There is a growing body of evidence that exposure to transportation related noise can adversely affect health and wellbeing. More recently, research on cardiovascular disease has specifically ...explored the hypothesis that exposure to transportation noise increases the risk for ischemic heart disease (IHD). Our objective was to review and conduct a meta-analysis to obtain an overall exposure–response association.
We conducted a systematic review and retained published studies on incident cases of IHD using sources of transportation noise as exposure. Study-specific results were transformed into risk estimates per 10dB increase in exposure. Subsequently we conducted a random effects meta-analysis to pool the estimates. We identified 10 studies on road and aircraft noise exposure conducted since the mid-1990s, providing a total of 12 risk estimates. Pooled relative risk for IHD was 1.06 (1.03–1.09) per 10dB increase in noise exposure with the linear exposure–response starting at 50dB. Based on a small number of studies, subgroup analyses were suggestive of higher risk for IHD for males compared to females (p=0.14), and for persons over 65 years of age compared to under (p=0.22). Air pollution adjustment, explored only in a subset of four studies, did not substantially attenuate the association between noise exposure and IHD.
The evidence for an effect of transportation noise with IHD necessitates further research into the threshold and the shape of the exposure–response association, potential sources of heterogeneity and effect modification. Research in different cultural contexts is also important to derive regional and local estimates for the contribution of transportation noise to the global burden of disease.
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•We review and conduct a meta-analysis on transportation noise exposure and IHD.•Novel approach to pool studies with a diversity of metrics and exposure categories.•We verify the assumption of a linear ER association by targeted statistical analyses.•The overall RR is 1.06 (1.03–1.09) per 10dB increase in noise, starting at 50dB.•More studies are needed to refine the shape and threshold for the ER relationship.
Green space may improve health by enabling physical activity and recovery from stress or by decreased pollution levels. We investigated the association between residential green (greenness or green ...space) and mortality in adults using the Swiss National Cohort (SNC) by mutually considering air pollution and transportation noise exposure. To reflect residential green at the address level, two different metrics were derived: normalised difference vegetation index (NDVI) for greenness, and high resolution land use classification data to identify green spaces (LU-green). We used stratified Cox proportional hazard models (stratified by sex) to study the association between exposure and all natural cause mortality, respiratory and cardiovascular disease (CVD), including ischemic heart disease, stroke and hypertension related mortality. Models were adjusted for civil status, job position, education, neighbourhood socio-economic position (SEP), geographic region, area type, altitude, air pollution (PM10), and transportation noise. From the nation-wide SNC, 4.2 million adults were included providing 7.8years of follow-up and respectively 363,553, 85,314 and 232,322 natural cause, respiratory and CVD deaths. Hazard ratios (and 95%-confidence intervals) for NDVI and LU-green per interquartile range within 500m of residence were highly comparable: 0.94 (0.93–0.95) 0.94 (0.93–0.95) for natural causes; 0.92 (0.91–0.94) 0.92 (0.90–0.95) for respiratory; and 0.95 (0.94–0.96) 0.96 (0.95–0.98) for CVD mortality. Protective effects were stronger in younger individuals and in women and, for most outcomes, in urban (vs. rural) and in the highest (vs. lowest) SEP quartile. Estimates remained virtually unchanged after incremental adjustment for air pollution and transportation noise, and mediation by these environmental factors was found to be small. We found consistent evidence that residential green reduced the risk of mortality independently from other environmental exposures. This suggests the protective effect goes beyond the absence of pollution sources. Environmental public health measures should not only aim at reducing pollutant exposure, but additionally maintain existing and increase residential green in areas where lacking.
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•Residential green is greenness or green spaces around the home address.•Exposure was defined in two ways: satellite NDVI vs. detailed land use classification data.•The two exposure metrics yielded highly comparable hazard ratios.•Residential green reduced natural cause, respiratory and cardiovascular deaths.•The protective effect was independent from transportation noise and air pollution.
Communication technologies are rapidly changing and this may affect public exposure to radiofrequency electromagnetic fields (RF-EMF). This systematic review of literature aims to update a previous ...review on public everyday RF-EMF exposure in Europe, which covered publications until 2015. From 144 eligible records identified by means of a systematic search in PubMed, Embase and Web of Knowledge databases, published between May 2015 and 1 July 2018, 26 records met the inclusion criteria. We extracted quantitative data on public exposure in different indoors, outdoors and transport environments. The data was descriptively analyzed with respect to the exposure patterns between different types of environments. Mean RF-EMF exposure in homes, schools and offices were between 0.04 and 0.76 V/m. Mean outdoor exposure values ranged from 0.07 to 1.27 V/m with downlink signals from mobile phone base stations being the most relevant contributor. RF-EMF levels tended to increase with increasing urbanity. Levels in public transport (bus, train and tram) and cars were between 0.14 and 0.69 V/m. The highest levels, up to 1.97 V/m, were measured in public transport stations with downlink as the most relevant contributor. In line with previous studies, RF-EMF exposure levels were highest in the transportation systems followed by outdoor and private indoor environments. This review does not indicate a noticeable increase in everyday RF-EMF exposure since 2012 despite increasing use of wireless communication devices.
•RF-EMF exposure, predominantly downlink signals, tends to increase with increasingurbanicity.•Highest RF-EMF exposure levels occurred in public settings such as libraries, train and tram stations, with typical RF-EMF exposure levels of 0.5 V/m or higher.•Typical exposure values in private homes are below 0.3 V/m•No indications was obtained that RF-EMFexposure increased since 2012.
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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.
The aim of this study is to investigate whether memory performance in adolescents is affected by radiofrequency electromagnetic fields (RF-EMF) from wireless device use or by the wireless device use ...itself due to non-radiation related factors in that context.
We conducted a prospective cohort study with 439 adolescents. Verbal and figural memory tasks at baseline and after one year were completed using a standardized, computerized cognitive test battery. Use of wireless devices was inquired by questionnaire and operator recorded mobile phone use data was obtained for a subgroup of 234 adolescents.
RF-EMF dose measures considering various factors affecting RF-EMF exposure were computed for the brain and the whole body.
Data were analysed using a longitudinal approach, to investigate whether cumulative exposure over one year was related to changes in memory performance. All analyses were adjusted for relevant confounders.
The kappa coefficients between cumulative mobile phone call duration and RF-EMF brain and whole body dose were 0.62 and 0.67, respectively for the whole sample and 0.48 and 0.28, respectively for the sample with operator data. In linear exposure–response models an interquartile increase in cumulative operator recorded mobile phone call duration was associated with a decrease in figural memory performance score by −0.15 (95% CI: −0.33, 0.03) units. For cumulative RF-EMF brain and whole body dose corresponding decreases in figural memory scores were −0.26 (95% CI: −0.42, −0.10) and −0.40 (95% CI: −0.79, −0.01), respectively. No exposure-response associations were observed for sending text messages and duration of gaming, which produces tiny RF-EMF emissions.
A change in memory performance over one year was negatively associated with cumulative duration of wireless phone use and more strongly with RF-EMF dose. This may indicate that RF-EMF exposure affects memory performance.
•This is a prospective cohort study with approx. one year of follow-up.•Self-reported and operator recorded mobile phone use data were collected.•The cumulative RF-EMF dose for the brain and for the whole body was calculated.•Associations were stronger for RF-EMF dose than for use of wireless devices.•RF-EMF exposure might impair memory performance in adolescents.
Recent studies linked adolescents' media use to a variety of physical, psychological and social impairments. However, research neglected that adolescents’ media use is complex and includes various ...combinations of activities such as mobile internet browsing, calling, online gaming or use of social network sites.
The aim of this study is to use latent class analysis in a sample 895 Swiss adolescents to classify different media usage types based on eleven media use variables. Subsequently, associations of these classes with health related quality of life (HRQoL) as measured by the KIDSCREEN-52 questionnaire were assessed using multivariable regression models adjusted for relevant confounding factors.
Five distinct media use classes could be identified: Low Use, Medium Use, Gaming, Call Preference and High Social Use. The Low Use class reported highest and the High Social Use class lowest HRQoL on the KIDSCREEN scales Moods and Emotions (mean adjusted scores: 55.1 (95%CI: 53.8; 57.0) vs. 49.1 (47.5; 50.7)), Self-Perception (51.8 (50.3; 53.3) vs. 48.0 (46.7; 49.28), Parents and Home Life (53.3 (51.7; 54.9) vs. 48.6 (47.2; 50.0)) and School Environment (52.7 (51.3; 54.0) vs. 49.3 (48.2; 50.7)). On the subscale Social Support and Peers the pattern was reversed. The Low Use class indicated least and the High Social Use class most well-being (48.5 (47.0; 50.0) vs. 53.8 (52.4; 55.3)).
Latent class analyses is a fruitful approach to differentiate between various media usage types and is expected to better characterize and evaluate potential causal associations between media use and HRQoL.
•Latent class analysis was used to identify five distinct patterns of media use in adolescents.•Eleven different media use related variables were included.•Patterns highlighted gender differences and recent technological changes.•Quality of social relationships and emotional well-being differ amongst media use pattern.
The potential impact of microwave radiofrequency electromagnetic fields (RF-EMF) emitted by wireless communication devices on neurocognitive functions of adolescents is controversial. In a previous ...analysis, we found changes in figural memory scores associated with a higher cumulative RF-EMF brain dose in adolescents.
We aimed to follow-up our previous results using a new study population, dose estimation, and approach to controlling for confounding from media usage itself.
RF-EMF brain dose for each participant was modeled. Multivariable linear regression models were fitted on verbal and figural memory score changes over 1 y and on estimated cumulative brain dose and RF-EMF related and unrelated media usage (
=669-676). Because of the hemispheric lateralization of memory, we conducted a laterality analysis for phone call ear preference. To control for the confounding of media use behaviors, a stratified analysis for different media usage groups was also conducted.
We found decreased figural memory scores in association with an interquartile range (IQR) increase in estimated cumulative RF-EMF brain dose scores: -0.22 (95% CI: -0.47, 0.03; IQR: 953 mJ/kg per day) in the whole sample, -0.39 (95% CI: -0.67, -0.10; IQR: 953 mJ/kg per day) in right-side users (
=532), and -0.26 (95% CI: -0.42, -0.10; IQR: 341 mJ/kg per day) when recorded network operator data were used for RF-EMF dose estimation (
=274). Media usage unrelated to RF-EMF did not show significant associations or consistent patterns, with the exception of consistent (nonsignificant) positive associations between data traffic duration and verbal memory.
Our findings for a cohort of Swiss adolescents require confirmation in other populations but suggest a potential adverse effect of RF-EMF brain dose on cognitive functions that involve brain regions mostly exposed during mobile phone use. https://doi.org/10.1289/EHP2427.
The aim of the present study is to establish exposure-response relationships reflecting the percentage highly annoyed (%HA) as functions of road traffic, railway, and aircraft noise exposure, ...measured as day-evening-night level (Lden), as well as to elucidate the degree to which the acoustic indicator Intermittency Ratio (IR), which reflects the “eventfulness” of a noise situation, predicts noise annoyance. We conducted a mixed-mode representative population survey in a stratified random sample of 5592 residents exposed to transportation noise all over Switzerland. Source-specific noise exposure was calculated for each floor and each façade based on comprehensive traffic data. Noise annoyance was measured using the ICBEN 11-point scale. The survey was carried out in 4 waves at different times of the year. We hypothesized that in addition to Lden, the effects of noise on annoyance can be better explained when also considering the intensity of short-term variations of noise level over time. We therefore incorporated the acoustic indicator IR in the statistical models. For all noise sources, results revealed significant associations between Lden and %HA after controlling for confounders and independent predictors such as IR (measured over 24 h), exposure to other transportation noise sources, sex and age, language, home ownership, education level, living duration, temperature, and access to a quiet side of the dwelling. Aircraft noise annoyance scored markedly higher than annoyance to railway and road traffic noise at the same Lden level. Railway noise elicited higher percentages of highly annoyed persons than road traffic noise. Results furthermore suggest that for road traffic noise, IR has an additional effect on %HA and can explain shifts of the exposure-response curve of up to about 6 dB between low IR and high IR exposure situations, possibly due to the effect of different durations of noise-free intervals between events. For railway and aircraft noise annoyance, the predictive value of IR was limited.
•Noise annoyance is associated with Lden of road, rail, and aircraft noise exposure.•The degree of intermittency of noise can explain differences in annoyance reactions.•Aircraft noise is more annoying than railway noise and road traffic noise.•We found no empirical basis for a “railway bonus” for noise regulation.
Many adolescents tend to leave their mobile phones turned on during night, accepting that they may be awakened by an incoming text message or call. Using self-reported and objective operator recorded ...mobile phone use data, we thus aimed to analyze how being awakened during night by mobile phone affects adolescents' perceived health and cognitive functions. In this cross-sectional study, 439 adolescents completed questionnaires about their mobile phone use during night, health related quality of life and possible confounding factors. Standardized computerized cognitive tests were performed to assess memory and concentration capacity. Objective operator recorded mobile phone use data was further collected for 233 study participants. Data were analyzed by multivariable regression models adjusted for relevant confounders including amount of mobile phone use. For adolescents reporting to be awakened by a mobile phone during night at least once a month the odds ratio for daytime tiredness and rapid exhaustibility were 1.86 (95% CI: 1.02-3.39) and 2.28 (95% CI: 0.97-5.34), respectively. Similar results were found when analyzing objective operator recorded mobile phone use data (tiredness: 1.63, 95% CI: 0.94-2.82 and rapid exhaustibility: 2.32, 95% CI: 1.01-5.36). The cognitive tests on memory and concentration capacity were not related to mobile phone use during night. Overall, being awakened during night by mobile phone was associated with an increase in health symptom reports such as tiredness, rapid exhaustibility, headache and physical ill-being, but not with memory and concentration capacity. Prevention strategies should focus on helping adolescents set limits for their accessibility by mobile phone, especially during night.
•Study of 1001 school-going children from three agricultural areas of South Africa.•Effects of pesticide related activities of children has rarely been investigated.•Cognitive performance was ...assessed with a validated test battery on a tablet.•Consistent associations between pesticide exposure and headache.•Suggestive, but mostly non-significant, negative associations with cognition.
Children and adolescents living in agricultural areas are likely to be exposed to mixtures of pesticides during their daily activities, which may impair their neurodevelopment. We investigated various such activities in relation to headache severity and neurodevelopment of school-children living in rural agricultural areas in the Western Cape of South Africa.
We used baseline date from 1001 school-children of the Child Health Agricultural Pesticide Cohort Study in South Africa (CapSA) aged 9–16 from seven schools and three agriculture areas in the Western Cape. Questionnaires were administrated to assess activities related to pesticide exposure and health symptoms addressing four types of activities: 1) child farm activities related to pesticide handling, 2) eating crops directly from the field, 3) contact with surface water around the field, and 4) seen and smelt pesticide spraying activities. Neurocognitive performance across three domains of attention, memory and processing speed were assessed by means of an iPad-based cognitive assessment tool, Cambridge Automated NeuroPsychological Battery (CANTAB). Headache severity was enquired using a standard Headache Impact Test (HIT-6) tool. Cross-sectional regression analysis was performed.
About 50% of the cohort report to have ever been engaged in activities related to pesticide exposure including farm activities, eating crops directly from the field and leisure activities. Headache severity score was consistently increased in relation to pesticide-related farm activities (score increase of 1.99; 95% CI: 0.86, 3.12), eating crops (1.52; 0.41, 2.67) and leisure activities of playing, swimming or bathing in nearby water (1.25; 0.18, 2.33). For neurocognitive outcomes, an overall negative trend with pesticide exposure-related activities was observed. Among others, involvement in pesticide-related farm activities was associated with a lower multi-tasking accuracy score (−2.74; −5.19, −0.29), while lower strategy in spatial working memory (−0.29; −0.56; −0.03) and lower paired associated learning (−0.88; −1.60, −0.17) was observed for those who pick crops off the field compared to those who do not pick crops off the field. Eating fruits directly from the vineyard or orchard was associated with a lower motor screening speed (−0.06; −0.11, −0.01) and lower rapid visual processing accuracy score (−0.02; −0.03, 0.00).
Children who indicate activities related to pesticide exposure may be at higher risk for developing headaches and lower cognitive performance in the domains of attention, memory and processing speed. However, self-reported data and cross-sectional design are a limitation. Future research in CapSA will consider pesticide exposure estimations via urinary biomarkers and longitudinal assessment of cognitive functions.
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