Noise inequalities and cardiovascular diseases in Bulgaria

Abstract Background Social determinants of health in the physical environment are among the social determinants that greatly impact population health. At very high levels, noise can cause permanent changes in a person’s psyche but, even at lower levels, it can cause stress and disorders. Global burden of diseases studies arrange noise on the second position among the environmental risk factors, related to sleep disturbance, cardiovascular effects etc. The study aims to analyse noise pollution in Bulgaria and measure its association with cardiovascular diseases. Methods National Statistical Institute and Eurostat data were used to analyse the noise pollution in Bulgaria. The 28 regions were compared according to the proportion of surveyed points above permissible limits and the death rates due to CVD, /2022/. Data were statistically processed with SPSS v.26. To establish the correlation, the Pearson coefficient was used. Results Data provided by Eurostat reveal that 9% of the total population suffers from noise but there is a very positive trend - from 17.7% /in 2005/ to 8.7% /in 2023/. The share of surveyed points above permissible limits shows a continuing trend of maintaining a high percentage - 71.80% /2011/ and 68.62%/2022/. The district comparison shows significant variations - Blagoevgrad -17.65% and Silistra, Kyustendil and Razgrad with shares above 80%. The study found that almost all districts with the highest share of surveyed points above permissible limits have higher levels of death rate due to CVD. The results of statistical data analysis show that there is a positive moderate linear correlation between the share of surveyed points above permissible limits and the death rate due to CVD - Pearson coefficient 0.423 (p = 0.025). Conclusions The study found a moderate correlation between noise pollution and the death rate due to cardiovascular disease. CVD have a multifactorial genesis, but reducing noise in urban areas would help prevent these diseases. Key messages • As a result of the performed analysis, it can be concluded that the investigated indicators determining the degree of discomfort during the daily period remained high in Bulgaria. • The established health inequalities between regions and the increasing mortality from CVD are one of the factors for the deteriorating level of public health in Bulgaria.