Noise sensitivity and future risk of illness and mortality

Highlights

• Research is scarce on whether noise sensitivity is a risk factor for illness

• Noise sensitivity did not show main effects on CVD morbidity or mortality

• Noise sensitivity did predict angina pectoris in low employment grades

• Noise sensitivity did predict the risk of future psychological distress

Abstract

Aircraft and road traffic noise exposure increase the risk of cardiovascular disease (CVD). Noise annoyance is the most frequent response to environmental noise. Noise annoyance has been shown to modify the association of transport noise exposure on CVD and noise sensitivity moderates the annoyance response to noise. This study uses prospective data from phases 1, 3, 5, 7 and 9 in 3630 male and female civil servants from the UK Whitehall II Study to examine whether a single question on noise sensitivity measured by annoyance responses to noise in general predicts physical and mental ill-health and mortality. Non-fatal myocardial infarction and stroke morbidity over the follow-up were defined by MONICA criteria based on study ECGs, hospital records, hospital admission statistics or General Practitioner confirmation. Depressive symptoms were measured by the Center for Epidemiologic Studies Depression Scale (CES-D) and psychological distress by the General Health questionnaire (GHQ). There was no association between noise sensitivity and CVD morbidity or mortality except in people from lower employment grades where there was an association with angina. Noise sensitivity was a consistent predictor of depressive symptoms and psychological distress at phases 3, 5 and 7. High noise sensitivity scores at baseline predicted GHQ caseness at phase 3 adjusting for age, sex, employment grade, self-rated health and GHQ caseness at baseline (OR = 1.56 95% CI 1.29–1.88). Noise sensitivity has been identified as a predictor of mental ill-health. More longitudinal research is needed including measures of noise exposure.

Introduction

Recently there have been several studies linking prolonged aircraft noise exposure to increased risk of cardiovascular and stroke mortality (Huss et al., 2010, Hansell et al., 2013). These studies are part of accumulating evidence that both aircraft noise exposure and road traffic noise exposure are related to an increased risk of cardiovascular disease and mortality (Sorensen et al., 2011, Sorensen et al., 2012, Floud et al., 2013). The putative mechanism behind these associations is thought to relate to the stress hypothesis where prolonged noise exposure leads to increased stress responses, hypertension and increased risk of cardiovascular disease (Babisch, 2008, Jarup et al., 2008, Munzel et al., 2014).

The most frequent response to environmental noise is annoyance, which is a mixture of reported discomfort, anger and feelings of intrusion. Exposure response relationships have been found for road, rail and aircraft noise in which the degree of annoyance rises with increasing noise levels (Miedema and Vos, 1998). Annoyance has also been suggested as a possible moderating factor of the effects of noise on cardiovascular disease — as a subjective indicator of the degree of disturbance from noise that amplifies the stress response to sound (Babisch et al., 2013). However, noise annoyance levels are probably inadequate as a proxy for noise levels in associations with health outcomes. This is because there are non-acoustic factors, that may account for at least 35% of the variance in annoyance such as personality factors, attitudes to the noise source and perceptions of malfeasance related to the source of the noise (Job, 1988). Despite this, noise annoyance is associated with health outcomes, especially psychiatric disorder. In cross sectional studies it has been suggested that prior ill-health may lead to increased levels of annoyance and not the other way round (Tarnopolsky et al., 1980, Stansfeld et al., 1993). This has been explained as people who feel unwell being likely to be less tolerant of environmental discomfort.

Noise sensitivity, as a stable response to noise in general, is an independent predictor of the annoyance response to environmental noise (Job, 1999, Paunović et al., 2009, van Kamp et al., 2004). It has been postulated that noise sensitivity might be an indicator of vulnerability to environmental stressors, so that highly sensitive people might be more prone to develop illness when exposed to environmental noise (Stansfeld, 1992).

It is of interest to understand whether noise sensitivity does indicate vulnerability to ill-health, especially that attributable to noise, as this has implications for public health policy on reducing noise and advising noise sensitive individuals of the potential consequences of noise exposure. This is best attempted in longitudinal analyses. A single question on annoyance to noise in general was included in the first phase of the Whitehall II Study of British civil servants. We examined whether this question, which is an indicator of noise sensitivity (Job, 1999), is a predictor of future cardiovascular morbidity and mortality and psychiatric disorder. We hypothesised that with increased levels of noise sensitivity there would be a greater risk of both cardiovascular disease and psychiatric morbidity adjusting for ill-health at baseline.