Rail Traffic Noise Research Articles

Environment-related health risks, knowledge and awareness among people in precarious milieus: secondary data analysis from the German "Environmental Awareness Study".

Precarious milieus more frequently suffer from environmental risks and show lower environmental awareness and behavior than other milieus in the German population. This study investigates the factors that influence environmental awareness in precarious milieus and the roles of environmental knowledge and the perception of environment-related health burdens. A quantitative secondary data analysis of the German Environmental Awareness Study 2018 (N = 2017) was used to analyze the perception of environmental health burdens, environmental knowledge, and environmental awareness between precarious milieus (n = 190) and seven other milieus. One-way analysis of variance (ANOVA) and Bonferroni post hoc tests were used for this purpose. More in-depth analyses of the precarious milieus were carried out using multiple regression analyses. There were significant differences in the perceptions of environmental health burdens affected by rail-traffic noise and neighborhood noise. Furthermore, environmental knowledge in precarious milieus was significantly lower than in five out of the seven other milieus (all p < 0.001) and was significantly associated with environmental cognition and gender. Precarious milieus had higher environmental affect than established milieus but less than that of critical-creative milieus and young idealists (all p < 0.001). Environmental cognition and environmental behavior were significantly associated with environmental affect. Environmental cognition was significantly higher in precarious milieus than in established milieus and among young pragmatists but was lower than in critical-creative milieus and among young idealists (all p < 0.001). Environmental affect, environmental knowledge, and gender were significantly associated with environmental cognition. In precarious milieus, environmental behavior was significantly lower than in traditional milieus and critical-creative milieus and among young idealists (all p < 0.001) and was significantly associated with environmental affect. The differences in the perception of environmental health burdens, environmental knowledge, and environmental awareness among precarious milieus indicate that there is a need for specific education and support structures for these population groups. Further research is needed to determine what other factors within the precarious milieus influence environmental knowledge and awareness, as well as the skills needed to understand environmental information, which are included in the framework of environmental (health) literacy.

Measures to abate railway noise

An important environmental issue in densely populated areas, such as Germany or France, is the problem of noise. Traffic noise from cars, railway vehicles and airports located in close proximity to the city is not only annoying for residents; it also leads to serious health issues and has an enormous negative economic impact. Unlike road traffic noise, which occurs virtually everywhere, rail traffic noise is much more localized to individual transport corridors. However, depending on the type of train and the volume of trains, high levels of noise can be generated, especially along freight corridors on which most of the rail traffic is at night. One example is the Middle Rhine Valley, which is part of the European freight corridor between Rotterdam and Genoa. In many places along this corridor, the noise levels are essentially higher than those considered desirable to maintain good health. The noise caused by rail traffic is therefore the ecological Achilles heel of the railway. However, there are measures for the reduction of noise emitted by rail traffic. In a recent research project, the German Environment Agency evaluated technical, operational and legal measures to abate the railway noise.

On the association between noise exposure and annoyance for road and rail traffic noise

There have been a number of small projects in the Oslo area attempting to determine how annoyance relates to noise exposure. There are several possible ways to measure annoyance, some of them are quantitative and some are qualitative. Noise exposure can be measured or calculated with acceptable accuracy in a given position. But it is still uncertain how the evaluation should be performed, as both outdoor and indoor levels should be taken into account. The subjective evaluation of noise immission for an exposed person also depends on other factors beside the physical noise. We will, however, claim that noise is a reasonable proxy for the total environmental exposure for a resident. It would also seem that a subjective evaluation requires grounding in objective facts in order to be useful. There are many possible reasons for a large variation between persons in the perceived annoyance due to the same noise exposure. We suggest a simple model with a wide range of uncertainty as a possible predictor of perceived annoyance within a given neighbourhood.

Factors influencing noise annoyance across various transportation modes: lessons from the citizen science project "De Oorzaak"

The citizen science initiative "De Oorzaak" invited adult residents of Flanders (Belgium) to fill out the "Large Sound Survey", gathering over 8,000 answers in a month. This comprehensive 51-question survey evaluated annoyance levels across various transportation modes, drawing on established questionnaires like the Epworth Sleepiness Scale, Weinstein Noise Sensitivity Scale and Written Environmental Survey (SLO), organized by the Flemish government. It also aided in selecting participants for subsequent project phases. Comparing LSS results to the latest SLO report revealed a significant self-selection bias, with 33.3% highly annoyed by noise compared to 11.6% from the SLO. A profile could be drawn for the most annoyed participants: noise-sensitive individuals living in apartments or studios, adults (26-61 years old), and residing in densely populated areas. Regarding transportation noise, passenger cars and trucks lead as the most annoying sources, with %HA of 24.5% and 23.5%, respectively, followed by motorcycles and alike (%HA =21.5%). Conversely, rail and air traffic annoyance are considerably lower. Correlations were drawn between the several noise annoyance sources and individuals' characteristics. Overall, population density, age, fatigue level and quality of life are the personal aspects that correlate more consistently with road, rail, and air traffic noise annoyance.

The effect of combined exposure to noise and vibrations from rail traffic on sleep: results from the follow-up study "Living in the vicinity of the railway"

As a result of policy aims to improve accessibility and achieve climate targets, an increase in rail traffic is foreseen for a while. It is therefore expected that in the future more problems will arise due to the vibrations and noise that trains produce. It is demonstrated that most problems are caused by freight trains, predominantly tracking during the night, hence affecting sleep. Research has shown that both noise and vibrations from rail traffic can affect sleep; evidence on the impact of combined exposures is scarce. To investigate the effect of combined exposure to noise and vibrations from rail traffic on self-reported sleep disturbance, we used data from a survey aimed to investigate people's reactions on railway vibrations. In 2021, 17,189 people of 16 years and older, living within 300 meters of a railway track in The Netherlands were invited to fill in a questionnaire. Exposure to vibration and noise levels from rail traffic during the night were modelled and linked to the addresses of the 5,611 (33%) participants. We used logistic regression models to test the associations between rail traffic vibration or noise exposure and sleep disturbance for different noise and vibration exposure groups. This paper presents preliminary results.

Cost-benefits analysis of noise abatement measures in the port of Halifax, Nova Scotia, Canada

Impacts of anthropogenic noise on human beings range from physiological to phycological and include direct damage to auditory organs, to elevated stress and annoyance, to impairments in mental development. Maritime transportation operations are also recognized as a major contributor of anthropogenic noise to nearby communities. The Port of Halifax, Nova Scotia, Canada may be a contributor to these concerns because of its noise emitting operations and it being near densely populated areas. This study examines the cost and benefits of implementing noise abatement measures to reduce potential impacts on residents by limiting road and rail traffic and cargo handling noise from Port operations. The upfront investment costs of noise abatement measures are estimated and compared to the associated human health and wellbeing benefits of reducing noise exposures in exposed residential areas. The hedonic price method was used to translate the benefits of reducing noise exposures in monetary terms. Geospatial analysis was conducted to analyze extent of dwellings exposed to unsafe levels of noise before and after the implementation of abatement measures. Total costs were calculated at $6,914,318 CAD and total benefits at $4,127,870 CAD. This equates to a return of investment of $-2,786,448 CAD. Although this may appear to be an unfavourable investment for the Port of Halifax, this study presents opportunities for improvements and recommendations for noise abatement in port operations.

Experimental Light Rail Traffic Noise Assessment in a Metropolitan Area

The growth in the utilization and development of rail transport within urban networks is crucial for transitioning towards a more sustainable form of mobility. However, challenges related to discomfort and noise pollution arising from rail traffic must be addressed and mitigated to foster a harmonious coexistence between residents and trains. This study focuses on analyzing an experimental campaign conducted on the surface metropolitan network of Porto to study and identify the frequency content and pressure levels associated with light rail traffic. The presented experimental campaign holds significant relevance as it comprises various and distinct circulation conditions within the railway network, enabling a comprehensive characterization of railway noise. The collected data indicates a noticeable increase in sound pressure levels as the speed of circulation rises, particularly emphasizing the 1/3 octave band centered around 1000 Hz. The choice of tracks with components having a limited capacity for absorbing acoustic energy leads to a significant rise in noise levels compared to track solutions with elements exhibiting excellent acoustic energy absorption. Furthermore, the study highlights a substantial increase in noise levels (10 dBA) associated with small radius curves, even at low speeds. These findings underscore the importance of considering the track characteristics and geometric features in noise assessment within rail networks. Therefore, the insights gained from this experimental campaign contribute significantly to the understanding and comprehensive characterization of railway noise under diverse circulation conditions within the railway network.

Effect of rail traffic noises on the perception of the acoustic environment in office spaces

This study conducted a laboratory experiment to investigate the effect of rail traffic noise on the perception of the acoustic environment in office spaces. The study considered two types of experiment stimuli, single noise, and combined noise. The single noise stimuli consisted of silence (SL), air conditioning noise (AC), irrelevant speech (SP), and six types of traffic noise (Tr). Traffic noise included road (R), maglev (Ma), tram (T), conventional train (C), high-speed train (H), and metro (Me). The combined noise stimuli used air conditioning sound and speech as background noise and combined with six types of traffic noise to form the experimental stimuli. Thirty subjects took part in laboratory experiments in which the acoustic environment was rated on two aspects: noise disturbance and acoustic comfort. Under single noises, the results showed that the noise source had a significant negative effect on the evaluation of the acoustic environment. The influence of traffic noises varied with the traffic type, which was lower and higher than that of irrelevant speech and air conditioning noise, respectively. Under combined acoustic conditions, acoustic comfort was affected by the main effects of background noise type, traffic noise type, and traffic noise level. In addition to the main effects, noise disturbance was also influenced by the interaction between traffic noise level and background noise type, and between traffic noise level and traffic noise type. Keywords: rail traffic noise; office space; acoustic environment; acoustic comfort; noise disturbance

Exposure response relationships of annoyance and vibration and noise from passenger and freight trains in Sweden - results from the EpiVib study

Rail traffic is increasing in Europe, still little is known about the health effects of rail traffic vibration and noise for people living close to the railways. The aim of this study was to investigate the associations between vibration respective noise from rail traffic and persons highly annoyed by vibration. The study population (N=7280) was randomly selected from residents (18-80 years) living within 1km of a trafficked railway in Sweden. Vibration and noise levels were modelled for each participant's home address. Result show exposure-response relationships between levels of vibration and noise and annoyance for all types of trains, especially freight trains. The association between maximum vibration velocity at building foundation (Vmax) and high annoyance by vibration from freight trains, accounting for potential confounders was (OR=1.37 per 0.1mm/s Vmax; 95% CI 1.32-1.42). Similarly, for railway noise (LAFmax) (OR=1.19 per 1 dB LAFmax; 95% CI 1.17-1.21). Analysis suggests an interaction between noise and vibration, where the effect of noise level on the probability of vibration annoyance by vibration differs with vibration exposure and vice versa. These findings may have implications for environmental health and transportation planning. Keywords: rail traffic vibration, railway noise, annoyance by vibration, freight trains

Traffic noise annoyance in the LIFE-adult study in Germany: Exposure-response relationships and a comparison to the WHO curves

BackgroundNoise annoyance is the second-highest cause of lost disability-adjusted life-years due to environmental noise in Europe. Evidence on exposure-response relationships (ERRs) for traffic noise annoyance with more accurate exposure values is still needed. ObjectivesIn an analysis of the population-based LIFE-Adult study in Leipzig, Germany, we aimed to investigate the effect of road, railway (train and tram), and aircraft noise on high annoyance (HA). MethodsTraffic exposure data was taken for 2012 and data on noise annoyance was evaluated between 2018 and 2021. HA was defined according to international standardized norms. We calculated risk estimates using logistic regression, controlling for age, sex, and socioeconomic status, and compared our ERRs with those from the last WHO review on this topic. ResultsAircraft noise had the highest relative risk for noise-related HA (OR = 12.7, 95% CI: 9.37–17.10 per 10 dB Lden increase). The road and railway traffic risk estimates were similar to each other (road: OR = 3.55, 95% CI: 2.78–4.54; railway: OR = 3.31, 95% CI: 2.77–3.97 per 10 dB Lden increase). Compared to the WHO curves, the proportion of highly annoyed individuals was somewhat lower for road and rail traffic noise, but higher for aircraft noise. DiscussionAircraft noise is particularly annoying. There were differences between our study's ERRs and those in the WHO review, especially for aircraft noise. These differences may be partly explained by the improved accuracy of the exposure values, as we considered secondary road networks and tram noise, and by a lack of a nighttime flight ban at the Leipzig airport. Geographical, regional and climatic variations, inconsistency in HA cut-offs, as well as temporal developments in the annoyance experience may also explain the differences. Since ERRs serve as a basis for decision making in public policies, regular updates of the curves based on new evidence is recommended.

Traffic-Related High Sleep Disturbance in the LIFE-Adult Cohort Study: A Comparison to the WHO Exposure-Response-Curves

Sleep is negatively affected by environmental noise. In the present study, we investigated self-reported high sleep disturbances (being "highly sleep disturbed"-HSD) from road traffic (primary and secondary road networks), rail (train and tram) and air traffic noise in the LIFE-Adult cohort study in Leipzig, Germany. For this, we used exposure data from 2012 and outcome data of Wave 2 (collected during 2018-2021). HSD was determined and defined according to internationally standardized norms. The highest risk for transportation noise-related HSD was found for aircraft noise: the odds ratio (OR) was 19.66, 95% CI 11.47-33.71 per 10 dB increase in Lnight. For road and rail traffic, similar risk estimates were observed (road: OR = 2.86, 95% CI 1.92-4.28; rail: OR = 2.67, 95% CI 2.03-3.50 per 10 dB Lnight increase). Further, we compared our exposure-risk curves with the curves of the WHO environmental noise guidelines for the European region. The proportion of individuals with HSD for a given noise level was lower for rail traffic but higher for aircraft noise in the LIFE study than in the WHO curves. For road traffic, curves are not directly comparable because we also included the secondary road network. The results of our study add to the body of evidence for increased health risks by traffic noise. Moreover, the results indicate that aircraft noise is particularly harmful to health. We recommend reconsidering threshold values for nightly aircraft exposure.

Acoustic monitoring to evaluate the effect of anthropogenic noise within a park

The aim of this paper is to propose the use of passive acoustic monitoring (PAM) as a non-invasive method to investigate the state of communities and ecosystems. PAM operates through the study and characterization of the soundscape of an area. One of the three components of the soundscape (beside geophony and biophony) is anthrophony, which is the collection of sounds produced by human activities. This kind of sounds can have effects on natural envi-ronments and natural population. In this study, recording instruments and sampling tech-niques have been used to acquire and collect sound data for long periods (two weeks) in a nat-ural terrestrial ecosystem (Ticino Park) which is affected by road and rail traffic noise. The analysis conducted studied the trends of the eco-acoustic indices belonging to three measure-ment sites to detect the presence of characteristic trends and to evaluate the influence of the two anthropogenic noise sources at different distances.

Psychophysiological responses to traffic noises in urban green spaces

The present study aims to explore the psychophysiological impact of different traffic sounds in urban green spaces. In the experiment, 30 subjects were recruited and exposed to different traffic sounds in the virtual reality (VR) scene. The road traffic sound and three railway sounds (con-ventional train, high-speed train, and tram) with three sound levels (45, 55, and 65 dB) were used as the acoustic stimuli. Physiological responses, electrodermal activity (EDA) and heart rate (HR) were monitored throughout the experiment. Psychological evaluations under each acoustic stimuli were also measured using scales within the VR system. The results showed that both the psychological and the physiological responses were significantly affected by the traffic sounds. As for psychological responses, considerable adverse effects of traffic sounds were observed, which constantly increased with the increase of the sound level. The peak sound level was found to have a better performance than the equivalent sound level in the assessment of the psycho-logical impact of traffic sounds. As for the physiological responses, significant effects of both the acoustic factors (sound type and sound level) and the non-acoustic factors (gender and exposure time) were observed. The physiological effect of high-speed train noise was significantly differ-ent from those of the other three traffic noises. The relationship between sound level and physi-ological parameters varied among different sound groups. The variation of sound level could hardly affect the participants' HR and EDA when exposed to the road traffic noise. On the con-trary, the physiological responses were significantly affected by the sound level of rail traffic noise. By a correlation analysis, no linear correlation between the psychological evaluations and HR was found.

Rail traffic noise-induced nocturnal awakenings might lead to depression and anxiety disorder – Results of the Leipzig LIFE cohort study

Background and Aim Recent studies found elevated depression risks for people exposed to traffic noise. In the LIFE cohort-study, we analysed the relationship between &amp;#x22;awakenings” induced by maximum railway-traffic noise levels and affective disorders. Methods Based on the 5-year-follow-up of the Leipzig LIFE cohort study (n=5679 participants), we examined the relationship between address-specific rail traffic noise-induced &amp;#x22;awakenings” and depression (incidence of 5.3% applying the CES-D scale) as well as anxiety disorder risks (incidence of 4.9% applying the GAD-7 scale). We converted maximum noise pressure levels induced by railroad noise into awakening probabilities according to Möhler et al. (2018), and we summed up the individual awakening probabilities to get the total number of nocturnal awakenings. Thus, for example, if the awakening probability for the passage of a freight train is 5.7%, then approximately 18 train passages would result arithmetically in 1 awakening. Results An increase in depression risk for &amp;#x2265;3 nocturnal awakenings was found (incidence rate ratio IRR=1.86; 95% 0.63-5.52, adjusted for gender, age and socioeconomic status) for rail traffic noise. The risk of depression reached statistical significance if people with missing values for depression at baseline were included. The risk of an incident anxiety disorder was increased due to an exposure of &amp;#x2265;3 awakenings due to rail traffic noise (IRR=2.56; 95% CI 1.02-6.43). Conclusions Increased risks for anxiety disorders (and less pronounced for depression) were found for &amp;#x2265;3 nocturnal awakenings due to rail traffic noise. Noise protection measures should take into account the reduction of maximum rail traffic noise levels to in turn reduce nocturnal awakenings. Keywords: rail traffic noise, maximum noise levels, nocturnal awakenings, depression, anxiety disorder, cohort study Acknowledgments: This study was supported by German Environment Agency (UBA). References Möhler U, Schreckenberg D, Müller U et al. Maximalpegelkriterien für die Beurteilung von Schienenverkehrslärm in der Nacht. Larmbekämpfung 2018;13:15-22.

Environmental Noise and Effects on Sleep: An Update to the WHO Systematic Review and Meta-Analysis.

Background:Nighttime noise carries a significant disease burden. The World Health Organization (WHO) recently published guidelines for the regulation of environmental noise based on a review of evidence published up to the year 2015 on the effects of environmental noise on sleep.Objectives:This systematic review and meta-analysis will update the WHO evidence review on the effects of environmental noise on sleep disturbance to include more recent studies.Methods:Investigations of self-reported sleep among residents exposed to environmental traffic noise at home were identified using Scopus, PubMed, Embase, and PsycINFO. Awakenings, falling asleep, and sleep disturbance were the three outcomes included. Extracted data were used to derive exposure–response relationships for the probability of being highly sleep disturbed by nighttime noise [average outdoor A-weighted noise level () 2300–0700 hours] for aircraft, road, and rail traffic noise, individually. The overall quality of evidence was assessed using Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) criteria.Results:Eleven studies ( responses) were included in addition to 25 studies ( responses) from the original WHO analysis. When sleep disturbance questions specifically mentioned noise as the source of disturbance, there was moderate quality of evidence for the probability of being highly sleep disturbed per 10-dB increase in for aircraft [; 95% confidence interval (CI): 2.01, 2.36], road (; 95% CI: 2.28, 2.79), and railway (; 95% CI: 2.57, 3.43) noise. When noise was not mentioned, there was low to very low quality of evidence for being sleep disturbed per 10-dB increase in for aircraft (; 95% CI: 1.20, 1.93), road (; 95% CI: 1.08, 1.21), and railway (; 95% CI: 0.91, 1.49) noise. Compared with the original WHO review, the exposure–response relationships closely agreed at low (40 dB ) levels for all traffic types but indicated greater disturbance by aircraft traffic at high noise levels. Sleep disturbance was not significantly different between European and non-European studies.Discussion:Available evidence suggests that transportation noise is negatively associated with self-reported sleep. Sleep disturbance in this updated meta-analysis was comparable to the original WHO review at low nighttime noise levels. These low levels correspond to the recent WHO noise limit recommendations for nighttime noise, and so these findings do not suggest these WHO recommendations need revisiting. Deviations from the WHO review in this updated analysis suggest that populations exposed to high levels of aircraft noise may be at greater risk of sleep disturbance than determined previously. https://doi.org/10.1289/EHP10197

Consider the Source: Noise-Stroke Association Varies by Transportation Type.

Consider the Source: Noise-Stroke Association Varies by Transportation Type.

Application of the noise annoyance equivalents model for aircraft, rail and road traffic noise to self-reported sleep disturbance

Sleep disturbances caused by noise exposure are the most relevant outcome measured in disability adjusted life years (DALYs). In analogy to the combined effects of noise from multiple sources on annoyance, these are also of interest for sleep disorders. The study “Overall Noise Assessment” Innsbruck examined data from 1031 personal interviews. Aircraft, rail and road noise were correlated. To choose participants combined exposures were clustered into small, medium and severely affected living situations. The effect of demographic features, noise sensitivity, access to a silent façade and other factors on self-reported sleep disturbances was investigated applying bivariate analyses. Exposure-response curves and their 95% confidence intervals with cut-off values of 72% for “highly disturbed sleep” were generated and the results were discussed in comparison to recently published curves. Using source-specific exposure-response relationships, an overall model for evaluating sleep disorders was developed based on the “annoyance equivalents model”. The “total sleep disturbance response” shows an accumulative outcome for each source measured. A protective effect of road traffic noise as background noise for air and railroad sources could not be proven. Both the “Total Sleep Disruption Assessment Model” and the “Dominant Source Model” have a Spearman-Rho of 0.3 and are therefore suitable for use in noise assessment.

Residential surrounding green, air pollution, traffic noise and self-perceived general health

Self-perceived general health (SGH) is one of the most inclusive and widely used measures of health status and a powerful predictor of mortality. However, only a limited number of studies evaluated associations of combined environmental exposures on SGH. Our aim was to evaluate associations of combined residential exposure to surrounding green, air pollution and traffic noise with poor SGH in the Netherlands. We linked data on long-term residential exposure to surrounding green based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and road- and rail-traffic noise with a Dutch national health survey, resulting in a study population of 354,827 adults. We analyzed associations of single and combined exposures with poor SGH. In single-exposure models, NDVI within 300 m was inversely associated with poor SGH [odds ratio (OR) = 0.91, 95% CI: 0.89, 0.94 per IQR increase], while NO2 was positively associated with poor SGH (OR = 1.07, 95% CI: 1.04, 1.11 per IQR increase). In multi-exposure models, associations with surrounding green and air pollution generally remained, but attenuated. Joint odds ratios (JOR) of combined exposure to air pollution, rail-traffic noise and decreased surrounding green were higher than the odds ratios of single-exposure models. Studies including only one of these correlated exposures may overestimate the risk of poor SGH attributed to the studied exposure, while underestimating the risk of combined exposures.

Combined Effects of Aircraft, Rail, and Road Traffic Noise on Total Noise Annoyance-A Cross-Sectional Study in Innsbruck.

Noise legislation in Austria does not provide an assessment of the cumulative effect of noise from different sources. The desire of citizens for a total noise assessment is getting stronger. Within the pilot project “Gesamtlärmbetrachtung” (Total Noise Investigation) Innsbruck, data from 1031 face-to-face interviews were correlated with exposure data from road, rail and air traffic noise. The interviews were selected in clusters according to the exposure combinations of these three sources. In addition to exposure-response relationships, it has also been found that the annoyance response to air and rail traffic noise is independent of the background noise from road traffic. The total noise annoyance response shows a cumulative effect in each source considered. From the source specific exposure-response relationships, a total noise assessment model based on the annoyance equivalents model was developed. This model is more suitable than the dominant source model and thus also considerable for legal application.

Associations of combined exposures to surrounding green, air pollution and traffic noise on mental health

BackgroundEvidence is emerging that poor mental health is associated with the environmental exposures of surrounding green, air pollution and traffic noise. Most studies have evaluated only associations of single exposures with poor mental health. ObjectivesTo evaluate associations of combined exposure to surrounding green, air pollution and traffic noise with poor mental health. MethodsIn this cross-sectional study, we linked data from a Dutch national health survey among 387,195 adults including questions about psychological distress, based on the Kessler 10 scale, to an external database on registered prescriptions of anxiolytics, hypnotics & sedatives and antidepressants. We added data on residential surrounding green in a 300 m and a 1000 m buffer based on the Normalized Difference Vegetation Index (NDVI) and a land-use database (TOP10NL), modeled annual average air pollutant concentrations (including particulate matter (PM10, PM2.5), and nitrogen dioxide (NO2)) and modeled road- and rail-traffic noise (Lden and Lnight) to the survey. We used logistic regression to analyze associations of surrounding green, air pollution and traffic noise exposure with poor mental health. ResultsIn single exposure models, surrounding green was inversely associated with poor mental health. Air pollution was positively associated with poor mental health. Road-traffic noise was only positively associated with prescription of anxiolytics, while rail-traffic noise was only positively associated with psychological distress. For prescription of anxiolytics, we found an odds ratio [OR] of 0.88 (95% CI: 0.85, 0.92) per interquartile range [IQR] increase in NDVI within 300 m, an OR of 1.14 (95% CI: 1.10, 1.19) per IQR increase in NO2 and an OR of 1.07 (95% CI: 1.03, 1.11) per IQR increase in road-traffic noise. In multi exposure analyses, associations with surrounding green and air pollution generally remained but attenuated. Joint odds ratios [JOR], based on the Cumulative Risk Index (CRI) method, of combined exposure to air pollution, traffic noise and decreased surrounding green were higher than the ORs of single exposure models. Associations of environmental exposures with poor mental health differed somewhat by age. ConclusionsStudies including only one of these three correlated exposures may overestimate the influence of poor mental health attributed to the studied exposure, while underestimating the influence of combined environmental exposures.