The association between traffic noise and self-rated health within the German National Cohort (NAKO)

Abstract Objectives Traffic noise can cause stress and disturb sleep, impacting health in many ways. However, few large studies on this topic exist. We investigated the association between traffic noise and self-rated health (SRH) within the German National Cohort (NAKO). Methods NAKO enrolled >200,000 adults ages 20-74 at 18 sites in Germany. We used logistic regression to test whether 1) annual mean 24-hour ambient traffic noise levels at or above 55 dB(A) within a 10-meter residential buffer and 2) subjectively reported nighttime traffic noise annoyance were associated with higher odds of reporting fair/poor SRH. We calculated these associations within the full sample, stratified by sex, and stratified by age group (≤39 years, 40-59 years, ≥60 years). We adjusted for study site, age, sex, marital status, education level, and migration background. Results Among participants without missing data (n = 121,232), moderate annoyance was associated with 1.27 higher odds (95% CI 1.21-1.32) and strong annoyance with 1.75 higher odds (95% CI 1.65-1.84) of fair/poor SRH, while annual mean noise ≥55 dB(A) was associated with 1.07 higher odds (95% CI 1.03-1.12). Females who reported strong annoyance had especially high odds of fair/poor SRH (OR 1.81, 95% CI 1.69-1.95), as did those aged 40-59 years who reported high annoyance (OR 1.78, 95% CI 1.66-1.92). Those 39 and under had no significant increase in odds of fair/poor SRH if they reported moderate annoyance or if they were exposed to ≥ 55 dB(A) annual mean noise. In single exposure models, noise annoyance and objectively measured noise were both significantly associated with higher odds of reporting fair/poor SRH, but in combined models, the effect of objectively measured noise became insignificant while the effect of annoyance remained strongly significant. Conclusions These findings confirm that traffic noise is an important public health issue. Further analyses on most affected populations should inform noise protection policies. Key messages • Higher levels of traffic noise are associated with worse self-rated health. • Ambient noise is an important public health issue for which more research is needed.