Abstract
Prospective evidence on the risk of depression in relation to transportation noise exposure and noise annoyance is limited and mixed. We aimed to investigate the associations of long-term exposure to source-specific transportation noise and noise annoyance with incidence of depression in the SAPALDIA (Swiss cohort study on air pollution and lung and heart diseases in adults) cohort.We investigated 4,581 SAPALDIA participants without depression in the year 2001/2002. Corresponding one-year mean road, railway and aircraft day-evening-night noise (Lden) was calculated at the most exposed façade of the participants’ residential floors, and transportation noise annoyance was assessed on an 11-point scale. Incident cases of depression were identified in 2010/2011, and comprised participants reporting physician diagnosis, intake of antidepressant medication or having a short form-36 mental health score < 50. We used robust Poisson regressions to estimate the mutually adjusted relative risks (RR) and 95% confidence intervals (CI) of depression, independent of traffic-related air pollution and other potential confounders.Incidence of depression was 11 cases per 1,000 person-years. In single exposure models, we observed positive but in part, statistically non-significant associations (per 10 dB) of road traffic Lden [RR: 1.06 (0.93, 1.22)] and aircraft Lden [RR: 1.19 (0.93, 1.53)], and (per 1-point difference) of noise annoyance [RR: 1.05 (1.02, 1.08)] with depression risk. In multi-exposure model, noise annoyance effect remained unchanged, with weaker effects of road traffic Lden [(RR: 1.02 (0.89, 1.17)] and aircraft Lden [(RR: 1.17 (0.90, 1.50)]. However, there were statistically significant indirect effects of road traffic Lden [(β: 0.02 (0.01, 0.03)] and aircraft Lden [β: 0.01 (0.002, 0.02)] via noise annoyance. There were no associations with railway Lden in the single and multi-exposure models [(RRboth models: 0.88 (0.75, 1.03)]. We made similar findings among 2,885 non-movers, where the effect modification and cumulative risks were more distinct. Noise annoyance effect in non-movers was stronger among the insufficiently active (RR: 1.09; 95%CI: 1.02, 1.17; pinteraction = 0.07) and those with daytime sleepiness [RR: 1.07 (1.02, 1.12); pinteraction = 0.008]. Cumulative risks of Lden in non-movers showed additive tendencies for the linear cumulative risk [(RRper 10dB of combined sources: 1.31 (0.90, 1.91)] and the categorical cumulative risk [(RRtriple- vs. zero-source ≥45 dB: 2.29 (1.02, 5.14)], and remained stable to noise annoyance.Transportation noise level and noise annoyance may jointly and independently influence the risk of depression. Combined long-term exposures to noise level seems to be most detrimental, largely acting via annoyance. The moderation of noise annoyance effect by daytime sleepiness and physical activity further contribute to clarifying the involved mechanisms. More evidence is needed to confirm these findings for effective public health control of depression and noise exposure burden.
Highlights
Depression ranks high among the risk factors for global disease burden (Vos et al, 2016)
We considered the following potential confounders at Second wave of the SAPALDIA study (SAP2)—that might be antecedent to, or associated with noise and depression, but not in the causal pathway—for inclusion in the present study: age, sex, educational attainment (≤9 years compulsory education/10–13 years corresponding to secondary education or apprenticeship/ > 13 years corresponding to tertiary education)
We focused the analyses on noise annoyance, body mass index (BMI) and sufficient physical activity, which capture in part, attributes of chronic diseases and excessive daytime sleepiness, and are likely more robust to reverse causation with depression
Summary
Depression ranks high among the risk factors for global disease burden (Vos et al, 2016). Transportation noise—a frequent correlate of traffic-related air pollution, which together constitute the greatest contribution to environmental disease burden—is thought to contribute to the burden of depression by inducing annoyance, and stress, and by its sleep disturbing properties (Babisch, 2003; Babisch et al, 2013; Persson-Waye et al, 2002; Slavich and Irwin, 2014). Differential methylation at TRIM39 gene, which is involved in inflammatory response (Roberts Jr et al, 2007; Zhang et al, 2012), was recently linked to depression (Crawford et al, 2018; Zhu et al, 2019) and to traffic-related noise and air pollution (Eze et al, 2020). Poor sleep resulting from noise-induced sleep disturbances relates to the occurrence of depression (Halperin, 2014; Sygna et al, 2014; Tsuno et al, 2005)
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