Transportation noise and self-rated health : evidence from the German national cohort (NAKO)

Abstract

Background A large proportion of Europeans are exposed to high levels of transportation noise, which can cause physiological and psychological stress, leading to negative health impacts. Few studies have examined the association between transportation noise and self-rated health (SRH), a summary indicator of morbidity. Objectives We aimed to assess the associations of SRH with both annual average road traffic noise exposure and nighttime transportation noise annoyance, examine geographic differences, evaluate potential effect modification and interaction by sex, and investigate whether annoyance mediates the relationship between road traffic noise and self-rated health. Methods Using NAKO baseline data (n = 174,956), we implemented a cross-sectional study using logistic regression to analyze associations of road traffic noise ≥55 dB(A) Lden and nighttime transportation noise annoyance with poor SRH, adjusting for relevant sociodemographic characteristics and environmental co-exposures, including air pollution and greenness. We examined geographic differences, tested for effect modification and interaction by sex, and used path analysis to assess mediation by annoyance. Results Road traffic noise ≥55 dB(A) (OR 1.06, 95 % CI 1.01; 1.10), and moderate (OR 1.28, 1.23; 1.32) and strong nighttime transportation noise annoyance (OR 1.73, 1.65; 1.81) were associated with higher odds of poor SRH. Associations were similar for males and females, but varied across study regions. The path analysis revealed that road traffic noise was associated with higher odds of poor SRH indirectly via nighttime transportation noise annoyance (indirect effect). Conclusions In our study, nighttime transportation noise annoyance was more strongly and consistently associated with poor SRH than road traffic noise. Reducing both transportation noise and related annoyance could help protect population health.