Abstract
Noise exposure is affecting health-related quality of life (HRQoL). There are many modelling approaches linking specific noise sources with single health-related outcomes. However, an integrated approach is missing taking into account measured levels as well as noise annoyance and sensitivity and assessing their independent association with HRQoL domains. Therefore, we investigated the predictive association of most common transportation noise sources (aircraft, railway and road traffic) as well as transportation noise annoyance and noise sensitivity with HRQoL using data from SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults).We assessed 2035 subjects, who participated in the second and third wave of SAPALDIA (3&4) and had complete information on exposure, outcome and covariates. At SAPALDIA3, we calculated annual means (Lden) of source-specific transportation noise exposure at the most exposed facade of participant’s dwelling floor height. Participants reported noise annoyance on the widely used 11-point ICBEN scale and answered to 10 questions assessing individual noise sensitivity. To assess the potentially predictive effect of these noise exposures, HRQoL was assessed about 8 years later (SAPALDIA4) using the SF-36. We performed predictive multiple quantile regression models to elucidate associations of noise parameters measured at SAPALDIA3 with median SF-36 scores at SAPALDIA4.Source-specific transportation noise exposures showed few yet not consistent associations with HRQoL scores. We observed statistically significant negative associations of transportation noise annoyance with HRQoL scores covering mental health components (adjusted difference in SF-36 mental health score between highest vs. lowest annoyance tertile: −2.54 (95%CI: −3.89; −1.20). Noise sensitivity showed strongest and most consistent associations with HRQoL scores covering both general and mental health components (adjusted difference in SF-36 scores between highest vs. lowest sensitivity tertile: Mental health −5.96 (−7.57; −4.36); general health −5.16 (−7.08; −3.24)).Within all noise parameters, we predominantly observed negative associations of noise sensitivity with HRQoL attaining a magnitude of potential clinical relevance. This implies that factors other than transportation noise exposure may be relevant for this exposure-outcome relation. Nonetheless, transportation noise annoyance showed relevant associations with mental health components, indicating a negative association of transportation noise with HRQoL.
Highlights
Noise has globally become one of the most common environmental exposures and has been included by the WHO in the first priority list of environmental stressors influencing public health (WHO, 2011)
Railway noise exposure showed little consistency in its association with domains of health-related quality of life (HRQoL) when compared to the larger sample of the main model and across the different time points
These differences across time points are not explained by differences in sample size, as the negative association of railway noise with general health perception (GH) and VT was observed in the reduced sample irrespective of adjustment for noise annoyance and sensitivity
Summary
Noise has globally become one of the most common environmental exposures and has been included by the WHO in the first priority list of environmental stressors influencing public health (WHO, 2011). A recent systematic review identified 20 studies on the association of transportation noise exposure with HRQoL in adults. Ninety percent of these studies were cross-sectional and only three studies looked at mutually adjusted co-exposures of noise sources (aircraft, railway and road traffic) (Clark and Paunovic, 2018). Most studies tended to make poor adjustments for the individual perception and ability to cope with higher noise levels These personal factors are captured in both noise annoyance (a measure of the grade of disturbance and dissatisfaction from noise exposure (Guski, 1999)), and in noise sensitivity (a measure of the individual variation in perception of noise effects (Smith, 2003)) making it difficult to disentangle the effects of noise on HRQoL. A further study elucidated the relationship of source-specific transportation noise and transportation noise annoyance with HRQoL, yet did not consider noise sensitivity (Héritier et al, 2014)
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