Abstract
Study Objectives:
The aims of the present study were to investigate how nighttime road traffic noise relates to self-reported symptoms of insomnia and sleep medication use.
Methods:
We used ...questionnaire data from the population-based study Health and Environment in Oslo (HELMILO) (2009–2010; n = 13019). The insomnia symptoms difficulties falling asleep, awakenings during the night, and waking up too early in the morning as well as self-reported sleep medication use were included as outcomes. Modeled noise levels (Lnight) were assigned to each participant’s home address. For selecting covariates to the statistical model, we used a directed acyclic graph. The associations between noise and sleep were analyzed using logistic regression models.
Results:
After adjustment for potential confounders, we found an odds ratio (OR) of 1.05 (95% confidence interval CI: 1.01–1.09) for the association between traffic noise and difficulties falling asleep, in the total study population. For the association between traffic noise and awakenings during the night, the OR was 1.04 (95% CI: 1.00–1.08) and for waking up too early, the OR was 1.06 (95% CI: 1.02–1.11). The effect estimates are given per 5-dB increase in traffic noise level (Lnight). Self-reported sleep medication use was not statistically significantly associated with traffic noise exposure.
Conclusions:
In an adult population from Oslo, traffic noise was associated with difficulties falling asleep and waking up too early. These findings indicate that sleep quantity may be compromised for individuals living in areas highly exposed to nighttime traffic noise.
Abstract Objectives Clinical studies indicate a strong association between tinnitus and mental health, but results from general population data are missing. The purpose of the study was to examine ...the association between tinnitus, mental health, and well-being in the general adult population and to identify factors that might mediate and moderate this association. Methods Data from 51,574 adults participating in the Nord-Trøndelag Hearing Loss Study (1995–1997), part of the Nord-Trøndelag Health Study (HUNT-2), were analyzed. The association between tinnitus symptom intensity and symptoms of depression, anxiety, self-esteem, and subjective well-being was examined by multivariate ANOVA, stratified by age group and sex. Explanatory variables were age, marital status, education, hearing, dizziness, vision, physical disability, and somatic illness. In a subsample of participants with tinnitus, the effects of “time since onset,” “predictability of tinnitus episodes,” and “noise sensitivity” were tested. Results Participants with tinnitus scored significantly higher on anxiety and depression and lower on self-esteem and well-being than people without tinnitus. The effect sizes were small and quite similar across levels of tinnitus symptom intensity. No significant effect of time since onset was found. A significant effect of predictability of tinnitus episodes and noise sensitivity was found in some groups. Conclusion A weak association between tinnitus and mental health was found in this general population study.
Influence of the Urban Exposome on Birth Weight Nieuwenhuijsen, Mark J; Agier, Lydiane; Basagaña, Xavier ...
Environmental health perspectives,
04/2019, Volume:
127, Issue:
4
Journal Article
Peer reviewed
Open access
The exposome is defined as the totality of environmental exposures from conception onwards. It calls for providing a holistic view of environmental exposures and their effects on human health by ...evaluating multiple environmental exposures simultaneously during critical periods of life.
We evaluated the association of the urban exposome with birth weight.
We estimated exposure to the urban exposome, including the built environment, air pollution, road traffic noise, meteorology, natural space, and road traffic (corresponding to 24 environmental indicators and 60 exposures) for nearly 32,000 pregnant women from six European birth cohorts. To evaluate associations with either continuous birth weight or term low birth weight (TLBW) risk, we primarily relied on the Deletion-Substitution-Addition (DSA) algorithm, which is an extension of the stepwise variable selection method. Second, we used an exposure-by-exposure exposome-wide association studies (ExWAS) method accounting for multiple hypotheses testing to report associations not adjusted for coexposures.
The most consistent statistically significant associations were observed between increasing green space exposure estimated as Normalized Difference Vegetation Index (NDVI) and increased birth weight and decreased TLBW risk. Furthermore, we observed statistically significant associations among presence of public bus line, land use Shannon's Evenness Index, and traffic density and birth weight in our DSA analysis.
This investigation is the first large urban exposome study of birth weight that tests many environmental urban exposures. It confirmed previously reported associations for NDVI and generated new hypotheses for a number of built-environment exposures. https://doi.org/10.1289/EHP3971.
Urban environmental design is increasingly considered influential for health and wellbeing, but evidence is mostly based on adults and single exposure studies. We evaluated the association between a ...wide range of urban environment characteristics and health behaviours in childhood.
We estimated exposure to 32 urban environment characteristics (related to the built environment, traffic, and natural spaces) for home and school addresses of 1,581 children aged 6–11 years from six European cohorts. We collected information on health behaviours including total amount of overall moderate-to-vigorous physical activity, physical activity outside school hours, active transport, sedentary behaviours and sleep duration, and developed patterns of behaviours with principal component analysis. We used an exposure-wide association study to screen all exposure-outcome associations, and the deletion-substitution-addition algorithm to build a final multi-exposure model.
In multi-exposure models, green spaces (Normalized Difference Vegetation Index, NDVI) were positively associated with active transport, and inversely associated with sedentary time (22.71 min/day less (95 %CI −39.90, −5.51) per interquartile range increase in NDVI). Residence in densely built areas was associated with more physical activity and less sedentary time, and densely populated areas with less physical activity outside school hours and more sedentary time. Presence of a major road was associated with lower sleep duration (-4.80 min/day (95 %CI −9.11, −0.48); compared with no major road). Results for the behavioural patterns were similar.
This multicohort study suggests that areas with more vegetation, more building density, less population density and without major roads are associated with improved health behaviours in childhood.
IntroductionThe European climate is getting warmer and the impact on childhood health and development is insufficiently understood. Equally, how heat-related health risks can be reduced through ...nature-based solutions, such as exposure to urban natural environments, is unknown. Green CURe In Outdoor CITY spaces (Green CURIOCITY) will analyse how heat exposure during pregnancy affects birth outcomes and how long-term heat exposure may influence children’s neurodevelopment. We will also investigate if adverse effects can be mitigated by urban natural environments. A final goal is to visualise intraurban patterns of heat vulnerability and assist planning towards healthier cities.Methods and analysisWe will use existing data from the Human Early-Life Exposure cohort, which includes information on birth outcomes and neurodevelopment from six European birth cohorts. The cohort is linked to data on prenatal heat exposure and impact on birth outcomes will be analysed with logistic regression models, adjusting for air pollution and noise and sociobehavioural covariates. Similarly, impact of cumulative and immediate heat exposure on neurodevelopmental outcomes at age 5 will be assessed. For both analyses, the potentially moderating impact of natural environments will be quantified. For visualisation, Geographical information systems data will be combined to develop vulnerability maps, demonstrating urban ‘hot spots’ where the risk of negative impacts of heat is aggravated due to sociodemographic and land use patterns. Finally, geospatial and meteorological data will be used for informing GreenUr, an existing software prototype developed by the WHO Regional Office for Europe to quantify health impacts and augment policy tools for urban green space planning.Ethics and disseminationThe protocol was approved by the Comité Ético de Investigación Clínica Parc de Salut MAR, Spain. Findings will be published in peer-reviewed journals and presented at policy events. Through stakeholder engagement, the results will also reach user groups and practitioners.
PurposeEssential to exposome research is the collection of data on many environmental exposures from different domains in the same subjects. The aim of the Human Early Life Exposome (HELIX) study was ...to measure and describe multiple environmental exposures during early life (pregnancy and childhood) in a prospective cohort and associate these exposures with molecular omics signatures and child health outcomes. Here, we describe recruitment, measurements available and baseline data of the HELIX study populations.ParticipantsThe HELIX study represents a collaborative project across six established and ongoing longitudinal population-based birth cohort studies in six European countries (France, Greece, Lithuania, Norway, Spain and the UK). HELIX used a multilevel study design with the entire study population totalling 31 472 mother-child pairs, recruited during pregnancy, in the six existing cohorts (first level); a subcohort of 1301 mother-child pairs where biomarkers, omics signatures and child health outcomes were measured at age 6–11 years (second level) and repeat-sampling panel studies with around 150 children and 150 pregnant women aimed at collecting personal exposure data (third level).Findings to dateCohort data include urban environment, hazardous substances and lifestyle-related exposures for women during pregnancy and their offspring from birth until 6–11 years. Common, standardised protocols were used to collect biological samples, measure exposure biomarkers and omics signatures and assess child health across the six cohorts. Baseline data of the cohort show substantial variation in health outcomes and determinants between the six countries, for example, in family affluence levels, tobacco smoking, physical activity, dietary habits and prevalence of childhood obesity, asthma, allergies and attention deficit hyperactivity disorder.Future plansHELIX study results will inform on the early life exposome and its association with molecular omics signatures and child health outcomes. Cohort data are accessible for future research involving researchers external to the project.
The urban exposome is the set of environmental factors that are experienced in the outdoor urban environment and that may influence child development.
The authors' goal was to describe the urban ...exposome among European pregnant women and understand its socioeconomic determinants.
Using geographic information systems, remote sensing and spatio-temporal modeling we estimated exposure during pregnancy to 28 environmental indicators in almost 30,000 women from six population-based birth cohorts, in nine urban areas from across Europe. Exposures included meteorological factors, air pollutants, traffic noise, traffic indicators, natural space, the built environment, public transport, facilities, and walkability. Socioeconomic position (SEP), assessed at both the area and individual level, was related to the exposome through an exposome-wide association study and principal component (PC) analysis.
Mean±standard deviation (SD) NO
levels ranged from 13.6±5.1 μg/m
(in Heraklion, Crete) to 43.2±11 μg/m
(in Sabadell, Spain), mean±SD walkability score ranged from 0.22±0.04 (Kaunas, Lithuania) to 0.32±0.07 (Valencia, Spain) and mean±SD Normalized Difference Vegetation Index ranged from 0.21±0.05 in Heraklion to 0.51±0.1 in Oslo, Norway. Four PCs explained more than half of variation in the urban exposome. There was considerable heterogeneity in social patterning of the urban exposome across cities. For example, high-SEP (based on family education) women lived in greener, less noisy, and less polluted areas in Bradford, UK (0.39 higher PC1 score, 95% confidence interval (CI): 0.31, 0.47), but the reverse was observed in Oslo (-0.57 PC1 score, 95% CI: -0.73, -0.41). For most cities, effects were stronger when SEP was assessed at the area level: In Bradford, women living in high SEP areas had a 1.34 higher average PC1 score (95% CI: 1.21, 1.48).
The urban exposome showed considerable variability across Europe. Pregnant women of low SEP were exposed to higher levels of environmental hazards in some cities, but not others, which may contribute to inequities in child health and development. https://doi.org/10.1289/EHP2862.
Introduction People with tinnitus are likely to have other co-occurring disorders that should be considered when diagnosing and understanding tinnitus as a health problem. The association between ...tinnitus and cardiovascular health in the general population is, however, unclear. This study aimed to examine whether tinnitus is associated with the prevalence of hypertension, myocardial infarction or stroke, in the general adult population. Methods We used data from the seventh survey of the Tromsø Study, a comprehensive population-based health study carried out in 2015–2016. All inhabitants aged ≥40 years in the municipality of Tromsø, Norway, (n=32 591) were invited, of which 21 083 individuals (65%), aged 40–99, participated. Poisson regression was used to analyse the relationships between tinnitus and cardiovascular disease, while adjusting for relevant covariates. We used three separate tinnitus variables as exposures in analyses: (1) ‘tinnitus status’, measured with the question ‘During the last 12 months, have you experienced ringing in your ears lasting more than five min?’; (2) ‘tinnitus symptom intensity’, generated as a function of tinnitus frequentness and tinnitus bother; and (3) ‘tinnitus bother’, analysed only among participants with tinnitus. Hypertension (measured blood pressure and/or self-reported use of antihypertensives), and self-reported myocardial infarction and stroke were the outcomes of analyses. Results Analyses of the complete sample (n=17 288, 51.2% women), in fully adjusted models, revealed non-significant and very weak associations between tinnitus status and all three cardiovascular outcomes (prevalence ratios (PRs): 1.04–1.11), while for tinnitus symptom intensity, we found significant positive associations between low-intensity tinnitus and hypertension (PR: 1.08, 95% CI: (1.01 to 1.16) and myocardial infarction (PR: 1.39, 95% CI: 1.07 to 1.81). Among participants with tinnitus (n=3570), there were no associations between tinnitus bother and cardiovascular outcomes. Conclusions Results from the present study indicate that there is a weak association between tinnitus and cardiovascular disease and that tinnitus should be taken seriously even at low intensities.
An increasing number of children are exposed to road traffic noise levels that may lead to adverse effects on health and daily functioning. Childhood is a period of intense growth and brain ...maturation, and children may therefore be especially vulnerable to road traffic noise. The objective of the present study was to examine whether road traffic noise was associated with reported inattention symptoms in children, and whether this association was mediated by sleep duration.
This study was based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. Parental reports of children's inattention at age 8 were linked to modelled levels of residential road traffic noise. We investigated the association between inattention and noise exposure during pregnancy (n = 1934), noise exposure averaged over 5 years (age 3 to 8 years; n = 1384) and noise exposure at age 8 years (n = 1384), using fractional logit response models. The participants were children from Oslo, Norway.
An association with inattention at age 8 years was found for road traffic noise exposure at age 8 years (coef = .0083, CI = .0012, .0154; 1.2% point increase in inattention score per 10 dB increase in noise level), road traffic noise exposure average for the last 5 years (coef = .0090, CI = .0016, .0164; 1.3% point increase/10 dB), and for pregnancy road traffic noise exposure for boys (coef = .0091, CI = .0010, .0171), but not girls (coef = -.0021, CI = -.0094, .0053). Criteria for doing mediation analyses were not fulfilled.
Results indicate that road traffic noise has a negative impact on children's inattention. We found no mediation by sleep duration.
Heritability of Hearing Loss Kvestad, Ellen; Czajkowski, Nikolai; Krog, Norun Hjertager ...
Epidemiology,
2012-March, Volume:
23, Issue:
2
Journal Article
Peer reviewed
Open access
Background: Hearing impairment is one of the most common permanent disabilities in the western world. Although hearing ability normally declines with age, there is great individual variation in age ...of onset, progression, and severity, indicating that individual susceptibility plays a role. The aim of the present study was to explore the relative importance of genetic and environmental effects in the etiology of impaired hearing. Methods: From August 1995 to June 1997, the total adult population of Nord-Trøndelag County, Norway, was invited to take part in the Nord-Trøndelag Health Study. The survey included as an integrated project the Nord-Trøndelag Hearing Loss Study with pure-tone audiometry assessment of the standard frequencies 0.25, 0.5, 1, 2, 3, 4, 6, and 8 kHz on 51,574 participants aged 20 to 101 years. We obtained information from Statistics Norway identifying 11,263 sibling pairs. After age stratification, we assessed similarity in hearing thresholds between siblings using polychoric correlations. The contribution of genetic effects in hearing ability was calculated. Results: The upper limit of the heritability of hearing loss was 0.36. We found little evidence for sex differences in the relative importance of genetic effects. Conclusions: There is a substantial genetic contribution to individual variation in hearing thresholds.
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