Association Between Exposure to Noise and Sleep and Mental Health Outcomes in a Nationally-Representative Sample of U.S. Adolescents

Background: In 1974, the U.S. Environmental Protection Agency (U.S. EPA) identified an equivalent 24-hour continuous average noise exposure level (LAeq, 24h) of < 55 A-weighted decibels to protect public health with an adequate margin of safety. To date, however, limited U.S.-based research has evaluated the relationship between noise pollution and health. We help fill this gap using data from a nationally-representative sample of U.S. adolescents.Methods: We used a cross-sectional geospatial sound model to estimate noise exposure at the block group level. We dichotomized noise as high (LAeq, 24h ≥ 55 dB) versus low (LAeq, 24h <55 dB). The National Comorbidity Survey Adolescent Supplement, conducted between 2001-2004 and including several self-reported sleep outcomes and DSM-IV disorder diagnoses, provided our study population. We evaluated the association between noise and sleep and mental health using doubly-robust targeted minimum loss-based estimation and propensity score matching to account for potential confounders, including air pollution.Results: The study included 4,508 urban-dwelling adolescents aged 13-18. Controlling for numerous adolescent, household, and environmental covariates, living in a high- versus low-noise census block-group was associated with later bedtimes on both weeknights and weekend nights (risk difference [RD]: 0.41 hours, 95% CI: -0.01, 0.83, and RD: 0.61 hours, 95% CI: 0.38, 0.84, respectively). We found no association with total number of hours slept. Further, we found that living in a high- versus low-noise census block-group was associated with 69% increased odds of an anxiety or depressive disorder (odds ratio [OR]: 1.69, 95% CI: 1.13, 2.25) and 79% increased odds of substance use disorder (OR: 1.79, 95% CI: 0.91, 2.66); we found no similar associations with behavioral disorders.Conclusion: We found evidence that noise exceeding the U.S. EPA threshold may hold adverse sleep and mental health consequences for U.S. adolescents.