Noise annoyance predicts symptoms of depression, anxiety and sleep disturbance 5 years later. Findings from the Gutenberg Health Study

Study on the effects of traffic noise and spring water sound at different sound pressure levels on brain dynamic activity

The correlation between sound and psychophysiological health is complex. This study explores effects of various sound pressure levels (SPLs) on psychophysiological responses, utilizing dynamic features of neural activity. Two sound types (traffic noise and spring water sound) and five SPLs (40, 45, 50, 55, and 60 dBA) were tested, with no sound serving as the control condition. The electrocardiography (ECG) and electroencephalogram (EEG) of 38 young college students were collected. The results indicate that spring water sound (SWS) significantly enhances sound perception, with sound comfort votes (SCV) and sound pleasure votes (SPV) increasing by 0.10-0.95 and 0.05-1.10, respectively. SWS facilitated parasympathetic nervous system comfort. Compared to the no sound, as SPLs increased, LF/HF decreased (by 0.07-0.41), and SDNN increased (by 8.85-18.56 ms), whereas traffic noise (TN) exhibited the opposite trend. For brain oscillatory activity, α, θ, and β power-associated with stress recovery-initially increased and then decreased with rising SPLs under spring water sound exposure. At 50 dBA SWS, effective delay duration, linked to comfort, peaked at 284.78 ms. Conversely, the α power and τe for TN diminished with increasing SPLs. The left frontal-parietal and right occipital lobes exhibited the highest sensitivity (p < 0.01). SWS exposure reduced the avalanche critical index (ACI) by 4.78-17.29% compared to no sound, enhancing brain comfort, while TN increased the ACI by 2.28-29.37%. The 50 dBA SWS showed the greatest improvement in brain comfort, being 1.74 times higher than that of TN. Furthermore, compared to no sound, brain power loss was lower for 52.63-63.16% of participants exposed to 50-60 dBA SWS. This study provides a methodology for soundscape evaluation and enhances understanding of how brain activity changes under sound exposure can improve the indoor acoustic environment.

Integrating Digital Health Innovations to Achieve Universal Health Coverage: Promoting Health Outcomes and Quality Through Global Public Health Equity

Digital health innovations are reshaping global healthcare systems by enhancing access, efficiency, and quality of care. Technologies such as artificial intelligence, telemedicine, mobile health applications, and big data analytics have been widely applied to support disease surveillance, enable remote care, and improve clinical decision making. This review critically identifies persistent implementation challenges that hinder the equitable adoption of digital health solutions, such as the digital divide, limited infrastructure, and weak data governance, particularly in low- and middle-income countries (LMICs). It aims to propose strategic pathways for integrating digital innovations to strengthen universal health coverage (UHC) and bridge health disparities in the region. By analyzing the best global practices and emerging innovations, this study contributes to the ongoing dialogue on leveraging digital health for inclusive, scalable, and sustainable healthcare delivery in underserved regions.

Construction noise annoyance and its evolution: Insights from the Turcot Project longitudinal study

This study examined how construction noise levels and associated annoyance evolved over 4 years during the rehabilitation work of a metropolitan highway interchange. A total of 1409 participants, grouped by their proximity to the construction sites, completed a socio-acoustic survey on their personal situation and noise perception. Noise levels were monitored using 18 autonomous stations near the construction sites. Findings showed that a significant portion of participants experienced annoyance due to construction noise, though annoyance levels decreased significantly over time in both groups. Interestingly, those living closer to the construction sites reported a faster decline in overall construction noise annoyance and annoyance from other aspects of the work undertaken. Regression models indicated that construction noise levels explained only a small portion of annoyance variance. Key contributing factors included annoyance from other construction nuisances, noise perception in the bedroom, and perceived safety. This study provides valuable insights for future development of policy concerning noise on construction sites. Specifically, the results suggest that taking into account identified socio-demographic, psychosocial, and contextual variables, as well as the individuals' perception of noise levels and construction-related nuisances, could help to reduce construction noise annoyance, ultimately improving the quality of life for nearby residents.

Earplug use during sleep and its association with cardiovascular disease - Results from a large sample of the general population

Introduction

Environmental factors contribute to cardiovascular disease (CVD) pathogenesis. Noise annoyance is linked to adverse cardiovascular outcomes, and earplug use may mitigate noise-related health effects. This study examines associations between earplug use, noise annoyance, and CVD in a general population sample.

Methods

Cross-sectional data from 15,010 participants (35-74 years, 2007-2012) in the German Gutenberg Health Study were analyzed. Noise annoyance from various sources and earplug use during sleep were self-reported. Prevalent CVD (atrial fibrillation, coronary artery disease, myocardial infarction, stroke, chronic heart failure, peripheral artery disease, or venous thromboembolism) was determined through self-report or medical records. Logistic regression analyses with sequential adjustments evaluated associations.

Results

Among 14,675 participants with earplug data, 713 (4.9%) reported use. Earplug users were more likely younger women with lower cardiovascular risk profiles but higher noise annoyance (90.3% vs. 78.8%). Logistic regression revealed consistent positive associations between earplug use and prevalent CVD across various noise sources, persisting after adjustments for covariates. For example, the odds ratio for earplug use and prevalent CVD, adjusted for neighborhood noise annoyance and other factors, was 1.91 (95% CI 1.39-2.59). No interaction between earplug use and noise annoyance was found.

Conclusions

This study provides valuable insights into the relationships between earplug use, noise annoyance, and CVD. Findings highlight the need for targeted interventions addressing noise-related cardiovascular risks and emphasize the complex dynamics of these factors in cardiovascular health.

The moderating effect of the psychosocial working conditions (effort/reward/overcommitment) on the association between noise annoyance and cognitive performance among adolescents

OBJECTIVES

The primary objective of the current study was to evaluate the correlation between noise-induced annoyance and the cognitive performance within the Lebanese adolescent population and the moderating effect of psychosocial work aspects-namely effort, reward, and overcommitment- in this association.

METHODS

An anonymous online survey was conducted in Lebanon between April and May 2023, using a snowball sampling technique and distributed across various social media platforms, to gather data from Lebanese adolescents. The sample was composed of 1269 adolescents. Participants voluntarily completed a self-administered Arabic questionnaire that consisted of a sociodemographic section and implemented three scales: Noise Annoyance scale, Effort-Reward in school scale, as well as LEAF scale.

RESULTS

The moderation analysis findings revealed that at low levels of effort, higher noise annoyance was significantly associated with worse memory function (Beta = 0.94; p =.002) and mathematics skills (Beta = 0.40; p =.002), whereas at low (Beta = 0.49; p <.001) and moderate (Beta = 0.29; p =.001) levels of effort, it was significantly associated with worse sustained sequential processing. At low and moderate levels of reward, higher noise annoyance was significantly associated with worse attention (Beta = 0.48; p <.001 and Beta = 0.20; p <.031 respectively), sustained sequential processing (Beta = 0.43; p <.001 and Beta = 0.22; p =.013 respectively) and working memory (Beta = 0.47; p <.001 and Beta = 0.28; p =.002 respectively). At low levels of reward, higher annoyance was significantly associated with worse memory function (Beta = 0.82; p =.007), processing speed (Beta = 0.38; p =.001) and mathematic skills (Beta = 0.28; p =.026). Finally, at low and moderate levels of overcommitment, higher noise annoyance was significantly associated with worse factual memory (Beta = 0.49; p <.001 and Beta = 0.25; p =.005 respectively), worse attention (Beta = 0.45; p <.001 and Beta = 0.26; p =.005 respectively) and worse processing speed (Beta = 0.43; p <.001 and Beta = 0.23; p =.012 respectively).

CONCLUSION

This study could encourage the integration of targeted interventions and strategic measures that address both noise annoyance and psychosocial working conditions, defined as the academic work students perform both at school and at home, to proactively prevent the emergence of cognitive impairment among the adolescent population.

Effects of Occupational Noise Exposure on Disease Control and Psychological Status in Patients with Diabetic Nephropathy

Objective To investigate the effects of occupational noise exposure on disease control and psychological status in patients with diabetic nephropathy.

METHODS

A cross-sectional study was conducted on 306 patients with diabetic nephropathy who visited the Second Affiliated Hospital of Fujian Medical University between January 2022 and January 2024. The patients were divided into two groups based on their occupational noise exposure level as follows: Group A (noise level ≥55 dB, 148 cases) and Group B (noise level <55 dB, 158 cases). The general information, noise exposure levels, glycaemic indicators [glycosylated haemoglobin (HbA1c), fasting plasma glucose (FPG), 2-hour postprandial plasma glucose (2hPG), glycated serum protein (GSP)], renal function indicators [blood urea nitrogen (BUN), urinary albumin excretion rate (UAER), serum creatinine (SCr), 24-hour urinary protein (24hUP)] and psychological status [Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)] were compared between Groups A and B. Univariate analysis was performed using Pearson correlation analysis.

RESULTS

No significant differences were observed in age, gender and body mass index between the two groups (P > 0.05). However, glycaemic indicators such as HbA1c, FPG, PBG, GSP; renal function indicators such as BUN, UAER, SCr, 24hUP and psychological status (SAS and SDS scores) in Group A were significantly higher than those in Group B (P < 0.05). A significantly positive association was found between noise levels with SDS score (r = 0.321), FPG (r = 0.320) and UAER level (r = 0.405) (P < 0.001).

CONCLUSION

This study reveals that occupational noise exposure negatively impacts disease control and psychological status in patients with diabetic nephropathy. Therefore, focusing on noise control in clinical practice is essential.

Noise annoyance due to different sources is associated with tinnitus presence and distress in the general population

BACKGROUND

The pathophysiology of tinnitus is not yet fully understood. Although there is a large amount of evidence associating traffic noise exposure with non-auditory health outcomes, there is no evidence regarding the impact of noise annoyance on auditory disorders such as tinnitus.

OBJECTIVE

Thus, we aimed to investigate the association between noise annoyance due to different sources and tinnitus presence and distress in the general population.

METHODS

Data of 6813 participants from a large German population-based cohort were used (Gutenberg Health Study). Participants were asked about the presence of tinnitus and how much they were bothered by it. In addition, information on annoyance from road traffic, aircraft, railways, industrial, and neighborhood noise during the day and sleep was collected through validated questionnaires.

RESULTS

The prevalence of tinnitus was 27.3%, and the predominant sources of noise annoyance in these subjects were aircraft, neighborhood, and road traffic noise. Overall, logistic regression results demonstrated consistent positive associations between annoyance due to different noise sources and prevalent risk of tinnitus with increases in odds ratios ranging from 4 to 11% after adjustment for sex, age, and socioeconomic status. Likewise, consistent increases in odds ratios were observed for tinnitus distress in subjects with prevalent tinnitus. For instance, neighborhood noise annoyance during the sleep was associated with a 26% increase in tinnitus distress (OR 1.26, 95% CI 1.13; 1.39).

IMPACT

This is the first study investigating the association between noise annoyance and tinnitus presence and distress in a large cohort of the general population. Our results indicate consistent and positive associations between various sources of noise annoyance and tinnitus. These unprecedented findings are highly relevant as noise annoyance and tinnitus are widespread. The precise etiology and locus of tinnitus remain unknown, but excessive noise exposure is thought to be among the major causes. This study suggests that transportation and neighborhood noise levels thought merely to contribute to annoyance and non-auditory health effects may be sufficient to cause or exacerbate tinnitus.

Environmental noise perception and risk of poor mental health in a region on the Mediterranean coast of Spain

BACKGROUND

Exposure to environmental noise may have a negative impact on a population's mental health. We estimated the prevalence of exposure perception to high environmental noise in the Valencian Community, a region on the Mediterranean coast of Spain, and analysed its association with poor mental health risk, adjusting for demographic, socioeconomic and health status variables.

METHODS

Cross-sectional study based on a sample of 5.485 subjects, aged 15 or above, of the 2016 Valencian Community Health Survey. The risk of poor mental health was assessed via Goldberg's questionnaire, a highly standardized self-reported questionnaire designed to screen for general psychological distress in the general population. Noise perception were determined in the home environment based on individuals' responses to the Valencian Survey question about external noise problems. Sociodemographic variables, such as sex, age, level of education, or country of birth, and health variables, such as self-perceived health, or chronic diseases, were also considered. Logistic regression was used to estimate the Odds Ratios and confidence intervals of association between variables according to sex.

RESULTS

The prevalence of poor mental health was 26.2% [n = 2665; 95% CI: 24.5-27.9] in men and 33.6% [n = 2820; 95% CI: 31.9-35.3] in women. A total of 7.8% [n = 5485; 95% CI: 6.8-8.8] presented exposure to high noise perception, with no differences according to sex. Being at risk of poor mental health was significantly associated (p < 0.05) with high noise perception after adjusting for the rest of the variables (OR: 2.16 [95% CI: 1.46-3.19] in men; 2.46 [95% CI: 1.72-3.50] in women).

CONCLUSIONS

Although the prevalence of exposure perception to high noise was not very high, population subgroups presenting high values were detected. High noise perception was related to the risk of poor mental health, regardless of other variables. Poor mental health risk was associated with exposure perception to high noise, other socioeconomic determinants, and health status. Improving noise exposure conditions could reduce the risk of poor mental health.

Effects of Nighttime Noise Reduction by Using Earplugs on the Recovery of Burn Patients after Reconstructive Surgery

OBJECTIVE

This study aims to investigate the effects of postoperative noise reduction by using earplugs at night on the healing time and scar quality of burn patients who underwent reconstructive surgery.

METHODS

This retrospective cohort study analyzed the clinical data of adult burn patients after they underwent reconstructive surgery at the First Affiliated Hospital of Soochow University from January 2022 to June 2023. The patients were divided into the postoperative noise reduction group (n = 66) and the control group (n = 75) based on whether they received postoperative noise reduction. The control group received standard humanized clinical care, while the postoperative noise reduction group received additional noise-reducing care by using earplugs at night. The effects of postoperative noise reduction on wound healing time, scar quality (Vancouver Scar Scale [VSS]), psychological state (Self-rating Anxiety Scale [SAS] and Self-rating Depression Scale [SDS]), quality of life (Abbreviated Burn Specific Health Scale [BSHS-A]) and incidence of complications were compared between the two groups.

RESULTS

Compared with the control group, the postoperative noise reduction group demonstrated significant differences in wound healing time (P < 0.001), VSS scores (P = 0.003), SAS scores (P = 0.005), SDS scores (P = 0.003), and BSHS-A scores (P < 0.05). No significant difference was found in the incidence of complications between the two groups (P > 0.05).

CONCLUSION

In conclusion, this study provides substantive evidence that postoperative noise reduction positively influences wound healing time, scar quality, quality of life, and psychological state in burn patients after reconstructive surgery. Such insight emphasized the importance of creating a healing-conducive hospital environment for burn patients, integrating noise reduction strategies as a part of holistic nursing practices to optimize recovery outcomes.

Noise and mental health: evidence, mechanisms, and consequences

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

Psychological Effects of Noise Exposure on Personnel in Central Sterile Supply Department in China

Objective

This study aimed to investigate whether noise exposure in hospital sterile supply centers exacerbated the psychological burden on staff, potentially mediated by concerns about physiological health.

Methods

Between July 5 and August 4, 2023, 308 staffs from central sterile supply departments in 30 hospitals in Hainan were chosen by convenient sampling method. They completed self-administered questionnaires to assess noise exposure status and used the Self-Reporting Inventory-90 to quantify the psychological state of staff across three dimensions: somatization, anxiety, and sleep and diet. Binary logistic regression analysis was used to assess the influencing factors of their psychological symptoms, while a mediation model was used to analyze the pathway of noise affecting psychology.

Results

(1) Predominantly, respondents reported air gun sounds (76.3%) and pressure steam sterilizer noises (78.2%) within central sterile supply departments to be the most troublesome. (2) Approximately 25.33% of participants expressed that their sleep was significantly impacted by noise, while 32.14% expressed concerns about the potential serious effects on their health. (3) Logistic regression analysis revealed that age (OR,1.06, 95% CI, [1.01, 1.11]), educational background (OR, 0.65, 95% CI, [0.49, 0.85]), perceived noise exposure (OR,1.57, 95% CI, [1.04, 2.48]), health concerns (OR, 1.91, 95% CI, [1.06, 3.52]), and hearing loss (OR, 1.46,95% CI [1.02, 2.10]) emerged as significant influencing factors of psychological symptoms. (4) Mediation effect model analysis demonstrated that health concerns (mediation effect value=0.11, 95% CI [0.08, 0.16], Effect ratio=53.83%) mediated the impact of noise affecting psychological state.

Conclusion

Noise exposure represents a concealed risk factor for service quality within hospital central sterile supply departments, with health concerns serving as a mediating factor in the relationship between noise exposure and psychological well-being.

Assessment of index-based traffic noise annoyance level at major road intersections in a tourist city: A case study towards environmental sustainability

Urban noise pollution poses significant challenges to public health and environmental sustainability, particularly in rapidly developing tourist destinations. Noise pollution and associated annoyance level in five major intersections of Cox's Bazar City, Bangladesh, was assessed in this study during the peak tourist season. Noise measurements were conducted using various indices (L10, Leq, and TNI) across morning, midday, and afternoon time slots. TNI scores were compared with Mean Dissatisfaction Score (MDS) standards to assess traffic-induced noise annoyance levels. Additionally, a survey of 675 respondents was conducted to assess their perceptions of noise pollution. Statistical analyses included linear regression for noise indices, multinomial logistic regression for TNI-related dissatisfaction, and ordinal logistic regression for respondents' perceived annoyances. Results revealed significant noise pollution issues, with Leq scores consistently exceeding national guidelines across all intersections and time periods, particularly on weekends during afternoon timeslots. TNI values frequently surpassed standard dissatisfaction regulations, with 19 out of 105 time slots exhibiting extreme dissatisfaction levels. Link Road and Kolatoli Circle intersections consistently showed higher noise levels and dissatisfaction. Over 95% of survey respondents perceived increased noise pollution during peak tourist seasons, with 87.11% describing it as "extremely" or "very" noisy. Longer exposure duration and awareness of health risks were significantly associated with reported perceived annoyance levels. Respondents reported various health impacts, including annoyance (84.44%), headaches (62.37%), and cognitive impairment (44.44%). This comprehensive study provides valuable insights for policymakers, city planners, and environmentalists to develop sustainable urban strategies that balance the acoustic environment with the well-being of residents and tourists alike.

Unveiling the impact of siren noise exposure on cognitive function and mental health among firefighters

Firefighters reside in inherently noisy environments with sirens and emergency alarms. This noise can negatively affect the performance of firefighters and further pose a safety risk. This study investigates the relationship between siren noise exposure and its mental health disorders. In doing so, the study focuses on cognitive function among firefighters, using a Bayesian network model for the first time. This case-control study involved 92 firefighters and was conducted in 2023. Participants were categorized into case and control groups based on their exposure levels to siren noise. Noise exposures were initially measured according to ISO 9612 standards. The questionnaires covered demographic information, scales of their depression, anxiety, and stress, the Buss-Perry aggression questionnaire, and the cognitive failure questionnaire. GeNIe academic software version 2.3 was employed for Bayesian network analysis. The study results indicated a strong association that heightened siren noise exposure with a 100% probability increases depression (10%), stress (14%), anxiety (13%), and aggression (16%). In addition, each variable-noise exposure, depression, stress, anxiety, and aggression was linked to cognitive failure by 8%, 28%, 8%, and 13%, respectively. The combination of variables including noise exposure, depression, anxiety, and other mental health disorders had a 57% increase in cognitive failure. The most influence values were observed between depression and cognitive failures (0.564). The results of this study demonstrated the effect of siren noise exposure and its mental health disorders on cognitive function among firefighters. The results further highlight proper implementation of measures to mitigate these effects, and further required investigation on their effectiveness.

Occupational noise, work-related stress, and teachers' health in the French CONSTANCES study

OBJECTIVE

Besides psychosocial stressors, teachers are exposed to disturbing noise at work, such as students' irrelevant speech. Few studies have focused on this issue and its health consequences. We explored occupational noise exposure among teachers within the French workforce and analyzed how noise and work-related stress are related to their health.

MATERIALS AND METHODS

The prevalence of perceived noise exposure, evaluated through the question "Do you work in an environment where you sometimes have to raise your voice to talk to people 2 to 3 m away?" was compared between teachers (n = 13,843) and various occupational groups (n = 34,338) using inclusion data (2012-2020) from the ongoing French population-based CONSTANCES cohort (>217,000 participants). Additionally, the relationships between perceived noise and two health dimensions, perceived health (poor vs. good) and depressive symptoms (Centre for Epidemiologic Studies-Depression Scale, high vs. low/moderate), among teachers were alternately investigated using logistic regressions. Moreover, how perceived noise may interact with work-related stress (effort-reward imbalance/strained relationships) was explored.

RESULTS

Thirty-two percent of teachers reported working in a noisy environment, compared with 14% of noneducation employees (P < 0.001). Primary school teachers were the most likely to report noise exposure (43%). Independent of stress, teachers exposed to noise had poorer perceived health and higher odds of depressive symptoms than nonexposed teachers, with odds ratios (95% confidence interval) of 1.21 (1.07; 1.37) and 1.14 (1.01; 1.28), respectively. Evidence of an interaction between perceived noise and strained relationships was observed on perceived health (P = 0.05).

CONCLUSION

French teachers commonly reported disturbing noise at work, and those exposed showed poorer health indicators, particularly when facing strained relationships. The findings call for further studies on noise in schools, especially longitudinal studies, to ascertain its long-term effect on teachers' health and its potential interaction with the psychosocial environment.

Powering the Future Green Buildings: Multifunctional Ultraviolet-Shielding Transparent Wood

Indoor UV damage is a serious problem that is often ignored. Common glasses cannot filter UV rays well and have fragility and environmental issues. UV-shielding transparent wood (TW) holds promise, yet striking the right balance between blocking UV rays and allowing sufficient visible-light transmission poses a challenge. The pronounced capillary force, fueled by persistent moisture and extractives in wood, alongside the existence of multiphase interfaces, collectively hinder the uniform penetration of polymers and the effective dispersion of nanomaterials within the wood skeleton. Here, we incorporate high-pressure supercritical CO2 fluid-assisted impregnation (HSCFI) into fabricating UV-shielding TW. The supercritical CO2 pretreatment efficiently eliminates moisture and refines wood structure by extracting polar substances, resulting in a prominent 52.4% increase in average water permeability. Subsequently, this HSCFI method facilitates the infiltration of methyl methacrylate (MMA) monomer and Ce-ZnO nanorods (NRDs) into the refined anhydrous wood, leveraging the excellent solvency of supercritical CO2 for MMA. The impregnation rate of PMMA undergoes a substantial increase from 34.5 to 59.1%. With the robust UV-blocking capability of Ce-ZnO NRDs, thanks to dual-valence Ce doping widening the ZnO energy gap via the Burstein-Moss effect and their unique photoactive microstructure featuring a solid prism with a sharp hexahedral pyramidal tip, along with intrinsic physical scattering/reflection actions, Ce-ZnO NRDs@TW achieves an impressive 99.6% UVA radiation blockage (the highest for TW) and maintains high visible-light transmission (83.2%). Furthermore, Ce-ZnO NRDs@TW presents favorable energy-saving, sound absorption, and antifungal abilities, making it a promising candidate for future green buildings.

Effects of Ward Night Noise Management in the Context of Enhanced Recovery After Surgery on Postoperative Sleep Quality, Anxiety, and Hormone Levels of Thoracic Surgery Patients with Lung Cancer

OBJECTIVE

This study aimed to analyze the effects of ward night noise management in the context of enhanced recovery after surgery (ERAS) on postoperative sleep quality and anxiety of thoracic surgery patients with lung cancer.

METHODS

This retrospective analysis included 118 patients with lung cancer who underwent thoracic surgery (from January 2020 to December 2021). The patients were categorized into the control and observation groups, which comprised 63 and 55 cases, respectively, on the basis of perioperative management plans. The two groups were compared in terms of their score in Athens Insomnia Scale (AIS), the State-Trait Anxiety Inventory (STAI) and Self-Rating Depression Scale (SDS), salivary cortisol (SC), thyroid hormone (TSH), and angiotensin II (Ang II) levels, and noise measurements at various timepoints.

RESULTS

The observation group exhibited a significantly lower noise level than the control group (P < 0.001). No statistically significant difference was found in the AIS, STAI, and SDS scores and Ang II, TSH and SC levels between the two groups before their surgery (P > 0.05). Compared with the control group, the observation group achieved significantly lower AIS scores at 1, 3 and 7 days after surgery (P < 0.05) and significantly lower STAI scores at 1 and 3 days postsurgery (P < 0.05). Significantly lower Ang II, TSH and SC indices were observed in the observation group after management than the control group (P < 0.05).

CONCLUSION

Night noise management in the context of ERAS can improve sleep quality and adverse moods of patients who underwent thoracic surgery for lung cancer, which helps in the promotion of prognosis.

Association of transportation noise with cardiovascular diseases

This comprehensive article delves into the intricate and multifaceted issue of noise pollution, shedding light on its diverse sources, profound health implications, and the economic burden it imposes on societies. Noise pollution is an increasingly prevalent environmental challenge, impacting millions of people worldwide, often without their full awareness of its adverse effects. Drawing from a wealth of scientific research, the article underscores the well-established links between noise pollution and a spectrum of health issues, including cardiovascular diseases, sleep disturbances, and psychological stress. While exploring the sources and consequences of noise pollution, the article highlights the urgent need for a holistic and collaborative approach to mitigate its impact. This entails a combination of regulatory measures, technological innovations, urban planning strategies, and public education campaigns. It is increasingly evident that the detrimental effects of noise pollution extend beyond physical health, encompassing mental and social well-being. The article also addresses the synergistic relationship between noise pollution and other environmental stressors, emphasizing the importance of considering noise in conjunction with factors like air pollution and access to green spaces. It examines the potential of green spaces to mitigate the effects of noise pollution and enhance overall health.

Effect of Ward Noise Management Combined with Meditation Training on Stroke Rehabilitation Patients

OBJECTIVE

To study the value of ward noise management combined with meditation training in stroke rehabilitation patients.

METHODS

According to the retrospective analysis method, 150 stroke patients hospitalized in the rehabilitation center of a Tangshan Workers' Hospital from July 2020 to December 2023 were selected as study objects. They were divided into three groups, namely the control group (routine rehabilitation care, n = 50), observation group A (meditation training, n = 50), and observation group B (meditation training and ward noise management, n = 50) according to whether they received ward noise management and meditation training. The general demographic data, Fatigue Severity Scale (FSS), Pittsburgh Sleep Quality Index (PSQI), and the Short Form 36 (SF-36) were collected. Chi-square test and analysis of variance were used to analyse the data.

RESULTS

The baseline data of the patients in each group were not statistically significant (P > 0.05). Before treatment, no difference in the FSS, PSQI, SF-36 scores and environmental noise level between the groups (P > 0.05) was observed. After management, the scores of SF-36 in observation group B were higher than those in the control group and observation group A (P < 0.05) except for somatic pain. Other indicators in observation group B were lower than those in the control and observation group A (P < 0.001).

CONCLUSIONS

Ward noise management and meditation training can effectively reduce patients' fatigue, significantly reducing ambient noise levels, promoting the improvement of life quality, and improving sleep quality.

Perceived Neighborhood Characteristics and Sleep in Australian Adults

BACKGROUND

Poor sleep can contribute to poorer health and socioemotional outcomes. Sleep health can be influenced by a range of individual and other socioecological factors. Perceptions of neighborhood physical and social characteristics reflect broader social-level factors that may influence sleep, which have not been well studied in the Australian context. This study examined the association between perceived neighborhood characteristics and sleep in a large sample of Australians.

METHODS

Data were from 9,792 people aged 16 years or older, from Waves 16 and 17 of the nationally representative Household, Income and Labour Dynamics in Australia Survey. Associations between perceived neighborhood characteristics (neighborly interaction and support, environmental noise, physical condition, and insecurity) and self-reported sleep duration, sleep disturbance, and napping were examined using multiple logistic regression models.

RESULTS

"Neighborhood interaction and support" and "neighborhood physical condition" were not significantly associated with any sleep outcomes after adjusting for relevant covariates. However, "environmental noise" and "neighborhood insecurity" remained significantly associated with sleep duration and sleep disturbance. None of the neighborhood characteristics were associated with napping. Furthermore, associations did not significantly vary by gender.

CONCLUSIONS

This study highlights the potential benefit of public health policies to address noise and safety in neighborhoods to improve sleep.

Health position paper and redox perspectives - Disease burden by transportation noise

Transportation noise is a ubiquitous urban exposure. In 2018, the World Health Organization concluded that chronic exposure to road traffic noise is a risk factor for ischemic heart disease. In contrast, they concluded that the quality of evidence for a link to other diseases was very low to moderate. Since then, several studies on the impact of noise on various diseases have been published. Also, studies investigating the mechanistic pathways underlying noise-induced health effects are emerging. We review the current evidence regarding effects of noise on health and the related disease-mechanisms. Several high-quality cohort studies consistently found road traffic noise to be associated with a higher risk of ischemic heart disease, heart failure, diabetes, and all-cause mortality. Furthermore, recent studies have indicated that road traffic and railway noise may increase the risk of diseases not commonly investigated in an environmental noise context, including breast cancer, dementia, and tinnitus. The harmful effects of noise are related to activation of a physiological stress response and nighttime sleep disturbance. Oxidative stress and inflammation downstream of stress hormone signaling and dysregulated circadian rhythms are identified as major disease-relevant pathomechanistic drivers. We discuss the role of reactive oxygen species and present results from antioxidant interventions. Lastly, we provide an overview of oxidative stress markers and adverse redox processes reported for noise-exposed animals and humans. This position paper summarizes all available epidemiological, clinical, and preclinical evidence of transportation noise as an important environmental risk factor for public health and discusses its implications on the population level.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Association between perceived noise at work and mental health among employed adults in Southwest China

BACKGROUND

Perceived noise at work may contribute more to worsening mental health than objectively measured noise. However, evidence regarding this association is scarce. We investigated the associations of perceived noise at work with anxiety and depression and identified vulnerable subpopulations.

METHODS

Data from 28,661 participants of the Chinese Cohort of Working Adults (CCWA) were analyzed. Logistic or multinomial logistic regression models were used to determine associations between perceived noise at work and the severity of probable anxiety, depression, and their comorbidity. The generalized additive model with restricted cubic splines was applied to estimate the non-linear trend of associations.

RESULTS

The mean age of participants was 36.55 ± 10.42 years. We observed that a higher level of perceived noise at work was associated with a higher risk of severe anxiety (OR = 1.55. 95%CI: 1.51-1.59) and severe depression (OR = 1.77. 95%CI: 1.72-1.84). More perceived noise at work was further associated with increased odds of comorbid anxiety and depression (OR = 1.28, 95%CI: 1.26-1.30). We observed an approximately J-shaped curve for the association between perceived noise at work with anxiety, depression, and their comorbidity. Participants, who were male, aged <45 years, had high education levels, and worked on trains were characterized by a greater impact of perceived noise at work on mental health problems.

CONCLUSION

Increased perceived noise at work was associated with an elevated risk of anxiety, depression, and their comorbidity. These associations were moderated by sex, age, education level and occupation. Interventions targeting perceived noise at work may promote employed adults' mental health.

The Poverty-Related Stress Scale: Development and Validation of a Multidimensional Measure Assessing Poverty-Related Stressors

Background

Poverty-related stress plays a pivotal role in mediating the impact of poverty on behavioral health outcomes. However, existing research on adult poverty-related stress suffers from limited scope and inadequate measurement approaches. To address these shortcomings, our study undertakes a comprehensive investigation to develop and validate a multidimensional Poverty-Related Stress Scale (PRSS).

Methods

A multistudy research design was employed to develop and validate the PRSS. Study 1 (N = 206) established a multidimensional framework for poverty-related stress by exploring the factor structure and internal consistency of our measure. Study 2 (N = 400) evaluated nuanced psychometric properties, including factorial validity, internal consistency, and temporal invariance, using confirmatory factor analyses (CFA) and modern exploratory structural equation models (ESEM). Lastly, Study 3 (N = 470/219) examined the criterion validity of our scale by investigating its concurrent and predictive relationships with depression, anxiety, and flourishing.

Results

The findings consistently supported a hierarchal ESEM model for overall poverty-related stress, reflecting the dynamic interaction among three stressors: noise disturbance, housing dysfunction, and financial distress. This model exhibited temporal invariance, with different studies reliably measuring distinct components of poverty-related stress. Concurrent validity was demonstrated by significant associations between overall poverty-related stress and theoretically relevant constructs, such as depression, anxiety, and flourishing, at different time points. Additionally, predictive validity was established, showing poverty-related stress measured at time 1 accounted for variations in depression, anxiety, and flourishing at time 2. The results provide robust evidence for the validity and reliability of the PRSS as a tool for measuring poverty-related stress and its underlying factors.

Conclusions

Our findings offer compelling preliminary support for the utility of our measure. Further research and potential clinical applications are discussed to deepen the understanding of poverty-related stress and its implications for behavioral health outcomes.

The effect of brief exposure to virtual nature on mental wellbeing in adolescents

Adolescence is a time of multiple transitions and a vulnerability period for mental health difficulties. There are many barriers to the treatment of mental health conditions which is one reason for developing alternatives to help improve efficacy in treatment and prevention. One approach is to use nature-based interventions (NBIs) to improve mental wellbeing. In this experimental proof-of-principle intervention study, we randomly allocated a sample of adolescents to brief exposure (6 min) to either a virtual woodland nature video or a busy train journey and tested the effect on mental wellbeing. Results showed beneficial effects in the nature condition on several self-reported outcomes including stress, relaxation, affect, mood, attention, nature connection and nature spirituality. The intervention was mainly acceptable and feasible to do suggesting that overall brief virtual nature interventions may have utility in a range of mental health contexts for adolescents including as self-help universal or targeted prevention strategies, adjunct to psychological therapy and as preparation for more intensive NBIs. Additionally, brief virtual nature interventions support accessibility for those who may be limited on time, unable to access real-life nature or who may be more biophobic.

Too Loud to Handle? Transportation Noise and Cardiovascular Disease

The World Health Organization reported that more than 1.6 million healthy life-years are lost yearly from traffic-related noise in western Europe. In addition, the number of studies on health side effects in response to traffic noise is steadily growing, mainly cardiovascular disease, such as acute and chronic ischemic heart disease, heart failure, arrhythmia, and stroke. Pathophysiologically nighttime noise has been shown to cause sleep disturbances, including too short sleep periods and frequent interruption of sleep leading to an increase in the levels of circulating stress hormones and subsequently to a significant increase in the production of reactive oxygen species (oxidative stress) and inflammation in the vasculature and the brain. The consequence is arterial hypertension and vascular (endothelial) dysfunction, which might increase the risk of cardiovascular disease. With the present review, we give an overview of the "so-called" nonauditory cardiovascular health effects of noise, which have been proposed to be responsible for the future development of cardiovascular disease. We present epidemiological evidence but also evidence provided by translational human and experimental noise studies. Finally, we discuss manoeuvres to mitigate noise effectively.

The Impact of Persistent Noise Exposure under Inflammatory Conditions

The aim of this study was to investigate the impact of noise exposure in an intensive care unit (ICU) environment on the development of postoperative delirium in a mouse model that mimics the ICU environment. Additionally, we aimed to identify the underlying mechanisms contributing to delirium and provide evidence for reducing the risk of delirium. In this study, to mimic an ICU environment, lipopolysaccharide (LPS)-injected sepsis mouse models were exposed to a 75 dB noise condition. Furthermore, we assessed neurobehavioral function and observed the level of neuroinflammatory response and blood-brain barrier (BBB) integrity in the hippocampal region. The LPS-injected sepsis mouse model exposed to noise exhibited increased anxiety-like behavior and cognitive impairment. Moreover, severe neuroinflammation and BBB disruption were detected in the hippocampal region. This study provides insights suggesting that persistent noise exposure under systemic inflammatory conditions may cause cognitive dysfunction and anxiety- like behavior via the mediation of BBB disruption and neuroinflammation. As a result, we suggest that the detailed regulation of noise exposure may be required to prevent the development of postoperative delirium.

Social and physical neighbourhood characteristics and 10-year incidence of depression and anxiety in older adults: Results from the Longitudinal Aging Study Amsterdam

OBJECTIVE

A growing literature suggests that neighbourhood characteristics are associated with mental health outcomes, but the evidence in older adults is inconsistent. We investigated the association of neighbourhood characteristics, pertaining to demographic, socio-economic, social and physical environment domains, with the subsequent 10-year incidence of depression and anxiety, in Dutch older adults.

METHODS

In the Longitudinal Aging Study Amsterdam depressive and anxiety symptoms were assessed four times between 2005/2006 and 2015/2016, using the Center for Epidemiological Studies Depression Scale (n = 1365) and the Anxiety subscale of the Hospital Anxiety and Depression Scale (n = 1420). Neighbourhood-level data on urban density, percent population over 65 years of age, percent immigrants, average house price, average income, percent low-income earners, social security beneficiaries, social cohesion, safety, proximity to retail facilities, housing quality, percent green space, percent water coverage, air pollution (particulate matter (PM2.5)), and traffic noise, were obtained for study baseline years 2005/2006. Cox proportional hazard regression models, clustered within neighbourhood, were used to estimate the association between each neighbourhood-level characteristic and the incidence of depression and anxiety.

RESULTS

The incidence of depression and anxiety was 19.9 and 13.2 per 1000 person-years, respectively. Neighbourhood characteristics were not associated with the incidence of depression. However, various neighbourhood characteristics were associated with an increased incidence of anxiety, including: higher urban density level, higher percent immigrants, greater proximity to retail facilities, lower housing quality score, lower safety score, higher PM2.5 levels and less green space.

CONCLUSION

Our results indicate that several neighbourhood characteristics are associated with anxiety but not with depression incidence in older age. Several of these characteristics have the potential to be modifiable and thus could serve as a target for interventions at the neighbourhood-level in improving anxiety, provided that future studies replicate our findings and provide further evidence for a causal effect.

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

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

Noise Disturbance and Well-Being in the North of Spain

Environmental noise is considered one of the main risks for physical and mental health and well-being, with a significant associated burden of disease in Europe. This work aims to explore the main sources of noise exposure at home and its effect on well-being in northern Spain. A transversal opinion study has been performed through a closed questionnaire. The questionnaire included three different parts: sociodemographic data, noise disturbance, and the 5-item World Health Organization Well-Being Index (WHO-5). A Binary Logistics Regression model was performed to analyze the relationship between noise exposure and well-being. Overall, 16.6% of the participants consider that the noise isolation of their homes is bad or very bad. The noise generated by the neighbors (air and impact noise) is considered the most disturbing indoor noise source, while street works are the most disturbing outdoor noise source in urban areas and road traffic is the most disturbing in rural areas. People who indicate that noise interferes with their life at home have a worse score on the WHO-5 (decreased perception of well-being). The exposure to outdoor noise (specifically the noise coming from the street and trains), internal impact noise produced by neighbors, and in general, the noise that wakes you up, is related to receiving a worse score in the WHO-5 (p < 0.05). Administrative bodies must ensure that laws regulating at-home noise levels, which are continually being updated with stricter restrictions, are enforced.

Noise annoyance and risk of prevalent and incident atrial fibrillation-A sex-specific analysis

Background

While chronic exposure to high levels of noise was demonstrated to increase the risk of various cardiovascular diseases, the association between noise annoyance and risk of cardiovascular disease remains still inconsistent. Recently, we showed that noise annoyance is associated with prevalent atrial fibrillation in the general population. However, the association between noise annoyance and risk of incident atrial fibrillation as well as potential sex-differences remain still elusive.

Methods and results

15,010 subjects from a German population-based cohort were examined at baseline (2007 to 2012) and follow-up five years later (2012 to 2017) to investigative the association between noise annoyance due to multiple sources and prevalent and incident atrial fibrillation. After multivariable adjustment, the results from logistic regression analyses revealed overall consistent and positive associations between noise annoyance and prevalent and incident atrial fibrillation in men, whereas this association was weaker in women, in particular with respect to incident atrial fibrillation. For instance, industrial noise annoyance was associated with 21% (95% confidence interval (CI) 9-34%) and 18% (8-29%) higher odds of prevalent atrial fibrillation in men and women, respectively. In prospective analysis, this association remained stable in men (odds ratio (OR) 1.25, 1.07-1.44), while in women no association was observed (OR 1.03, 0.89-1.18).

Conclusions

The findings suggest that noise annoyance can increase the risk of incident atrial fibrillation in a large population-based cohort and that men may be more sensitive to the adverse effects of noise annoyance with regard to the risk of atrial fibrillation.

Association of indoor noise level with depression in hotel workers: A multicenter study from 111 China's cities

Several studies have elucidated the link between outdoor noise and depression, but the relationship between indoor noise levels and depression symptoms in residential and public places remains unclear. This study was a multicenter observational study with a cross-sectional design. In 2019, a total of 10 545 indoor noise levels on-site and 26 018 health data from practitioners were collected from 2402 hotels in 111 cities. Indoor daily noise data levels were detected, and PHQ-9 questionnaires were used to collect health data. Logistic analysis was used to determine the association between depression score and noise level, negative binomial regression was used to determine potential risks. The geometric mean indoor noise level was 38.9 dB (A), with approximately 40.9% of hotels exceeding the 45 dB value (A). Approximately 19.1% of hotel workers exhibited mild and above depressive symptoms. In addition to functional zoning, geographic location, central air conditioner, decoration status, and other factors had an impact on noise levels (p < 0.05). Results of logistic and negative binomial regression showed the following: (1) there was significantly positive association between indoor noise and high depression scores above 2 (OR = 1.007, 95% CI: 1.002, 1.012) and (2) some sub-groups were more susceptible to this effect, especially for the younger female workers working in the first-tier cities, having higher education level, lower level of income, smoking, and longer working hours. This study confirms an early potential effect of indoor noise on depression. It is recommended to implement evidence-based measures to control noise sources in hotels.

Environmental noise-induced cardiovascular, metabolic and mental health disorders: a brief review

BACKGROUND

Environmental noise is a pervasive pollutant that is one of the greatest environmental threats to mental, physiological and psychological well-being and has a significant global health burden associated with it. Many epidemiological studies indicate long-term relationship of noise pollution with wide range of metabolic, cardio-vascular and respiratory disorders and diseases.

OBJECTIVE

The goal of this study was to thoroughly analyse available literature on public health implications and various underlying biological mechanisms associated with ambient noise exposure, taking into account both objective and subjective measures of noise exposure.

METHODS

A search of literature for review on environmental noise and associated cardiovascular, mental health and metabolic implications on human health was done using Web of Science, Google Scholar and PubMed databases.

DISCUSSION

Experimental studies indicate that noise exposure leads to endocrine effects, increased incidence of diabetes, impairment of cognitive performance, sleep disturbance and annoyance. Epidemiological evidence indicates that high levels of noise, particularly at night, may cause arterial hypertension and endothelial dysfunction due to higher level of stress hormones and oxidative stress. An increased incidence of cardio-vascular diseases like myocardial infarction, heart rate, ischemic heart disease, stroke and heart failure is associated with noise-induced mental stress. Furthermore, psychological and mental health issues like anxiety and depression are also related with exposure to noise pollution.

CONCLUSION

This article summarises a comprehensive and systematic knowledge established in recent noise research with the spotlight on cardiovascular, metabolic and mental health disorders of environmental noise, providing unique understanding into underlying mechanisms.

New determinants of mental health: the role of noise pollution. A narrative review

Urbanisation processes and anthropogenic actions led to a significant increase in pollution levels, with relevant consequences on global health. In particular, noise pollution demonstrated an association with cardiovascular, metabolic, and respiratory diseases. Furthermore, increasing evidence underlined the possible role of air and noise pollution in the development of psychiatric disorders. In this narrative review, evidence concerning the relationship between noise pollution and the emergence of psychiatric symptoms or psychiatric disorders is summarised. After the literature search process was completed, 40 papers were included in the present review. The exposure to road-, rail-, and air- traffic represented a risk factor for the emergence of affective disorders. This could also be mediated by the occurrence of circadian rhythms disturbances or by noise annoyance and noise sensitivity, both influencing psychological well-being and health-related quality of life. Fewer studies concentrated on special populations, particularly pregnant women and children, for whom noise pollution was confirmed as a risk factor for psychopathology. The better clarification of the complex interaction between noise pollution and mental health may help to identify subjects at risk and targeting specific prevention and intervention strategies in the urban environment.

The association of smoking and smoking cessation with prevalent and incident symptoms of depression, anxiety, and sleep disturbance in the general population

BACKGROUND

Smoking is a well-established risk factor for chronic non-communicable diseases. However, the relationship between cigarette smoking and the risk of developing mental health conditions remains largely elusive. This study examined the relationship between cigarette smoking as well as smoking cessation and prevalent and incident symptoms of depression, anxiety, and sleep disturbance in the general population.

METHODS

In a cohort of 15,010 individuals from the Gutenberg Health Study (aged 35-74 years at enrollment), prevalent (at baseline from 2007 to 2012) and incident symptoms (at follow-up from 2012 to 2017) of depression, anxiety, and sleep disturbance were determined by validated questionnaires and/or medical records. Smoking status, pack-years of smoking in current and former smokers, and years since quitting smoking in former smokers were assessed by a standardized computer-assisted interview.

RESULTS

In multivariable logistic regression models with comprehensive adjustment for covariates, smoking status was independently associated with prevalent and incident symptoms of depression (Patient Health Questionnaire-9 ≥ 10), whereas this association was weaker for anxiety (Generalized Anxiety Disorder Scale-2 ≥ 3) and sleep disturbance (Patient Health Questionnaire-9 > 1). Among current and former smokers, smoking ≥30 or ≥10 pack-years, respectively, yielded in general the highest effect estimates. Smoking cessation was weakly associated with the prevalence and incidence of all outcomes, here consistent associations were observed for prevalent symptoms of depression.

LIMITATIONS

The observational nature of the study does not allow for causal inferences.

CONCLUSIONS

The results of the present study suggest that cigarette smoking is positively and that smoking cessation is negatively associated with symptoms of common mental health conditions, in particular of depression.

Remote work: Aircraft noise implications, prediction, and management in the built environment

The COVID-19 pandemic has greatly changed workplace management. Most workplaces have adopted the work-from-home policy to minimize the risk of community spread. Consequently, housing estates remain largely occupied during office hours. Since some housing estates are situated in the vicinity of an airport, noise pollution resulted from the takeoff and landing of aircraft is now more noticed by residents, causing annoyance. This problem would be most acute for those located directly under the flight path. Before the pandemic, such aircraft operations had lower effect on the residents because most of them were not at home but at workplaces. Evidently, it is timely that more emphasis should now be placed during urban planning to predict and minimize aircraft noise in the built environment. This article first defines the aircraft noise metrics commonly used to assess environmental impact. Preceded by an overview of how aircraft noise affects the built environment, this article reviews how various aircraft noise prediction models have been used in urban planning. Lastly, this article reviews how aircraft noise can be managed for better acoustic comfort of the residents. Anticipating the adoption of hybrid work arrangement moving forward, this article aims to provide urban planning professionals with an avenue to understand how aircraft noise can negatively affect the built environment, which, in turn, justify why prediction and management of aircraft noise should be emphasized from the outset of urban planning.

A Review of Recent Research into the Causes and Control of Noise during High-Speed Train Movement

Since the invention of the train, the problem of train noise has been a constraint on the development of trains. With increases in train speed, the main noise from high-speed trains has changed from rolling noise to aerodynamic noise, and the noise level and noise frequency range have also changed significantly. This paper provides a comprehensive overview of recent advances in the development of high-speed train noise. Firstly, the train noise composition is summarized; next, the main research methods for train noise, which include real high-speed train noise tests, wind tunnel tests, and numerical simulations, are reviewed and discussed. We also discuss the current methods of noise reduction for trains and summarize the progress in current research and the limitations of train body panels and railroad sound barrier technology. Finally, the article introduces the development and potential future applications of acoustic metamaterials and proposes application scenarios of acoustic metamaterials for the specific needs of railroad sound barriers and train car bodies. This synopsis provides a useful platform for researchers and engineers to cope with problems of future high-speed rail noise in the future.

Cerebral consequences of environmental noise exposure

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

Protective actions of nuclear factor erythroid 2-related factor 2 (NRF2) and downstream pathways against environmental stressors

Environmental risk factors, including noise, air pollution, chemical agents, ultraviolet radiation (UVR) and mental stress have a considerable impact on human health. Oxidative stress and inflammation are key players in molecular pathomechanisms of environmental pollution and risk factors. In this review, we delineate the impact of environmental risk factors and the protective actions of the nuclear factor erythroid 2-related factor 2 (NRF2) in connection to oxidative stress and inflammation. We focus on well-established studies that demonstrate the protective actions of NRF2 and its downstream pathways against different environmental stressors. State-of-the-art mechanistic considerations on NRF2 signaling are discussed in detail, e.g. classical concepts like KEAP1 oxidation/electrophilic modification, NRF2 ubiquitination and degradation. Specific focus is also laid on NRF2-dependent heme oxygenase-1 induction with detailed presentation of the protective down-stream pathways of heme oxygenase-1, including interaction with BACH1 system. The significant impact of all environmental stressors on the circadian rhythm and the interactions of NRF2 with the circadian clock will also be considered here. A broad range of NRF2 activators is discussed in relation to environmental stressor-induced health side effects, thereby suggesting promising new mitigation strategies (e.g. by nutraceuticals) to fight the negative effects of the environment on our health.

Neighborhoods and sleep health among adults: A systematic review

OBJECTIVE

Sleep is an important determinant of various health outcomes, and insufficient sleep and sleep disorders are a public health crisis in the United States. The objective of this review is to provide an update on scientific contributions to our understanding of the social/built environmental determinants of sleep health. In particular, this review focuses on the diverse measurements of neighborhood characteristics and sleep outcomes, as well as analytic approaches for quantifying the effect of neighborhood on sleep health.

METHODS

Two major electronic databases were searched and reviewed for relevant articles that examined the associations of social/built environments with sleep health. Inclusion criteria included peer-reviewed empirical studies on neighborhood-level characteristics and sleep health among adult populations.

RESULTS

Systematic searches in MEDLINE/PubMed and SCOPUS identified 52 eligible articles (out of 11,084). Various social/built environmental characteristics of neighborhoods were identified as potential determinants of sleep health, and the majority of studies examined neighborhood social capital, safety, and environmental stressors. However, 88% of included articles employed cross-sectional study designs, limiting causal identification. We found substantial differences in neighborhood measures, variations in sleep health measurements with the majority employing self-reported methods, and inconsistent model specifications. While the majority of articles (48%) utilized perceived neighborhood conditions as the main exposure, more recent studies (23%) employed geographic information systems to measure neighborhood characteristics.

CONCLUSIONS

To establish the causal relationships between social/physical neighborhood characteristics and sleep health, more studies should be conducted with longitudinal, quasi-experimental, and randomized trial designs coupled with objectively measured neighborhood and sleep health parameters.

Overcoming Decisional Gaps in High-Risk Prescribing by Junior Physicians Using Simulation-Based Training: Protocol for a Randomized Controlled Trial

BACKGROUND

Gaps between rational thought and actual decisions are increasingly recognized as a reason why people make suboptimal choices in states of heightened emotion, such as stress. These observations may help explain why high-risk medications continue to be prescribed to acutely ill hospitalized older adults despite widely accepted recommendations against these practices. Role playing and other efforts, such as simulation training, have demonstrated benefits to help people avoid decisional gaps but have not been tested to reduce overprescribing of high-risk medications.

OBJECTIVE

This study aims to evaluate the impact of a simulation-based training program designed to address decisional gaps on prescribing of high-risk medications compared with control.

METHODS

In this 2-arm pragmatic trial, we are randomizing at least 36 first-year medical resident physicians (ie, interns) who provide care on inpatient general medicine services at a large academic medical center to either intervention (simulation-based training) or control (online educational training). The intervention comprises a 40-minute immersive individual simulation training consisting of a reality-based patient care scenario in a simulated environment at the beginning of their inpatient service rotation. The simulation focuses on 3 types of high-risk medications, including benzodiazepines, antipsychotics, and sedative hypnotics (Z-drugs), in older adults, and is specifically designed to help the physicians identify their reactions and prescribing decisions in stressful situations that are common in the inpatient setting. The simulation scenario is followed by a semistructured debriefing with an expert facilitator. The trial's primary outcome is the number of medication doses for any of the high-risk medications prescribed by the interns to patients aged 65 years or older who were not taking one of the medications upon admission. Secondary outcomes include prescribing by all providers on the care team, being discharged on 1 of the medications, and prescribing of related medications (eg, melatonin, trazodone), or the medications of interest for the control intervention. These outcomes will be measured using electronic health record data.

RESULTS

Recruitment of interns began on March 29, 2021. Recruitment for the trial ended in Q42021, with follow-up completed by Q12022.

CONCLUSIONS

This trial will evaluate the impact of a simulation-based training program designed using behavioral science principles on prescribing of high-risk medications by junior physicians. If the intervention is shown to be effective, this approach could potentially be reproducible by others and for a broader set of behaviors.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04668248; https://clinicaltrials.gov/ct2/show/NCT04668248.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/31464.

Physical Properties and Environmental Impact of Sound Barrier Materials Based on Fly Ash Cenosphere

Traffic noise and solid waste pollution are two major problems that restrict urban development and affect urban environments. In this study, a new kind of cement-based material for sound barriers was prepared using industrial waste fly ash cenosphere to explore the material ratio of the sound absorption, sound insulation, and composite layers and to optimize the material’s properties. The research findings showed that the compressive strength had significant effects on the material properties of the sound absorption layer, with the optimal compressive strength range being 0.2–0.4 MPa. At 0.4 MPa, the material with an aggregate-to-binder ratio of 1.0 had the best comprehensive properties. The sound insulation layer had the best compressive strength of 29.00 MPa at a 45% fiber admixture. The composite had the best sound insulation when the thickness ratio of the sound absorption and insulation layers was 60:40, and the sound transmission loss was 38 dB. The embodied carbon (EC) and embodied energy (EE) of the new fly ash cenosphere across the whole life cycle were 57.57 kgCO2e and 477.08 MJ, respectively, which were 4.8−52.9% and 53.2−82.3% lower than other traditional sound barriers, respectively. Thus, they were environmentally friendly and had satisfactory energy-saving and environmental protection values.

Association between Noise Annoyance and Mental Health Outcomes: A Systematic Review and Meta-Analysis

To date, most studies of noise and mental health have focused on noise exposure rather than noise annoyance. The purpose of this systematic review and meta-analysis was to evaluate whether the available evidence supports an adverse association between noise annoyance and mental health problems in people. We carried out a literature search of Web of Science, PubMed, Scopus, PsycINFO, and conference proceedings published between 2000 and 2022. Thirteen papers met the inclusion criteria. We conducted meta-analyses of noise annoyance in relation to depression, anxiety, and general mental health. In the meta-analyses, we found that depression was approximately 1.23 times greater in those who were highly noise-annoyed (N = 8 studies). We found an approximately 55% higher risk of anxiety (N = 6) in highly noise-annoyed people. For general mental health (N = 5), highly annoyed participants had an almost 119% increased risk of mental health problems as assessed by Short Form (SF) or General Household Questionnaires (GHQ), but with high heterogeneity and risk of publication bias. In conclusion, findings are suggestive of a potential link between noise annoyance and poorer mental health based on a small number of studies. More evidence is needed to confirm these findings.

The Impact of Occupational Noise on Hypertension Risk: A Case-Control Study in Automobile Factory Personnel

Background

Many epidemiological studies have investigated the relationship between occupational noise and hypertension, but with conflicting findings. This study aimed to assess the relationship between occupational noise exposure and the risk of hypertension.

Methods

A case-control study was conducted to explore hypertension predictors, and then sensitivity analysis was performed based on propensity score matching (PSM). Data were collected from participants' annual physical examinations and occupational noise exposure measurements. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression analysis. A restricted cubic spline (RCS) function was used to fit the dose-effect relationship.

Results

500 cases and 4,356 controls were included in the study. Multivariate logistic regression showed that an increase in the level of occupational noise [range 68–102 dB(A)] of 1 dB(A), corresponded to an increase in hypertension risk of 8.3% (OR: 1.083, 95% CI: 1.058–1.109). Compared to the first quartile, the risk of hypertension in the fourth quartile was 1.742 (95% CI: 1.313–2.310). After applying PSM to minimize bias, we obtained a population of 500 cases and 1,000 controls. Noise level was significantly associated with the risk of hypertension. In addition, the RCS curve showed the risk of hypertension was relatively stable until a predicted noise level of around 80 dB(A) and then started to increase rapidly afterward (Pnonlinear = 0.002).

Conclusions

Occupational noise exposure was significantly associated with hypertension risk and there was a positively correlated dose-response relationship.

Mental health problems and their related factors among seafarers: a scoping review

BACKGROUND

Seafarers are often reported to be engaged in a dangerous physical and psychosocial work environment. However, mental health status among seafarers has not been focused on compared with physical health issues. Systematic, comprehensive reviews of mental health problems and their relevant factors are lacking. This review aimed to clarify beneficial approaches to the mental health problems faced among seafarers using a scoping review to systematically map the evidence regarding mental health issues and their related factors.

METHODS

Studies were searched on MEDLINE/PubMed, Science Direct, Academic search complete using EBSCOhost databases, SCOPUS, EMBASE, and Web of science on 20, August 2020. This scoping review was conducted based on the framework of Arksey and O'Malley and Preferred Reporting items for Scoping Reviews flow diagram. The inclusion criteria were studies which determined the relationship between factors relevant to working conditions or working environment, and mental health in seafarers, and etc. Data were narratively summarized and reported.

RESULTS

Twenty-four were included in this review while two major findings were clarified. Firstly, the prevalence of stress, depressive symptoms, and burnout have been mentioned for decades. Secondly, factors related to mental health and psychological issues can be categorized as individual and work environmental factors. The individual factors include experience, age, health status (high BMI, poor sleep, and diabetics), and resilience. The work environmental factors consist of two parts. Job demands comprise pressure from contractors/customers/time, working hours, ship department, job title, voyage episodes, period of seafaring, noise, and vibration. The job resources included instrumental support, team cohesion, shipboard caring and effort-reward imbalance.

CONCLUSIONS

A beneficial approach to mental health problems faced among seafarers is necessary to understand comprehensively at individual and organization levels. Promoting health behaviors, training resilience, and managing obesity and chronic diseases comprise individual level strategies. Providing seafarers with adequate instrumental support, and practical support to communicate with customers, managing their distinct work-rest hours and adequate effort-reward balance comprise organization level methods.

Noise levels in the dialysis unit and its relationship with sleep quality and anxiety in patients receiving HD: A pilot study

INTRODUCTION

HD unit is a noisy environment for patients, and noise can affect anxiety levels and sleep quality.

METHODS

The aim of the study is to determine noise level, the relationship between noise levels, and sleep quality and anxiety in patients in HD unit. A descriptive and observational study design was used. Three Benetech GM1351 manual sound-level meters were used to measure noise. A patient information form, the State Anxiety Inventory, and the modified Post-Sleep Inventory were used for data collection.

RESULTS

The noise range detected in the HD unit ranges from 48.40 to 72 dB(A). Our findings show that patients in the HD unit are exposed to high noise levels and the noise significantly negatively impacts quality of sleep and anxiety level of the patients.

CONCLUSIONS

It is important to be aware that HD patients are constantly exposed to high levels of noise and to plan nursing interventions to reduce this noise level.

Redox Switches in Noise-Induced Cardiovascular and Neuronal Dysregulation

Environmental exposures represent a significant health hazard, which cumulatively may be responsible for up to 2/3 of all chronic non-communicable disease and associated mortality (Global Burden of Disease Study and The Lancet Commission on Pollution and Health), which has given rise to a new concept of the exposome: the sum of environmental factors in every individual’s experience. Noise is part of the exposome and is increasingly being investigated as a health risk factor impacting neurological, cardiometabolic, endocrine, and immune health. Beyond the well-characterized effects of high-intensity noise on cochlear damage, noise is relatively well-studied in the cardiovascular field, where evidence is emerging from both human and translational experiments that noise from traffic-related sources could represent a risk factor for hypertension, ischemic heart disease, diabetes, and atherosclerosis. In the present review, we comprehensively discuss the current state of knowledge in the field of noise research. We give a brief survey of the literature documenting experiments in noise exposure in both humans and animals with a focus on cardiovascular disease. We also discuss the mechanisms that have been uncovered in recent years that describe how exposure to noise affects physiological homeostasis, leading to aberrant redox signaling resulting in metabolic and immune consequences, both of which have considerable impact on cardiovascular health. Additionally, we discuss the molecular pathways of redox involvement in the stress responses to noise and how they manifest in disruptions of the circadian rhythm, inflammatory signaling, gut microbiome composition, epigenetic landscape and vessel function.

Lärm und Luftverschmutzung: Ihr Einfluss auf psychische Erkrankungen

Immer mehr Studien belegen die Einflüsse von Lärm und Luftverschmutzung als bedeutsame Umweltrisikofaktoren für kardiovaskuläre Erkrankungen. Weniger gut geklärt ist, wie diese Faktoren die psychische Gesundheit beeinflussen. Aktuelle Studienergebnisse zeigen, dass Umgebungslärm (vor allem Verkehrslärm) und verschiedene Bestandteile von Luftverschmutzung (vor allem Feinstaub) das Risiko für psychische Erkrankungen, insbesondere Depressionen und Angststörungen, erhöhen können. Pathophysiologische Mechanismen umfassen das enge Zusammenspiel von biologischen (wie oxidativem Stress und Inflammation) und psychosozialen Faktoren (wie mentalem Stress, subjektive Lärmbelästigung und -sensitivität). Umweltrisikofaktoren wie Lärm- und Luftverschmutzung können einen signifikanten Einfluss auf die psychische Gesundheit ausüben. Aufgrund der teils heterogenen Studienergebnisse und der limitierten Verfügbarkeit von methodisch hochwertigen Längsschnittstudien sind zwingend weitere Untersuchungen notwendig, um die zugrunde liegenden Mechanismen zu verstehen und präventive Maßnahmen abzuleiten.

Environmental risk factors and cardiovascular diseases: a comprehensive review

Noncommunicable diseases (NCDs) are fatal for more than 38 million people each year and are thus the main contributors to the global burden of disease accounting for 70% of mortality. The majority of these deaths are caused by cardiovascular disease. The risk of NCDs is strongly associated with exposure to environmental stressors such as pollutants in the air, noise exposure, artificial light at night and climate change, including heat extremes, desert storms and wildfires. In addition to the traditional risk factors for cardiovascular disease such as diabetes, arterial hypertension, smoking, hypercholesterolemia and genetic predisposition, there is a growing body of evidence showing that physicochemical factors in the environment contribute significantly to the high NCD numbers. Furthermore, urbanization is associated with accumulation and intensification of these stressors. This comprehensive expert review will summarize the epidemiology and pathophysiology of environmental stressors with a focus on cardiovascular NCDs. We will also discuss solutions and mitigation measures to lower the impact of environmental risk factors with focus on cardiovascular disease.

The relative effects of self-reported noise and odour annoyance on psychological distress: Different effects across sociodemographic groups?

In earlier research, both higher levels of noise and odour annoyance have been associated with decreased mental health. Presumably, these perceptions can trigger feelings of threat and stress reactions and in turn evoke psychological distress. There are two important lacunas in the research on this topic: most studies only consider either noise or odour annoyance and not their relative effect on psychological distress and there is scarce evidence about whether different sociodemographic groups experience more psychological distress due to noise and odour annoyance. Starting from the diversity in the available coping resources and in their daily life patterns, we distinguish gender, age and educational level as relevant sociodemographic variables. Using data from the Health Monitor (n = 25236) in Noord-Brabant, we found using Ordinary Least Squares Regression that individuals that reported higher levels of noise and odour annoyance reported higher levels of psychological distress. Furthermore, the effect of noise annoyance was relatively stronger compared to that of odour annoyance. Regarding the interaction effects, we found that younger adults’ psychological distress was more strongly affected by noise annoyance compared to older adults, but not by odour annoyance. The psychological distress of individuals with no or primary education was more strongly affected by both noise and odour annoyance compared those with tertiary education, but not when compared to those who completed lower or higher secondary education. Contrary to our expectations, we did not find different effects between men and women. Though the evidence for the interactions was mixed, classic health inequalities along age and education lines are reinforced when considering the relationship between noise and odour annoyance and psychological distress.