Long-term exposure to transportation noise is related to cardio-metabolic diseases, with more recent evidence also showing associations with diabetes mellitus (DM) incidence. This study aimed to ...evaluate the association between transportation noise and DM mortality within the Swiss National Cohort.
During 15 years of follow-up (2001-2015; 4.14 million adults), over 72,000 DM deaths were accrued. Source-specific noise was calculated at residential locations, considering moving history. Multi-exposure, time-varying Cox regression was used to derive hazard ratios (HR, and 95%-confidence intervals). Models included road traffic, railway and aircraft noise, air pollution, and individual and area-level covariates including socio-economic position. Analyses included exposure-response modelling, effect modification, and a subset analysis around airports. The main findings were integrated into meta-analyses with published studies on mortality and incidence (separately and combined).
HRs were 1.06 (1.05, 1.07), 1.02 (1.01, 1.03) and 1.01 (0.99, 1.02) per 10 dB day evening-night level (L
) road traffic, railway and aircraft noise, respectively (adjusted model, including NO
). Splines suggested a threshold for road traffic noise (~ 46 dB L
, well below the 53 dB L
WHO guideline level), but not railway noise. Substituting for PM
, or including deaths with type 1 DM hardly changed the associations. HRs were higher for males compared to females, and in younger compared to older adults. Focusing only on type 1 DM showed an independent association with road traffic noise. Meta-analysis was only possible for road traffic noise in relation to mortality (1.08 0.99, 1.18 per 10 dB, n = 4), with the point estimate broadly similar to that for incidence (1.07 1.05, 1.09 per 10 dB, n = 10). Combining incidence and mortality studies indicated positive associations for each source, strongest for road traffic noise (1.07 1.05, 1.08, 1.02 1.01, 1.03, and 1.02 1.00, 1.03 per 10 dB road traffic n = 14, railway n = 5 and aircraft noise n = 5, respectively).
This study provides new evidence that transportation noise is associated with diabetes mortality. With the growing evidence and large disease burden, DM should be viewed as an important outcome in the noise and health discussion.
In the light of growing urbanization and projected temperature increases due to climate change, heat-related mortality in urban areas is a pressing public health concern. Heat exposure and ...vulnerability to heat may vary within cities depending on structural features and socioeconomic factors. This study examined the effect modification of the temperature-mortality association of three socio-environmental factors in eight Swiss cities and population subgroups (<75 and ≥ 75 years, males, females): urban heat islands (UHI) based on within-city temperature contrasts, residential greenness measured as normalized difference vegetation index (NDVI) and neighborhood socioeconomic position (SEP). We used individual death records from the Swiss National Cohort occurring during the warm season (May to September) in the years 2003–2016. We performed a case time series analysis using conditional quasi-Poisson and distributed lag non-linear models with a lag of 0–3 days. As exposure variables, we used daily maximum temperatures (Tmax) and a binary indicator for warm nights (Tmin ≥20 °C).
In total, 53,593 deaths occurred during the study period. Overall across the eight cities, the mortality risk increased by 31% (1.31 relative risk (95% confidence interval: 1.20–1.42)) between 22.5 °C (the minimum mortality temperature) and 35 °C (the 99th percentile) for warm-season Tmax. Stratified analysis suggested that the heat-related risk at 35 °C is 26% (95%CI: −4%, 67%) higher in UHI compared to non-UHI areas. Indications of smaller risk differences were observed between the low vs. high greenness strata (Relative risk difference = 13% (95%CI: −11%; 44%)). Living in low SEP neighborhoods was associated with an increased heat related risk in the non-elderly population (<75 years). Our results indicate that UHI are associated with increased heat-related mortality risk within Swiss cities, and that features beyond greenness are responsible for such spatial risk differences.
•Application of the novel case time series design for area-level analysis.•Definition of urban heat islands using a high resolution temperature model.•Comparison of intra urban variability of heat related mortality in Swiss cities.•Increased heat vulnerability observed in urban heat islands and low greenness areas.
Land use regression models environmental predictors to estimate ground-floor air pollution concentration surfaces of a study area. While many cities are expanding vertically, such models typically ...ignore the vertical dimension.
We took integrated measurements of NO2 at up to three different floors on the facades of 25 buildings in the mid-sized European city of Basel, Switzerland. We quantified the decrease in NO2 concentration with increasing height at each facade over two 14-day periods in different seasons. Using predictors of traffic load, population density and street configuration, we built conventional land use regression (LUR) models which predicted ground floor concentrations. We further evaluated which predictors best explained the vertical decay rate. Ultimately, we combined ground floor and decay models to explain the measured concentrations at all heights.
We found a clear decrease in mean nitrogen dioxide concentrations between measurements at ground level and those at higher floors for both seasons. The median concentration decrease was 8.1% at 10 m above street level in winter and 10.4% in summer. The decrease with height was sharper at buildings where high concentrations were measured on the ground and in canyon-like street configurations. While the conventional ground floor model was able to explain ground floor concentrations with a model R2 of 0.84 (RMSE 4.1 μg/m3), it predicted measured concentrations at all heights with an R2 of 0.79 (RMSE 4.5 μg/m3), systematically overpredicting concentrations at higher floors. The LUR model considering vertical decay was able to predict ground floor and higher floor concentrations with a model R2 of 0.84 (RMSE 3.8 μg/m3) and without systematic bias.
Height above the ground is a relevant determinant of outdoor residential exposure, even in medium-sized European cities without much high-rise. It is likely that conventional LUR models overestimate exposure for residences at higher floors near major roads. This overestimation can be minimized by considering decay with height.
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•NO2 concentrations are typically 8 to 10% lower 10 m above the street than at street level.•The higher the NO2 concentration at ground level, the sharper the vertical decay.•Canyon-like street configurations trap NO2 at ground level, causing sharper vertical decay.•Land use regression (LUR) models can consider decay by including height as a predictor.•When predicting NO2 at higher floors, 3D LUR models outperformed conventional models.
Air pollution is a major global public health problem. The situation is most severe in low- and middle-income countries, where pollution control measures and monitoring systems are largely lacking. ...Data to quantify the exposure to air pollution in low-income settings are scarce.
In this study, land use regression models (LUR) were developed to predict the outdoor nitrogen dioxide (NO2) concentration in the study area of the Western Region Birth Cohort in São Paulo. NO2 measurements were performed for one week in winter and summer at eighty locations. Additionally, weekly measurements at one regional background location were performed over a full one-year period to create an annual prediction.
Three LUR models were developed (annual, summer, winter) by using a supervised stepwise linear regression method. The winter, summer and annual models explained 52 %, 75 % and 66 % of the variance (R2) respectively. Cross-holdout validation tests suggest robust models. NO2 levels ranged from 43.2 μg/m3 to 93.4 μg/m3 in the winter and between 28.1 μg/m3 and 72.8 μg/m3 in summer. Based on our annual prediction, about 67 % of the population living in the study area is exposed to NO2 values over the WHO suggested annual guideline of 40 μg/m3 annual average.
In this study we were able to develop robust models to predict NO2 residential exposure. We could show that average measures, and therefore the predictions of NO2, in such a complex urban area are substantially high and that a major variability within the area and especially within the season is present. These findings also suggest that in general a high proportion of the population is exposed to high NO2 levels.
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•Measured NO2 in São Paulo largely exceed the concentrations recommended by WHO.•Especially in winter the NO2 measurements were high (43.2 μg/m3 to 93.4 μg/m3).•NO2 LUR models explains 52 %, 75 % and 66 % (winter-summer-annual) of variance (R2).•67 % of the residential population is exposed to annual NO2 levels over WHO guidelines.
Indoor air pollution can be a major health risk because urban populations spend up to 90% of their time in closed rooms. Gaseous elemental mercury (GEM) has not been measured as routinely as other ...indoor air pollutants due to the high costs and limited mobility of active Hg analyzers. However, household GEM concentrations may exceed Hg air quality guidelines as a result of potential indoor GEM sources like broken Hg thermometers. Here we deploy novel low-cost mercury passive air samplers (MerPAS) in 27 households (7 days) and at 14 outdoor locations (29–31 days) in Basel, Switzerland. Average Hg concentrations ranged from 2.0 to 10.8 ng m–3 indoors and from 1.8 to 2.5 ng m–3 outdoors. These results reveal that households are a net source of Hg to the urban atmosphere and exceed outdoor Hg levels by a factor of 2 on average. We estimated an average weekly intake rate of 0.01 μg of Hg/kg of body weight for adult residents in Basel, which is usually lower than Hg exposure of people with dental amalgam fillings. Our campaign demonstrates that air monitoring programs can easily be complemented by straightforward Hg measurements using MerPAS.
Noise pollution has negative health consequences, which becomes increasingly relevant with rapid urbanization. In low- and middle-income countries research on health effects of noise is hampered by ...scarce exposure data and noise maps. In this study, we developed land use regression (LUR) models to assess spatial variability of community noise in the Western Region of São Paulo, Brazil.We measured outdoor noise levels continuously at 42 homes once or twice for one week in the summer and the winter season. These measurements were integrated with various geographic information system variables to develop LUR models for predicting average A-weighted (dB(A)) day-evening-night equivalent sound levels (Lden) and night sound levels (Lnight). A supervised mixed linear regression analysis was conducted to test potential noise predictors for various buffer sizes and distances between home and noise source. Noise exposure levels in the study area were high with a site average Lden of 69.3 dB(A) ranging from 60.3 to 82.3 dB(A), and a site average Lnight of 59.9 dB(A) ranging from 50.7 to 76.6 dB(A). LUR models had a good fit with a R2 of 0.56 for Lden and 0.63 for Lnight in a leave-one-site-out cross validation. Main predictors of noise were the inverse distance to medium roads, count of educational facilities within a 400 m buffer, mean Normalized Difference Vegetation Index (NDVI) within a 100 m buffer, residential areas within a 50 m (Lden) or 25 m (Lnight) buffer and slum areas within a 400 m buffer. Our study suggests that LUR modelling with geographic predictor data is a promising and efficient approach for noise exposure assessment in low- and middle-income countries, where noise maps are not available.
•Measured weekly average levels of community noise in São Paolo (Lden 73 dB(A) and Lnight 65 dB(A) exceed recommended limits by the WHO.•LUR models for community noise exposure in São Paulo explains 56% of variance of Lden and 63% of variance of Lnight.•Increase in noise was found in relation to vicinity to medium roads and informal settlements (“favelas”) and number of educational facilities.•Decrease in noise was found in relation to proportion of residential areas and Normalized Difference Vegetation Index.
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•Long-term road traffic and railway noise are associated with most CVD causes of death.•Risk increases often start well below the WHO Environmental Noise guideline ...levels.•Associations are independent of air pollution.•Higher levels of noise intermittency are independently associated with each outcome.•Relative and absolute risk are higher in males compared to females.
Death from cardiovascular diseases (CVD) has been associated with transportation noise. This nationwide cohort, with state-of-the-art exposure assessment, evaluates these associations by noise source.
Road traffic, railway and aircraft noise for 2001 and 2011 were linked to 4.1 million adults in the Swiss National Cohort, accounting for address history. Mean noise exposure in 5-year periods was calculated. Time-varying Cox regression models, with age as timescale, were applied to all and cause-specific cardiovascular causes of death. Models included all three noise sources plus PM2.5, adjusted for individual and spatial covariates. Nighttime noise events for all sources combined (expressed as intermittency ratio or number of events) were considered in sensitivity analyses. Absolute excess risk was calculated by multiplying deaths/100,000 person-years by the excess risk (hazard ratio-1) within each age/sex group.
During a 15-year follow-up, there were 277,506 CVD and 34,200 myocardial infarction (MI) deaths. Associations (hazard ratio; 95%-CIs) for road traffic, railway and aircraft noise and CVD mortality were 1.029 (1.024–1.034), 1.013 (1.010–1.017), and 1.003 (0.996–1.010) per 10 dB Lden, respectively. Associations for MI mortality were a respective 1.043 (1.029–1.058), 1.020 (1.010–1.030) and 1.040 (1.020–1.060) per 10 dB Lden. Blood pressure-related, ischemic heart disease, and all stroke mortality were significantly associated with road traffic and railway noise, while ischemic stroke mortality was associated with aircraft noise. Associations were mostly linear, often starting below 40 dB Lden for road traffic and railway noise. Higher levels of noise intermittency were also independently associated with each outcome. While the absolute number of deaths attributed to noise increased with age, the hazard ratios declined with age. Relative and absolute risk was higher in males compared to females.
Independent of air pollution, transportation noise exposure is associated with all and cause-specific CVD mortality, with effects starting below current guideline limits.
•Inner-city speed reduction reduces road traffic crashes and noise exposure.•Speed reduction prevents cardiovascular diseases and diabetes.•Speed reduction reduces the number of noise annoyed and ...sleep disturbed people.•For road traffic crashes, speed limits on major roads are most relevant.•Overall, health benefit from noise reduction is more relevant than safety benefits.
Reductions of speed limits for road traffic are effective in reducing casualties, and are also increasingly promoted as an effective way to reduce noise exposure.
The aim of this study was to estimate the health benefits of the implementation of 30 km/h speed limits in the city of Lausanne (136′077 inhabitants) under different scenarios addressing exposure to noise and road crashes.
The study followed a standard methodology for quantitative health impact assessments to derive the number of attributable cases in relation to relevant outcomes. We compared a reference scenario (without any 30 km/h speed limits) to the current situation with partial speed limits and additional scenarios with further implementation of 30 km/h speed limits, including a whole city scenario.
Compared to the reference scenario, noise reduction due to the current speed limit situation was estimated to annually prevent 1 cardiovascular death, 72 hospital admissions from cardiovascular disease, 17 incident diabetes cases, 1′127 individuals being highly annoyed and 918 individuals reporting sleep disturbances from noise. Health benefits from a reduction in road traffic crashes were less pronounced (1 severe injury and 4 minor injuries). The whole city speed reduction scenario more than doubled the annual benefits, and was the only scenario that contributed to a reduction in mortality from road traffic crashes (one death per two years). Implementing 30 km/h speed limits in a city yields health benefits due to reduction in road traffic crashes and noise exposure. We found that the benefit from noise reduction was more relevant than safety benefits.
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•Consequences of noise have rarely been studied in children aged 6 years or younger.•Average noise exposure among Brazilian children in this sample is high.•In longitudinal analysis, ...noise was associated with increased behavioral problems.•Also cognitive development was negatively correlated with community noise exposure.
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.
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.
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.
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.
Outdoor air pollution is increasingly recognised as a key threat to population health globally, with particularly high risks for urban residents. In this study, we assessed the association between ...residential nitrogen dioxide (NO2) exposure and children's cognitive and behavioural development using data from São Paulo Brazil, one of the largest urban agglomerations in the world.
We used data from the São Paulo Western Region Birth Cohort, a longitudinal cohort study aiming to examine determinants as well as long-term implications of early childhood development. Cross-sectional data from the 72-month follow-up was analysed. Data on NO2 concentration in the study area was collected at 80 locations in 2019, and land use regression modelling was used to estimate annual NO2 concentration at children's homes. Associations between predicted NO2 exposure and children's cognitive development as well as children's behavioural problems were estimated using linear regression models adjusted for an extensive set of confounders. All results were expressed per 10 μg/m3 increase in NO2.
1143 children were included in the analysis. We found no association between NO2 and children's cognitive development (beta -0.05, 95% CI -0.20; 0.10) or behavioural problems (beta 0.02, 95% CI -0.80; 0.12).
No association between child cognition or child behaviour and NO2 was found in this cross-sectional analysis. Further research will be necessary to understand the extent to which these null results reflect a true absence of association or other statistical, biological or adaptive factors not addressed in this paper.
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