Gunn Marit Aasvang

Noise, sleep and poor health: Modeling the relationship between road traffic noise and cardiovascular problems

Several adverse effects have been associated with exposure to traffic noise. Studies supporting a noise-stress-health model have suggested links between noise level and increased noradrenalin concentrations in urine, hypertension and myocardial infarction. Among the more commonly documented effects, sleep disturbances have been regarded as being the most serious. Both noise annoyance and sleep disturbance have been proposed as important mediators of the impact of noise on health. The present paper investigates the relationships among long-term noise exposure, annoyance, sleeping problems and subjective health complaints by the use of a structural equation model. Further, it aims at giving insight into how noise sensitivity is related to sleep disturbances from road traffic noise. Finally, it examines whether any effect of noise exposure or response to noise can be detected on prevalence of cardiovascular problems, when information on sleep disturbances is included in a model. Data from a questionnaire survey conducted among a population sample in Oslo (N=2786) are combined with nighttime noise levels calculated from outside each respondents dwelling, at the bedroom façade. The results of the analysis showed significant relationships between noise annoyance at night and sleeping problems. The model also showed strong links among pseudoneurological complaints, annoyance and sleeping problems, thus pointing to the importance of including information on psychosomatic disorders and mild psychological problems in future studies looking at potential health effects of noise. The analysis showed no relationship between neither noise exposure nor response to noise and cardiovascular problems.

Exposure to traffic noise and markers of obesity

Objectives Limited evidence suggests adverse effects of traffic noise exposure on the metabolic system. This study investigates the association between road traffic noise and obesity markers as well as the role of combined exposure to multiple sources of traffic noise. Methods In a cross-sectional study performed in 2002–2006, we assessed exposure to noise from road traffic, railways and aircraft at the residences of 5075 Swedish men and women, primarily from suburban and semirural areas of Stockholm County. A detailed questionnaire and medical examination provided information on markers of obesity and potential confounders. Multiple linear and logistic regression models were used to assess associations between traffic noise and body mass index (BMI), waist circumference and waist–hip ratio using WHO definitions of obesity. Results Road traffic noise was significantly related to waist circumference with a 0.21 cm (95% CI 0.01 to 0.41) increase per 5 dB(A) rise in Lden. The OR for central obesity among those exposed to road traffic noise ≥45 dB(A) was 1.18 (95% CI 1.03 to 1.34) in comparison to those exposed below this level. Similar results were seen for waist–hip ratio (OR 1.29; 95% CI 1.14 to 1.45) but not for BMI (OR 0.89; 95% CI 0.76 to 1.04). Central obesity was also associated with exposure to railway and aircraft noise, and a particularly high risk was seen for combined exposure to all three sources of traffic noise (OR 1.95; 95% CI 1.24 to 3.05). Conclusions Our results suggest that traffic noise exposure can increase the risk of central obesity. Combined exposure to different sources of traffic noise may convey a particularly high risk.

Road traffic noise, sleep and mental health.

This study examines the relationship between road traffic noise, self-reported sleep quality and mental health. The study is cross-sectional and based on data from a survey conducted in Oslo, Norway, in 2000. Psychological distress (Hopkins Symptom Checklist, HSCL-25) was measured along with self-reported somatic health, sleep quality, noise sensitivity and socioeconomic variables. Questionnaire data were combined with modeled estimates of noise exposure. The total study sample consisted of 2898 respondents. After adjustment for potential confounders and stratifying for sleep quality, we found a positive, but not statistically significant association between noise exposure and symptoms of psychological distress among participants with poor sleep quality (slope=0.06, 95% CI: -0.02 to 0.13, per 10 dB increase in noise exposure). In the same sleep quality group, we found a borderline statistically significant association between noise exposure and a symptom level indicating a probable mental disorder (HSCL≥1.55) (odds ratio=1.47, 95% CI: 0.99-1.98, per 10 dB increase in noise exposure). We found no association between road traffic noise and mental health among subjects reporting good and medium sleep quality. The results suggest that road traffic noise may be associated with poorer mental health among subjects with poor sleep. Individuals with poor sleep quality may be more vulnerable to effects of road traffic noise on mental health than individuals with better sleep quality.

Road traffic noise and markers of obesity - a population-based study.

BACKGROUND Noise has been found to be associated with endocrine changes and cardiovascular disease. Increased cortisol levels and chronic sleep problems due to noise may increase the risk of obesity. OBJECTIVES We investigated the relationship between road traffic noise and obesity markers. Furthermore, we explored the modifying role of noise sensitivity, noise annoyance, and sleep disturbances. METHODS We used data from a population-based study, HUBRO (N=15,085), and its follow-up study HELMILO (N=8410) conducted in Oslo, Norway. Measurements were used to define body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR), and these binary outcomes: BMI≥30kg/m(2), WC≥102cm (men)/88cm (women), and WHR≥0.90 (men)/0.85 (women). Modelled levels of road traffic noise (Lden) were assigned to each participants home address. Linear and logistic regression models were used to examine the associations. RESULTS The results indicated no significant associations between road traffic noise and obesity markers in the total populations. However, in highly noise sensitive women (n=1106) a 10dB increase in noise level was associated with a slope (=beta) of 1.02 (95% confidence interval (CI): 1.01, 1.03) for BMI, 1.01 (CI: 1.00, 1.02) for WC, and an odds ratio (OR) of 1.24 (CI: 1.01, 1.53) for WHR ≥0.85. The associations appeared weaker in highly noise sensitive men. We found no effect modification of noise annoyance or sleep disturbances. In a sub-population with bedroom facing a road, the associations increased in men (e.g. an OR of 1.25 (CI: 0.88, 1.78) for BMI ≥30kg/m(2)), but not in women. Among long-term residents the associations increased for BMI ≥30kg/m(2) (OR of 1.07 (CI: 0.93, 1.24) in men and 1.10 (CI: 0.97, 1.26) in women), but not for the other outcomes. CONCLUSION In an adult urban Scandinavian population, road traffic noise was positively associated with obesity markers among highly noise sensitive women. The associations appeared stronger among men with bedroom facing a street, representing a population with more accurately assigned exposure.

A field study of effects of road traffic and railway noise on polysomnographic sleep parameters

The aim of this study was to explore and compare the effect of noise from railway and road traffic on sleep in subjects habitually exposed to nocturnal noise. Forty young and middle aged healthy subjects were studied with polysomnography (PSG) during two consecutive nights in their own bedroom. Noise measurements and recordings were conducted concurrently outside of the bedroom façade as well as inside the bedroom of each participant. Different noise exposure parameters were calculated (L(p,A,eq,night), L(p,A,Fmax,night), and L(AF5,night)) and analyzed in relation to whole-night sleep parameters. The group exposed to railway noise had significantly less Rapid eye movement, (REM) sleep than the group exposed to road traffic noise. A significant association was found between the maximum level (L(p,A,Fmax,night)) of railway noise and time spent in REM sleep. REM sleep was significantly shorter in the group exposed to at least a single railway noise event above 50 dB inside the bedroom. These results, obtained in an ecological valid setting, support previous laboratory findings that railway noise has a stronger impact than road traffic noise on physiological parameters during sleep, and that the maximum noise level is an important predictor of noise effects on sleep assessed by PSG, at least for railway noise.

The Norwegian Façade Insulation Study: The efficacy of façade insulation in reducing noise annoyance due to road traffic

The efficacy of façade insulation in providing an improved indoor noise environment and in reducing indoor noise annoyance was examined in a socio-acoustic before-and-after study with a control group. An average equivalent noise reduction inside the dwellings of 7 dB was obtained from the façade insulation. Whereas 42% of the respondents were highly annoyed in the before-situation, this dropped to 16% in the after study. The conclusion is therefore that the façade insulation provided a substantial improvement in the indoor noise environment. The advantage with respect to indoor noise annoyance, of having the bedroom facing the least noise-exposed side of the dwelling corresponded to a 6 dB noise reduction. The changes in annoyance from noise reduction due to the façade insulation were in accordance with what would be expected from the exposure-response curves obtained in the before-situation. A total of 637 respondents participated in the before-study. Of these, 415 also participated in the after study. Indoor and outdoor noise exposure calculations for each of the dwellings were undertaken before and after the façade insulation was implemented.

A Population-Based Study on Nighttime Road Traffic Noise and Insomnia

Study Objectives: The aims of the present study were to investigate how nighttime road traffic noise relates to self‐reported symptoms of insomnia and sleep medication use. Methods: We used questionnaire data from the population‐based study Health and Environment in Oslo (HELMILO) (2009‐2010; n = 13019). The insomnia symptoms difficulties falling asleep, awakenings during the night, and waking up too early in the morning as well as self‐reported sleep medication use were included as outcomes. Modeled noise levels (Lnight) were assigned to each participants home address. For selecting covariates to the statistical model, we used a directed acyclic graph. The associations between noise and sleep were analyzed using logistic regression models. Results: After adjustment for potential confounders, we found an odds ratio (OR) of 1.05 (95% confidence interval [CI]: 1.01‐1.09) for the association between traffic noise and difficulties falling asleep, in the total study population. For the association between traffic noise and awakenings during the night, the OR was 1.04 (95% CI: 1.00‐1.08) and for waking up too early, the OR was 1.06 (95% CI: 1.02‐1.11). The effect estimates are given per 5‐dB increase in traffic noise level (Lnight). Self‐reported sleep medication use was not statistically significantly associated with traffic noise exposure. Conclusions: In an adult population from Oslo, traffic noise was associated with difficulties falling asleep and waking up too early. These findings indicate that sleep quantity may be compromised for individuals living in areas highly exposed to nighttime traffic noise.

Outdoor air pollution and risk for kidney parenchyma cancer in 14 European cohorts

Several studies have indicated weakly increased risk for kidney cancer among occupational groups exposed to gasoline vapors, engine exhaust, polycyclic aromatic hydrocarbons and other air pollutants, although not consistently. It was the aim to investigate possible associations between outdoor air pollution at the residence and the incidence of kidney parenchyma cancer in the general population. We used data from 14 European cohorts from the ESCAPE study. We geocoded and assessed air pollution concentrations at baseline addresses by land‐use regression models for particulate matter (PM10, PM2.5, PMcoarse, PM2.5 absorbance (soot)) and nitrogen oxides (NO2, NOx), and collected data on traffic. We used Cox regression models with adjustment for potential confounders for cohort‐specific analyses and random effects models for meta‐analyses to calculate summary hazard ratios (HRs). The 289,002 cohort members contributed 4,111,908 person‐years at risk. During follow‐up (mean 14.2 years) 697 incident cancers of the kidney parenchyma were diagnosed. The meta‐analyses showed higher HRs in association with higher PM concentration, e.g. HR = 1.57 (95%CI: 0.81–3.01) per 5 μg/m3 PM2.5 and HR = 1.36 (95%CI: 0.84–2.19) per 10−5m−1 PM2.5 absorbance, albeit never statistically significant. The HRs in association with nitrogen oxides and traffic density on the nearest street were slightly above one. Sensitivity analyses among participants who did not change residence during follow‐up showed stronger associations, but none were statistically significant. Our study provides suggestive evidence that exposure to outdoor PM at the residence may be associated with higher risk for kidney parenchyma cancer; the results should be interpreted cautiously as associations may be due to chance.

Long-Term Exposure to Ambient Air Pollution and Incidence of Postmenopausal Breast Cancer in 15 European Cohorts within the ESCAPE Project

Background: Epidemiological evidence on the association between ambient air pollution and breast cancer risk is inconsistent. Objective: We examined the association between long-term exposure to ambient air pollution and incidence of postmenopausal breast cancer in European women. Methods: In 15 cohorts from nine European countries, individual estimates of air pollution levels at the residence were estimated by standardized land-use regression models developed within the European Study of Cohorts for Air Pollution Effects (ESCAPE) and Transport related Air Pollution and Health impacts - Integrated Methodologies for Assessing Particulate Matter (TRANSPHORM) projects: particulate matter (PM) ≤2.5μm, ≤10μm, and 2.5–10μm in diameter (PM2.5, PM10, and PMcoarse, respectively); PM2.5 absorbance; nitrogen oxides (NO2 and NOx); traffic intensity; and elemental composition of PM. We estimated cohort-specific associations between breast cancer and air pollutants using Cox regression models, adjusting for major lifestyle risk factors, and pooled cohort-specific estimates using random-effects meta-analyses. Results: Of 74,750 postmenopausal women included in the study, 3,612 developed breast cancer during 991,353 person-years of follow-up. We found positive and statistically insignificant associations between breast cancer and PM2.5 {hazard ratio (HR)=1.08 [95% confidence interval (CI): 0.77, 1.51] per 5 μg/m3}, PM10 [1.07 (95% CI: 0.89, 1.30) per 10 μg/m3], PMcoarse [1.20 (95% CI: 0.96, 1.49 per 5 μg/m3], and NO2 [1.02 (95% CI: 0.98, 1.07 per 10 μg/m3], and a statistically significant association with NOx [1.04 (95% CI: 1.00, 1.08) per 20 μg/m3, p=0.04]. Conclusions: We found suggestive evidence of an association between ambient air pollution and incidence of postmenopausal breast cancer in European women. https://doi.org/10.1289/EHP1742

AIRCRAFT NOISE IN RECREATIONAL AREAS: A QUASI-EXPERIMENTAL FIELD STUDY ON INDIVIDUAL ANNOYANCE RESPONSES AND DOSE--RESPONSE RELATIONSHIPS

A quasi-experimental field study was conducted to investigate aircraft-noise-induced annoyance in outdoor recreational areas. This study, which is part of a larger project that also includes a social survey, was conducted near Fornebu Airport in Oslo, Norway. The aim of the study was to investigate annoyance due to aircraft noise in an outdoor setting under partially controlled conditions. Results are presented for exposure--annoyance relationships, acceptability judgments, and relationhips between immediate annoyance responses to overflights and total annoyance over a longer period.