Aircraft noise and cardiovascular morbidity and mortality near Heathrow Airport: A case-crossover study.

Aircraft noise causes annoyance and sleep disturbance and there is some evidence of associations between long-term exposures and cardiovascular disease (CVD). We investigated short-term associations between previous day aircraft noise and cardiovascular events in a population of 6.3 million residing near Heathrow Airport using a case-crossover design and exposure data for different times of day and night. We included all recorded hospitalisations (n = 442,442) and deaths (n = 49,443) in 2014-2018 due to CVD. Conditional logistic regression was used to estimate the ORs and adjusted for NO2 concentration, temperature, and holidays. We estimated an increase in risk for 10 dB increment in noise during the previous evening (Leve OR = 1.007, 95% CI 0.999-1.015), particularly from 22:00-23:00 h (OR = 1.007, 95% CI 1.000-1.013), and the early morning hours 04:30-06:00 h (OR = 1.012, 95% CI 1.002-1.021) for all CVD admissions, but no significant associations with day-time noise. There was effect modification by age-sex, ethnicity, deprivation, and season, and some suggestion that high noise variability at night was associated with higher risks. Our findings are consistent with proposed mechanisms for short-term impacts of aircraft noise at night on CVD from experimental studies, including sleep disturbance, increases in blood pressure and stress hormone levels and impaired endothelial function.

Spatial assessment of the attributable burden of disease due to transportation noise in England.

BACKGROUND: Noise pollution from transportation is one of the leading contributors to the environmental disease burden in Europe. We provide a novel assessment of spatial variations of these health impacts within a country, using England as an example. METHODS: We estimated the burden of annoyance (highly annoyed), sleep disturbance (highly sleep disturbed), ischemic heart disease (IHD), stroke, and diabetes attributable to long-term transportation noise exposures in England for the adult population in 2018 down to local authority level (average adult population: 136,000). To derive estimates, we combined literature-informed exposure-response relationships, with population data on noise exposures, disease, and mortalities. Long-term average noise exposures from road, rail and aircraft were sourced from strategic noise mapping, with a lower exposure threshold of 50 dB (decibels) Lden and Lnight. RESULTS: 40 %, 4.5 % and 4.8 % of adults in England were exposed to road, rail, and aircraft noise exceeding 50 dB Lden. We estimated close to a hundred thousand (∼97,000) disability adjusted life years (DALY) lost due to road-traffic, ∼13,000 from railway, and âˆ¼ 17,000 from aircraft noise. This excludes some noise-outcome pairs as there were too few studies available to provide robust exposure-response estimates. Annoyance and sleep disturbance accounted for the majority of the DALYs, followed by strokes, IHD, and diabetes. London, the South East, and North West regions had the greatest number of road-traffic DALYs lost, while 63 % of all aircraft noise DALYs were found in London. The strategic noise mapping did not include all roads, which may still have significant traffic flows. In sensitivity analyses using modelled noise from all roads in London, the DALYs were 1.1x to 2.2x higher. CONCLUSION: Transportation noise exposures contribute to a significant and unequal environmental disease burden in England. Omitting minor roads from the noise exposure modelling leads to underestimation of the disease burden.

Association between Noise Annoyance and Mental Health Outcomes: A Systematic Review and Meta-Analysis.

To date, most studies of noise and mental health have focused on noise exposure rather than noise annoyance. The purpose of this systematic review and meta-analysis was to evaluate whether the available evidence supports an adverse association between noise annoyance and mental health problems in people. We carried out a literature search of Web of Science, PubMed, Scopus, PsycINFO, and conference proceedings published between 2000 and 2022. Thirteen papers met the inclusion criteria. We conducted meta-analyses of noise annoyance in relation to depression, anxiety, and general mental health. In the meta-analyses, we found that depression was approximately 1.23 times greater in those who were highly noise-annoyed (N = 8 studies). We found an approximately 55% higher risk of anxiety (N = 6) in highly noise-annoyed people. For general mental health (N = 5), highly annoyed participants had an almost 119% increased risk of mental health problems as assessed by Short Form (SF) or General Household Questionnaires (GHQ), but with high heterogeneity and risk of publication bias. In conclusion, findings are suggestive of a potential link between noise annoyance and poorer mental health based on a small number of studies. More evidence is needed to confirm these findings.

The link between unemployment and opioid prescribing. An instrumental variable approach using evidence from England.

BACKGROUND: Unemployment has been associated with chronic pain, which is often treated with prescription opioids. Opioid mortality has been included in the so-called category of 'deaths of despair' due to the role of lack of opportunity. While previous studies have found an association between unemployment and opioids, the relationship is endogenous and examining any effect is challenging. OBJECTIVE: The objective of this paper is to study the association between unemployment and opioid prescribing in England. DATA AND METHODS: We used data from the GP prescribing database in England for the period 2011-2017 and followed ordinary least squares (OLS) and Instrumental Variable econometric approaches, controlling for other confounders. We used the number of foreign direct investment projects and the number of registered companies as instruments for unemployment, taking population size into account. RESULTS: The OLS model suggests that an increase in the unemployment rate by 1 percentage point is associated with 0.017 additional opioid defined daily doses per capita-a 0.9% increase compared with the mean of 1.745. According to the instrumental variable model, an increase in unemployment by 1 percentage point leads to an increase in the number of opioid doses prescribed per capita by between 0.315 and 0.437, which constitutes a 18-25% increase compared with the mean of 1.745. CONCLUSIONS: Unemployment appears to have an impact on opioid prescribing volume in England. This reveals yet another negative effect of unemployment on health. Relevant labour market policies may play a protective role with regards to opioid use.

Traffic violations in Guangdong Province of China: speeding and drunk driving.

The number of speeding- and drunk driving-related injuries in China surged in the years immediately preceding 2004 and then began to decline. However, the percent decrease in the number of speeding and drunk driving incidents (decrease by 22%) is not proportional to the corresponding percent decrease in number of automobile accident-related injuries (decrease by 47%) from the year 2004 to 2010 (Traffic Management Bureau, Ministry of Public Security, Annual Statistical Reports on Road Traffic Accidents). Earlier studies have established traffic violations as one of the major risks threatening road safety. In this study, we examine in greater detail two important types of traffic violation events, speeding and drunk driving, and attempt to identify significant risk factors associated with these types of traffic violations. Risk factors in several different dimensions, including driver, vehicle, road and environmental factors, are considered. We analyze the speeding (N=11,055) and drunk driving (N=10,035) data for the period 2006-2010 in Guangdong Province, China. These data, obtained from the Guangdong Provincial Security Department, are extracted from the Traffic Management Sector-Specific Incident Case Data Report and are the only comprehensive and official source of traffic accident data in China. Significant risk factors associating with speeding and drunk driving are identified. We find that several factors are associated with a significantly higher probability of both speeding and drunk driving, particularly male drivers, private vehicles, the lack of street lighting at night and poor visibility. The impact of other specific and unique risk factors for either speeding or drunk driving, such as hukou, road type/grades, commercial vehicles, compulsory third party insurance and vehicle safety status, also require particular attention. Legislative or regulatory measures targeting different vehicle types and/or driver groups with respect to the various driver, vehicle, road and environmental risk factors can subsequently be devised to reduce the speeding and drunk driving rates. As the country with the highest number of traffic accident fatalities in the world, applying these findings in workable legislation and enforcement to reduce speeding and drunk driving rates will save tens of thousands of lives.