Environmental noise exposure, early biological risk and mental health in nine to ten year old children: a cross-sectional field study

Association of road traffic noise exposure and school childrens' cognition: A structural equation model approach

This study explores the complex relationship between traffic noise and school children's cognition, acknowledging existing empirical inconsistencies and aiming to contribute to a richer understanding of this pivotal issue. Schools adjacent to noisy roads were selected, and outdoor noise levels were measured employing a Kimo dB300 sound level meter, focusing on noise level indices LAeq, L10, and L90. Subsequent calculations were performed to determine the noise pollution level (Lnp), noise climate (NC), and traffic noise index (TNI), revealing a severe noise exposure when compared to standard guidelines. A perception questionnaire for various noise and acoustic factors influencing cognition was developed, and 1524 student responses were collected. Data analysis incorporated Principal Component Analysis (PCA) and Exploratory Factor Analysis (EFA) for dimension reduction, revealing three latent factors labelled 'annoyance,' 'behaviour,' and 'cognition'. Further, Structural Equation Modeling (SEM) was utilized to explore multivariate relationships between variables and latent factors. Resultant path coefficients were obtained as 0.12, 0.98, and 0.10 for the impact of 'behaviour' and 'annoyance' on 'cognition' and the correlation between 'annoyance' and 'behaviour', respectively. Findings underscore a potent positive impact of annoyance, stemming from acute ambient noise exposure, on the deterioration of children's cognition. While suggesting that ambient noise may be correlated with adverse health impacts due to its influence on cognition, this study emphasizes the pressing necessity for noise mitigation in roadside schools and stringent enforcement of noise pollution guidelines in academic zones.

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.

The Association between Physical Environment and Externalising Problems in Typically Developing and Neurodiverse Children and Young People: A Narrative Review

The physical environment is of critical importance to child development. Understanding how exposure to physical environmental domains such as greenspace, urbanicity, air pollution or noise affects aggressive behaviours in typical and neurodiverse children is of particular importance given the significant long-term impact of those problems. In this narrative review, we investigated the evidence for domains of the physical environment that may ameliorate or contribute to the display of aggressive behaviours. We have considered a broad range of study designs that include typically developing and neurodiverse children and young people aged 0-18 years. We used the GRADE system to appraise the evidence. Searches were performed in eight databases in July 2020 and updated in June 2022. Additional articles were further identified by hand-searching reference lists of included papers. The protocol for the review was preregistered with PROSPERO. Results: We retrieved 7174 studies of which 67 are included in this review. The studies reported on green space, environmental noise and music, air pollution, meteorological effects, spatial density, urban or rural setting, and interior home elements (e.g., damp/sensory aspects/colour). They all used well validated parent and child reported measures of aggressive behaviour. Most of the studies were rated as having low or unclear risk of bias. As expected, noise, air pollution, urbanicity, spatial density, colour and humidity appeared to increase the display of aggressive behaviours. There was a dearth of studies on the role of the physical environment in neurodiverse children. The studies were heterogeneous and measured a range of aggressive behaviours from symptoms to full syndromes. Greenspace exposure was the most common domain studied but certainty of evidence for the association between environmental exposures and aggression problems in the child or young person was low across all domains. We found a large knowledge gap in the literature concerning neurodiverse children, which suggests that future studies should focus on these children, who are also more likely to experience adverse early life experiences including living in more deprived environments as well as being highly vulnerable to the onset of mental ill health. Such research should also aim to dis-aggregate the underlying aetiological mechanisms for environmental influences on aggression, the results of which may point to pathways for public health interventions and policy development to address inequities that can be relevant to ill health in neurodiverse young people.

Noise Indicators Relating to Non-Auditory Health Effects in Children-A Systematic Literature Review

A systematic literature review was conducted to investigate which objective noise indicators related to various noise sources (i.e., aircraft, road-traffic, and ambient noise) are the best predictors of non-auditory health-effects in children. These relationships are discussed via a conceptual framework, taking into account main parameters such as the type of noise source, the exposure locations and their environments, the type of noise indicators, the children's mediating factors, and the type of non-auditory health effects. In terms of the procedure, four literature databases were screened and data was extracted on study design, types of noise sources, assessment method, health-based outcomes and confounders, as well as their associations. The quality of the studies was also assessed. The inclusion criteria focused on both indoor and outdoor environments in educational buildings and dwellings, considering that children spend most of their time there. From the 3337 uniquely collected articles, 36 articles were included in this review based on the defined inclusion and exclusion criteria. From the included literature, it was seen that noise exposure, assessed by energetic indicators, has significant associations with non-auditory health effects: psychophysiological, cognitive development, mental health and sleep effects. Percentile and event-based indicators provided significant associations to cognitive performance tasks and well-being dimension aspects.

Exposure to road traffic noise and behavioral problems in Chinese schoolchildren: A cross-sectional study

BACKGROUND

Transportation noise is second only to air pollution as an environmental contributor to adverse health outcomes in Western countries. However, no studies investigated the association between road traffic noise and behavioral problems among schoolchildren in China.

OBJECTIVE

To investigate the association between exposure to road traffic noise at home and behavioral problems in Chinese schoolchildren.

METHODS

From January to June 2017, we screened 3236 children aged 7-13 years in Guangzhou (Guangdong, China) from the first investigation of an ongoing school-based cohort study with complete information on behavioral problems and residential geolocation. Residential road traffic noise exposure levels were assessed using a validated modeling method in different periods of the day, including daytime (L_day), nighttime (L_night), and weighted 24-hr (L_dn). The annual mean concentration of nitrogen dioxide was also modeled in our study. Behavioral problems were assessed by the parent-rated Strengths and Difficulties Questionnaire (SDQ). Generalized linear mixed models were utilized to estimate the associations between road traffic noise and behavioral problems.

RESULTS

In the main adjusted model, a 10-dB increase in L_dn was associated with 0.33 (95% CI: 0.08, 0.59), 0.08 (95% CI: -0.01, 0.17), and 0.09 (95% CI: 0.01, 0.16) increases in three subscales score for total difficulties score, emotional problems, and conduct problems, respectively. The same increase in L_dn was also associated with the abnormal total difficulties score (OR = 1.25, 95%CI: 1.01, 1.55), emotional problems (OR = 1.19, 95%CI: 0.98, 1.44), and conduct problems (OR = 1.28, 95%CI:1.02, 1.63). Externalising behavior appears more susceptible to traffic noise than internalising behavior. NO₂ had a small impact on the associations between L_dn and behavioral problems. Our estimates were generally robust in several sensitivity analyses.

CONCLUSION

Residential road traffic noise exposure might be related to increased behavioral problems in Chinese schoolchildren, such as emotional symptoms and conduct problems.

The role of physical environmental characteristics and intellectual disability in conduct problem trajectories across childhood: A population-based Cohort study

BACKGROUND

The paucity of research investigating the role of the physical environment in the developmental progression of conduct problems and the potential moderating effects of intellectual disability (ID) is surprising, given the clinical relevance of elucidating environmental determinants of disruptive behaviours.

AIMS

To use data from a large UK cohort study to assess associations between physical environmental exposures, ID, and conduct problem trajectories.

METHOD

The sample included 8168 Millennium Cohort Study children (1.9% with ID). Multilevel growth curve modelling was used to examine the role of physical environment characteristics in the developmental trajectories of conduct problems after adjustments for ID status.

RESULTS

Exposure to external environmental domains was not associated with differences in children's conduct problems across development. Alternatively, internal aspects of the household environment: spatial density (b = 0.40, p < .001) and damp problems (b = 0.14, p < .001) were both significantly associated with increased trajectories. Various individual and familial covariates were positively associated with conduct problems over time, including: presence of ID (b = 0.96, p < .001), autism spectrum disorder (b = 1.18, p < .001), male sex (b = 0.26, p < .001), poverty (b = 0.19, p < .001), maternal depression (b = 0.65, p < .001), and non-nuclear family structure (b = 0.35, p < .001). Positive ID status appeared to moderate the effects of internal household spatial density, reporting a non-linear negative association with spatial density and conduct problems across development (b = -1.08, p < .01).

CONCLUSIONS

Our findings highlight the potential harmful consequences of poor internal residential conditions on children's development of disruptive behaviours.

Association between community noise and children's cognitive and behavioral development: A prospective cohort study

BACKGROUND

Noise exposure has been associated with adverse cognitive and behavioral outcomes in children, but evidence on longitudinal associations between community noise and child development in low- and middle-income countries is rare. We investigated associations between community noise and behavioral and cognitive development in preschool children in São Paulo.

METHODS

We linked child development data from the São Paulo Western Region Birth Cohort with average (Lden) and night-time (Lnight) community noise exposure at children's home, estimated by means of a land use regression model using various predictors (roads, schools, greenness, residential and informal settlements). Outcomes were the Strengths and Difficulties Questionnaire (SDQ) and Regional Project on Child Development Indicators (PRIDI) at 3 years of age and the Child Behavior Checklist (CBCL) and International Development and Early Learning Assessment (IDELA) at 6 years of age. We investigated the relationship between noise exposure and development using cross-sectional and longitudinal regression models.

RESULTS

Data from 3385 children at 3 years of age and 1546 children at 6 years of age were analysed. Mean Lden and Lnight levels were 70.3 dB and 61.2 dB, respectively. In cross-sectional analyses a 10 dB increase of Lden above 70 dB was associated with a 32% increase in the odds of borderline or abnormal SDQ total difficulties score (OR = 1.32, 95% CI: 1.04; 1.68) and 0.72 standard deviation (SD) increase in the CBCL total problems z-score (95% CI: 0.55; 0.88). No cross-sectional association was found for cognitive development. In longitudinal analyses, each 10 dB increase was associated with a 0.52 SD increase in behavioral problems (95% CI: 0.28; 0.77) and a 0.27 SD decrease in cognition (95%-CI: 0.55; 0.00). Results for Lnight above 60 dB were similar.

DISCUSSION

Our findings suggest that community noise exposure above Lden of 70 dB and Lnight of 60 dB may impair behavioral and cognitive development of preschool children.

Spectral content (colour) of noise exposure affects work efficiency

Introduction:

As part of an effort to enhance the efficiency of workers, experiments relating to three types of noise exposure were conducted. Previous studies have proved that pink noise can cause a brain wave to reach a lower potential. In this study, we utilized physical methods, in cognitive experiments, to understand the impacts that three colour noises have on working efficiency.

Subjects and Methods:

All 22 participants were exposed to a sound environment of quiet, red, pink and white noises respectively. After a laboratory experiment, details of psychomotor speed, continuous performance, executive function and working memory were recorded.

Results:

Red, pink and white noises were significantly positive in comparison with the quiet environment of the psychomotor speed test. As for the continuous performance test, pink noise gave the only significantly positive result. Red, pink and white noise resulted in a better executive function test. Red and pink noise showed significantly positive improvement, while white noise was significantly positive in comparison with the quiet environment of the working memory test. In addition, the results from the comfort questionnaires showed that red and pink noise increase the possibility of better judgment, implementation, and overall environment.

Conclusion:

At present time, it is considered that noise has negative effects on hearing and health. However, experimental results show that certain noise can enhance environmental comfort. It is feasible, in the future, to use knowledge of colour noises to improve productivity in a workplace with a healthy environment.

The mediating effect of self-esteem on the relationship of living environment, anxiety, and depression of underprivileged children: A path analysis in Chinese context

This study aimed to explore the relationships of living environment, self-esteem, anxiety, and depression of children in poverty. A sample of 1314 children (grades 4–9) was collected by a school-based survey in Xiushui city, Mainland China. Structural equation modeling was adopted to analyze the data and verify the hypothesized model. Results showed that living environment was negatively correlated with poor children’s anxiety and depression levels, and self-esteem had a mediating effect on the relationship between living environment and the mental health of underprivileged children. Based on these findings, we proposed relevant theoretical and practical implications.

Influence of Classroom Acoustics on Noise Disturbance and Well-Being for First Graders

Several studies have shown so far that poor acoustics inside classrooms negatively affects the teaching and learning processes, especially at the lowest grades of education. However, the extent to which noise exposure or excessive reverberation affect well-being of children at school in their early childhood is still unanswered, as well as their awareness of noise disturbance. This work is a pilot study to investigate to which extent classroom acoustics affects the perceived well-being and noise disturbance in first graders. About 330 pupils aged from 6 to 7 years participated in the study. They belonged to 20 classes of 10 primary schools located in Torino (Italy), where room acoustic measurements were performed and where noise level was monitored during classes. The school buildings and the classrooms were balanced between socioeconomic status and acoustic conditions. Trained experimenters administered questionnaires in each class, where pupils answered all together during the last month of the school year (May). Questions included the happiness scale, subscales assessing self-esteem, emotional health, relationship at home and with friends, enjoyment of school, intensity and noise disturbance due to different sound sources, and quality of voice. The findings of the study suggest that long reverberation times, which are associated with poor classroom acoustics as they generate higher noise levels and degraded speech intelligibility, bring pupils to a reduced perception of having fun and being happy with themselves. Furthermore, bad classroom acoustics is also related to an increased perception of noise intensity and disturbance, particularly in the case of traffic noise and noise from adjacent school environments. Finally, happy pupils reported a higher perception of noise disturbance under bad classroom acoustic conditions, whereas unhappy pupils only reported complaints in bad classroom acoustics with respect to the perception of pleasances with himself or herself and of fitting in at school. Being a mother tongue speaker is a characteristic of children that brings more chances of attending classes in good acoustics, of being less disturbed, and of having more well-being, and richer districts presented better acoustic conditions, in turn resulting in richer districts also revealing a greater perception of well-being.

Negative impact of noise and noise sensitivity on mental health in childhood

Introduction:

Noise and noise sensitivity have negative effects on mental health and are not well-studied in children and adolescents. In this study, we investigated these effects in the aforementioned population with respect to sociodemographic variables and environmental factors.

Materials and Methods:

In this population-based study conducted in two large cities in South Korea, 918 elementary and middle-school students were included. After direct measurements at the selected sites, a noise map was created using an interpolation method. The road traffic noise of the participants’ residential areas was calculated based on this noise map. Noise sensitivity was assessed on an 11-point Likert scale. Using multivariate logistic regression, we investigated the relationship among noise, noise sensitivity, and the Child Behavior Checklist. Further analyses were performed subdividing the data according to household income levels.

Results:

Noise sensitivity was significantly associated with internalizing, externalizing, and total behavioral problems. Noise was positively associated with total behavioral problems. In the low-income group, the degree of association with problem behaviors was higher, whereas the relationship between noise sensitivity and externalization problems disappeared in the high-income group.

Conclusion:

Noise and noise sensitivity are negatively associated with the mental health of children and adolescents, particularly in low-income groups. The findings of this study suggest that noise sensitivity and socioeconomic status should be considered in coping with negative effects of noise in children and adolescents.

Behavioral and Emotional Disorders and Transportation Noise among Children and Adolescents: A Systematic Review and Meta-Analysis

Children and adolescents may be particularly vulnerable to environmental influences such as noise which can affect mental well-being. The aim of this systematic review was to evaluate the effect of transportation noise on behavioral and emotional disorders in children and adolescents using a meta-analytic approach. Therefore, we searched four databases (Pubmed, Embase, PsychINFO, and PSYNDEX) and grey literature until February of 2019. We identified 14 articles from 10 studies examining the effect of transportation noise exposure on the mental health of children. These studies predominately used the Strength and Difficulties Questionnaire (SDQ) and mainly focused on schoolchildren and adolescents aged 9–10 years and 15–17 years in Europe. Three studies could be included in the meta-analysis. In sum, the odds for hyperactivity/inattention and total difficulties was significantly increased by 11% (Odds Ratio, OR = 1.11 (95% Confidence Interval, CI 1.04–1.19), respectively 9% (95% CI 1.02–1.16) per 10 dB road traffic noise. Thus, we obtained evidence for an effect of road traffic noise on hyperactivity/inattention and total difficulties, although we could consider few studies. Future studies are needed that use similar techniques to assess outcomes and exposures at schools and in homes. This would make it possible to conduct an individual participant data pooled analysis of the data.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Residential exposure to green space and early childhood neurodevelopment

BACKGROUND

A few studies reported that exposure to high levels of residential surrounding green spaces was associated with better cognitive development in primary school children. However, no studies have been conducted to examine such association in early childhood.

OBJECTIVES

We investigated the association between residential exposure to green space and early childhood neurodevelopment, and further explored the mediation effects of traffic-related air pollution and maternal physical activity on this association.

METHODS

We enrolled 1312 pregnant women between January 2012 and October 2015 and their children were followed up until an age of 2 years. We measured residential exposure to green space by calculating averaged normalized difference vegetation index (NDVI) within a 300 meter buffer area surrounding residential address at birth. The neurodevelopment, which included mental development index (MDI) and psychomotor development index (PDI), was assessed using Bayley Scales of Infant Development for each child at about 24 months. The associations of residential exposure to NDVI with early childhood MDI score and PDI score were evaluated using multiple linear regression models. The mediation effects of traffic-related air pollution and maternal physical activities on those associations were estimated by causal mediation analyses.

RESULTS

Exposure to higher levels of residential surrounding green spaces was associated with increased early childhood PDI score (adjusted changes for one SD increment of NDVI: 3.28 (95% CI: 2.15, 4.41)) and MDI score (adjusted changes for one SD increment of NDVI: 1.97 (95% CI: 0.63, 3.30). These associations were more pronounced in children of mothers whose pre-pregnancy BMI were lower than 24 kg/m². Further mediation analyses indicated that reduced levels of traffic-related air pollution explained 13.6% to 28.0% of the association between exposure to green space and early childhood PDI score.

CONCLUSION

Exposure to higher levels of residential surrounding green spaces was associated with better early childhood neurodevelopment. The association between exposure to green space and early childhood psychomotor development might be partly explained by reduced levels of traffic-related air pollution.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Quality of Life, Wellbeing and Mental Health

This systematic review assesses the quality of the evidence across studies on the effect of environmental noise (road traffic noise, aircraft noise, railway noise, wind-turbine noise) on quality of life, wellbeing and mental health. Quantitative studies of noise effects on children and adults published from January 2005 up to October 2015 were reviewed. A total of 29 papers were identified. 90% of the papers were of cross-sectional design, with fewer studies of longitudinal or intervention design. Outcomes included depression and anxiety, medication use and childhood emotional problems. The quality of the evidence across the studies for each individual noise source was assessed using an adaptation of the GRADE methodology. Overall, given the predominance of cross-sectional studies, most evidence was rated as very low quality, with evidence of effects only being observed for some noise sources and outcomes. These ratings reflect inconsistent findings across studies, the small number of studies and a lack of methodological robustness within some domains. Overall, there are few studies of clinically significant mental health outcomes; few studies of railway noise exposure; and studies of large samples are needed. The lack of evidence for noise effects across studies for many of the quality of life, wellbeing and mental health domains examined does not necessarily mean that there are no effects: rather, that they have not yet been studied robustly for different noise sources.

Traffic noise, noise annoyance and psychotropic medication use

BACKGROUND

Road-traffic noise can induce stress, which may contribute to mental health disorders. Mental health problems have not received much attention in noise research. People perceive noise differently, which may affect the extent to which noise contributes to poor mental health at the individual level. This paper aims to assess the relationships between outdoor traffic noise and noise annoyance and the use of psychotropic medication.

METHODS

We conducted a survey to assess noise annoyance and psychotropic medication among residents of the Helsinki Capital Region of Finland. We also assessed the associations of annoyance and road-traffic noise with sleep disorders, anxiety and depression. Respondents were randomly sampled from the Finnish Population registry, and data was collected using a self-administered questionnaire. Outdoor traffic noise was modelled using the Nordic prediction model. Associations between annoyance and modelled façade-noise levels with mental health outcome indicators were assessed using a binary logistic regression while controlling for socioeconomic, lifestyle and exposure-related factors.

RESULTS

A total of 7321 respondents returned completed questionnaires. Among the study respondents, 15%, 7% and 7% used sleep medication, anxiolytic and antidepressant medications, respectively, in the year preceding the study. Noise annoyance was associated with anxiolytic drug use, OR = 1.41 (95% CI: 1.02-1.95), but not with sedative or antidepressant use. There was suggestive association between modelled noise at levels higher than 60 dB and anxiolytic or antidepressant use. In respondents whose bedroom windows faced the street, modelled noise was definitively associated with antidepressant use. Noise sensitivity did not modify the effect of noise but was associated with an increased use of psychotropic medication.

CONCLUSION

We observed suggestive associations between high levels of road-traffic noise and psychotropic medication use. Noise sensitivity was associated with psychotropic medication use.

Residential road traffic noise and general mental health in youth: The role of noise annoyance, neighborhood restorative quality, physical activity, and social cohesion as potential mediators

Given the ubiquitous nature of both noise pollution and mental disorders, their alleged association has not escaped the spotlight of public health research. The effect of traffic noise on mental health is probably mediated by other factors, which have not been elucidated sufficiently. Herein, we aimed to disentangle the pathways linking road traffic noise to general mental health in Bulgarian youth, with a focus on several candidate mediators - noise annoyance, perceived restorative quality of the living environment, physical activity, and neighborhood social cohesion. A cross-sectional sample was collected in October - December 2016 in the city of Plovdiv, Bulgaria. It consisted of 399 students aged 15-25years, recruited from two high schools and three universities. Road traffic noise exposure (L_den) was derived from the strategic noise map of Plovdiv. Mental health was measured with the 12-item form of the General Health Questionnaire (GHQ-12). Noise annoyance, perceived restorative quality of the living environment, commuting and leisure time physical activity, and neighborhood social cohesion were assessed using validated questionnaires. Analyses were based on linear regression mediation models and a structural equation modeling (SEM) to account for the hypothesized interdependencies between candidate mediators. Results showed that higher noise exposure was associated with worse mental health only indirectly. More specifically, tests of the single and parallel mediation models indicated independent indirect paths through noise annoyance, social cohesion, and physical activity. In addition, the SEM revealed that more noise annoyance was associated with less social cohesion, and in turn with worse mental health; noise annoyance was also associated with lower neighborhood restorative quality, thereby with less social cohesion and physical activity, and in turn with worse mental health. However, causality could not be established. Further research is warranted to expand our still limited understanding of these person-environment interactions.

The mediating effect of self-esteem on the relationship of living environment, anxiety, and depression of underprivileged children: A path analysis in Chinese context

This study aimed to explore the relationships of living environment, self-esteem, anxiety, and depression of children in poverty. A sample of 1314 children (grades 4-9) was collected by a school-based survey in Xiushui city, Mainland China. Structural equation modeling was adopted to analyze the data and verify the hypothesized model. Results showed that living environment was negatively correlated with poor children's anxiety and depression levels, and self-esteem had a mediating effect on the relationship between living environment and the mental health of underprivileged children. Based on these findings, we proposed relevant theoretical and practical implications.

Comparative Investigation of Indicators of Growth and Behavioral Disorders in Children with Normal, Low, and Very Low Birth Weight at Pre-school Age in Isfahan during 2015

INTRODUCTION

Birth weight is one of the most important indicators of infant's health and could predict their health condition in future. This study was conducted to determine and compare indicators of growth [weight, height, and body mass index (BMI)] and behavioral disorders in children with normal, low, and very low birth weight at pre-school age.

MATERIALS AND METHODS

In this descriptive analytical study, 236 children (126 with normal weight, 100 with low birth weight, and 10 with very low birth weight) at pre-school age were investigated in three groups. Data collection tools were a two-part questionnaire including the Rutter Children Behavior Questionnaire for parents, and parents' and children's demographic characteristics questionnaire, scale, and stadiometer. Data were analyzed using descriptive statistics, variance analysis, Chi square, and Kruskal-Wallis tests.

RESULTS

The mean of weight, height, and BMI at pre-school age in three groups had a significant difference (P = 0.009) and it was lower in the group with very low birth weight than the other two groups; however, the difference between the group with normal birth weight and the group with low birth weight was not significant (P = 0.10). The mean score of behavioral disorder had no significant difference between groups (P = 0.49).

CONCLUSIONS

Results showed that children with very low birth weight grew less than the other two groups. Therefore, this group needs special attention and long-term follow-up for taking care of them to ensure better growth. It is recommended to conduct more extended studies to evaluate behavioral disorders in these children.

Residential Road Traffic Noise and High Depressive Symptoms after Five Years of Follow-up: Results from the Heinz Nixdorf Recall Study

BACKGROUND

Traffic noise affects a large number of people, particularly in urbanized areas. Noise causes stress and annoyance, but less is known about the relationship between noise and depression.

OBJECTIVE

We investigated the association of residential road traffic noise with depressive symptoms using 5-year follow-up data from a German population-based study.

METHODS

We analyzed data from 3,300 participants in the Heinz Nixdorf Recall study who were between 45 and 75 years old and were without depressive symptoms at baseline (2000-2003). Depressive symptoms were defined based on the Center for Epidemiologic Studies Depression scale (CES-D) 15-item questionnaire (total score ≥ 17) and antidepressant medication intake. Road traffic noise was modeled according to European Parliament/Council Directive 2002/49/EC. High noise exposure was defined as annual mean 24-hr noise levels > 55 A-weighted decibels [dB(A)]. Poisson regression with robust variance was used to estimate relative risks (RRs) a) adjusting for the potential confounders age, sex, socioeconomic status (SES), neighborhood-level SES, and traffic proximity; b) additionally adjusting for body mass index and smoking; and c) additionally adjusting for the potential confounders/intermediates comorbidities and insomnia.

RESULTS

Overall, 35.7% of the participants were exposed to high residential road traffic noise levels. At follow-up (mean = 5.1 years after baseline), 302 participants were classified as having high depressive symptoms, corresponding to an adjusted RR of 1.29 (95% CI: 1.03, 1.62; Model 1) for exposure to > 55 versus ≤ 55 dB(A). Adjustment for potential confounders/intermediates did not substantially alter the results. Associations were stronger among those who reported insomnia at baseline (RR = 1.62; 95% CI: 1.10, 2.59 vs. RR = 1.21; 95% CI: 0.94, 1.57) and appeared to be limited to those with ≤ 13 years of education (RR = 1.43; 95% CI: 1.10, 1.85 vs. 0.92; 95% CI: 0.56, 1.53 for > 13 years).

CONCLUSION

Our results suggest that exposure to residential road traffic noise increases the risk of depressive symptoms.

CITATION

Orban E, McDonald K, Sutcliffe R, Hoffmann B, Fuks KB, Dragano N, Viehmann A, Erbel R, Jöckel KH, Pundt N, Moebus S. 2016. Residential road traffic noise and high depressive symptoms after five years of follow-up: results from the Heinz Nixdorf Recall Study. Environ Health Perspect 124:578-585; http://dx.doi.org/10.1289/ehp.1409400.

Traffic-Related Air Pollution, Noise at School, and Behavioral Problems in Barcelona Schoolchildren: A Cross-Sectional Study

BACKGROUND

The available evidence of the effects of air pollution and noise on behavioral development is limited, and it overlooks exposure at schools, where children spend a considerable amount of time.

OBJECTIVE

We aimed to investigate the associations of exposure to traffic-related air pollutants (TRAPs) and noise at school on behavioral development of schoolchildren.

METHODS

We evaluated children 7-11 years of age in Barcelona (Catalonia, Spain) during 2012-2013 within the BREATHE project. Indoor and outdoor concentrations of elemental carbon (EC), black carbon (BC), and nitrogen dioxide (NO2) were measured at schools in two separate 1-week campaigns. In one campaign we also measured noise levels inside classrooms. Parents filled out the strengths and difficulties questionnaire (SDQ) to assess child behavioral development, while teachers completed the attention deficit/hyperactivity disorder criteria of the DSM-IV (ADHD-DSM-IV) list to assess specific ADHD symptomatology. Negative binomial mixed-effects models were used to estimate associations between the exposures and behavioral development scores.

RESULTS

Interquartile range (IQR) increases in indoor and outdoor EC, BC, and NO2 concentrations were positively associated with SDQ total difficulties scores (suggesting more frequent behavioral problems) in adjusted multivariate models, whereas noise was significantly associated with ADHD-DSM-IV scores.

CONCLUSION

In our study population of 7- to 11-year-old children residing in Barcelona, exposure to TRAPs at school was associated with increased behavioral problems in schoolchildren. Noise exposure at school was associated with more ADHD symptoms.

CITATION

Forns J, Dadvand P, Foraster M, Alvarez-Pedrerol M, Rivas I, López-Vicente M, Suades-Gonzalez E, Garcia-Esteban R, Esnaola M, Cirach M, Grellier J, Basagaña X, Querol X, Guxens M, Nieuwenhuijsen MJ, Sunyer J. 2016. Traffic-related air pollution, noise at school, and behavioral problems in Barcelona schoolchildren: a cross-sectional study. Environ Health Perspect 124:529-535; http://dx.doi.org/10.1289/ehp.1409449.

Exposure to Road Traffic Noise and Behavioral Problems in 7-Year-Old Children: A Cohort Study

BACKGROUND

Exposure to traffic noise has been associated with adverse effects on neuropsychological outcomes in children, but findings with regard to behavioral problems are inconsistent.

OBJECTIVE

We investigated whether residential road traffic noise exposure is associated with behavioral problems in 7-year-old children.

METHODS

We identified 46,940 children from the Danish National Birth Cohort with complete information on behavioral problems at 7 years of age and complete address history from conception to 7 years of age. Road traffic noise (Lden) was modeled at all present and historical addresses. Behavioral problems were assessed by the parent-reported Strengths and Difficulties Questionnaire (SDQ). Associations between pregnancy and childhood exposure to noise and behavioral problems were analyzed by multinomial or logistic regression and adjusted for potential confounders.

RESULTS

A 10-dB increase in average time-weighted road traffic noise exposure from birth to 7 years of age was associated with a 7% increase (95% CI: 1.00, 1.14) in abnormal versus normal total difficulties scores; 5% (95% CI: 1.00, 1.10) and 9% (95% CI: 1.03, 1.18) increases in borderline and abnormal hyperactivity/inattention subscale scores, respectively; and 5% (95% CI: 0.98, 1.14) and 6% (95% CI: 0.99, 1.12) increases in abnormal conduct problem and peer relationship problem subscale scores, respectively. Exposure to road traffic noise during pregnancy was not associated with child behavioral problems at 7 years of age.

CONCLUSIONS

Residential road traffic noise in early childhood may be associated with behavioral problems, particularly hyperactivity/inattention symptoms.

Environmental noise and incident mental health problems: A prospective cohort study among school children in Germany

BACKGROUND

Environmental noise is considered a threat to public health as 20% of the EU population is exposed to health influencing noise levels. An association of noise and mental health problems in children has been suggested by some studies, but results are not consistent and there are no longitudinal studies of this association. Our aim was to investigate the influence of different environmental noise sources at children's homes on incident mental health problems in school-aged children.

METHOD

A cohort study of children from first (t0) to fourth grade (t1) of primary school was conducted. Different environmental noise sources (day/night separately) at children's home were assessed via parental annoyance reports. Increased noise exposure between t0 and t1 was the exposure variable. Incident mental health problems were assessed with the parental version of the Strengths and Difficulties Questionnaire (SDQ). RRs and 95% CIs were analysed to investigate the association between different noise sources and incident mental health problems.

RESULTS

The study population consisted of 583 boys and 602 girls. The most common increase in noise exposure between t0 and t1 was road traffic noise day (26.38%). After adjusting for covariates exposure to road traffic night was significantly associated with the total difficulties score (RR=2.06; 95% CI=1.25-3.40), emotional symptoms (RR=1.69, 95% CI=1.04-2.72), and conduct problems (RR=1.57, 95% CI=1.04-2.38). Noise by neighbours during the day was associated with conduct problems (RR=1.62, 95% CI=1.11-2.40) and hyperactivity (RR=1.69, 95% CI=1.08-2.65). Aircraft noise day and construction work day were not associated with any of the SDQ categories at a significant level.

CONCLUSION

Environmental noise is an important public health problem. This is the first study to investigate the association of a broad range of noise sources and incident mental health problems in children in a cohort study. Our results suggest that exposure to noise at children's home is associated with mental health problems such as emotional symptoms, conduct problems and hyperactivity.

Pilot study of methods and equipment for in-home noise level measurements

Knowledge of the auditory and non-auditory effects of noise has increased dramatically over the past decade, but indoor noise exposure measurement methods have not advanced appreciably, despite the introduction of applicable new technologies. This study evaluated various conventional and smart devices for exposure assessment in the National Children's Study. Three devices were tested: a sound level meter (SLM), a dosimeter, and a smart device with a noise measurement application installed. Instrument performance was evaluated in a series of semi-controlled tests in office environments over 96-hour periods, followed by measurements made continuously in two rooms (a child's bedroom and a most used room) in nine participating homes over a 7-day period with subsequent computation of a range of noise metrics. The SLMs and dosimeters yielded similar A-weighted average noise levels. Levels measured by the smart devices often differed substantially (showing both positive and negative bias, depending on the metric) from those measured via SLM and dosimeter, and demonstrated attenuation in some frequency bands in spectral analysis compared to SLM results. Virtually all measurements exceeded the Environmental Protection Agency's 45 dBA day-night limit for indoor residential exposures. The measurement protocol developed here can be employed in homes, demonstrates the possibility of measuring long-term noise exposures in homes with technologies beyond traditional SLMs, and highlights potential pitfalls associated with measurements made by smart devices.

Effect of preterm birth on motor development, behavior, and school performance of school-age children: a systematic review

OBJECTIVES

to examine and synthesize the available knowledge in the literature about the effects of preterm birth on the development of school-age children.

SOURCES

this was a systematic review of studies published in the past ten years indexed in MEDLINE/Pubmed, MEDLINE/BVS; LILACS/BVS; IBECS/BVS; Cochrane/BVS, CINAHL, Web of Science, Scopus, and PsycNET in three languages (Portuguese, Spanish, and English). Observational and experimental studies that assessed motor development and/or behavior and/or academic performance and whose target-population consisted of preterm children aged 8 to 10 years were included. Article quality was assessed by the Strengthening the reporting of observational studies in epidemiology (STROBE) and Physiotherapy Evidence Database (PEDro) scales; articles that did not achieve a score of 80% or more were excluded.

SUMMARY OF FINDINGS

the electronic search identified 3,153 articles, of which 33 were included based on the eligibility criteria. Only four studies found no effect of prematurity on the outcomes (two articles on behavior, one on motor performance and one on academic performance). Among the outcomes of interest, behavior was the most searched (20 articles, 61%), followed by academic performance (16 articles, 48%) and motor impairment (11 articles, 33%).

CONCLUSION

premature infants are more susceptible to motor development, behavior and academic performance impairment when compared to term infants. These types of impairments, whose effects are manifested in the long term, can be prevented through early parental guidance, monitoring by specialized professionals, and interventions.