title: Environmental noise and incident mental health problems: A prospective cohort study among school children in Germany.
abstract: BACKGROUND
  Environmental noise is considered a threat to public health as 20% of the EU population is exposed to health influencing noise levels. An association of noise and mental health problems in children has been suggested by some studies, but results are not consistent and there are no longitudinal studies of this association. Our aim was to investigate the influence of different environmental noise sources at children's homes on incident mental health problems in school-aged children.
  
  
  METHODS
  A cohort study of children from first (t0) to fourth grade (t1) of primary school was conducted. Different environmental noise sources (day/night separately) at children's home were assessed via parental annoyance reports. Increased noise exposure between t0 and t1 was the exposure variable. Incident mental health problems were assessed with the parental version of the Strengths and Difficulties Questionnaire (SDQ). RRs and 95% CIs were analysed to investigate the association between different noise sources and incident mental health problems.
  
  
  RESULTS
  The study population consisted of 583 boys and 602 girls. The most common increase in noise exposure between t0 and t1 was road traffic noise day (26.38%). After adjusting for covariates exposure to road traffic night was significantly associated with the total difficulties score (RR=2.06; 95% CI=1.25-3.40), emotional symptoms (RR=1.69, 95% CI=1.04-2.72), and conduct problems (RR=1.57, 95% CI=1.04-2.38). Noise by neighbours during the day was associated with conduct problems (RR=1.62, 95% CI=1.11-2.40) and hyperactivity (RR=1.69, 95% CI=1.08-2.65). Aircraft noise day and construction work day were not associated with any of the SDQ categories at a significant level.
  
  
  CONCLUSIONS
  Environmental noise is an important public health problem. This is the first study to investigate the association of a broad range of noise sources and incident mental health problems in children in a cohort study. Our results suggest that exposure to noise at children's home is associated with mental health problems such as emotional symptoms, conduct problems and hyperactivity.
authors.affiliation: Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany; Health Sciences Bremen, University of Bremen, Germany. Electronic address: stefanie.dreger@uni-bremen.de.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Dreger
authors.affiliation: Bavarian Health and Food Safety Authority, Munich, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Meyer
authors.affiliation: Bavarian Health and Food Safety Authority, Munich, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Fromme
authors.affiliation: Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany; Health Sciences Bremen, University of Bremen, Germany; Bavarian Health and Food Safety Authority, Munich, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bolte
mesh_terms: D002648:Child; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology; D008603:Mental Health; D009622:Noise / Q000009:adverse effects*; D011446:Prospective Studies; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Children; Environment; Mental health; Noise; SDQ