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BACKGROUND: Mechanisms underlying the associations between changes in the urban environment and changes in health-related outcomes are complex and their study requires specific approaches. We describe the protocol of the interdisciplinary UrbASanté study, which aims to explore how urban interventions can modify environmental exposures (built, social, and food environments; air quality; noise), health-related behaviors, and self-reported health using a natural experiment approach. METHODS: The study is based on a natural experiment design using a before/after protocol with a control group to assess changes in environmental exposures, health-risk behaviors, and self-reported health outcomes of a resident adult population before and after the implementation of a time series of urban interventions in four contiguous neighborhoods in Paris (France). The changes in environmental exposures, health-related behaviors, and self-reported health outcomes of a resident adult population will be concurrently monitored in both intervention and control areas. We will develop a mixed-method framework combining substantial fieldwork with quantitative and qualitative analytical approaches. This study will make use of (i) data relating to exposures and health-related outcomes among all participants and in subsamples and (ii) interviews with residents regarding their perceptions of their neighborhoods and with key stakeholders regarding the urban change processing, and (iii) existing geodatabases and field observations to characterize the built, social, and food environments. The data collected will be analyzed with a focus on interrelationships between environmental exposures and health-related outcomes using appropriate approaches (e.g., interrupted time series, difference-in-differences method). DISCUSSION: Relying on a natural experiment approach, the research will provide new insights regarding issues such as close collaboration with urban/local stakeholders, recruitment and follow-up of participants, identification of control and intervention areas, timing of the planned urban interventions, and comparison of subjective and objective measurements. Through the collaborative work of a consortium ensuring complementarity between researchers from different disciplines and stakeholders, the UrbASanté study will provide evidence-based guidance for designing future urban planning and public health policies. TRIAL REGISTRATION: This research was registered at the ClinicalTrial.gov (NCT05743257).
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Contaminación del Aire , Adulto , Humanos , Exposición a Riesgos Ambientales/prevención & control , Política Pública , Conductas de Riesgo para la Salud , Factores SocioeconómicosRESUMEN
BACKGROUND: Although several cross-sectional studies have shown that aircraft noise exposure was associated with an increased risk of hypertension, a limited number of longitudinal studies have addressed this issue. This study is part of the DEBATS (Discussion on the health effect of aircraft noise) research programme and aimed to investigate the association between aircraft noise exposure and the incidence of hypertension. METHODS: In 2013, 1244 adults living near three major French airports were included in this longitudinal study. Systolic and diastolic blood pressure, as well as demographic and lifestyle factors, were collected at baseline and after 2 and 4 years of follow-up during face-to-face interviews. Exposure to aircraft noise was estimated for each participant's home address using noise maps. Statistical analyses were performed using mixed Poisson and linear regression models adjusted for potential confounding factors. RESULTS: A 10 dB(A) increase in aircraft noise levels in terms of Lden was associated with a higher incidence of hypertension (incidence rate ratio (IRR)=1.36, 95% CI 1.02 to 1.82). The association was also significant for Lday (IRR 1.41, 95% CI 1.07; to 1.85) and Lnight (IRR 1.31, 95% CI 1.01 to 1.71). Systolic and diastolic blood pressure increased with all noise indicators. CONCLUSION: These results strengthen those obtained from the cross-sectional analysis of the data collected at the time of inclusion in DEBATS, as well as those from previous studies conducted in other countries. Hence, they support the hypothesis that aircraft noise exposure may be considered as a risk factor for hypertension.
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Hipertensión , Ruido del Transporte , Adulto , Aeronaves , Estudios Transversales , Exposición a Riesgos Ambientales/efectos adversos , Francia/epidemiología , Humanos , Hipertensión/epidemiología , Hipertensión/etiología , Estudios Longitudinales , Ruido del Transporte/efectos adversosRESUMEN
In response to the demand from a growing number of people concerned about the possible impact of RF-EMF on health, the French National Frequency Agency (ANFR) has published a standardized protocol for in-situ measurements of radiofrequency electromagnetic fields (RF-EMF). This protocol was based on the search for the point of highest field strength and the use of spot measurement. In the framework of an epidemiological study, such spot measurements were implemented in the homes of 354 participants located in urban areas within 250 m of a mobile-phone base station (MPBS) and in the main beam direction of the antenna. Among the participants, more than half accepted to be enrolled in a longer-term study, among whom 152 were equipped with a personal exposure meter (PEM) for 48 h and 40 for seven continuous days. Both spot and PEM measurements quantified downlink field strengths, i.e. FM, TV3-4-5, TETRA I-II-III, 2 GHz-5GHz Wi-Fi, WiMax, GSM900, GSM1800, UMTS900, UMTS 2100, LTE800, LTE1800, and LTE2600. Spot measurements showed a mean/median field strength of 0.58/0.44 V/m for total RF-EMF and 0.43/0.27 V/m from the MPBS. RF-EMF from the MPBS was the dominant source of exposure in 64% of households. Exposure to RF-EMF was influenced by the position of the windows with respect to the MPBS, in particular line-of-site visibility, the distance of the antenna and the floor of the apartment. The PEM surveys showed the measured exposure to be higher during outings than at home and during the day than at night, but there was no difference between the weekends and working days. There was a strong correlation between exposure quantified by both spot and PEM measurements, although spot measures were approximately three times higher than those by PEMs. This study is the first to assess exposure to RF-EMF of people living near a MPBS in urban areas in France. These preliminary results suggest the value of using spot measurements to estimate the impact of the evolution of the mobile-phone network and technology on the exposure of populations to RF-EMF. The low levels of RF-RMF expressed as mean values do not necessarily rule out possible health effects of this exposure.
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Teléfono Celular , Exposición a Riesgos Ambientales , Campos Electromagnéticos , Francia , Humanos , Ondas de RadioRESUMEN
The effects of radiofrequency exposure on the health of people living near mobile-phone base stations (MPBSs) have been the subject of several studies since the mid-2000s, with contradictory results. We aimed to investigate the association between measured exposure to radiofrequency electromagnetic fields (RF-EMF) from MPBSs and the presence of self-reported non-specific and insomnia-like symptoms. A cross-sectional survey conducted between 2015 and 2017 in five large cities in France involved 354 people living in buildings located at a distance of 250 m or less from an MPBS and in the main transmit beam of the antennas. Information on environmental concerns, anxiety, and non-specific and insomnia-like symptoms was collected with a questionnaire administrated by telephone. A complete broadband field-meter measurement [100 kHz - 6 GHz] was then made at five points of each dwelling, followed by a spectral analysis at the point of highest exposure, detailing the contribution of each service, including MPBS. The median exposure from MPBS was 0.27 V/m (0.44 V/m for global field), ranging from 0.03 V/m to 3.58 V/m, MPBSs being the main source of exposure for 64% of the dwellings. In this study population, the measured exposure from MPBSs was not associated with self-reported non-specific or insomnia-like symptoms. However, for insomnia-like symptoms, a significant interaction was found between RF-EMF exposure from MPBSs and environmental concerns. These findings do not support the hypothesis of an effect of RF-EMF from MPBSs on non-specific or insomnia-like symptoms in the overall population. Studies are needed to further investigate the positive association observed between exposure from MPBSs and insomnia-like symptoms among people reporting environmental concerns.
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Teléfono Celular , Campos Electromagnéticos , Ciudades , Estudios Transversales , Campos Electromagnéticos/efectos adversos , Exposición a Riesgos Ambientales , Francia , Humanos , Ondas de Radio/efectos adversosRESUMEN
BACKGROUND: Noise is a major public health issue because of its negative impacts on health, including annoyance, sleep disturbance, cardiovascular diseases and altered cognitive performance among children. Self-rated health status (SRHS) can be considered as a reliable indicator of quality of life, morbidity and mortality but few studies have considered SRHS in relation to aircraft noise exposure. The present study aims to investigate the association between this exposure and SRHS of people living near airports in France, and to consider the mediating or moderating role of aircraft noise annoyance and noise sensitivity in this association. METHODS: This cross-sectional study included 1242 participants older than 18 and living near three major French airports. Information on their SRHS, aircraft noise annoyance, noise sensitivity and demographic, socioeconomic and lifestyle factors was collected during a face-to-face interview performed at home. Outdoor aircraft noise levels were estimated for each participant's home address using noise maps. Logistic regressions with adjustment for potential confounders were used. The moderating and mediating effects of aircraft noise annoyance and noise sensitivity were investigated following Baron and Kenny's recommendations. RESULTS: A significant association was shown between aircraft noise levels and a fair/poor SRHS, only in men (OR=1.55, 95%CI 1.01-2.39, for a 10 dB(A)-increase in Lden). This relationship was higher in men highly sensitive to noise (OR=3.26, 95%CI 1.19-8.88, for a 10 dB(A)-increase in Lden). Noise sensitivity was associated with a fair/poor SRHS significantly in women (OR=1.74, 95%CI 1.12-2.68) and at the borderline of significance in men (OR=1.68, 95% CI 0.94-3.00), whereas aircraft noise annoyance was associated with a fair/poor SRHS only in men (OR=1.81, 95%CI 1.00-3.27). CONCLUSION: The present study confirms findings in the small number of available studies to date suggesting a positive association between aircraft noise levels and a fair/poor SRHS. These results also support the hypothesis that noise sensitivity would moderate this association. However, a mediating effect of annoyance cannot be excluded.
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Ruido del Transporte , Calidad de Vida , Aeronaves , Niño , Estudios Transversales , Exposición a Riesgos Ambientales/efectos adversos , Femenino , Francia/epidemiología , Estado de Salud , Humanos , Masculino , Ruido del Transporte/efectos adversosRESUMEN
BACKGROUND: Few studies have considered aircraft noise annoyance and noise sensitivity in analyses of the health effects of aircraft noise, especially in relation to medication use. This study aims to investigate the moderating and mediating role of these two factors in the relationship between aircraft noise levels and medication use among 5860 residents of ten European airports included in the HYENA and DEBATS studies. METHODS: Information on aircraft noise annoyance, noise sensitivity, medication use, and demographic, socio-economic and lifestyle factors was collected during a face-to-face interview at home. Medication was coded according to the Anatomical Therapeutic Chemical (ATC) classification. Outdoor aircraft noise exposure was estimated by linking the participant's home address to noise contours using Geographical Information Systems (GIS) methods. Logistic regressions with adjustment for potential confounding factors were used. In addition, Baron and Kenny's recommendations were followed to investigate the moderating and mediating effects of aircraft noise annoyance and noise sensitivity. RESULTS: A significant association was found between aircraft noise levels at night and antihypertensive medication only in the UK (OR = 1.43, 95%CI 1.19-1.73 for a 10 dB(A)-increase in Lnight). No association was found with other medications. Aircraft noise annoyance was significantly associated with the use of antihypertensive medication (OR = 1.33, 95%CI 1.14-1.56), anxiolytics (OR = 1.48, 95%CI 1.08-2.05), hypnotics and sedatives (OR = 1.60, 95%CI 1.07-2.39), and antasthmatics (OR = 1.44, 95%CI 1.07-1.96), with no difference between countries. Noise sensitivity was significantly associated with almost all medications, with the exception of the use of antasthmatics, showing an increase in ORs with the level of noise sensitivity, with differences in ORs among countries only for the use of antihypertensive medication. The results also suggested a mediating role of aircraft noise annoyance and a modifying role of both aircraft noise annoyance and noise sensitivity in the association between aircraft noise levels and medication use. CONCLUSIONS: The present study is consistent with the results of the small number of studies available to date suggesting that both aircraft noise annoyance and noise sensitivity should be taken into account in analyses of the health effects of exposure to aircraft noise.
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Ruido del Transporte , Aeronaves , Aeropuertos , Exposición a Riesgos Ambientales/efectos adversos , Europa (Continente) , Humanos , Ruido del Transporte/efectos adversosRESUMEN
INTRODUCTION: Many studies, including the HYENA and the DEBATS studies, showed a significant association between aircraft noise exposure and the risk of hypertension. Few studies have considered aircraft noise annoyance and noise sensitivity as factors of interest, especially in relation to hypertension risk, or as mediating or modifying factors. The present study aims 1) to investigate the risk of hypertension in relation to aircraft noise annoyance or noise sensitivity; and 2) to examine the role of modifier or mediator of these two factors in the association between aircraft noise levels and the risk of hypertension. METHODS: This study included 6,105 residents of ten European airports from the HYENA and DEBATS studies. Information on aircraft noise annoyance, noise sensitivity, and demographic, socioeconomic and lifestyle factors was collected during an interview performed at home. Participants were classified as hypertensive if they had either blood pressure levels above the WHO cut-off points or physician-diagnosed hypertension in conjunction with the use of antihypertensive medication. Outdoor aircraft noise exposure was estimated for each participant's home address. Poisson regression models with adjustment for potential confounders were used. Interactions between noise exposure and country were tested to consider possible differences between countries. RESULTS: An increase in aircraft noise levels at night was weekly but significantly associated with an increased risk of hypertension (RR = 1.03, 95% CI 1.01-1.06 for a 10-dB(A) increase in Lnight). A significant association was found between aircraft noise annoyance and hypertension risk (RR = 1.06, 95%CI 1.00-1.13 for highly annoyed people compared to those who were not highly annoyed). The risk of hypertension was slightly higher for people highly sensitive to noise compared to people with low sensitivity in the UK (RR = 1.29, 95%CI 1.05-1.59) and in France (RR = 1.11, 95%CI 0.68-1.82), but not in the other countries. The association between aircraft noise levels and the risk of hypertension was higher among highly sensitive participants (RR = 1.00, 95%CI 0.96-1.04; RR = 1.03, 95%CI 0.90-1.11; RR = 1.12, 95%CI 1.01-1.24, with a 10-dB(A) increase in Lnight for low, medium, and high sensitive people respectively) or, to a lesser extent, among highly annoyed participants (RR = 1.06, 95%CI 0.95-1.18 for a 10-dB(A) increase in Lnight among highly annoyed participants, and RR = 1.02, 95%CI 0.99-1.06 among those not highly annoyed). CONCLUSIONS: The present study confirms findings in the small number of available studies to date suggesting adverse health effects associated with aircraft noise annoyance and noise sensitivity. The findings also indicate possible modifier effects of aircraft noise annoyance and noise sensitivity in the relationship between aircraft noise levels and the risk of hypertension. However, further investigations are needed to better understand this role using specific methodology and tools related to mediation analysis and causal inference.
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Hipertensión , Ruido del Transporte , Aeronaves , Exposición a Riesgos Ambientales/efectos adversos , Europa (Continente)/epidemiología , Francia , Humanos , Hipertensión/epidemiología , Hipertensión/etiología , Ruido del Transporte/efectos adversosRESUMEN
BACKGROUND: Many studies have demonstrated adverse effects of exposure to aircraft noise on health. Possible biological pathways for these effects include hormonal disturbances. Few studies deal with aircraft noise effects on saliva cortisol in adults, and results are inconsistent. OBJECTIVE: We aimed to assess the effects of aircraft noise exposure on saliva cortisol levels and its variation in people living near airports. METHODS: This study focused on the 1300 residents included in the HYENA and DEBATS cross-sectional studies, with complete information on cortisol sampling. All the participants followed a similar procedure aiming to collect both a morning and an evening saliva cortisol samples. Socioeconomic and lifestyle information were obtained during a face-to-face interview. Outdoor aircraft noise exposure was estimated for each participant's home address. Associations between aircraft noise exposure and cortisol outcomes were investigated a priori for male and female separately, using linear regression models adjusted for relevant confounders. Different approaches were used to characterize cortisol levels, such as morning and evening cortisol concentrations and the absolute and relative variations between morning and evening levels. RESULTS: Statistically significant increases of evening cortisol levels were shown in women with a 10-dB(A) increase in aircraft noise exposure in terms of LAeq, 16h (exp(ß) = 1.08; CI95% = 1.00-1.16), Lden (exp(ß) = 1.09; CI95% = 1.01-1.18), Lnight (exp(ß) = 1.11; CI95% = 1.02-1.20). A statistically significant association was also found in women between a 10-dB(A) increase in terms of Lnight and the absolute variation per hour (exp(ß) = 0.90; CI95% = 0.80-1.00). Statistically significant decreases in relative variation per hour were also evidenced in women, with stronger effects with the Lnight (exp(ß) = 0.89; CI95% = 0.83-0.96) than with other noise indicators. The morning cortisol levels were unchanged whatever noise exposure indicator considered. There was no statistically significant association between aircraft noise exposure and cortisol outcomes in men. CONCLUSIONS: The results of the present study show statistically significant associations between aircraft noise exposure and evening cortisol levels and related flattening in the (absolute and relative) variations per hour in women. Further biological research is needed to deepen knowledge of the pathway between noise exposure and disturbed hormonal regulation, and specially the difference in effects between genders.
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Aeronaves , Exposición a Riesgos Ambientales/efectos adversos , Hidrocortisona/metabolismo , Ruido del Transporte/efectos adversos , Anciano , Aeropuertos , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Saliva/químicaRESUMEN
Background: Exposure to aircraft noise has been shown to have adverse effects on health, particularly on sleep. Exposure to nighttime aircraft noise clearly affects sleep architecture, as well as subjective sleep quality. Objectives: This study aimed to investigate the relationship between aircraft noise exposure and subjective sleep quality in the population living near airports in France. Methods: A total of 1,244 individuals older than 18 and living near three French airports (Paris-Charles de Gaulle, Lyon-Saint-Exupéry, and Toulouse-Blagnac) were randomly selected to participate in the study. Information on sleep as well as health, socioeconomic, and lifestyle factors was collected by means of a face-to-face questionnaire performed at their place of residence by an interviewer. For each participant, aircraft noise exposure was estimated at home using noise maps. Logistic regression models were used with adjustment for potential confounders. Results: Aircraft noise exposure was significantly associated with a short total sleep time (TST; ≤ 6 h) and with the feeling of tiredness while awakening in the morning. An increase of 10 dB(A) in aircraft noise level at night was associated with an OR of 1.63 (95% CI: 1.15-2.32) for a short TST and an OR of 1.23 (95% CI: 1.00-1.54) for the feeling of tiredness while awakening in the morning. Conclusions: These findings contribute to the overall evidence suggesting that aircraft noise exposure at nighttime may decrease the subjective amount and quality of sleep.
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Aeronaves , Aeropuertos/estadística & datos numéricos , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Ruido del Transporte/efectos adversos , Ruido del Transporte/estadística & datos numéricos , Sueño/fisiología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Francia/epidemiología , Humanos , Estilo de Vida , Modelos Logísticos , Masculino , Persona de Mediana Edad , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVES: The largest study until now around 6 major European airports, the HYENA (HYpertension and Exposure to Noise near Airports) study, reported an excess risk of hypertension related to long-term aircraft noise exposure. The DEBATS (Discussion on the health effects of aircraft noise) study investigated the relationship between this exposure and the risk of hypertension in men and in women near French airports. METHODS: Blood pressure of 1244 participants older than 18â years of age was measured. Information about health, socioeconomic and lifestyle factors was collected by means of a face-to-face questionnaire performed at home by an interviewer. Aircraft noise exposure was assessed for each participant's home address using noise maps. They were calculated with the Integrated Noise Model with a 1â dB(A)-resolution. The major potential confounders being risk factors for hypertension were included in the logistic regression models: age, occupational activity, body mass index, physical activity and alcohol consumption. RESULTS: After adjustment for the main potential confounders, an exposure-response relationship was evidenced between the risk of hypertension and aircraft noise exposure at night for men only. A 10-dB(A) increase in Lnight was associated with an OR of 1.34 (95% CI 1.00 to 1.97). CONCLUSIONS: These findings contribute to the overall evidence suggesting that aircraft noise exposure at night-time may increase the risk of hypertension in men. Hypertension is a well-known and established risk factor for cardiovascular disease. The association reported in the present study between aircraft noise and hypertension implies that aircraft noise might be a risk factor also for cardiovascular disease.
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Aeronaves , Exposición a Riesgos Ambientales/efectos adversos , Hipertensión/epidemiología , Hipertensión/etiología , Ruido del Transporte/efectos adversos , Adolescente , Adulto , Anciano , Aeropuertos , Presión Sanguínea , Femenino , Francia/epidemiología , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Factores de Riesgo , Distribución por Sexo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
BACKGROUND: Saliva cortisol is a possible marker of noise-induced stress and could then mediate the relation observed between exposure to aircraft or road traffic noise and cardiovascular diseases. However, the association between transportation noise and cortisol levels is still unclear. The objective of the study was to investigate the variability of saliva cortisol concentration as an indicator of disturbed hypothalamus-pituitary-adrenal (HPA) axis regulation in relation to long-term aircraft noise exposure. METHODS: Saliva samples were taken when awakening and before going to bed for 1244 participants older than 18 years of age. Information about health, socioeconomic and lifestyle factors was also collected by means of a face-to-face questionnaire performed at home by an interviewer. Aircraft noise exposure was assessed for each participant's home address using noise maps. Linear regression models were used to evaluate the effects of aircraft noise exposure on the morning and evening cortisol levels and on the daily variation of cortisol per hour. RESULTS: This study suggests a modification of the cortisol circadian rhythm in relation to aircraft noise exposure. This exposure was associated with a smaller variation of cortisol levels over the day, with unchanged morning cortisol levels, but higher cortisol levels in the evening. CONCLUSIONS: These findings provide some support for a psychological stress induced by aircraft noise exposure, resulting in HPA dysregulation and a flattened cortisol rhythm, thus contributing to cardiovascular diseases.
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Exposición a Riesgos Ambientales/efectos adversos , Hidrocortisona/metabolismo , Ruido del Transporte/efectos adversos , Estrés Psicológico/etiología , Adulto , Aeronaves , Aeropuertos , Monitoreo del Ambiente , Femenino , Francia , Humanos , Sistema Hipotálamo-Hipofisario/metabolismo , Entrevistas como Asunto , Modelos Lineales , Masculino , Persona de Mediana Edad , Sistema Hipófiso-Suprarrenal/metabolismo , Saliva/química , Adulto JovenRESUMEN
The impact of aircraft noise on health is of growing concern. We investigated the relationship between this exposure and mortality from cardiovascular disease, coronary heart disease, myocardial infarction, and stroke. We performed an ecological study on 161 communes (commune being the smallest administrative unit in France) close to the following three major French airports: Paris-Charles de Gaulle, Lyon Saint-Exupéry, and Toulouse-Blagnac. The mortality data were provided by the French Center on Medical Causes of Death for the period 2007-2010. Based on the data provided by the French Civil Aviation Authority, a weighted average exposure to aircraft noise (L den AEI) was computed at the commune level. A Poisson regression model with commune-specific random intercepts, adjusted for potential confounding factors including air pollution, was used to investigate the association between mortality rates and L den AEI. Positive associations were observed between L den AEI and mortality from cardiovascular disease [adjusted mortality rate ratio (MRR) per 10 dB(A) increase in L den AEI = 1.18; 95% confidence interval (CI): 1.11-1.25], coronary heart disease [MRR = 1.24 (1.12-1.36)], and myocardial infarction [MRR = 1.28 (1.11-1.46]. Stroke mortality was more weakly associated with L den AEI [MRR = 1.08 (0.97-1.21]. These significant associations were not attenuated after the adjustment for air pollution. The present ecological study supports the hypothesis of an association between aircraft noise exposure and mortality from cardiovascular disease, coronary heart disease, and myocardial infarction. However, the potential for ecological bias and the possibility that this association could be due to residual confounding cannot be excluded.
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Aeronaves , Enfermedades Cardiovasculares/mortalidad , Causas de Muerte , Exposición a Riesgos Ambientales , Ruido del Transporte , Características de la Residencia , Anciano , Aeropuertos , Fenómenos Ecológicos y Ambientales , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Francia/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Ruido del Transporte/efectos adversos , Ruido del Transporte/estadística & datos numéricos , Medición de Riesgo , Factores de Riesgo , Análisis Espacio-TemporalRESUMEN
Background: Transportation noise seems to impair self-reported health status (SRHS). However, only a few studies have considered the role of noise annoyance and noise sensitivity in this deleterious effect. This study aims investigating mediator and moderator roles of noise annoyance and noise sensitivity. Methods: In 2013, the DEBATS longitudinal study included 1244 participants aged over 18 years and living around three French airports. These participants were followed up in 2015 and 2017. They self-reported their perceived health status, aircraft noise annoyance, and their noise sensitivity via a questionnaire during the three visits. Noise maps were used to estimate aircraft noise levels at the facade of participants' residence. Generalized linear mixed models with a random intercept at the participant level were used. Results: Aircraft noise levels were associated with severe annoyance. Severe annoyance tent to be associated with impaired SRHS. Aircraft noise levels were associated with impaired SRHS only in men (odds ratio [OR] = 1.47, 95% confidence interval [CI] = [1.02, 2.11], for a 10-dBA Lden increase in aircraft noise levels) with a weaker association adjusted for annoyance (OR = 1.36, 95% CI = [0.94, 1.98]). The association was stronger in men who reported high noise sensitivity (OR = 1.84, 95% CI = [0.92, 3.70], versus OR = 1.39, 95% CI = [0.90, 2.14], for men who were not highly sensitive to noise). Conclusion: From our results, the deleterious effect of aircraft noise on SRHS could be mediated by noise annoyance and moderated by noise sensitivity. Further studies using causal inference methods are needed for identifying causal effect of exposure, mediator, and moderator.
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Exposición a Riesgos Ambientales , Ruido del Transporte , Masculino , Humanos , Adulto , Persona de Mediana Edad , Estudios Longitudinales , Autoinforme , Exposición a Riesgos Ambientales/efectos adversos , Ruido del Transporte/efectos adversos , Francia , Encuestas y Cuestionarios , AeronavesRESUMEN
The use of different noise annoyance scales across studies and socio-acoustic surveys, in particular the popular 5-point verbal and 11-point numerical scales, has made the evaluation, comparison, and pooling of noise annoyance responses among studies a taxing issue. This is particularly the case when "high annoyance" (HA) responses need to be compared and when the original studies used different scales; thus, there are different so-called cutoff points that define the part of the scale that indicates the HA status. This paper provides practical guidance on pooling and comparing the respective annoyance data in both the linear and logistic regression context in a statistically adequate manner. It caters to researchers who want to carry out pooled analyses on annoyance data that have been collected on different scales or need to compare exposure-HA relationships between the 5-point and 11-point scales. The necessary simulation of a cutoff point non-native to an original scale can be achieved with a random assignment approach, which is exemplified in the paper using original response data from a range of recent noise annoyance surveys. A code example in the R language is provided for easy implementation of the pertinent procedures with one's own survey data. Lastly, the not insignificant limitations of combining and/or comparing responses from different noise annoyance scales are discussed.
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Ruido del Transporte , Acústica , Exposición a Riesgos Ambientales , Humanos , Modelos Logísticos , Encuestas y CuestionariosRESUMEN
The WHO guidelines on environmental noise highlight that evidence on the health effects of wind turbine sound levels is either non-existent or of poor quality. In this context, a feasibility study was conducted in France in 2017. The objective was to suggest a methodology for calculating wind turbine sound levels in order to quantify the number of windfarms' residents exposed to this sound. Based on a literature review, the Harmonoise model was selected for sound exposure calculation. It was validated by quantifying its uncertainties, and finally used to estimate the population exposed to wind turbine sound in metropolitan France. Compared to other environmental noise sources (e.g., transportation), sound exposure is very moderate, with more than 80% of the exposed people exposed to sound levels below 40 dBA. The total number of people exposed to more than 30 dBA is about 686,000 and 722,000 people for typical daytime and night-time meteorological conditions respectively, i.e., about 1% of the French population in 2017. These results represent the first ever assessment of sound exposure from wind turbines at the scale of the entire metropolitan France.
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Centrales Eléctricas , Sonido , Francia , Humanos , Ruido/efectos adversosRESUMEN
Since the 2000s, increased aircraft noise annoyance has been observed in the populations living near airports. The DEBATS-study compared the exposure-response relationship estimated among airports' residents in France with old and new EU standard curves. It also examines whether non-acoustical factors may explain this annoyance. For 1244 adults living near three French airports, information about demographic and socio-economic factors as well as aircraft noise annoyance, situational, personal and attitudinal factors was collected with a face-to-face questionnaire. Outdoor aircraft noise exposure was estimated by linking home address to noise exposure maps. Logistic regression models were used to investigate the association between annoyance and a broad range of other variables in addition to the Lden. Severe noise annoyance was associated not only with increased aircraft noise levels, but also with non-acoustical factors. Annoyance was higher than predicted by the old EU standard curve when estimated with the model including non-acoustical factors in addition to the Lden. It was even higher when only noise exposure was considered. However, annoyance was lower in DEBATS than predicted by the new EU standard curve provided by WHO. The increase of noise annoyance does not seem to be explained by the factors already mentioned in the literature as possible explanations. However, it cannot be ruled out that methodological differences in the HA assessment may be the reason for changes in annoyance over the years. For this reason, we argue for a definition of HA derived substantially as recommended by ICBEN. The findings of the DEBATS study also confirm that taking into account non-acoustical factors such as situational, personal and attitudinal factors would improve annoyance predictions.
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Aeropuertos , Ruido del Transporte , Aeronaves , Exposición a Riesgos Ambientales , Francia , Ruido del Transporte/efectos adversosRESUMEN
In July 1999, the European Laryngological Society (ELS) has accepted a proposal for the classification of different laryngeal endoscopic cordectomies. This is actually a common classification system used as a tool for surgical training, documentation and comparison of results. The same harmonization work is deemed necessary for the treatment of supraglottic lesions. The ELS is proposing a classification of the different laryngeal endoscopic supraglottic partial laryngectomies. This classification comprises four types of supraglottic laryngectomies: Type I, limited excision of small size superficial lesions of the free edge of the epiglottis, the ary-epiglottic fold, the arytenoid, or the ventricular fold or any other part of the supraglottis; Type II, medial supraglottic laryngectomy without resection of the pre-epiglottic space, suitable for T1 lesions of either the suprahyoid or the infrahyoid laryngeal surface of the epiglottis (Type IIa, superior hemi-epiglottectomy or Type IIb, total epiglottectomy, respectively); Type III, medial supraglottic laryngectomy with resection of the pre-epiglottic space, suitable for T1-T2 tumors of the infrahyoid endolaryngeal epiglottis without (Type IIIa) or with (Type IIIb) extension to the ventricular fold, necessitating its excision; finally, Type IV, lateral supraglottic laryngectomy, suitable for tumors of the threefolds' region, which may include the ventricular fold (Type IVa) or the arytenoid (Type IVb), when involved. As in the cases of endoscopic cordectomies, these operations are similarly classified according to the surgical approach used and the degree of resection completed in order to facilitate their use in daily clinical practice.
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Neoplasias Laríngeas/cirugía , Laringectomía/clasificación , Endoscopía , Humanos , Laringectomía/métodosRESUMEN
Background Noise in the vicinity of airports is a public health problem. Many laboratory studies have shown that heart rate is altered during sleep after exposure to road or railway noise. Fewer studies have looked at the effects of exposure to aircraft noise on heart rate during sleep in populations living near airports. Objective The aim of this study was to investigate the relationship between the sound pressure level (SPL) of aircraft noise and heart rate during sleep in populations living near airports in France. Methods In total, 92 people living near the Paris-Charles de Gaulle and Toulouse-Blagnac airports participated in this study. Heart rate was recorded every 15 s during one night, using an Actiheart monitor, with simultaneous measurements of SPL of aircraft noise inside the participants' bedrooms. Energy and event-related indicators were then estimated. Mixed linear regression models were applied, taking into account potential confounding factors, to investigate the relationship between energy indicators and heart rate during sleep measured every 15 s. Event-related analyses were also carried out in order to study the effects of an acoustic event associated with aircraft noise on heart rate during sleep. Results The more the SPL from all sources (LAeq,15s) and the SPL exceeded for 90% of the measurement period (LA90,15s) increased, the more heart rate also increased. No significant associations were observed between the maximum 1-s equivalent SPL associated with aircraft overflight (LAmax,1s) and differences between the heart rate recorded during or 15 or 30 s after an aircraft noise event and that recorded before the event. On the other hand, a positive and significant association was found between LAmax,1s and the heart rate amplitude calculated during an aircraft noise event. Results were unchanged when analyses were limited to participants who had lived more than five years in their present dwelling. Conclusion Our study shows that exposure to the maximum SPL linked to aircraft overflight affect the heart rate during sleep of residents near airports. However, further studies on a larger number of participants over several nights are needed to confirm these results.
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Aeronaves , Exposición a Riesgos Ambientales/análisis , Frecuencia Cardíaca/fisiología , Ruido del Transporte/estadística & datos numéricos , Higiene del Sueño , Adolescente , Adulto , Anciano , Aeropuertos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Paris , Salud Urbana , Adulto JovenRESUMEN
BACKGROUND: Noise in the vicinity of airports is a public health issue. Exposure to aircraft noise has been shown to have adverse effects on health and particularly on sleep. Many studies support the hypothesis that noise at night can affect subjective sleep quality. Fewer studies, however, have performed objective measurements of sleep. OBJECTIVES: This study aimed to investigate by actigraphy the relationship between aircraft noise exposure and objective parameters of sleep quality in the population living near two French airports. METHODS: This study includes 112 participants living in the vicinity of Paris-Charles de Gaulle and Toulouse-Blagnac airports. Wrist actigraphy measurements were performed during eight nights to evaluate objective parameters of sleep quality such as sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TB) and sleep efficiency (SE). Acoustic measurements were made simultaneously both inside the participants' bedrooms and outside (at the exterior frontage) to estimate aircraft noise levels. Energy indicators related to the sound energetic average for a given period of time, as well as indicators related to noise events (eg, the number of events that exceed a given threshold), were estimated. Logistic and linear regression models were used, taking into account potential confounders: age; gender; marital status; education; and body mass index (BMI). RESULTS: Energy indicators, in particular, indicators related to noise events were significantly associated with objective parameters of sleep quality. Increased levels of aircraft noise and increased numbers of aircraft noise events increased the time required for sleep onset (SOL) and the total wake time after sleep onset (WASO) and decreased sleep efficiency (SE). An association was also observed between aircraft noise exposure and an increase in total sleep time (TST) and time in bed (TB). CONCLUSION: The findings of the present study contribute to the overall evidence suggesting that nocturnal aircraft noise exposure may decrease the objective quality of sleep. Aircraft noise exposure affects objective parameters of sleep quality, not only regarding noise levels but also regarding the number of events. Mechanisms for adapting to sleep deprivation could be observed.
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Aeronaves , Aeropuertos/estadística & datos numéricos , Exposición a Riesgos Ambientales , Ruido del Transporte/efectos adversos , Sueño/fisiología , Actigrafía/estadística & datos numéricos , Adulto , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Femenino , Francia , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A case-control study of hematological malignancies was conducted among Chernobyl liquidators (accident recovery workers) from Belarus, Russia and Baltic countries to assess the effect of low- to medium-dose protracted radiation exposures on the relative risk of these diseases. The study was nested within cohorts of liquidators who had worked around the Chernobyl plant in 1986-1987. A total of 117 cases [69 leukemia, 34 non-Hodgkin lymphoma (NHL) and 14 other malignancies of lymphoid and hematopoietic tissue] and 481 matched controls were included in the study. Individual dose to the bone marrow and uncertainties were estimated for each subject. The main analyses were restricted to 70 cases (40 leukemia, 20 NHL and 10 other) and their 287 matched controls with reliable information on work in the Chernobyl area. Most subjects received very low doses (median 13 mGy). For all diagnoses combined, a significantly elevated OR was seen at doses of 200 mGy and above. The excess relative risk (ERR) per 100 mGy was 0.60 [90% confidence interval (CI) -0.02, 2.35]. The corresponding estimate for leukemia excluding chronic lymphoid leukemia (CLL) was 0.50 (90% CI -0.38, 5.7). It is slightly higher than but statistically compatible with those estimated from A-bomb survivors and recent low-dose-rate studies. Although sensitivity analyses showed generally similar results, we cannot rule out the possibility that biases and uncertainties could have led to over- or underestimation of the risk in this study.