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Background: This cross-sectional study assessed the sleep quality using the ActiGraph and investigated the relationship between the parameters of sleep assessment and the type of shift work in Korean firefighters. Methods: The participants were 359 firefighters: 65 day workers (control group) and 294 shift workers (shift work group: 77 firefighters with 3-day shift, 72 firefighters with 6-day shift, 65 firefighters with 9-day shift, and 80 firefighters with 21-day shift). Sleep assessments were performed using the ActiGraph (wGT3X-BT) for 24 hours during day shift (control and shift work group) and night shift and rest day (shift work group). The participants recorded bed time and sleep hours during the measurement period. Results: Sleep efficiency, total sleep time, and percentage of wake after sleep onset during night work were lower in the shift work group than control group (p

Background: Recent research indicates that shift work is associated with neurocognitive function. However, studies that examine the association between shift work and neurocognitive function in firefighters have not yet been performed. We examined the effect of shift work on neurocognitive function in firefighters by measuring and comparing neurocognitive function before and after night shift. Methods: 352 firefighters from eight fire stations in South Korea were included in this study. We performed neurocognitive function test using central nervous system vital signs (CNSVS) during daytime work and on the next day after night work. We performed paired t-tests to assess differences between neurocognitive function before and after night work. We also compared neurocognitive function in insomnia and depression. We used a general linear model to analyze the associations between shiftwork schedule and the changes in neurocognitive function. Results: The neurocognitive function significantly decreased in six domains (composite memory, verbal memory, visual memory, complex attention, psychomotor speed, and motor speed) as did the neurocognitive index on the next day after night work compared with during day work. These decreased domains were the same following night work regardless of the type of shift work. Conclusion: Night work in firefighters may cause neurocognitive decline.

(1) Study Objectives: By investigating the change of cortisol levels during shift cycles among professional firefighters in Korea, this study aims to evaluate the difference between individuals&rsquo, stress response and the recovery of their circadian rhythm after working night shifts. (2) Methods: A total of 325 shift firefighters, who were working in 3, 6, 9, or 21 day cycles, participated in the study. Their urinary and serum cortisol levels were measured during the day (09&ndash, 18), during the night (18&ndash, 09), and every 24 h (09&ndash, 09) per shift cycle, and adjustments were made for confounding factors. (3) Results: Serum cortisol levels were significantly increased after working during the night or for 24 h compared with that of working throughout the day. However, whether working night or 24 h shifts, the serum cortisol levels were undoubtedly different based on the 3, 6, 9, or 21 day cycles. In all shift cycles, the urinary cortisol level decreased during the night or throughout the 24 h shifts compared with sleeping during this time, but this was considered to be significantly applicable only to those working in 21 day cycles. Additionally, in serial measurements, the recovery of urinary cortisol secretion after a night or 24 h shift was successful for individuals working in 9 day cycles, but the recovery was delayed for those working in 6 or 21 day cycles. (4) Conclusions: After analyzing the urine cortisol levels, the study indicates that only subjects working in 9 day cycles fully recovered their circadian rhythm while those working in 6 day or 21 day cycles did not completely recover. Therefore, it is important to recognize how stressful night shifts can be, and it is crucial to enhance firefighters&rsquo, current shift cycles in order to allow sufficient recovery of their circadian rhythm as well as the prevention of disrupting their circadian rhythm after working at night. Further research is necessary to take into account the amount of work load, the challenges of being sleep deprived, and the individual&rsquo, s capacity to overcome sleepiness.

Study Objectives Shift work is known to be detrimental to an individual’s health as it disrupts the circadian rhythm and is a risk factor for cancer. It has been reported that elevated fibroblast growth factor (FGF)-23, increased serum soluble α-klotho, and decreased vitamin D3 are associated with cancer progression. We studied the relationship between shift work and the levels of FGF-23, α-klotho, and vitamin D3 amongst firefighters, as they work in long shifts outside the traditional daytime schedule. Methods The study consisted of 450 participants who were firefighters. We measured FGF-23, α-klotho, and vitamin D3 levels in their blood and a set of questionnaires were given to the participants to evaluate their health habits. After determining and adjusting for potential confounding factors, we compared the levels of FGF-23, α-klotho, and serum vitamin D3 by job and shift types. Results FGF-23 and α-klotho levels were significantly higher in shift workers than traditional day workers, and in 3-day cycle shift workers than workers with another shift schedule. When the levels of these substances were compared based on different types of jobs, firefighters had a lower level of vitamin D3. We conclude that shift work is positively correlated with the levels of FGF-23 and α-klotho. Conclusions Levels of FGF-23 and α-klotho were linked to shift work and job types. Although vitamin levels did not differ by shift types, vitamin D3 levels were lower in firefighters. These findings suggest that high levels of FGF-23 and α-klotho are potential risk factors for cancer among firefighters.

Objective The effect of acute noise on cognitive function has long been a topic of study, yet these effects remain a serious problem for learning performance in school children. Methods From November 15, 2010 to December 8, 2010, we enrolled 268 students from three elementary schools (135 boys and 133 girls, 10-12 years old) in Ulsan, Korea. The study subjects were divided into two groups according to their test conditions (background versus additional noise), and tests were conducted using psychological examination tools. Chi-square tests and general linear models were used to assess the differences of impacts on cognition between the two groups. Results After adjusting for socio-demographic covariates, the noise significantly affected the results of full-scale IQ, verbal IQ, Continuous Performance Test scores, and Children's Color Trails Test and Stroop test scores. The groups at high risk of learning difficulties were more affected by noise than low-risk groups. Conclusion These findings suggest that noise is hazardous to the attention and performance of elementary school students, particularly for groups at greater risk for poor academic achievement. Additional studies are needed to identify subject-specific levels of noise that can affect attention and cognitive function.

Background Recently, noise coming from the neighborhood via floor wall has become a great social problem. The noise between the floors can be a cause of physical and psychological problems, and the different types of floor impact sound (FIS) may have the different effects on the human’s body and mind. The purpose of this study is to assess the responses of subjective feeling, task performance ability, cortisol and HRV for the various types of floor impact. Methods Ten men and 5 women were enrolled in our study, and the English listening test was performed under the twelve different types of FIS, which were made by the combinations of bang machine (B), tapping machine (T), impact ball (I) and sound-proof mattress (M). The 15 subjects were exposed to each FIS for about 3 min, and the subjective annoyance, performance ability (English listening test), cortisol level of urine/saliva and heart rate variability (HRV) were examined. The sound pressure level (SPL) and frequency of FIS were analyzed. Repeated-measures ANOVA, paired t-test, Wilcoxon signed rank test were performed for data analysis. Results The SPL of tapping machine (T) was reduced with the soundproof mattress (M) by 3.9–7.3 dBA. Impact ball (I) was higher than other FIS in low frequency (31.5–125 Hz) by 10 dBA, and tapping machine (T) was higher than other FIS in high frequency (2–4 k Hz) by 10 dBA. The subjective annoyance is highest in the combination of bang machine and tapping machine (BT), and next in the tapping machine (T). The English listening score was also lowest in the BT, and next in T. The difference of salivary cortisol levels between various types of FIS was significant ( p = 0.003). The change of HRV parameters by the change of FIS types was significant in some parameters, which were total power (TP) ( p = 0.004), low frequency (LF) ( p = 0.002) and high frequency (HF) ( p = 0.011). Conclusions These results suggest that the human’s subjective and objective responses were different according to FIS types and those combinations.

Introduction. We first examined the association of an ocular refractive error with allergic conjunctivitis in school children and then examined this association in children attending a suburban school and an urban school. Methods. We enrolled 426 children attending a primary school in a suburban area and 550 children attending a primary school in an urban area which had a higher level of air pollution. Allergic conjunctivitis was defined as the diagnosis of this condition at any time during a child’s life. The ophthalmic examinations included measurements of visual acuity and refraction, and a slit lamp examination. Skin prick tests were also performed at each school during 2018. The significance of associations was determined by the calculation of odds ratios (ORs) and 95% confidence intervals (CIs). Results. Astigmatism (increase of 1 cylindrical diopter) was associated with allergic conjunctivitis in children overall (OR = 1.287, 95% CI = 1.010 to 1.642) and in children attending the urban school (OR = 1.408, 95% CI = 1.029 to 1.926), but not in children attending the suburban school (OR = 1.040, 95% CI = 0.672 to 1.610). Allergic conjunctivitis also had a higher prevalence among children attending the urban school. The urban school had higher levels of air pollutants than the suburban school. Skin prick tests indicated that the major allergens in children with allergic conjunctivitis were house dust mites and various types of pollen. Conclusion. Astigmatism is associated with allergic conjunctivitis in children attending an urban school.

Objective The aim of this study was to estimate the progress of insomnia prevalence and incidence over the past several years. Also, this study compared survival rates between individuals with and without insomnia.Methods The National Health Insurance Service-National Sample Cohort (NHIS-NSC) from 2002–2013 was used for this study. Prevalent cases of insomnia were defined using ICD-10 codes F51.0 or G47.0, or a prescription of sedatives. Cox’s proportional hazard analysis was conducted to compare survival rates between insomnia patients and people without insomnia.Results In 2013, there were 46,167 (5.78%) insomnia patients over 20 years old in this cohort. Insomnia was more common among women and the elderly. Annual incidence over the past several years remained steady but the prevalence increased. The survival of insomnia patients was lower than that of people without insomnia, and the hazard ratio for overall mortality was 1.702 (p

Actigraphy is useful to assess sleep pattern of subjects for several days to several weeks, and collected sleep data is usually averaged out to know the general sleep pattern of each individual. However, intra-individual variability should be considered when assessing sleep patterns, with regard to the phenomenon of daily fluctuation. The aim of this study was to explore whether the mean sleep indices reflect intra-individual variability with regard to environmental noise. Indoor noise and sleep pattern were collected over 5 days, among 22 citizens of Ulsan Metropolitan city. We observed an association between environmental noise indices and various sleep indices such as sleep efficiency, number of awakenings, or fragmentation indices when we analyzed the data of 108 nights from 22 subjects. However, the significances were weakened when we analyzed noise and sleep/wake pattern after averaging out. In conclusion, we observed that the sleep/wake pattern over several days to weeks should not be averaged out when studied in relation with variable physiological phenomena, such as night-to-night variability.

Objectives/Hypothesis To investigate the relationship between sleep-disordered breathing (SDB) and nocturnal enuresis (NE) in children and to prospectively evaluate the effectiveness of adenotonsillectomy on resolving enuresis in indicated SDB patients with NE. Methods We prospectively collected data from 183 children (121 males, mean age 8.17 ± 2.84 years) who underwent adenotonsillectomy to treat SDB between July 2011 and July 2013, and analyzed the prevalence of NE. Before and 3 months after surgery, all parents were requested to answer a self-reported SDB scale questionnaire (22 questions, 0–22 points) and a NE questionnaire (episodes of enuresis per month). Paired t test, Student t test, and Chi-square test were used to analyze the data. Results Overall prevalence of NE was 9.3% (17 patients) preoperatively and 1.5% postoperatively (four patients). After adenotonsillectomy, prevalence of NE and the mean SDB scale were significantly decreased (both P values < 0.001). After adenotonsillectomy, 13 of the 17 NE patients (76.5%) showed complete resolution. There was significantly higher prevalence of NE in patients with obstructive sleep apnea (OSA) than those without OSA (13.1%, 14 of 107 vs. 3.9%, 3 of 76; P = 0.036). Conclusion There is strong association between NE and SDB, and adenotonsillectomy can markedly improve enuresis in the majority of children with NE and SDB. Levels of Evidence 4. Laryngoscope, 126:1241–1245, 2016

In Korea, lung cancer is a common cancer, and has the highest mortality rate in both males and females. Approximately 80% of lung cancer is due to smoking, and the remaining cases are known to be due to genetic factors, history of respiratory disease, infection, diet, and occupational and environmental factors. Since the occupational and environmental hazards may differ from region to region, the lung cancer risk may differ too. To identify this, we selected seven metropolitan cities, and compared occupational and environmental hazards. Furthermore, we calculated smoking rate adjusted standardized rate ratio (ratio of 10-year cumulative age-standardized incidence rate of lung cancer during the 2000&ndash, 2009 period at target region versus reference region) to compare the regional lung cancer risk. The result showed that the emissions and concentrations of air pollutant were higher in high-risk regions, and the risk of lung cancer was significantly elevated in such area. In this study, we simultaneously consider the cumulative incidence, age-standardization and smoking rate adjustment. Therefore, we can conclude that the validity of the finding of this study is higher than that of past studies. In conclusion, the occupational and environmental hazards have an effect on lung cancer.

Background Industrial pollution may affect the heavy metal body burden of people living near industrial complexes. We determined the average concentrations of atmospheric heavy metals in areas close to and distant from industrial complexes in Korea, and the body concentrations of these heavy metals in residents living near and distant from these facilities. Methods The atmospheric data of heavy metals (lead and cadmium) were from the Regional Air Monitoring Network in Ulsan. We recruited 1,148 participants, 872 who lived near an industrial complex (“exposed” group) and 276 who lived distant from industrial complexes (“non-exposed” group), and measured their concentrations of blood lead, urinary cadmium, and urinary total mercury. Results The results showed that atmospheric and human concentrations of heavy metals were higher in areas near industrial complexes. In addition, residents living near industrial complexes had higher individual and combined concentrations (cadmium + lead + mercury) of heavy metals. Conclusion We conclude that residents living near industrial complexes are exposed to high concentrations of heavy metals, and should be carefully monitored., Graphical Abstract

Objective The present study aimed to examine the potential mediating effect of income level on the association between noise exposure and insomnia. Methods 706 individuals were evaluated in conjunction with 2014 noise map data from Seoul, South Korea. Cross-sectional analysis was performed to examine differences in noise level according to household income, while three separate logistic regression models were used to examine factors influencing insomnia. Odds ratios (ORs) were calculated after adjusting for depression, anxiety, auditory acuity and noise sensitivity in the first model. Analyses were adjusted for sociodemographic variables in the second model, lifestyle factors and medical illnesses in the third model. Results Noise level was significantly associated with an increased risk of insomnia in the low-income group, although no such association was observed in the high-income group. Groups exposed to >60 dB of noise (Lden; day-evening-night equivalent) exhibited a 1.79-fold increase in the incidence of insomnia relative to those exposed to

Background Excessive noise affects human health and interferes with daily activities. Although environmental noise may not directly cause mental illness, it may accelerate and intensify the development of latent mental disorders. Noise sensitivity (NS) is considered a moderator of non-auditory noise effects. In the present study, we aimed to assess whether NS is associated with non-auditory effects. Methods We recruited a community sample of 1836 residents residing in Ulsan and Seoul, South Korea. From July to November 2015, participants were interviewed regarding their demographic characteristics, socioeconomic status, medical history, and NS. The non-auditory effects of noise were assessed using the Center of Epidemiologic Studies Depression, Insomnia Severity index, State Trait Anxiety Inventory state subscale, and Stress Response Inventory-Modified Form. Individual noise levels were recorded from noise maps. A three-model multivariate logistic regression analysis was performed to identify factors that might affect psychiatric illnesses. Results Participants ranged in age from 19 to 91 years (mean: 47.0 ± 16.1 years), and 37.9% (n = 696) were male. Participants with high NS were more likely to have been diagnosed with diabetes and hyperlipidemia and to use psychiatric medication. The multivariable analysis indicated that even after adjusting for noise-related variables, sociodemographic factors, medical illness, and duration of residence, subjects in the high NS group were more than 2 times more likely to experience depression and insomnia and 1.9 times more likely to have anxiety, compared with those in the low NS group. Noise exposure level was not identified as an explanatory value. Conclusions NS increases the susceptibility and hence moderates there actions of individuals to noise. NS, rather than noise itself, is associated with an elevated susceptibility to non-auditory effects.

Background The need of efficient resource management and full-time accessibility to resources has increased with the development of industry, resulting in the increase of shift workers. Previous researches of past decades show that there are various health effects on shift workers. However, the definition and the form of shift work have varied from each research and occupational harmful factors except for shift work have not been excluded completely in previous researches. Therefore, in this research, we tried to find out the effect of shift work focusing on the hypertension. To complement previously mentioned weakness of other researches, we performed our research on participants to whom we could minimize other risk factors excluding shift work. Methods This research examined 1,953 petrochemical plant male workers (shift work 1,075, day worker 878) who did medical checkup from 1st Jan. 2014 to 31th Dec. 2014 in a general hospital located in Ulsan, based on their medical records and questionnaires. With the questionnaire, we found out their basic information including age, social status, occupational history, and we took their physical measurements. Results Compared to day workers, shift workers’ odds ratio of developing hypertension was 1.31 (95% CI 0.98–1.75). After adjusting confounding variables, adjusted odds ratio for entire subjects was 1.51 (95% CI 1.11–2.06). Also, for subjects who were in continuous service for over 20 years, odds ratio was 1.51 (95% CI 1.08–2.11). Conclusions Shift workers had a higher chance of hypertension than day workers do. Particularly, the longer the workers work continuously, the risk of hypertension getting higher.

Environmental noise is known to cause noise annoyance. Since noise annoyance is a subjective indicator, other mediators-such as noise sensitivity-may influence its perception. However, few studies have thus far been conducted on noise annoyance in South Korea that consider noise sensitivity and noise level simultaneously. The aim of this study was to evaluate the correlations between noise sensitivity or noise level and noise annoyance on a large scale in South Korea. This study estimated the level of noise exposure based on a noise map created in 2014; identified and surveyed 1836 subjects using a questionnaire; and assessed the impact of transportation noise and noise sensitivity on noise annoyance. The result showed that noise exposure level and noise sensitivity simultaneously affect noise annoyance, and noise sensitivity has a relatively larger impact on noise annoyance. In conclusion, when study subjects were exposed to a similar level of noise, the level of noise annoyance differed depending on the noise sensitivity of the individual.

Background The purpose of this study was to investigate hearing threshold changes of workers with unilateral conductive hearing loss who were exposed to workplace noise for 8-years. Methods Among 1819 workers at a shipyard in Ulsan, 78 subjects with an air-bone gap ≥10 dBHL in unilateral ears were selected. Factors that could affect hearing were acquired from questionnaires, physical examinations, and biochemistry examinations. Paired t-test was conducted to compare the hearing threshold changes over time between conductive hearing loss (CHL) ear and sensorineural hearing loss (SNHL) ear. Results The study included male subjects aged 48.7 ± 2.9, having worked for 29.8 ± 2.7 years. Hearing thresholds increased significantly in CHL ears and SNHL ears at all frequencies (0.5–6 kHz) during follow-up period (p

Background There is a paucity of data on the distribution of disease severity. In this study, we estimated disease severity distributions in South Korea using two EQ-5D-3L population surveys. Methods A total of 110 health states for 35 diseases with 2–5 severity levels (e.g., mild, moderate, severe) were included in this study. A general population of 360 participants from the areas surrounding Seoul and Gyunggi evaluated these health states using EQ-5D-3L via face-to-face interviews and a paper questionnaire. The EQ-5D indices were used to measure the severity levels of health states and used as the cutoff points for the disease severity distributions. Finally, these cutoff points were applied to disease prevalence data with EQ-5D-3L, which were obtained from the Korean National Health and Nutrition Examination Surveys (KNHNES) and Korean Community Health Survey, in order to estimate the disease severity distributions. Results The severity distributions of 8 diseases were estimated, including asthma, angina, stroke, chronic obstructive pulmonary disease, major depressive disorder, musculoskeletal problems in the legs, anemia, and allergic rhinitis and conjunctivitis. For example, the EQ-5D indices for chronic obstructive pulmonary disease severity were 0.929, 0.742, and 0.620, and the cut-off points were 0.835 (between mild and moderate) and 0.681 (between moderate and severe). Using these cutoff points, the distributions of chronic obstructive pulmonary disease severity were 66.5 % (mild), 23.3 % (moderate), and 10.1 % (severe) according to KNHNES. Conclusions The estimated severity distributions in this study can be used as a valid calculation of the disease burden in the general population. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-2904-5) contains supplementary material, which is available to authorized users.

Previous studies have suggested that development of Mycobacterium kansasii lung disease (MKLD) was associated with COPD, pneumoconiosis, aging, male, immunosuppression, alcohol, malignancy, and certain occupations such as mining and sandblasting. However, previous studies were outdated and used non-comparative statistical methods. We aimed to determine the current risk factors for developing MKLD in Korea by using appropriate statistical techniques. Eighty-six MKLD patients were identified through a search of the Ulsan University Hospital database between January 2010 and December 2014. These cases were matched with 172 controls who had normal respiratory systems in a health examination during the same period (matching variables, age and sex; case: control ratio of 1:2). Clinical and demographic characteristics were gathered by reviewing the medical record and telephone survey. Multivariate logistic regression analyses were performed to evaluate risk factors for developing MKLD. Multivariate analysis showed that occupation in heavy industries (adjusted odds ratio (aOR) 6.41, 95% confidence interval (CI) 2.19−18.74, P = .001) and low body mass index (BMI) (aOR [per kg/m2] 0.73, 95% CI 0.63−0.85, P

We utilized a mice model of Parkinsonism: (1) to evaluate 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced neurotoxicity; and (2) to evaluate whether manganese (Mn) exposure can affect MPTP-induced neurotoxicity. A 2 × 3 experimental design (MPTP ×± Mn) was as follows: SS, MPTP(-) × Mn(-); SLMn, MPTP(-) × low Mn(+); SHMn, MPTP(-) × high Mn(+); MpS, MPTP(+) × Mn(-); MpLMn, MPTP(+) × low Mn(+); MpHMn, MPTP(+) × high Mn(+). We administered MPTP (30 mg/kg per day) to male C57BL/6 mice intraperitoneally, once a day for 5 days. Subsequently, mice were treated with either 2 or 8 mg/kg of MnCl2.4H2O intraperitoneally, once a day for 3 weeks. Blood and striatal Mn levels were elevated in the Mnexposed groups. The number of tyrosine hydroxylase (TH)-immunoreactive (ir) neurons in the substantia nigra pars compacta were decreased significantly in the MPTP-exposed groups. The densities of TH-ir axon terminals in caudate-putamen (CPU) were significantly decreased in the MPTP-treated groups. However, Mn treatment did not affect MPTP neurotoxicity. The densities of glial fibrillary acidic protein (GFAP)-ir astrocytes in the CPU or globus pallidus were significantly increased in the MPTP-treated groups. Concentrations of dopamine in the striatum were decreased significantly in the MPTP-exposed groups only, but Mn had no effect.

Sensitivity to noise, particularly road traffic noise, can increase cortisol levels and result in changes in immune system biomarkers. Therefore, continuous exposure to noise can have an effect on immune function, hormonal levels, and cardiovascular function, leading to hypertension and stress. The purpose of this study was to investigate the changes in stress-and immune system-related biomarkers according to the self-reported sensitivity to noise and exposure to road traffic noise, to ultimately determine the potential effects of noise on health. A survey was conducted through questionnaire (ISO/TS 15666) sent to 172 female subjects in Korea, including 128 from Ulsan and 44 from Seoul. The average noise level was calculated, and blood samples were collected for measurements of cortisol levels, Natural killer (NK) / Natural killer T (NKT) cell populations, and NK cell activity (through measurements of interleukin-12 (IL-12) and interferon-gamma (INF-γ) concentrations). Multivariate linear regression analysis of the measured biomarkers according to the road traffic noise level and self-reported noise sensitivity was conducted adjusting for the effects of age, alcohol status, smoking status, regular exercise, and residence period. IL-12 levels increased, whereas the NKT cell population decreased with increasing noise levels. The results further suggested that cortisol levels are more influenced by the subject's sensitivity to noise than to the level of chronic road traffic noise. Therefore, noise appears to have the largest effect on IL-12 levels as well as the population and activity of NKT cells. In conclusion, our results suggest that low-level road traffic noise and sensitivity to noise can affect health by causing changes in the immune response through mechanisms other than increased cortisol.

Transportation noise is known to have negative impact on both public health and life quality. This study evaluated the relationship between transportation noise and annoyance levels, and also the difference of annoyance levels in two metropolitan cities based on epidemiologic surveys. Two thousand adult subjects living in Seoul and Ulsan were enrolled by stratified random sampling on the basis of noise maps from July 2015 to January 2016. Individual annoyance in accordance with transportation noise levels in two metropolitan cities were surveyed using an 11-point visual analog scale questionnaire. The results show that transportation noise level was significantly correlated with annoyance in both cities. Logistic regression analysis revealed that the risk of being 'highly annoyed' increased with noise level (Ldn, day-night average sound level) in both cities. After adjusting for age, residence period, sociodemographic factors (sex, education, marriage, income, alcohol, smoking, and exercise) and noise sensitivity, the risk of being 'highly annoyed' was increased with noise levels in both cities. In comparison to those of areas with noise levels below 55 dBA, the adjusted odds ratios of 'highly annoyed' for areas with 55-65 dBA and over 65 dBA were 2.056 (95% confidence interval [CI] 1.225-3.450), 3.519 (95% CI 1.982-6.246) in Seoul and 1.022 (95% CI 0.585-1.785), 1.704 (95% CI 1.005-2.889) in Ulsan, respectively. Based on the results of a population study, we showed that transportation noise levels were significantly associated with annoyance in adults. However, there were some differences between the two cities. In this study, there were differences in transportation noise between the two cities. Seoul has complex noise (traffic and aircraft), compared to single road traffic noise in Ulsan. Therefore, single and complex transportation noise may have different effects on annoyance levels.