西班牙巴塞罗那学童道路交通噪声暴露与认知发展:一项基于人群的队列研究

IF 10.5 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL PLoS Medicine Pub Date : 2022-06-01 DOI:10.1371/journal.pmed.1004001
M. Foraster, M. Esnaola, Mónica López-Vicente, I. Rivas, M. Álvarez-Pedrerol, C. Persavento, N. Sebastián-Gallés, Jesús Pujol, P. Dadvand, J. Sunyer
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Children underwent computerised cognitive tests 4 times (n = 10,112), for working memory (2-back task, detectability), complex working memory (3-back task, detectability), and inattentiveness (Attention Network Task, hit reaction time standard error, in milliseconds). Road traffic noise was measured indoors and outdoors at schools, at the start of the school year, using standard protocols to obtain A-weighted equivalent sound pressure levels, i.e., annual average levels scaled to human hearing, for the daytime (daytime LAeq, in dB). We also derived fluctuation indicators out of the measurements (noise intermittency ratio, %; and number of noise events) and obtained individual estimated indoor noise levels (LAeq) correcting for classroom orientation and classroom change between years. Home-outdoor noise exposure at home (Lden, i.e., EU indicator for the 24-hour annual average levels) was estimated using Barcelona’s noise map for year 2012, according to the European Noise Directive (2002). We used linear mixed models to evaluate the association between exposure to noise and cognitive development adjusting for age, sex, maternal education, socioeconomical vulnerability index at home, indoor or outdoor traffic-related air pollution (TRAP) for corresponding school models or outdoor nitrogen dioxide (NO2) for home models. Child and school were included as nested random effects. The median age (percentile 25, percentile 75) of children in visit 1 was 8.5 (7.8; 9.3) years, 49.9% were girls, and 50% of the schools were public. School-outdoor exposure to road traffic noise was associated with a slower development in working memory (2-back and 3-back) and greater inattentiveness over 1 year in children, both for the average noise level (e.g., ‒4.83 points [95% CI: ‒7.21, ‒2.45], p-value < 0.001, in 2-back detectability per 5 dB in street levels) and noise fluctuation (e.g., ‒4.38 [‒7.08, ‒1.67], p-value = 0.002, per 50 noise events at street level). Individual exposure to the road traffic average noise level in classrooms was only associated with inattentiveness (2.49 ms [0, 4.81], p-value = 0.050, per 5 dB), whereas indoor noise fluctuation was consistently associated with all outcomes. Home-outdoor noise exposure was not associated with the outcomes. Study limitations include a potential lack of generalizability (58% of mothers with university degree in our study versus 50% in the region) and the lack of past noise exposure assessment. 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引用次数: 9

摘要

背景道路交通噪声是一种普遍且已知的健康危害。然而,人们对其对儿童认知的影响知之甚少。我们旨在研究小学儿童暴露于道路交通噪声与工作记忆和注意力发展之间的关系,考虑学校室外和学校室内的年平均噪声水平和噪声波动特征,以及家庭室外噪声暴露。方法和发现我们在2012年1月至2013年3月期间对巴塞罗那(西班牙加泰罗尼亚)38所学校的2680名7至10岁儿童进行了基于人群的随访。儿童接受了4次计算机认知测试(n=10112),包括工作记忆(2背任务,可检测性)、复杂工作记忆(3背任务,检测性)和注意力不集中(注意力网络任务,命中反应时间标准误差,以毫秒为单位)。在学年开始时,使用标准协议对学校的室内和室外道路交通噪声进行了测量,以获得A加权等效声压水平,即按人类听力换算的日间平均水平(日间LAeq,单位为dB)。我们还从测量中得出了波动指标(噪声间歇率,%;和噪声事件的数量),并获得了个人估计的室内噪声水平(LAeq),校正了教室方向和教室在不同年份之间的变化。根据《欧洲噪音指令》(2002年),使用巴塞罗那2012年的噪音地图估计了家中的家庭户外噪音暴露量(Lden,即欧盟24小时年平均水平指标)。我们使用线性混合模型来评估暴露于噪音与认知发展之间的关系,并根据年龄、性别、母亲教育、家庭社会经济脆弱性指数、相应学校模型的室内或室外交通相关空气污染(TRAP)或家庭模型的室外二氧化氮(NO2)进行调整。儿童和学校被纳入嵌套随机效应。访视1中儿童的中位年龄(百分位数25,百分位数75)为8.5(7.8;9.3)岁,49.9%为女孩,50%的学校为公立学校。学校户外暴露于道路交通噪音与儿童工作记忆(2背和3背)发展较慢和1年以上注意力不集中有关,平均噪声水平(例如,-4.83点[95%CI:-7.21,-2.45],p值<0.001,在街道水平每5 dB的2个背景可检测性中)和噪声波动(例如,街道水平每50个噪声事件-4.38[-7.08,-1.67],p=0.002)。个人在教室中暴露于道路交通平均噪音水平仅与注意力不集中有关(2.49ms[04.81],p值=0.050,每5dB),而室内噪音波动始终与所有结果有关。家庭户外噪声暴露与结果无关。研究的局限性包括潜在的缺乏可推广性(在我们的研究中,58%的母亲拥有大学学历,而该地区只有50%)以及缺乏过去的噪音暴露评估。结论我们观察到,在学校而不是在家暴露于道路交通噪音与1年以上学童的工作记忆、复杂工作记忆和注意力发展较慢有关。与教室中的平均噪音水平相比,与噪音波动指标的关联更为明显。
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Exposure to road traffic noise and cognitive development in schoolchildren in Barcelona, Spain: A population-based cohort study
Background Road traffic noise is a prevalent and known health hazard. However, little is known yet about its effect on children’s cognition. We aimed to study the association between exposure to road traffic noise and the development of working memory and attention in primary school children, considering school-outdoor and school-indoor annual average noise levels and noise fluctuation characteristics, as well as home-outdoor noise exposure. Methods and findings We followed up a population-based sample of 2,680 children aged 7 to 10 years from 38 schools in Barcelona (Catalonia, Spain) between January 2012 to March 2013. Children underwent computerised cognitive tests 4 times (n = 10,112), for working memory (2-back task, detectability), complex working memory (3-back task, detectability), and inattentiveness (Attention Network Task, hit reaction time standard error, in milliseconds). Road traffic noise was measured indoors and outdoors at schools, at the start of the school year, using standard protocols to obtain A-weighted equivalent sound pressure levels, i.e., annual average levels scaled to human hearing, for the daytime (daytime LAeq, in dB). We also derived fluctuation indicators out of the measurements (noise intermittency ratio, %; and number of noise events) and obtained individual estimated indoor noise levels (LAeq) correcting for classroom orientation and classroom change between years. Home-outdoor noise exposure at home (Lden, i.e., EU indicator for the 24-hour annual average levels) was estimated using Barcelona’s noise map for year 2012, according to the European Noise Directive (2002). We used linear mixed models to evaluate the association between exposure to noise and cognitive development adjusting for age, sex, maternal education, socioeconomical vulnerability index at home, indoor or outdoor traffic-related air pollution (TRAP) for corresponding school models or outdoor nitrogen dioxide (NO2) for home models. Child and school were included as nested random effects. The median age (percentile 25, percentile 75) of children in visit 1 was 8.5 (7.8; 9.3) years, 49.9% were girls, and 50% of the schools were public. School-outdoor exposure to road traffic noise was associated with a slower development in working memory (2-back and 3-back) and greater inattentiveness over 1 year in children, both for the average noise level (e.g., ‒4.83 points [95% CI: ‒7.21, ‒2.45], p-value < 0.001, in 2-back detectability per 5 dB in street levels) and noise fluctuation (e.g., ‒4.38 [‒7.08, ‒1.67], p-value = 0.002, per 50 noise events at street level). Individual exposure to the road traffic average noise level in classrooms was only associated with inattentiveness (2.49 ms [0, 4.81], p-value = 0.050, per 5 dB), whereas indoor noise fluctuation was consistently associated with all outcomes. Home-outdoor noise exposure was not associated with the outcomes. Study limitations include a potential lack of generalizability (58% of mothers with university degree in our study versus 50% in the region) and the lack of past noise exposure assessment. Conclusions We observed that exposure to road traffic noise at school, but not at home, was associated with slower development of working memory, complex working memory, and attention in schoolchildren over 1 year. Associations with noise fluctuation indicators were more evident than with average noise levels in classrooms.
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来源期刊
PLoS Medicine
PLoS Medicine 医学-医学:内科
CiteScore
21.60
自引率
0.60%
发文量
227
审稿时长
3 months
期刊介绍: PLOS Medicine aims to be a leading platform for research and analysis on the global health challenges faced by humanity. The journal covers a wide range of topics, including biomedicine, the environment, society, and politics, that affect the well-being of individuals worldwide. It particularly highlights studies that contribute to clinical practice, health policy, or our understanding of disease mechanisms, with the ultimate goal of improving health outcomes in diverse settings. Unwavering in its commitment to ethical standards, PLOS Medicine ensures integrity in medical publishing. This includes actively managing and transparently disclosing any conflicts of interest during the reporting, peer review, and publication processes. The journal promotes transparency by providing visibility into the review and publication procedures. It also encourages data sharing and the reuse of published work. Author rights are upheld, allowing them to retain copyright. Furthermore, PLOS Medicine strongly supports Open Access publishing, making research articles freely available to all without restrictions, facilitating widespread dissemination of knowledge. The journal does not endorse drug or medical device advertising and refrains from exclusive sales of reprints to avoid conflicts of interest.
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