with hypertension and decrease fasting blood glucose levels (FBG) in those with diabetes.

METHOD

This is a prospective randomised crossover study in Dalkhola, India-an area of high ambient PM_2.5 levels. Participants between 18-70 years of age with hypertension (n=128) and diabetes (n=33) will be invited to participate in the study. They will be randomised to either an intervention or control arm for 4 weeks, after which they will cross over to the other arm following a 2-week washout period. The intervention will consist of using an indoor air purifier at night and N95 mask when outdoors. The control period will involve using an identical air purifier and N95 mask with the filter removed (sham filtration). Participants and outcome assessors will be blinded to study arm assignment.

OUTCOME EVALUATION

The primary outcome of the study is the absolute reduction in SBP among people with hypertension and absolute reduction in FBG among people with diabetes.

DISCUSSION

This is the first randomised controlled trial to evaluate the use of personal protective aids as a therapeutic measure in people with hypertension and diabetes exposed to high levels of PM_2.5. Given the high burden of air pollution in LMIC, there is an urgent need for adaptation measures targeting people at high risk for mortality from this exposure. The results of our study will demonstrate whether personal protective aids can be a viable adaptation measure for people living with hypertension and diabetes in areas with a high burden of air pollution.

TRIAL REGISTRATION

This is clinicaltrials.gov Identifier: NCT04854187.

Association between noise exposure during pregnancy and pregnancy complications: A meta-analysis

Background

Noise exposure has a significant impact on human health. However, the effect of occupational and residential noise on the risk of pregnancy complications was controversial in the literature. This study looked at previous research and performed a meta-analysis to determine how noise exposure during pregnancy affected the risk of pregnancy complications.

Methods

Systematic searches were conducted in PubMed, Web of Science, Scopus, Embase, Ovid, and Cochrane, and all relevant studies were included. Two investigators independently evaluated the eligibility of these studies. The risk of bias in each study and the quality and strength of each outcome was evaluated by using the GRADE approach and Navigation Guide. Random effects meta-analysis model was used.

Results

The meta-analysis retrieved 1,461 study records and finally included 11 studies. Occupational noise exposure during pregnancy was associated with preeclampsia (RR = 1.07, 95%CI: 1.04, 1.10). Neither occupational nor residential noise exposure was associated with hypertensive disorders of pregnancy (HDP) (RR = 1.10, 95%CI: 0.96, 1.25 and RR = 1.05, 95%CI: 0.98, 1.11) or gestational diabetes mellitus (GDM) (RR = 0.94, 95%CI: 0.88, 1.00 and RR = 1.06, 95%CI: 0.98, 1.16). Further bias analysis showed that the results were reliable. All outcomes were rated as low in quality and inadequate evidence of harmfulness in strength.

Conclusions

Occupational noise exposure could increase the risk of preeclampsia, according to the findings. There was no clear evidence of a harmful effect of noise exposure during pregnancy on HDP or GDM.

Informing about the invisible: communicating en route air pollution and noise exposure to cyclists and pedestrians using focus groups

Active mobility and public transport are considered beneficial for health and wellbeing and valuable for climate change mitigation. However, cyclists and pedestrians have high air pollution and noise exposure alongside traffic, which adversely impact health and wellbeing. The measured exposure can differ from the perceived exposure, hence, communicating en route exposure is crucial. Therefore, this study investigates how to communicate route-based exposure to cyclists and pedestrians and explores if exposure communication, e.g. via smartphones, is worthwhile for healthy and pleasant commute. It is investigated how exposure feedback influences the motivation to protect oneself and how exposure information should be designed. Three focus groups with 20 cyclists/pedestrians living in Berlin, Germany, were conducted. Based on Protection Motivation Theory and Environmental Health Literacy concept, (1) experiences and practices after recognizing exposure were discussed and (2) information needs and communication strategies were developed. The results reveal a feeling of helplessness regarding the ubiquity and uncertainty of pollution and a heightened threat appraisal. Anger, anxiety and rejection were stated. Making sense of pollution levels and protective alternatives were central. A healthy routing app, including also pleasant route factors, was desired. However, information provision was also denied. Participants argued the responsibility should not be left to the commuters and planning for exposed road users would be crucial. Information provision may not be worthwhile if planning authorities do not provide healthy alternatives. People-centered approaches for tackling air pollution and noise exposure en route should be investigated further.

Lung cancer as adverse health effect by indoor radon exposure in China from 2000 to 2020: A systematic review and meta-analysis

Indoor radon exposure is thought to be associated with adverse health effect as lung cancer. Lung cancer incidences in China have been the highest worldwide during the past two decades. It is important to quantitively address indoor radon exposure and its health effect, especially in countries like China. In this paper, we have conducted a meta-analysis based on indoor radon and its health effect studies from a systematic review between 2000 and 2020. A total of 8 studies were included for lung cancer. We found that the relative risk (RR) was 1.01 (95% CI: 1.01-1.02) per 10 Bq/m³ increase of indoor radon for lung cancer in China. The subgroup analysis found no significant difference between the conclusions from the studies from China and other regions. The health effect of indoor radon exposure is relatively consistent for the low-exposure and high-exposure groups in the subgroup analysis. With a better understanding of exposure level of indoor radon, the outcomes and conclusions of this study will provide supports for next phase of researches on estimation of environmental burden of disease by indoor radon exposures in countries like China.

Industrial noise: A new stimulus for dental pulp aging? Qualitative and quantitative analysis in Wistar rat teeth–A pilot study

Morphological changes induced by industrial noise have been experimentally observed in several organs. This study aims to characterize the effect of industrial noise on the pulp cell density of Wistar rats from a histological point of view, through qualitative and quantitative analysis. The histologic sections were observed over the optical microscope and photographed using 10x and 40x magnifications and analyzed using an image processing software. They refer to a group of animals exposed to industrial noise for 3 months and for 7 months (EG) and another group of animals kept in silence for control (CG) during the same periods. There was a significant decrease in pulp cell density in teeth of the animals exposed for 3 months when compared to control teeth group (p = 0.01). However, in the group exposed for 7 months, no statistically significant differences were found (p = 0.66). Even so, we found an evident relationship between exposure to industrial noise and teeth morphological changes. The observed changes are similar to the modifications found on aged teeth. Therefore, this study places industrial noise as an aggressive stimulus that can cause a reaction of the pulp-dentin complex with morphological changes compatible with premature aging of the tooth.

Can biodiverse streetscapes mitigate the effects of noise and air pollution on human wellbeing?

Most of the global population are urban, with inhabitants exposed to raised levels of pollution. Pollutants negatively impact human wellbeing, and can alter the structure and diversity of ecosystems. Contrastingly, urban biodiversity can positively contribute to human wellbeing. We know little, however, about whether the negative impacts of pollution on wellbeing could be lessened for householders living on more biodiverse streets, as the complex interlinkages between pollution, biodiversity and wellbeing have rarely been examined. Here, we used structural equation modelling to simultaneously test whether biodiversity (actual and perceived) mediates the relationship between traffic-related pollution (noise, dB; nitrogen dioxide, NO₂) or air pollution (PM_2.5) and wellbeing (mental wellbeing, happiness). In summer 2019, we conducted questionnaires and biodiversity surveys, and collected noise and air pollution data, from households (n = 282) across the streetscapes of Leeds, UK. Biodiversity (actual or perceived) showed no mediating effects. However, increased flowering plant richness was positively associated with mental wellbeing. Traffic-related pollution negatively affected pollinator and flowering plant richness, but not wellbeing. This could be because householders are not exposed to high levels of noise or NO₂ because they do not maintain front gardens on noisier streets. There was no measurable effect of air pollution on biodiversity or wellbeing. These findings shed light on the complex mechanisms through which biodiversity could improve human wellbeing. Enhancing the diversity of plant species in streetscapes would have a positive effect on wellbeing, further emphasising the important role that biodiverse urban streetscapes play in improving the liveability of cities.

Residential road traffic and railway noise and risk of childhood cancer: A nationwide register-based case-control study in Denmark

BACKGROUND

The aetiology of most childhood cancers remains poorly understood. We conducted a nationwide register-based case-control study to assess the association between residential road traffic and railway noise exposure and risk of childhood cancers.

METHODS

We identified all cases of first cancers diagnosed in children aged 0-19 years in 1985-2013 from the Danish Cancer Registry (N = 3962) and sampled four individually matched (by sex and date of birth) controls per case (N = 14,790) using the Central Population Register. We estimated time-weighted exposure averages of residential road traffic and railway noise at the most (Lden max) and least (Lden min) exposed façades from birth to index-date (for additional analysis: in utero period) based on the individual address history for the respective time windows. We fitted conditional logistic regression models to estimate odds ratios (OR) and their 95% confidence intervals (CI).

RESULTS

ORs varied by noise estimate and cancer type, with generally wide CIs mostly including 1.00. We found a tendency of higher ORs with increasing railway and road traffic noise for Hodgkin lymphoma (ORs for railway and road Lden min were 1.63 (95% CI 1.00; 2.66) and 1.14 (95% CI 0.87; 1.48) per 10 dB), as well as a tendency of higher ORs with increasing railway noise for non-Hodgkin lymphoma. For embryonal CNS tumours and astrocytoma and other glioma we observed also some weak suggestions of a positive association. Analysing exposure to traffic noise in utero revealed similar patterns to those of the main analyses.

CONCLUSIONS

This nationwide study with minimal risk of bias suggests no strong associations between traffic noise and risk of most childhood cancers. We found however some suggestive evidence for a positive association with Hodgkin lymphoma, non-Hodgkin lymphoma and some CNS tumours. Further research is warranted to confirm these associations in other populations and elucidate the underlying biological mechanisms.

How Noise Can Influence Experience-Based Decision-Making under Different Types of the Provided Information

Pervasive noise undermines many cognitive processes. Across two studies, we examined how noise influences experience-based decision-making and whether the nature of the information provided moderates this influence. Study 1 used the repeated choice paradigm and found that noise can significantly reduce people's performance in experience-based decision-making by increasing the likelihood of choosing the option with the lower expected value. This negative influence can be attenuated when experience-congruent suggestions are provided, but significantly worsened when experience-incongruent suggestions are provided. Study 2 investigated how noise influences decision-making performance in two experience-incongruent conditions differing in error salience. By replicating noise's general negative effect, we found that the noise effect could be attenuated when incongruent suggestions were obvious. We suggest that noise can undermine the information updating and integration process, which is necessary for experience-based decision-making. We also discuss the principles for designing better information aids based on these findings.

Risk Associations between Vehicular Traffic Noise Exposure and Cardiovascular Diseases: A Residential Retrospective Cohort Study

Environmental noise can induce detrimental health effects such as cardiovascular disease (CVD). The relationship between vehicular traffic noise pollution and CVD was investigated through a retrospective residential cohort study in the city of Pisa. Four exposure classes were defined for noise pollution, using noise propagation maps. The association between noise exposures and cause-specific mortality or hospitalization of the subjects of the cohort was calculated using the hazard ratio (HR) for night and day through a multiple time-dependent and sex-specific Cox regression adjusting for age, the socio-economic deprivation index, and traffic air pollution. Mortality excess for CVD and risk trends for a 1 decibel noise increment were observed among the most exposed women (mortality: HRnight_class4 1.15 (1.03-1.28); Trend_night 1.007 (1.002-1.012); HRday_class4 1.14 (1.02-1.27); Trend_day 1.008 (1.003-1.013)), particularly for ischaemic disease (mortality: Trend_night 1.008 (0.999-1.017); Trend_day 1.009 (0.999-1.018)) and cerebrovascular disease (mortality: HRnight_class3 1.23 (1.02-1.48), HRday_class3 1.24 (1.03-1.49)). Hospitalization analyses confirm mortality results. A decreased risk for hospitalization was also observed among the most exposed men (HRday_class4 0.94 (0.88-1.01), particularly for ischaemic disease (HRnight_class4 0.90 (0.80-1.02); HRday_class4 0.86 (0.77-0.97)) and cerebrovascular disease (HRnight_class4 0.89 (0.78-1.01)). Authors recommend the adoption of prevention measures aimed at mitigating noise and the activation of a monitoring of the risk profile in the Pisa population updating both the residential cohort and health data.

Short-term exposure to ozone and economic burden of premature mortality in Italy: A nationwide observation study

Italy is among the countries with the highest ozone concentration in Europe. However, the mortality burden of ozone and related economic loss has not been fully characterized. This study aimed to estimate the ozone-mortality association in Italy and evaluate attributable mortality burden and related economic loss in 2015-2019. We collected daily all-cause mortality data stratified by age and sex from 2015 to 2019 in 107 provinces of Italy. A two-stage time-series framework was applied to estimate the association between daily maximum eight-hour average ozone and mortality as well as economic loss. An overall increase in the risk of mortality (RR=1.0043, 95% CI: 1.0029, 1.0057) was associated with every 10 µg/m³ increase in ozone. Generally, a total of 70,060 deaths and $65 billion economic loss were attributed to ozone exposure, corresponding to 3.11% of mortality and about 0.5% of the national GDP during the study period, respectively. The highest ozone-related mortality burden (30,910 deaths) and economic loss ($29.24 billion) were observed in the hot season. This nationwide study suggested considerable mortality burden and economic loss were associated with exposure to ozone. More actions and policies should be proposed to reduce ozone levels and help the public protect their health.

Environmental impacts of autonomous vehicles: A review of the scientific literature

Autonomous vehicles (AVs) may have significant environmental impacts although there are still few studies focusing solely on these effects. A vast majority of articles address environmental issues as a secondary outcome and, above all, emissions are the main topic. As the notion of environmental impacts concerns many aspects than just air pollution, this paper aims to explore and show the findings and flaws of current research with a wider vision. For that purpose, a systematic review of the scientific literature was carried out broadening the scope to land, water, noise, and light pollution in addition to air. The results reveal potential benefits of AVs due to technical improvements, new possibilities in design and traffic flow enhancement, but the benefits depend on penetration levels, shared mobility acceptance and the interaction with other modes of transport. On the other hand, negative effects are also identified related to the decrease in the value of trip time and user tendencies. Among other potential impacts, changes in land use are increasingly being studied. These changes can lead to significative impacts on emissions as well as on soil and water although the latter have not yet been considered. Lastly, the likely improvements in noise and light pollution are scarcely explored. Given the lack of study of some of the environmental outcomes of AVs, it is not possible to draw a precise conclusion on their overall impact, calling for more comprehensive studies that enable to identify all the measures to be taken to achieve a sustainable future.

Environmental Noise and Effects on Sleep: An Update to the WHO Systematic Review and Meta-Analysis

BACKGROUND

Nighttime noise carries a significant disease burden. The World Health Organization (WHO) recently published guidelines for the regulation of environmental noise based on a review of evidence published up to the year 2015 on the effects of environmental noise on sleep.

OBJECTIVES

This systematic review and meta-analysis will update the WHO evidence review on the effects of environmental noise on sleep disturbance to include more recent studies.

METHODS

Investigations of self-reported sleep among residents exposed to environmental traffic noise at home were identified using Scopus, PubMed, Embase, and PsycINFO. Awakenings, falling asleep, and sleep disturbance were the three outcomes included. Extracted data were used to derive exposure-response relationships for the probability of being highly sleep disturbed by nighttime noise [average outdoor A-weighted noise level (Lnight) 2300-0700 hours] for aircraft, road, and rail traffic noise, individually. The overall quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.

RESULTS

Eleven studies (n=109,070 responses) were included in addition to 25 studies (n=64,090 responses) from the original WHO analysis. When sleep disturbance questions specifically mentioned noise as the source of disturbance, there was moderate quality of evidence for the probability of being highly sleep disturbed per 10-dB increase in Lnight for aircraft [odds ratio (OR)=2.18; 95% confidence interval (CI): 2.01, 2.36], road (OR=2.52; 95% CI: 2.28, 2.79), and railway (OR=2.97; 95% CI: 2.57, 3.43) noise. When noise was not mentioned, there was low to very low quality of evidence for being sleep disturbed per 10-dB increase in Lnight for aircraft (OR=1.52; 95% CI: 1.20, 1.93), road (OR=1.14; 95% CI: 1.08, 1.21), and railway (OR=1.17; 95% CI: 0.91, 1.49) noise. Compared with the original WHO review, the exposure-response relationships closely agreed at low (40 dB Lnight) levels for all traffic types but indicated greater disturbance by aircraft traffic at high noise levels. Sleep disturbance was not significantly different between European and non-European studies.

DISCUSSION

Available evidence suggests that transportation noise is negatively associated with self-reported sleep. Sleep disturbance in this updated meta-analysis was comparable to the original WHO review at low nighttime noise levels. These low levels correspond to the recent WHO noise limit recommendations for nighttime noise, and so these findings do not suggest these WHO recommendations need revisiting. Deviations from the WHO review in this updated analysis suggest that populations exposed to high levels of aircraft noise may be at greater risk of sleep disturbance than determined previously. https://doi.org/10.1289/EHP10197.

Location, Location, Location: Modelling of Noise Mitigation by Urban Woodland Shows the Benefit of Targeted Tree Planting in Cities

Noise pollution from road traffic is ubiquitous in modern cities and is the second greatest environmental risk to health in Western Europe. Urban woodland can provide substantial noise mitigation if located properly, yet such considerations are often absent from the urban planning process. Current approaches for quantifying this important ecosystem service (ES) do not account adequately for important spatial factors and are unable to identify effectively the best locations to place new woodland for noise mitigation. We present new methods, in which we exploit the concept of least-cost-distance, to map and value the mitigating effect of urban woodland, and to identify optimal locations to place new woodland. Applying these methods, we show that urban woodland currently provides Birmingham City (UK) with over GBP 3.8 million in noise mitigation benefits, annually. We also show that our new ‘opportunity’ mapping methods effectively identify the best locations for new woodland, achieving close to a maximum service with less than a quarter of the additional woodland needed to achieve it. This has important implications for the design and implementation of urban tree planting for noise mitigation, and these methods can be adapted for other ES, allowing consideration of multiple service outcomes.

Association between Indoor Environment, Blood Trace Elements, and Immune Globulin among Workers from Vegetables Plastic Greenhouses in Yinchuan, China

BACKGROUND

To study the association between indoor environment (MiE), blood trace elements (BTE), and immune globulin (PRO) among workers from vegetables plastic greenhouse, and to assess the mediate effects on MiE and PRO by BTE.

METHODS

Overall, 168 practitioner and corresponding sheds were included from cross-sectional study in 2016. BTE and PRO were determined by physical test and MiE data from field and laboratory measurement. The association was assessed using canonical correlation analysis. The direct and indirect effects between MiE, PRO and BTE were conducted by structural equation model. 5000 times bootstrap methods were performed to estimate coefficient and 95% confidence interval.

RESULTS

MiE was moderately correlated with BTE (canonical coefficient = 0.439), and BTE was strongly correlated with PRO (canonical coefficient = 0.514 and 0.481). No statistical evidence was found for the overall impact of MiE on PRO, and BTE as an intermediary affecting its relevance was not confirmed. Only the path way of the BTE impact on PRO had a significant positive effect (P=0.012).

CONCLUSION

BTE was positively associated with PRO, therefore, reducing exposure in greenhouse is a pathway to remain blood trace elements, and further effect the immune protein in human body.

Exposure to road traffic noise and cognitive development in schoolchildren in Barcelona, Spain: A population-based cohort study

BACKGROUND

Road traffic noise is a prevalent and known health hazard. However, little is known yet about its effect on children's cognition. We aimed to study the association between exposure to road traffic noise and the development of working memory and attention in primary school children, considering school-outdoor and school-indoor annual average noise levels and noise fluctuation characteristics, as well as home-outdoor noise exposure.

METHODS AND FINDINGS

We followed up a population-based sample of 2,680 children aged 7 to 10 years from 38 schools in Barcelona (Catalonia, Spain) between January 2012 to March 2013. Children underwent computerised cognitive tests 4 times (n = 10,112), for working memory (2-back task, detectability), complex working memory (3-back task, detectability), and inattentiveness (Attention Network Task, hit reaction time standard error, in milliseconds). Road traffic noise was measured indoors and outdoors at schools, at the start of the school year, using standard protocols to obtain A-weighted equivalent sound pressure levels, i.e., annual average levels scaled to human hearing, for the daytime (daytime LAeq, in dB). We also derived fluctuation indicators out of the measurements (noise intermittency ratio, %; and number of noise events) and obtained individual estimated indoor noise levels (LAeq) correcting for classroom orientation and classroom change between years. Home-outdoor noise exposure at home (Lden, i.e., EU indicator for the 24-hour annual average levels) was estimated using Barcelona's noise map for year 2012, according to the European Noise Directive (2002). We used linear mixed models to evaluate the association between exposure to noise and cognitive development adjusting for age, sex, maternal education, socioeconomical vulnerability index at home, indoor or outdoor traffic-related air pollution (TRAP) for corresponding school models or outdoor nitrogen dioxide (NO2) for home models. Child and school were included as nested random effects. The median age (percentile 25, percentile 75) of children in visit 1 was 8.5 (7.8; 9.3) years, 49.9% were girls, and 50% of the schools were public. School-outdoor exposure to road traffic noise was associated with a slower development in working memory (2-back and 3-back) and greater inattentiveness over 1 year in children, both for the average noise level (e.g., ‒4.83 points [95% CI: ‒7.21, ‒2.45], p-value < 0.001, in 2-back detectability per 5 dB in street levels) and noise fluctuation (e.g., ‒4.38 [‒7.08, ‒1.67], p-value = 0.002, per 50 noise events at street level). Individual exposure to the road traffic average noise level in classrooms was only associated with inattentiveness (2.49 ms [0, 4.81], p-value = 0.050, per 5 dB), whereas indoor noise fluctuation was consistently associated with all outcomes. Home-outdoor noise exposure was not associated with the outcomes. Study limitations include a potential lack of generalizability (58% of mothers with university degree in our study versus 50% in the region) and the lack of past noise exposure assessment.

CONCLUSIONS

We observed that exposure to road traffic noise at school, but not at home, was associated with slower development of working memory, complex working memory, and attention in schoolchildren over 1 year. Associations with noise fluctuation indicators were more evident than with average noise levels in classrooms.

Burden of diseases attributed to traffic noise in the metropolis of Tehran in 2017

Although road traffic noise is the most important source of environmental noise emission in large cities, little is known about health burden. The present study was conducted to estimate the burden of diseases attributed to traffic noise in the metropolis of Tehran in 2017. Using noise maps provided by the municipality of Tehran, we calculated population exposure distribution in term of L_dn and L_night and the number of DALYs lost due to ischemic heart disease, hypertension, high sleep disturbance, annoyance and stroke endpoints based on the World Health Organization Environmental Noise Guidelines for the European Region. We applied published dose-response functions to estimate the traffic noise burden for high sleep disturbance and annoyance. We estimated 61,284 DALYs or 697 DALYs per 100,000 population attributed to traffic noise in Tehran for the reference year 2017. Highly sleep disturbance with a share of 58.74% of the DALYs was recognized as the most important contributor of disease burden, and noise annoyance with a share of 23.12% was ranked next. Ischemic heart disease (11.71%), stroke (5.12%), and hypertension (1.31%) were ranked third to fourth, respectively, in terms of the burden of disease caused by environmental noise. A considerable fraction of the population of Tehran lives in areas with an environmental noise higher than the standard level. The findings showed that traffic noise pollution is an important environmental risk factor in Tehran imposes the greatest burden on the community, mainly through highly sleep disturbance and noise annoyance endpoints.

Health effects of exposure to indoor volatile organic compounds from 1980 to 2017: A systematic review and meta-analysis

Exposure to volatile organic compounds (VOCs) indoors is thought to be associated with several adverse health effects. However, we still lack concentration-response (C-R) relationships between VOC levels in civil buildings and various health outcomes. For this paper, we conducted a systematic review and meta-analysis of observational studies to summarize related associations and C-R relationships. Four databases were searched to collect all relevant studies published between January 1980 and December 2017. A total of 39 studies were identified in the systematic review, and 32 of these were included in the meta-analysis. We found that the pooled relative risk (RR) for leukemia was 1.03 (95% CI: 1.01-1.05) per 1 μg/m³ increase of benzene and 1.25 (95%CI: 1.14-1.37) per 0.1 μg/m³ increase of butadiene. The pooled RRs for asthma were 1.08 (95% CI: 1.02-1.14), 1.02 (95% CI: 1.00-1.04), and 1.04 (95% CI: 1.02-1.06) per 1 μg/m³ increase of benzene, toluene, and p-dichlorobenzene, respectively. The pooled RR for low birth weight was 1.12 (95% CI: 1.05-1.19) per 1 μg/m³ increase of benzene. Our findings provide robust evidence for associations between benzene and leukemia, asthma, and low birth weight, as well as for health effects of some other VOCs.

Using global optimization methods for three-dimensional localization and quantification of incoherent acoustic sources

Complex acoustic systems typically present three-dimensional distributions of noise sources. Conventional acoustic imaging methods with planar microphone arrays are unsuitable for three-dimensional acoustic imaging, given the computational demands and the incapability to explicitly account for the presence of multiple sources. This paper proposes the use of global optimization methods to solve these shortcomings. An experiment with three incoherent speakers proved that this method can accurately determine the three-dimensional location and the respective sound level of each individual source. In addition, super-resolution is achieved beyond half the Rayleigh resolution limit.