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Background: Long-term exposure to transportation noise is related to cardio-metabolic diseases, with more recent evidence also showing associations with diabetes mellitus (DM) incidence. This study aimed to evaluate the association between transportation noise and DM mortality within the Swiss National Cohort., Methods: During 15 years of follow-up (2001-2015; 4.14 million adults), over 72,000 DM deaths were accrued. Source-specific noise was calculated at residential locations, considering moving history. Multi-exposure, time-varying Cox regression was used to derive hazard ratios (HR, and 95%-confidence intervals). Models included road traffic, railway and aircraft noise, air pollution, and individual and area-level covariates including socio-economic position. Analyses included exposure-response modelling, effect modification, and a subset analysis around airports. The main findings were integrated into meta-analyses with published studies on mortality and incidence (separately and combined)., Results: HRs were 1.06 (1.05, 1.07), 1.02 (1.01, 1.03) and 1.01 (0.99, 1.02) per 10 dB day evening-night level (L den ) road traffic, railway and aircraft noise, respectively (adjusted model, including NO 2 ). Splines suggested a threshold for road traffic noise (~ 46 dB L den , well below the 53 dB L den WHO guideline level), but not railway noise. Substituting for PM 2.5 , or including deaths with type 1 DM hardly changed the associations. HRs were higher for males compared to females, and in younger compared to older adults. Focusing only on type 1 DM showed an independent association with road traffic noise. Meta-analysis was only possible for road traffic noise in relation to mortality (1.08 [0.99, 1.18] per 10 dB, n = 4), with the point estimate broadly similar to that for incidence (1.07 [1.05, 1.09] per 10 dB, n = 10). Combining incidence and mortality studies indicated positive associations for each source, strongest for road traffic noise (1.07 [1.05, 1.08], 1.02 [1.01, 1.03], and 1.02 [1.00, 1.03] per 10 dB road traffic [n = 14], railway [n = 5] and aircraft noise [n = 5], respectively)., Conclusions: This study provides new evidence that transportation noise is associated with diabetes mortality. With the growing evidence and large disease burden, DM should be viewed as an important outcome in the noise and health discussion., (© 2024. The Author(s).)

Background: The technological applications of radiofrequency electromagnetic fields (RF-EMF) have been steadily increasing since the 1950s exposing large proportions of the population. The World Health Organization (WHO) is assessing the potential health effects of exposure to RF-EMF., Objectives: To systematically assess the effects of exposure to RF-EMF on self-reported non-specific symptoms in human subjects and to assess the accuracy of perceptions of presence or absence of RF-EMF exposure., Methods: Eligibility criteria: experimental studies carried out in the general population and in individuals with idiopathic environmental intolerance attributed to EMF (IEI-EMF), in any language., Information Sources: Medline, Web of Science, PsycInfo, Cochrane Library, Epistemonikos, Embase and EMF portal, searched till April 2022. Risk of Bias (ROB): we used the RoB tool developed by OHAT adapted to the topic of this review., Synthesis of Results: we synthesized studies using random effects meta-analysis and sensitivity analyses, where appropriate., Results: Included studies: 41 studies were included, mostly cross over trials and from Europe, with a total of 2,874 participants., Synthesis of Results: considering the primary outcomes, we carried out meta-analyses of 10 exposure-outcomes pairs. All evidence suggested no or small non-significant effects of exposure on symptoms with high (three comparisons), moderate (four comparisons), low (one comparison) and very low (two comparisons) certainty of evidence. The effects (standard mean difference, where positive values indicate presence of symptom being exposed) in the general population for head exposure were (95% confidence intervals) 0.08 (-0.07 to 0.22) for headache, -0.01 (-0.22 to 0.20) for sleeping disturbances and 0.13 (-0.51 to 0.76) for composite symptoms; and for whole-body exposure: 0.09 (-0.35 to 0.54), 0.00 (-0.15 to 0.15) for sleeping disturbances and -0.05 (-0.17 to 0.07) for composite symptoms. For IEI-EMF individuals SMD ranged from -0.19 to 0.11, all of them with confidence intervals crossing the value of zero. Further, the available evidence suggested that study volunteers could not perceive the EMF exposure status better than what is expected by chance and that IEI-EMF individuals could not determine EMF conditions better than the general population., Discussion: Limitations of evidence: experimental conditions are substantially different from real-life situations in the duration, frequency, distance and position of the exposure. Most studies were conducted in young, healthy volunteers, who might be more resilient to RF-EMF than the general population. The outcomes of interest in this systematic review were symptoms, which are self-reported. The available information did not allow to assess the potential effects of exposures beyond acute exposure and in elderly or in chronically ill people. It cannot be ruled out that a real EMF effect in IEI-EMF groups is masked by a mix with insensitive subjects. However, studies on symptoms reporting and/or field perceptions did not find any evidence that there were particularly vulnerable individuals in the IEI-EMF group, although in open provocation studies, when volunteers were informed about the presence or absence of EMF exposure, such differences were consistently observed., Interpretation: available evidence suggests that acute RF-EMF below regulatory limits does not cause symptoms and corresponding claims in the everyday life are related to perceived and not to real EMF exposure status., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: All institutions of all authors reports financial support was provided by World Health Organization. Martin Röösli’s research is entirely funded by public or not-for-profit foundations. He has served as advisor to a number of national and international public advisory and research steering groups concerning the potential health effects of exposure to nonionizing radiation, including the World Health Organization, the International Agency for Research on Cancer, the International Commission on Non-Ionizing Radiation Protection (ICNIRP), the Swiss Government (member of the working group “mobile phone and radiation” and chair of the expert group BERENIS), the German Radiation Protection Commission (member of the committee Non-ionizing Radiation (A6) and member of the working group 5G (A630)) and the Independent Expert Group of the Swedish Radiation Safety Authority. From 2011 to 2018, M.R. was an unpaid member of the foundation board of the Swiss Research Foundation for Electricity and Mobile Communication, a non-profit research foundation at ETH Zurich. Neither industry nor nongovernmental organizations are represented on the scientific board of the foundation. For the other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Introduction: The real-life short-term implications of electromagnetic fields (RF-EMF) on cognitive performance and health-related quality of life have not been well studied. The SPUTNIC study (Study Panel on Upcoming Technologies to study Non-Ionizing radiation and Cognition) aimed to investigate possible correlations between mobile phone radiation and human health, including cognition, health-related quality of life and sleep., Methods: Adult participants tracked various daily markers of RF-EMF exposures (cordless calls, mobile calls, and mobile screen time 4 h prior to each assessment) as well as three health outcomes over ten study days: 1) cognitive performance, 2) health-related quality of life (HRQoL), and 3) sleep duration and quality. Cognitive performance was measured through six "game-like" tests, assessing verbal and visuo-spatial performance repeatedly. HRQoL was assessed as fatigue, mood and stress on a Likert-scale (1-10). Sleep duration and efficiency was measured using activity trackers. We fitted mixed models with random intercepts per participant on cognitive, HRQoL and sleep scores. Possible time-varying confounders were assessed at daily intervals by questionnaire and used for model adjustment., Results: A total of 121 participants ultimately took part in the SPUTNIC study, including 63 from Besancon and 58 from Basel. Self-reported wireless phone use and screen time were sporadically associated with visuo-spatial and verbal cognitive performance, compatible with chance findings. We found a small but robust significant increase in stress 0.03 (0.00-0.06; on a 1-10 Likert-scale) in relation to a 10-min increase in mobile phone screen time. Sleep duration and quality were not associated with either cordless or mobile phone calls, or with screen time., Discussion: The study did not find associations between short-term RF-EMF markers and cognitive performance, HRQoL, or sleep duration and quality. The most consistent finding was increased stress in relation to more screen time, but no association with cordless or mobile phone call time., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Noise exposure has been associated with adverse cognitive and behavioral outcomes in children, but evidence on longitudinal associations between community noise and child development in low- and middle-income countries is rare. We investigated associations between community noise and behavioral and cognitive development in preschool children in São Paulo., Methods: We linked child development data from the São Paulo Western Region Birth Cohort with average (Lden) and night-time (Lnight) community noise exposure at children's home, estimated by means of a land use regression model using various predictors (roads, schools, greenness, residential and informal settlements). Outcomes were the Strengths and Difficulties Questionnaire (SDQ) and Regional Project on Child Development Indicators (PRIDI) at 3 years of age and the Child Behavior Checklist (CBCL) and International Development and Early Learning Assessment (IDELA) at 6 years of age. We investigated the relationship between noise exposure and development using cross-sectional and longitudinal regression models., Results: Data from 3385 children at 3 years of age and 1546 children at 6 years of age were analysed. Mean Lden and Lnight levels were 70.3 dB and 61.2 dB, respectively. In cross-sectional analyses a 10 dB increase of Lden above 70 dB was associated with a 32% increase in the odds of borderline or abnormal SDQ total difficulties score (OR = 1.32, 95% CI: 1.04; 1.68) and 0.72 standard deviation (SD) increase in the CBCL total problems z-score (95% CI: 0.55; 0.88). No cross-sectional association was found for cognitive development. In longitudinal analyses, each 10 dB increase was associated with a 0.52 SD increase in behavioral problems (95% CI: 0.28; 0.77) and a 0.27 SD decrease in cognition (95%-CI: 0.55; 0.00). Results for Lnight above 60 dB were similar., Discussion: Our findings suggest that community noise exposure above Lden of 70 dB and Lnight of 60 dB may impair behavioral and cognitive development of preschool children., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: The impact of nitrogen dioxide ( NO 2 ) and particulate matter with an aerodynamic diameter of less than or equal to 2.5. microns ( PM 2.5 ) exposures on lung function has been investigated mainly in children and less in adults. Furthermore, it is unclear whether short-term deviations of air pollutant concentration need to be considered in long-term exposure models., Objectives: The aims of this study were to investigate the association between short-term air pollution exposure and lung function and to assess whether short-term deviations of air pollutant concentration should be integrated into long-term exposure models., Methods: Short-term (daily averages 0-7 d prior) and long-term (1- and 4-y means) NO 2 and PM 2.5 concentrations were modeled using satellite, land use, and meteorological data calibrated on ground measurements. Forced expiratory volume within the first second (FEV1) of forced exhalation and forced vital capacity (FVC) were measured during a LuftiBus assessment (2003-2012) and linked to exposure information from the Swiss National Cohort for 36,085 adults (ages 18-95 y). We used multiple linear regression to estimate adjusted associations, and additionally adjusted models of long-term exposures for short-term deviations in air pollutant concentrations., Results: A 1 0 μ g / m 3 increase in NO 2 and PM 2.5 on the day of the pulmonary function test was associated with lower FEV1 and FVC ( NO 2 : FEV1 - 8.0  ml [95% confidence interval: - 13.4 , - 2.7 ], FVC - 16.7  ml [ - 23.4 , - 10.0 ]; PM 2.5 : FEV1 - 15.3  ml [ - 21.9 , - 8.7 ], FVC - 18.5  ml [ - 26.5 , - 10.5 ]). A 10 μ g / m 3 increase in 1-y mean NO 2 was also associated with lower FEV1 ( - 7.7  ml ; - 15.9 , 0.5) and FVC ( - 21.6  ml ; - 31.9 , - 11.4 ), as was a 10 μ g / m 3 increase in 1-y mean PM 2.5 (FEV1: - 42.2  ml ; - 56.9 , - 27.5 ; FVC: - 82.0  ml ; - 100.1 , - 63.9 ). These associations were robust to adjustment for short-term deviations in the concentration of each air pollutant., Conclusions: Short- and long-term air pollution exposures were negatively associated with lung function, in particular long-term PM 2.5 exposure with FVC. Our findings contribute substantially to the evidence of adverse associations between air pollution and lung function in adults. https://doi.org/10.1289/EHP7529.

Background: Few epigenome-wide association studies (EWAS) on air pollutants exist, and none have been done on transportation noise exposures, which also contribute to environmental burden of disease., Objective: We performed mutually independent EWAS on transportation noise and air pollution exposures., Methods: We used data from two time points of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA) from 1,389 participants contributing 2,542 observations. We applied multiexposure linear mixed-effects regressions with participant-level random intercept to identify significant Cytosine-phosphate-Guanine (CpG) sites and differentially methylated regions (DMRs) in relation to 1-y average aircraft, railway, and road traffic day-evening-night noise (Lden); nitrogen dioxide ( NO 2 ); and particulate matter (PM) with aerodynamic diameter < 2.5 μ m ( PM 2.5 ). We performed candidate (CpG-based; cross-systemic phenotypes, combined into "allostatic load") and agnostic (DMR-based) pathway enrichment tests, and replicated previously reported air pollution EWAS signals., Results: We found no statistically significant CpGs at false discovery rate < 0.05 . However, 14, 48, 183, 8, and 71 DMRs independently associated with aircraft, railway, and road traffic Lden; NO 2 ; and PM 2.5 , respectively, with minimally overlapping signals. Transportation Lden and air pollutants tendentially associated with decreased and increased methylation, respectively. We observed significant enrichment of candidate DNA methylation related to C-reactive protein and body mass index (aircraft, road traffic Lden, and PM 2.5 ), renal function and "allostatic load" (all exposures). Agnostic functional networks related to cellular immunity, gene expression, cell growth/proliferation, cardiovascular, auditory, embryonic, and neurological systems development were enriched. We replicated increased methylation in cg08500171 ( NO 2 ) and decreased methylation in cg17629796 ( PM 2.5 )., Conclusions: Mutually independent DNA methylation was associated with source-specific transportation noise and air pollution exposures, with distinct and shared enrichments for pathways related to inflammation, cellular development, and immune responses. These findings contribute in clarifying the pathways linking these exposures and age-related diseases but need further confirmation in the context of mediation analyses. https://doi.org/10.1289/EHP6174.

Background: The individual effects of biological constituents of particulate matter (PM) such as fungal spores, on lung function in children are not well known. This study investigated the seasonal short-term effect of daily variation in Alternaria and Cladosporium fungal spores on lung function in schoolchildren., Methods: This panel study evaluated 313 schoolchildren in informal settlements of the Western Cape of South Africa, exposed to spores of two commonly encountered fungi, Alternaria and Cladosporium species. The children provided forced-expiratory volume in 1-s (FEV 1 ) and peak-expiratory flow (PEF) measurements thrice daily for two consecutive school-weeks in summer and winter. Daily PM 10 levels, from a stationary ambient air quality monitor and fungal spore levels using spore traps were measured in each study area throughout the year. The effects of Alternaria and Cladosporium spores, on lung function were analysed for lag periods up to five-days, adjusting-for PM 10 , other pollen exposures, study area, and other host and meteorological factors. Same-day exposure-response curves were computed for both fungal species., Results: There was more variability in Alternaria spores level with noticeable peaks in summer. There were consistent lag-effects for Alternaria on PEF compared to Cladosporium, with the largest PEF deficit observed in winter (mean deficit: 13.78 L/min, 95%CI: 24.34 to -3.23 L/min) per 10spores/m 3 increase in Alternaria spores on lag day-2. Although there were no observable lag-effects for Alternaria and Cladosporium on FEV 1 , same-day effects of Cladosporium spores on FEV 1 was present across both seasons. Threshold effects of Alternaria on both PEF and FEV 1 deficits were apparent at levels of 100 spores/m 3 , but could not be explored for Cladosporium beyond the levels observed during the study., Conclusion: The study provides evidence for the independent effects of daily exposure to ambient fungal spores of Alternaria and Cladosporium on lung function deficits, more especially in winter for PEF., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Exposure to traffic noise is associated with stress and sleep disturbances. The World Health Organization (WHO) recently concluded that road traffic noise increases the risk for ischemic heart disease and potentially other cardiometabolic diseases, including stroke, obesity, and diabetes. The WHO report focused on whole-day noise exposure, but new epidemiological and translational field noise studies indicate that nighttime noise, in particular,is an important risk factor for cardiovascular disease (CVD) through increased levels of stress hormones and vascular oxidative stress, leading to endothelial dysfunction and subsequent development of various CVDs. Novel experimental studies found noise to be associated with oxidative stress-induced vascular and brain damage, mediated by activation of the NADPH oxidase, uncoupling of endothelial and neuronal nitric oxide synthase, and vascular/brain infiltration with inflammatory cells. Noise-induced pathophysiology was more pronounced in response to nighttime as compared with daytime noise. This review focuses on the consequences of nighttime noise.

Exposimeters measuring radiofrequency electromagnetic fields (RF-EMF) are commonly used to assess personal exposure to RF-EMF in real-life environments. They are usually calibrated in an anechoic chamber using single, well-defined signals such as the center frequency of each band, and standardized orientations, but it is not clear how different devices compare in the real environment where complex mixtures of signals from all directions are present. We thus tested the comparability of six ExpoM-RF exposimeters before and after calibration in an anechoic chamber by varying their position and orientation while repeatedly measuring 15 microenvironments (9 walking routes, 4 tram routes and 2 bus routes) on 6 different days. We modelled the geometric mean levels of RF-EMF as a function of orientation, position, device ID, whether the device was recently calibrated, correcting for the microenvironment in which each measurement took place. We found that systematic differences introduced by device ID, calibration, day of the week, orientation and position are relatively small compared to exposure differences between microenvironments. Any corrections (if desired) should include both device ID and calibration session, but would have a small impact considering the negligible differences between devices. This supports the validity of previous exposure measurement studies relying on ExpoM-RF devices, which did not correct for device ID. We further found that summarizing the exposure per microenvironment as geometric means results in better models than arithmetic means and medians, and recommend that further exposure assessment studies report observed levels as geometric means., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Summary: Several decades of research provides compelling evidence that exposure to air pollution causes various diseases. Time series studies in Europe and the USA examined the short term effects on mortality and found about 1% increase for cardiovascular mortality per 10 μg/m3 increase in daily PM2.5 concentration. A comprehensive analysis of 12 European cohort studies addressing the long term effects found a 13% increased risk of coronary events per 5 μg/m3 increase in estimated annual mean PM2.5. Noise exposure triggers an increase in sympathetic responses (fight-flight reactions) and increased release of corticoids (defeat reactions). In 2018 the World Health Organization has published new Environmental Noise Guidelines reporting an 8% increase in risk of incident ischemic heart disease per 10 dB(A) increase in road traffic noise exposure. Transportation noise and air pollution impact health through different pathways, though they also share many biologic pathways. In a recent cohort study, we did not find indications for synergistic or antagonistic effects from combined exposure to noise and air pollution. A study estimating the Environmental Burden of Disease in Europe concluded that ambient air pollution and transportation noise are the two most relevant environmental stressors for the population living in Europe., Competing Interests: The authors of this article have no conflict of interests to disclose., (Copyright© by Aracne Editrice, Roma, Italy.)

This survey investigates the cross-sectional association between nighttime road, rail and aircraft noise exposure and the probability to be highly sleep disturbed (%HSD), as measured by self-report in postal and online questionnaires. As part of the Swiss SiRENE study, a total of 5592 survey participants in the entire country were selected based on a stratified random sample of their dwelling. Self-reported sleep disturbance was measured using an ICBEN-style 5-point verbal scale. The survey was carried out in four waves at different times of the year. Source-specific noise exposure was calculated for several façade points for each dwelling. After adjustment for potential confounders, all three noise sources showed a statistically significant association between the nighttime noise level LNight at the most exposed façade point and the probability to report high sleep disturbance, as determined by logistic regression. The association was strongest for aircraft noise and weakest for road traffic noise. We a priori studied the role of a range of effect modifiers, including the "eventfulness" of noise exposure, expressed as the Intermittency Ratio (IR) metric, bedroom window position, bedroom orientation towards the closest street, access to a quiet side of the dwelling, degree of urbanization, sleep timing factors (bedtime and sleep duration), sleep medication intake, survey season and night air temperature. While bedroom orientation exhibited a strong moderating effect, with an Leq-equivalent of nearly 20 dB if the bedroom faces away from the nearest street, the LNight-%HSD associations were not affected by bedroom window position, sleep timing factors, survey season, or temperature., Competing Interests: The authors declare no conflicts of interest.

It is unclear which noise exposure time window and noise characteristics during nighttime are most detrimental for sleep quality in real-life settings. We conducted a field study with 105 volunteers wearing a wrist actimeter to record their sleep during seven days, together with concurrent outdoor noise measurements at their bedroom window. Actimetry-recorded sleep latency increased by 5.6 min (95% confidence interval (CI): 1.6 to 9.6 min) per 10 dB(A) increase in noise exposure during the first hour after bedtime. Actimetry-assessed sleep efficiency was significantly reduced by 2%-3% per 10 dB(A) increase in measured outdoor noise (L eq, 1h ) for the last three hours of sleep. For self-reported sleepiness, noise exposure during the last hour prior to wake-up was most crucial, with an increase in the sleepiness score of 0.31 units (95% CI: 0.08 to 0.54) per 10 dB(A) L eq,1h . Associations for estimated indoor noise were not more pronounced than for outdoor noise. Taking noise events into consideration in addition to equivalent sound pressure levels (L eq ) only marginally improved the statistical models. Our study provides evidence that matching the nighttime noise exposure time window to the individual's diurnal sleep-wake pattern results in a better estimate of detrimental nighttime noise effects on sleep. We found that noise exposure at the beginning and the end of the sleep is most crucial for sleep quality.

Communication technologies are rapidly changing and this may affect public exposure to radiofrequency electromagnetic fields (RF-EMF). This systematic review of literature aims to update a previous review on public everyday RF-EMF exposure in Europe, which covered publications until 2015. From 144 eligible records identified by means of a systematic search in PubMed, Embase and Web of Knowledge databases, published between May 2015 and 1 July 2018, 26 records met the inclusion criteria. We extracted quantitative data on public exposure in different indoors, outdoors and transport environments. The data was descriptively analyzed with respect to the exposure patterns between different types of environments. Mean RF-EMF exposure in homes, schools and offices were between 0.04 and 0.76 V/m. Mean outdoor exposure values ranged from 0.07 to 1.27 V/m with downlink signals from mobile phone base stations being the most relevant contributor. RF-EMF levels tended to increase with increasing urbanity. Levels in public transport (bus, train and tram) and cars were between 0.14 and 0.69 V/m. The highest levels, up to 1.97 V/m, were measured in public transport stations with downlink as the most relevant contributor. In line with previous studies, RF-EMF exposure levels were highest in the transportation systems followed by outdoor and private indoor environments. This review does not indicate a noticeable increase in everyday RF-EMF exposure since 2012 despite increasing use of wireless communication devices., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Adverse effects of higher air pollution levels before and after birth on subsequent lung function are often reported in the literature. We assessed whether low-to-moderate levels of air pollution during preschool-age impact upon lung function at school-age., Methods: In a prospective birth cohort of 304 healthy term-born infants, 232 (79%) completed lung function at follow-up at six years. Using spatial-temporal models, levels of individual air pollution (nitrogen dioxide (NO 2 ) and ozone (O 3 ), particulate matter with a diameter <10 μm (PM 10 )) were estimated for the time windows pregnancy, first up to the sixth year of life separately, and birth until follow-up at six years. Time window means were compared to World Health Organization (WHO) guideline limits. Associations of exposure windows with spirometry and body plethysmography indices were analyzed using regression models, adjusting for potential confounders. For subgroup analysis, air pollution exposure was categorized into quartiles (four groups of 52 children)., Results: Mean NO 2 level from birth until follow-up was [mean (range)] [11.8 (4.9 to 35.9 μg/m 3 )], which is almost 4-times lower than the WHO suggested limit of 40 μg/m 3 . In the whole population, increased air pollution levels from birth until follow-up were associated with reduced lung function at six years. In the subgroup analysis, the 52 children exposed to NO 2 levels from the highest quartile during pregnancy, the first and second years of life and from birth until follow-up, had a significant decrease in forced expiratory volume in 1 s (FEV 1 ). Per interquartile range increase of NO 2 , FEV 1 decreased by [z-score change (95% confidence interval)] [-1.07 (-1.67 to -0.47)], [-1.02 (-1.66 to -0.39)], [-0.51 (-0.86 to -0.17)] and [-0.80 (-1.33 to -0.27)], respectively. Air pollution exposure during pregnancy and childhood resulted in a non-significant decrease in lung volume at six years, as assessed by functional residual capacity measured by body plethysmography (FRC pleth )., Conclusion: Our results suggest that exposure to higher NO 2 levels, which are still much lower than WHO guideline limits, especially during the sensitive period of early lung development, may be associated with reduced lung function at school-age. These findings support the concept of age and dose-dependent pollution effects on lung function in healthy school-aged children and underline the importance of pollution reduction measures., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The aim of the present study is to establish exposure-response relationships reflecting the percentage highly annoyed (%HA) as functions of road traffic, railway, and aircraft noise exposure, measured as day-evening-night level (Lden), as well as to elucidate the degree to which the acoustic indicator Intermittency Ratio (IR), which reflects the "eventfulness" of a noise situation, predicts noise annoyance. We conducted a mixed-mode representative population survey in a stratified random sample of 5592 residents exposed to transportation noise all over Switzerland. Source-specific noise exposure was calculated for each floor and each façade based on comprehensive traffic data. Noise annoyance was measured using the ICBEN 11-point scale. The survey was carried out in 4 waves at different times of the year. We hypothesized that in addition to Lden, the effects of noise on annoyance can be better explained when also considering the intensity of short-term variations of noise level over time. We therefore incorporated the acoustic indicator IR in the statistical models. For all noise sources, results revealed significant associations between Lden and %HA after controlling for confounders and independent predictors such as IR (measured over 24 h), exposure to other transportation noise sources, sex and age, language, home ownership, education level, living duration, temperature, and access to a quiet side of the dwelling. Aircraft noise annoyance scored markedly higher than annoyance to railway and road traffic noise at the same Lden level. Railway noise elicited higher percentages of highly annoyed persons than road traffic noise. Results furthermore suggest that for road traffic noise, IR has an additional effect on %HA and can explain shifts of the exposure-response curve of up to about 6 dB between low IR and high IR exposure situations, possibly due to the effect of different durations of noise-free intervals between events. For railway and aircraft noise annoyance, the predictive value of IR was limited., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aims: The present study aimed to disentangle the risk of the three major transportation noise sources-road, railway, and aircraft traffic-and the air pollutants NO2 and PM2.5 on myocardial infarction (MI) mortality in Switzerland based on high quality/fine resolution exposure modelling., Methods and Results: We modelled long-term exposure to outdoor road traffic, railway, and aircraft noise levels, as well as NO2 and PM2.5 concentration for each address of the 4.40 million adults (>30 years) in the Swiss National Cohort (SNC). We investigated the association between transportation noise/air pollution exposure and death due to MI during the follow-up period 2000-08, by adjusting noise [Lden(Road), Lden(Railway), and Lden(Air)] estimates for NO2 and/or PM2.5 and vice versa by multipollutant Cox regression models considering potential confounders. Adjusting noise risk estimates of MI for NO2 and/or PM2.5 did not change the hazard ratios (HRs) per 10 dB increase in road traffic (without air pollution: 1.032, 95% CI: 1.014-1.051, adjusted for NO2 and PM2.5: 1.034, 95% CI: 1.014-1.055), railway traffic (1.020, 95% CI: 1.007-1.033 vs. 1.020, 95% CI: 1.007-1.033), and aircraft traffic noise (1.025, 95% CI: 1.006-1.045 vs. 1.025, 95% CI: 1.005-1.046). Conversely, noise adjusted HRs for air pollutants were lower than corresponding estimates without noise adjustment. Hazard ratio per 10 μg/m³ increase with and without noise adjustment were 1.024 (1.005-1.043) vs. 0.990 (0.965-1.016) for NO2 and 1.054 (1.013-1.093) vs. 1.019 (0.971-1.071) for PM2.5., Conclusion: Our study suggests that transportation noise is associated with MI mortality, independent from air pollution. Air pollution studies not adequately adjusting for transportation noise exposure may overestimate the cardiovascular disease burden of air pollution., (Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2018. For permissions, please email: journals.permissions@oup.com.)

Background: Epidemiological research on transportation noise uses different exposure assessment strategies based on façade point estimates or regulatory noise maps. The degree of exposure measurement error and subsequent potentially biased risk estimates related to exposure definition is unclear. We aimed to evaluate associations between transportation noise exposure and myocardial infarction (MI) mortality considering: assumptions about residential floor, façade point selection (loudest, quietest, nearest), façade point vs. noise map estimates, and influence of averaging exposure at coarser spatial scales (e.g. in ecological health studies)., Methods: L den from the façade points were assigned to >4 million eligible adults in the Swiss National Cohort for the best match residential floor (reference), middle floor, and first floor. For selected floors, the loudest and quietest exposed façades per dwelling, plus the nearest façade point to the residential geocode, were extracted. Exposure was also assigned from 10 × 10 m noise maps, using "buffers" from 50 to 500 m derived from the maps, and by aggregating the maps to larger areas. Associations between road traffic and railway noise and MI mortality were evaluated by multi-pollutant Cox regression models, adjusted for aircraft noise, NO 2 and socio-demographic confounders, following individuals from 2000 to 2008. Bias was calculated to express differences compared to the reference., Results: Hazard ratios (HRs) for the best match residential floor were 1.05 (1.02-1.07) and 1.03 (1.01-1.05) per IQR (11.3 and 15.0 dB) for road traffic and railway noise, respectively. In most situations, comparing the alternative exposure definitions to this reference resulted in attenuated HRs. For example, assuming everyone resided on the middle or everyone on first floor introduced little bias (%Bias in excess risk: -1.9 to 4.4 road traffic and -4.4 to 10.7 railway noise). Using the noise grids generated a bias of approximately -26% for both sources. Averaging the maps at a coarser spatial scale led to bias from -19.4 to -105.1% for road traffic and 17.6 to -34.3% for railway noise and inflated the confidence intervals such that some HRs were no longer statistically significant., Conclusion: Changes in spatial scale introduced more bias than changes in residential floor. Use of noise maps to represent residential exposure may underestimate noise-induced health effects, in particular for small-scale heterogeneously distributed road traffic noise in urban settings., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Transportation noise leads to sleep disturbance and to psychological and physiological sustained stress reactions, which could impact respiratory health. However, epidemiologic evidence on associations of objective transportation noise exposure and also perceived noise annoyance with respiratory morbidity is limited. We investigated independent associations of transportation noise exposure and noise annoyance with prevalent respiratory symptoms and incident asthma in adults. Using 17,138 observations (from 7049 participants) from three SAPALDIA (Swiss Cohort Study on Lung and Heart Diseases in Adults) surveys, we assessed associations of transportation noise exposure and noise annoyance with prevalent respiratory symptoms, and with incident asthma (in 10,657 nested observations from 6377 participants). Annual day-evening-night transportation noise comprising road, railway and aircraft Lden (Transportation Lden) was calculated for the most exposed façade of participants' residence using Swiss noise models. Transportation noise annoyance was assessed using an 11-point scale, and participants reported respiratory symptoms and doctor-diagnosed asthma at each survey. We estimated associations with transportation Lden (as well as source-specific Lden) and noise annoyance, independent of air pollution and other potential confounders, using mutually-adjusted mixed logistic and Poisson models and applying random intercepts at the level of the participants. Prevalent respiratory symptoms ranged from 5% (nocturnal dyspnoea) to 23% (regular cough/phlegm). Transportation noise annoyance, but not Lden, was independently associated with respiratory symptoms and current asthma in all participants, with odds ratios (OR) and 95% confidence intervals (CI) ranging between 1.03 (95%CI: 1.01, 1.06) and 1.07 (95% CI: 1.04, 1.11) per 1-point difference in noise annoyance. Both noise annoyance and Lden showed independent associations with asthma symptoms among asthmatics, especially in those reporting adult-onset asthma [OR Lden : 1.90 (95% CI: 1.25, 2.89) per 10 dB; p-value of interaction (adult-onset vs. childhood-onset): 0.03; OR noise annoyance : 1.06 (95%CI: 0.97, 1.16) per 1-point difference; p-value of interaction: 0.06]. No associations were found with incident asthma. Transportation noise level and annoyance contributed to symptom exacerbation in adult asthma. This suggests both psychological and physiological noise reactions on the respiratory system, and could be relevant for asthma care. More studies are needed to better understand the effects of objective and perceived noise in asthma aetiology and overall respiratory health., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The contribution of different transportation noise sources to metabolic disorders such as obesity remains understudied. We evaluated the associations of long-term exposure to road, railway and aircraft noise with measures of obesity and its subphenotypes using cross-sectional and longitudinal designs. We assessed 3796 participants from the population-based Swiss Cohort Study on Air Pollution and Lung and Heart Diseases (SAPALDIA), who attended the visits in 2001 (SAP2) and 2010/2011 (SAP3) and who were aged 29-72 at SAP2. At SAP2 we measured body mass index (BMI, kg/m 2 ). At SAP3 we measured BMI, waist circumference (centimetres) and Kyle body Fat Index (%) and derived overweight, central and general obesity. Longitudinally for BMI, we derived change in BMI, incidence of overweight and obesity and a 3-category outcome combining the latter two. We assigned source-specific 5-year mean noise levels before visits and during follow-up at the most exposed dwelling façade (Lden, dB), using Swiss noise models for 2001 and 2011 and participants' residential history. Models were adjusted for relevant confounders, including traffic-related air pollution. Exposure to road traffic noise was significantly associated with all adiposity subphenotypes, cross-sectionally (at SAP3) [e.g. beta (95% CI) per 10 dB, BMI: 0.39 (0.18; 0.59); waist circumference: 0.93 (0.37; 1.50)], and with increased risk of obesity, longitudinally (e.g. RR = 1.25, 95% CI: 1.04; 1.51, per 10 dB in 5-year mean). Railway noise was significantly related to increased risk of overweight. In cross-sectional analyses, we further identified a stronger association between road traffic noise and BMI among participants with cardiovascular disease and an association between railway noise and BMI among participants reporting bad sleep. Associations were independent of the other noise sources, air pollution and robust to all adjustment sets. No associations were observed for aircraft noise. Long-term exposure to transportation noise, particularly road traffic noise, may increase the risk of obesity and could constitute a pathway towards cardiometabolic and other diseases., (Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Exposure to radiofrequency electromagnetic fields (RF-EMF) from mobile communication technologies is changing rapidly. To characterize sources and associated variability, we studied the differences and correlations in exposure patterns between children aged 8 to 18 and their parents, over the course of the day, by age, by activity pattern, and for different metrics of exposure., Methods: Using portable RF-EMF measurement devices, we collected simultaneous real-time personal measurements of RF-EMF over 24 to 72 h in 294 parent-child pairs from Denmark, the Netherlands, Slovenia, Switzerland, and Spain. The devices measured the power flux density (mW/m 2 ) in 16 different frequency bands every 4 s, and activity diary Apps kept by the participants were used to collect time-activity information in real-time. We analyzed their exposures by activity, for the different source constituents of exposure: downlink (radiation emitted from mobile phone base stations), uplink (transmission from phone to base station), broadcast, DECT (digital enhanced cordless telecommunications) and Wi-Fi. We looked at the correlations between parents and children overall, during day (06:00-22.00) and night (22:00-06:00) and while spending time at home., Results: The mean of time-weighted average personal exposures was 0.16 mW/m 2 for children and 0.15 mW/m 2 for parents, on average predominantly originating from downlink sources (47% for children and 45% for parents), followed by uplink (18% and 27% respectively) and broadcast (25% and 19%). On average, exposure for downlink and uplink were highest during the day, and for Wi-Fi and DECT during the evening. Exposure during activities where most of the time is spent (home, school and work) was relatively low whereas exposure during travel and outside activities was higher. Exposure to uplink increased with age among young people, while DECT decreased slightly. Exposure to downlink, broadcast, and Wi-Fi showed no obvious trend with age. We found that exposure to total RF-EMF is correlated among children and their parents (R spearman  = 0.45), especially while at home (0.62) and during the night (0.60). Correlations were higher for environmental sources such as downlink (0.57) and broadcast (0.62) than for usage-related exposures such as uplink (0.29)., Conclusion: The generation gap between children and their parents is mostly evident in uplink exposure, due to more and longer uplink and cordless phone calls among parents, and their tendency to spend slightly more time in activities with higher environmental RF-EMF exposure, such as travel. Despite these differences in personal behavior, exposure to RF-EMF is moderately correlated between children and their parents, especially exposures resulting from environmental RF-EMF sources., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

In developing countries, noise annoyance and noise sensitivity are not commonly investigated. The present study aimed to assess the annoyance and sensitivity to noise in 364 adults living in informal settings in the Western Cape Province, South Africa and to compare with a similar study conducted in Switzerland. Compared to Switzerland, higher percentages of highly noise sensitive individuals (women: 35.1% vs 26.9%; men: 25% vs 20.5%) and people highly annoyed to road traffic noise (women: 20.5% vs 12.4%; men: 17.9% vs 11.1%) were observed in South Africa. While in South Africa women were more annoyed to neighborhood noise than in Switzerland (21.1% vs 9.4%), this was not the case among men (7.1% vs 7.8%). Multivariable logistic regression models showed that in both countries men tended to be less sensitive and less annoyed by noise. Corresponding associations with age and education were somewhat different between the countries, which may be explained by socioeconomic and environmental differences. This study indicates that noise exposure considerably affects people living in informal settlements, and noise should be considered when improving the housing conditions., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

In this study, children's exposure to extremely low frequency magnetic fields (ELF-MF, 40⁻800 Hz) is investigated. The interest in this thematic has grown due to a possible correlation between the increased risk of childhood leukemia and a daily average exposure above 0.4 µT, although the causal relationship is still uncertain. The aim of this paper was to present a new method of characterizing the children's exposure to ELF-MF starting from personal measurements using a stochastic approach based on segmentation (and to apply it to the personal measurements themselves) of two previous projects: the ARIMMORA project and the EXPERS project. The stochastic model consisted in (i) splitting the 24 h recordings into stationary events and (ii) characterizing each event with four parameters that are easily interpretable: the duration of the event, the mean value, the dispersion of the magnetic field over the event, and a final parameter characterizing the variation speed. Afterward, the data from the two databases were divided in subgroups based on a characteristic (i.e., children's age, number of inhabitants in the area, etc.). For every subgroup, the kernel density estimation (KDE) of each parameter was calculated and the p -value histogram of the parameters together was obtained, in order to compare the subgroups and to extract information about the children's exposure. In conclusion, this new stochastic approach allows for the identification of the parameters that most affect the level of children's exposure.

Introduction: Radiofrequency (RF) fields are widely used and, while it is still unknown whether children are more vulnerable to this type of exposure, it is essential to explore their level of exposure in order to conduct adequate epidemiological studies. Personal measurements provide individualized information, but they are costly in terms of time and resources, especially in large epidemiological studies. Other approaches, such as estimation of time-weighted averages (TWAs) based on spot measurements could simplify the work., Objectives: The aims of this study were to assess RF exposure in the Spanish INMA birth cohort by spot measurements and by personal measurements in the settings where children tend to spend most of their time, i.e., homes, schools and parks; to identify the settings and sources that contribute most to that exposure; and to explore if exposure assessment based on spot measurements is a valid proxy for personal exposure., Methods: When children were 8 years old, spot measurements were conducted in the principal settings of 104 participants: homes (104), schools and their playgrounds (26) and parks (79). At the same time, personal measurements were taken for a subsample of 50 children during 3 days. Exposure assessment based on personal and on spot measurements were compared both in terms of mean exposures and in exposure-dependent categories by means of Bland-Altman plots, Cohen's kappa and McNemar test., Results: Median exposure levels ranged from 29.73 (in children's bedrooms) to 200.10 μW/m 2 (in school playgrounds) for spot measurements and were higher outdoors than indoors. Median personal exposure was 52.13 μW/m 2 and median levels of assessments based on spot measurements ranged from 25.46 to 123.21 μW/m 2 . Based on spot measurements, the sources that contributed most to the exposure were FM radio, mobile phone downlink and Digital Video Broadcasting-Terrestrial, while indoor and personal sources contributed very little (altogether <20%). Similar distribution was observed with personal measurements. There was a bias proportional to power density between personal measurements and estimates based on spot measurements, with the latter providing higher exposure estimates. Nevertheless, there were no systematic differences between those methodologies when classifying subjects into exposure categories. Personal measurements of total RF exposure showed low to moderate agreement with home and bedroom spot measurements and agreed better, though moderately, with TWA based on spot measurements in the main settings where children spend time (homes, schools and parks; Kappa = 0.46)., Conclusions: Exposure assessment based on spot measurements could be a feasible proxy to rank personal RF exposure in children population, providing that all relevant locations are being measured., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Exposure to radiofrequency electromagnetic fields (RF-EMF) has rapidly increased and little is known about exposure levels in children. This study describes personal RF-EMF environmental exposure levels from handheld devices and fixed site transmitters in European children, the determinants of this, and the day-to-day and year-to-year repeatability of these exposure levels., Methods: Personal environmental RF-EMF exposure (μW/m 2 , power flux density) was measured in 529 children (ages 8-18 years) in Denmark, the Netherlands, Slovenia, Switzerland, and Spain using personal portable exposure meters for a period of up to three days between 2014 and 2016, and repeated in a subsample of 28 children one year later. The meters captured 16 frequency bands every 4 s and incorporated a GPS. Activity diaries and questionnaires were used to collect children's location, use of handheld devices, and presence of indoor RF-EMF sources. Six general frequency bands were defined: total, digital enhanced cordless telecommunications (DECT), television and radio antennas (broadcast), mobile phones (uplink), mobile phone base stations (downlink), and Wireless Fidelity (WiFi). We used adjusted mixed effects models with region random effects to estimate associations of handheld device use habits and indoor RF-EMF sources with personal RF-EMF exposure. Day-to-day and year-to-year repeatability of personal RF-EMF exposure were calculated through intraclass correlations (ICC)., Results: Median total personal RF-EMF exposure was 75.5 μW/m 2 . Downlink was the largest contributor to total exposure (median: 27.2 μW/m 2 ) followed by broadcast (9.9 μW/m 2 ). Exposure from uplink (4.7 μW/m 2 ) was lower. WiFi and DECT contributed very little to exposure levels. Exposure was higher during day (94.2 μW/m 2 ) than night (23.0 μW/m 2 ), and slightly higher during weekends than weekdays, although varying across regions. Median exposures were highest while children were outside (157.0 μW/m 2 ) or traveling (171.3 μW/m 2 ), and much lower at home (33.0 μW/m 2 ) or in school (35.1 μW/m 2 ). Children living in urban environments had higher exposure than children in rural environments. Older children and users of mobile phones had higher uplink exposure but not total exposure, compared to younger children and those that did not use mobile phones. Day-to-day repeatability was moderate to high for most of the general frequency bands (ICCs between 0.43 and 0.85), as well as for total, broadcast, and downlink for the year-to-year repeatability (ICCs between 0.49 and 0.80) in a small subsample., Conclusion: The largest contributors to total personal environmental RF-EMF exposure were downlink and broadcast, and these exposures showed high repeatability. Urbanicity was the most important determinant of total exposure and mobile phone use was the most important determinant of uplink exposure. It is important to continue evaluating RF-EMF exposure in children as device use habits, exposure levels, and main contributing sources may change., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Although studies have consistently found an association between childhood leukaemia risk and magnetic fields, the associations between childhood leukaemia and distance to overhead power lines have been inconsistent. We pooled data from multiple studies to assess the association with distance and evaluate whether it is due to magnetic fields or other factors associated with distance from lines., Methods: We present a pooled analysis combining individual-level data (29,049 cases and 68,231 controls) from 11 record-based studies., Results: There was no material association between childhood leukaemia and distance to nearest overhead power line of any voltage. Among children living < 50 m from 200 + kV power lines, the adjusted odds ratio for childhood leukaemia was 1.33 (95% CI: 0.92-1.93). The odds ratio was higher among children diagnosed before age 5 years. There was no association with calculated magnetic fields. Odds ratios remained unchanged with adjustment for potential confounders., Conclusions: In this first comprehensive pooled analysis of childhood leukaemia and distance to power lines, we found a small and imprecise risk for residences < 50 m of 200 + kV lines that was not explained by high magnetic fields. Reasons for the increased risk, found in this and many other studies, remains to be elucidated.

Background: Traffic noise has been associated with an increased risk for several non-auditory health effects, which may be explained by a noise-induced release of stress hormones (e.g. glucocorticoids). Although several studies in children and adults have indicated an increased secretion of glucocorticoids after exposure to noise, information regarding newborns is scarce., Objectives: To investigate the association between residential exposure to road traffic noise and postnatal stress response, as assessed by the concentration of glucocorticoids at five weeks of age., Methods: Residential noise exposure was estimated for each infant based on spatially detailed modeled data. Adjusted multivariable linear regression models were used to estimate the association between noise exposure and the concentration of nine glucocorticoid metabolites measured in urine of 165 infants from a prospective birth cohort in Bern, Switzerland. Noise exposure (Lden, dB) was categorized into tertiles: low (reference), medium and high., Results: Indications of a positive association were found between high road traffic noise and cortisol (% change relative to the reference: 12.1% [95% confidence interval: -10.3, 40.1%]) and cortisone (22.6% [-1.8, 53.0%]), but just the latter was borderline significant. Borderline significant associations were also found between downstream metabolites and higher road traffic noise levels; associations were found to be both positive (i.e. for β-cortolone (51.5% [-0.9, 131.5%])) and negative (i.e. for α-cortolone (-18.3% [-33.6, 0.6%]) and tetrahydrocortisol (-23.7% [-42.8, 1.9%]))., Conclusions: Our findings suggest a potential association between exposure to higher road traffic noise levels and changes in glucocorticoid metabolism in early postnatal life. A possible physiological relevance and associations with short- and long-term adverse health effects in a larger study population need to be further investigated., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Research on reproductive health effects on children from low-level, long-term exposure to pesticides currently used in the agricultural industry is limited and those on neurobehavioral effects have produced conflicting evidence. We aim at investigating the association between pesticide exposure on the reproductive health and neurobehavior of children in South Africa, by including potential relevant co-exposures from the use of electronic media and maternal alcohol consumption., Methods: The design entails a prospective cohort study with a follow-up duration of 2 years starting in 2017, including 1000 school going children between the ages of 9 to 16 years old. Children are enrolled with equal distribution in sex and residence on farms and non-farms in three different agricultural areas (mainly apple, table grapes and wheat farming systems) in the Western Cape, South Africa. The neurobehavior primary health outcome of cognitive functioning was measured through the iPad-based CAmbridge Neuropsychological Test Automated Battery (CANTAB) including domains for attention, memory, and processing speed. The reproductive health outcomes include testicular size in boys and breast size in girls assessed in a physical examination, and blood samples to detect hormone levels and anthropometric measurements. Information on pesticide exposure, co-exposures and relevant confounders are obtained through structured questionnaire interviews with the children and their guardians. Environmental occurrence of pesticides will be determined while using a structured interview with farm owners and review of spraying records and collection of passive water and air samples in all three areas. Pesticide metabolites will be analysed in urine and hair samples collected from the study subjects every 4 months starting at baseline., Discussion: The inclusion of three different agricultural areas will yield a wide range of pesticide exposure situations. The prospective longitudinal design is a further strength of this study to evaluate the reproductive and neurobehavioural effects of different pesticides on children. This research will inform relevant policies and regulatory bodies to improve the health, safety and learning environments for children and families in agricultural settings.

We aimed to assess the personal radiofrequency electromagnetic field (RF-EMF) exposure levels of children and adults through their activities, with consideration to the body shadowing effect. We recruited 50 child-adult pairs, living in Seoul, Cheonan, and Ulsan, South Korea. RF-EMF measurements were performed between September and December 2016, using a portable exposure meter tailored to capture 14 Korean radiofrequency (RF) bands ranging from 87.5 to 5875MHz. The participants carried the device for 48h and kept a time-activity diary using a smartphone application in flight mode. To enhance accuracy of the exposure assessment, the body shadowing effect was compensated during the statistical analysis with the measured RF-EMF exposure. The compensation was conducted using the hybrid model that represents the decrease of the exposure level due to the body shadowing effect. A generalized linear mixed model was used to compare the RF-EMF exposure levels by subjects and activities. The arithmetic (geometric) means of the total power density were 174.9 (36.6) μW/m 2 for all participants, 226.9 (44.6) for fathers, 245.4 (44.8) for mothers, and 116.2 (30.1) for children. By compensating for the body shadowing effect, the total RF-EMF exposure increased marginally, approximately 1.4 times. Each frequency band contribution to total RF-EMF exposure consisted of 76.7%, 2.4%, 9.9%, 5.0%, 3.3%, and 2.6% for downlink, uplink, WiFi, FM Radio, TV, and WiBro bands, respectively. Among the three regions, total RF-EMF exposure was highest in Seoul, and among the activities, it was highest in the metro, followed by foot/bicycle, bus/car, and outside. The contribution of base-station exposure to total RF-EMF exposure was the highest both in parents and children. Total and base-station RF-EMF exposure levels in Korea were higher than those reported in European countries., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The aim of this study was to quantify RF-EMF exposure applying a tested protocol of RF-EMF exposure measurements using portable devices with a high sampling rate in different microenvironments of Switzerland, Ethiopia, Nepal, South Africa, Australia and the United States of America., Method: We used portable measurement devices for assessing RF-EMF exposure in 94 outdoor microenvironments and 18 public transport vehicles. The measurements were taken either by walking with a backpack with the devices at the height of the head and a distance of 20-30 cm from the body, or driving a car with the devices mounted on its roof, which was 170-180 cm above the ground. The measurements were taken for about 30 min while walking and about 15-20 min while driving in each microenvironment, with a sampling rate of once every 4 s (ExpoM-RF) and 5 s (EME Spy 201)., Results: Mean total RF-EMF exposure in various outdoor microenvironments varied between 0.23 V/m (non-central residential area in Switzerland) and 1.85 V/m (university area in Australia), and across modes of public transport between 0.32 V/m (bus in rural area in Switzerland) and 0.86 V/m (Auto rickshaw in urban area in Nepal). For most outdoor areas the major exposure contribution was from mobile phone base stations. Otherwise broadcasting was dominant. Uplink from mobile phone handsets was generally very small, except in Swiss trains and some Swiss buses., Conclusions: This study demonstrates high RF-EMF variability between the 94 selected microenvironments from all over the world. Exposure levels tended to increase with increasing urbanity. In most microenvironments downlink from mobile phone base stations is the most relevant contributor., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Background: Most epidemiological noise studies consider 24 h average noise exposure levels. Our aim was to exploratively analyze the impact of noise exposure at different time windows during day and night on cardiovascular mortality., Methods: We generated Switzerland-wide exposure models for road traffic, railway and aircraft noise for different time windows for the year 2001. Combined noise source equivalent continuous sound levels (L eq ) for different time windows at the most exposed façade were assigned to each of the 4.41 million Swiss National Cohort adult participants. Follow-up period was from 2000 to 2008. Hazard ratios (HR) of noise effects on various cardiovascular primary causes of death were computed by Cox regression models adjusted for potential confounders and NO 2 levels., Results: For most cardiovascular causes of death we obtained indications for a diurnal pattern. For ischemic heart disease the highest HR was observed for the core night hours from 01 h to 05 h (HR per standard deviation of L eq : 1.025, 95% CI: 1.016-1.034) and lower HR for the daytime 07 h to 19 h (1.018 [1.009-1.028]). Heart failure and daytime L eq yielded the highest HR (1.047 [1.027-1.068])., Conclusion: For acute cardiovascular diseases, nocturnal intermittent noise exposure tended to be more relevant than daytime exposure, whereas it was the opposite for chronic conditions such as heart failure most strongly associated with continuous daytime noise. This suggests that for acute diseases sleep is an important mediator for health consequences of transportation noise., (Copyright © 2018 Elsevier GmbH. All rights reserved.)

The impact of the introduction and advancement in communication technology in recent years on exposure level of the population is largely unknown. The main aim of this study is to systematically review literature on the distribution of radiofrequency electromagnetic field (RF-EMF) exposure in the everyday environment in Europe and summarize key characteristics of various types of RF-EMF studies conducted in the European countries. We systematically searched the ISI Web of Science for relevant literature published between 1 January 2000 and 30 April 2015, which assessed RF-EMF exposure levels by any of the methods: spot measurements, personal measurement with trained researchers and personal measurement with volunteers. Twenty-one published studies met our eligibility criteria of which 10 were spot measurements studies, 5 were personal measurement studies with trained researchers (microenvironmental), 5 were personal measurement studies with volunteers and 1 was a mixed methods study combining data collected by volunteers and trained researchers. RF-EMF data included in the studies were collected between 2005 and 2013. The mean total RF-EMF exposure for spot measurements in European "Homes" and "Outdoor" microenvironments was 0.29 and 0.54 V/m, respectively. In the personal measurements studies with trained researchers, the mean total RF-EMF exposure was 0.24 V/m in "Home" and 0.76 V/m in "Outdoor". In the personal measurement studies with volunteers, the population weighted mean total RF-EMF exposure was 0.16 V/m in "Homes" and 0.20 V/m in "Outdoor". Among all European microenvironments in "Transportation", the highest mean total RF-EMF 1.96 V/m was found in trains of Belgium during 2007 where more than 95% of exposure was contributed by uplink. Typical RF-EMF exposure levels are substantially below regulatory limits. We found considerable differences between studies according to the type of measurements procedures, which precludes cross-country comparison or evaluating temporal trends. A comparable RF-EMF monitoring concept is needed to accurately identify typical RF-EMF exposure levels in the everyday environment.

Traffic noise has been linked to diabetes, with limited understanding of its mechanisms. We hypothesize that night-time road traffic noise (RTN) may impair glucose homeostasis through circadian rhythm disturbances. We prospectively investigated the relationship between residential night-time RTN and subsequent eight-year change in glycosylated hemoglobin (ΔHbA1c) in 3350 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), adjusting for diabetes risk factors and air pollution levels. Annual average RTN (Lnight) was assigned to participants in 2001 using validated Swiss noise models. HbA1c was measured in 2002 and 2011 using liquid chromatography. We applied mixed linear models to explore RTN-ΔHbA1c association and its modification by a genetic risk score of six common circadian-related MTNR1B variants (MGRS). A 10 dB difference in RTN was associated with a 0.02% (0.003-0.04%) increase in mean ΔHbA 1c in 2142 non-movers. RTN-ΔHbA1c association was modified by MGRS among diabetic participants ( P interaction = 0.001). A similar trend in non-diabetic participants was non-significant. Among the single variants, we observed strongest interactions with rs10830963, an acknowledged diabetes risk variant also implicated in melatonin profile dysregulation. Night-time RTN may impair glycemic control, especially in diabetic individuals, through circadian rhythm disturbances. Experimental sleep studies are needed to test whether noise control may help individuals to attain optimal glycemic levels., Competing Interests: The authors declare no competing interests. The founding sponsors had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

In low- and middle-income countries, noise exposure and its negative health effects have been little explored. The present study aimed to assess the noise exposure situation in adults living in informal settings in the Western Cape Province, South Africa. We conducted continuous one-week outdoor noise measurements at 134 homes in four different areas. These data were used to develop a land use regression (LUR) model to predict A-weighted day-evening-night equivalent sound levels (L den ) from geographic information system (GIS) variables. Mean noise exposure during day (6:00-18:00) was 60.0 A-weighted decibels (dB(A)) (interquartile range 56.9-62.9 dB(A)), during night (22:00-6:00) 52.9 dB(A) (49.3-55.8 dB(A)) and average L den was 63.0 dB(A) (60.1-66.5 dB(A)). Main predictors of the LUR model were related to road traffic and household density. Model performance was low (adjusted R 2 = 0.130) suggesting that other influences than those represented in the geographic predictors are relevant for noise exposure. This is one of the few studies on the noise exposure situation in low- and middle-income countries. It demonstrates that noise exposure levels are high in these settings., Competing Interests: The authors declare no conflict of interest.

Background: There is evidence from existing literature that ambient air pollutant exposure in early childhood likely plays an important role in asthma exacerbation and other respiratory symptoms, with greater effect among asthmatic children. However, there is inconclusive evidence on the role of ambient air pollutant exposures in relation to increasing asthma prevalence as well as asthma induction in children. At the population level, little is known about the potential synergistic effects between pollen allergens and air pollutants since this type of association poses challenges in uncontrolled real life settings. In particular, data from sub-Sahara Africa is scarce and virtually absent among populations residing in informal residential settlements., Methods/design: A prospective cohort study of 600 school children residing in four informal settlement areas with varying potential ambient air pollutant exposure levels in the Western Cape in South Africa is carried-out. The study has two follow-up periods of at least six-months apart including an embedded panel study in summer and winter. The exposure assessment component models temporal and spatial variability of air quality in the four study areas over the study duration using land-use regression modelling (LUR). Additionally, daily pollen levels (mould spores, tree, grass and weed pollen) in the study areas are recorded. In the panel study asthma symptoms and serial peak flow measurements is recorded three times daily to determine short-term serial airway changes in relation to varying ambient air quality and pollen over 10-days during winter and summer. The health outcome component of the cohort study include; the presence of asthma using a standardised ISAAC questionnaire, spirometry, fractional exhaled nitric-oxide (FeNO) and the presence of atopy (Phadiatop)., Discussion: This research applies state of the art exposure assessment approaches to characterize the effects of ambient air pollutants on childhood respiratory health, with a specific focus on asthma and markers of airway inflammation (FeNO) in South African informal settlement areas by considering also pollen counts and meteorological factors. The study will generate crucial data on air pollution and asthma in low income settings in sub-Sahara Africa that is lacking in the international literature.

Background: The impact of different transportation noise sources and noise environments on arterial stiffness remains unknown., Objectives: We evaluated the association between residential outdoor exposure to annual average road, railway, and aircraft noise levels, total noise intermittency (IR), and total number of noise events (NE) and brachial-ankle pulse wave velocity (baPWV) following a cross-sectional design., Methods: We measured baPWV (meters/second) in 2,775 participants (49-81 y old) at the second follow-up (2010-2011) of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA). We assigned annual average road, railway, and aircraft noise levels (Ldensource), total day- and nighttime NEtime and IRtime (percent fluctuation=0%, none or constant noise; percent fluctuation=100%, high fluctuation) at the most exposed façade using 2011 Swiss noise models. We applied multivariable linear mixed regression models to analyze associations., Results: Medians [interquartile ranges (IQRs)] were baPWV=13.4 (3.1) m/s; Ldenair (57.6% exposed)=32.8 (8.0) dB; Ldenrail (44.6% exposed)=30.0 (8.1) dB; Ldenroad (99.7% exposed): 54.2 (10.6) dB; NEnight=123 (179); NEday=433 (870); IRnight=73% (27); and IRday=63.8% (40.3). We observed a 0.87% (95% CI: 0.31, 1.43%) increase in baPWV per IQR of Ldenrail, which was greater with IRnight>80% or with daytime sleepiness. We observed a nonsignificant positive association between Ldenroad and baPWV in urban areas and a negative tendency in rural areas. NEnight, but not NEday, was associated with baPWV. Associations were independent of the other noise sources and air pollution., Conclusions: Long-term exposure to railway noise, particularly in an intermittent nighttime noise environment, and to nighttime noise events, mainly related to road noise, may affect arterial stiffness, a major determinant of cardiovascular disease. Ascertaining noise exposure characteristics beyond average noise levels may be relevant to better understand noise-related health effects. https://doi.org/10.1289/EHP1136.

A three-dimensional model for calculating long term exposure to extremely low-frequency magnetic fields from high-voltage overhead power lines is presented, as well as its validation by measurements. For the validation, the model was applied to two different high-voltage overhead power lines in Iffwil and Wiler (Switzerland). In order to capture the daily and seasonal variations, each measurement was taken for 48 h and the measurements were carried out six times at each site, at intervals of approximately two months, between January and December 2015. During each measurement, a lateral transect of the magnetic flux density was determined in the middle of a span from nine measurement points in the range of ±80 m. The technical data of both the lines as well as the load flow data during the measurement periods were provided by the grid operators. These data were used to calculate 48 h averages of the absolute value of the magnetic flux density and compared with modelled values. The highest 48 h average was 1.66 µT (centre of the line in Iffwil); the lowest 48 h average was 22 nT (80 m distance from the centre line in Iffwil). On average, the magnetic flux density was overestimated by 2% (standard deviation: 9%) in Iffwil and underestimated by 1% (8%) in Wiler. Sensitivity analyses showed that the uncertainty is mainly driven by errors in the coordinates and height data. In particular, for predictions near the centre of the line, an accurate digital terrain model is critical., Competing Interests: The authors declare no conflict of interest.

Background: Epidemiological studies have inconsistently linked transportation noise and air pollution (AP) with diabetes risk. Most studies have considered single noise sources and/or AP, but none has investigated their mutually independent contributions to diabetes risk., Methods: We investigated 2631 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), without diabetes in 2002 and without change of residence between 2002 and 2011. Using questionnaire and biomarker data, incident diabetes cases were identified in 2011. Noise and AP exposures in 2001 were assigned to participants' residences (annual average road, railway or aircraft noise level during day-evening-night (Lden), total night number of noise events, intermittency ratio (temporal variation as proportion of event-based noise level over total noise level) and nitrogen dioxide (NO2) levels. We applied mixed Poisson regression to estimate the relative risk (RR) of diabetes and their 95% confidence intervals (CI) in mutually-adjusted models., Results: Diabetes incidence was 4.2%. Median [interquartile range (IQR)] road, railway, aircraft noise and NO2 were 54 (10) dB, 32 (11) dB, 30 (12) dB and 21 (15) μg/m3, respectively. Lden road and aircraft were associated with incident diabetes (respective RR: 1.35; 95% CI: 1.02-1.78 and 1.86; 95% CI: 0.96-3.59 per IQR) independently of Lden railway and NO2 (which were not associated with diabetes risk) in mutually adjusted models. We observed stronger effects of Lden road among participants reporting poor sleep quality or sleeping with open windows., Conclusions: Transportation noise may be more relevant than AP in the development of diabetes, potentially acting through noise-induced sleep disturbances., (© The Author 2017. Published by Oxford University Press on behalf of the International Epidemiological Association)

Historically, assessment of human exposure to electric and magnetic fields has focused on the extremely-low-frequency (ELF) and radiofrequency (RF) ranges. However, research on the typically emitted fields in the intermediate-frequency (IF) range (300Hz to 1MHz) as well as potential effects of IF fields on the human body remains limited, although the range of household appliances with electrical components working in the IF range has grown significantly (e.g., induction cookers and compact fluorescent lighting). In this study, an extensive measurement survey was performed on the levels of electric and magnetic fields in the IF range typically present in residences as well as emitted by a wide range of household appliances under real-life circumstances. Using spot measurements, residential IF field levels were found to be generally low, while the use of certain appliances at close distance (20cm) may result in a relatively high exposure. Overall, appliance emissions contained either harmonic signals, with fundamental frequencies between 6kHz and 300kHz, which were sometimes accompanied by regions in the IF spectrum of rather noisy, elevated field strengths, or much more capricious spectra, dominated by 50Hz harmonics emanating far in the IF domain. The maximum peak field strengths recorded at 20cm were 41.5V/m and 2.7A/m, both from induction cookers. Finally, none of the appliance emissions in the IF range exceeded the exposure summation rules recommended by the International Commission on Non-Ionizing Radiation Protection guidelines and the International Electrotechnical Commission (IEC 62233) standard at 20cm and beyond (maximum exposure quotients EQ E 1.0 and E Q H 0.13)., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: We investigated whether radiofrequency electromagnetic fields (RF-EMF) from mobile phones and other wireless devices or by the wireless device use itself due to non-radiation related factors in that context are associated with an increase in health symptom reports of adolescents in Central Switzerland., Methods: In a prospective cohort study, 439 study participants (participation rate: 36.8%) aged 12-17 years, completed questionnaires about their mobile and cordless phone use, their self-reported symptoms and possible confounding factors at baseline (2012/2013) and one year later (2013/2014). Operator recorded mobile phone data was obtained for a subgroup of 234 adolescents. RF-EMF dose measures considering various factors affecting RF-EMF exposure were computed for the brain and the whole body. Data were analysed using a mixed-logistic cross-sectional model and a cohort approach, where we investigated whether cumulative dose over one year was related to a new onset of a symptom between baseline and follow-up. All analyses were adjusted for relevant confounders., Results: Participation rate in the follow-up was 97% (425 participants). In both analyses, cross-sectional and cohort, various symptoms tended to be mostly associated with usage measures that are only marginally related to RF-EMF exposure such as the number of text messages sent per day (e.g. tiredness: OR:1.81; 95%CI:1.20-2.74 for cross-sectional analyses and OR:1.87; 95%CI:1.04-3.38 for cohort analyses). Outcomes were generally less strongly or not associated with mobile phone call duration and RF-EMF dose measures., Conclusions: Stronger associations between symptoms of ill health and wireless communication device use than for RF-EMF dose measures were observed. Such a result pattern does not support a causal association between RF-EMF exposure and health symptoms of adolescents but rather suggests that other aspects of extensive media use are related to symptoms., (Copyright © 2017 Elsevier Inc. All rights reserved.)

The type of noise annoyance scale and aspects of its presentation such as response format or location within a questionnaire and other contextual factors may affect self-reported noise annoyance. By means of a balanced experimental design, the effect of type of annoyance question and corresponding scale (5-point verbal vs. 11-point numerical ICBEN (International Commission on Biological Effects of Noise) scale), presentation order of scale points (ascending vs. descending), question location (early vs. late within the questionnaire), and survey season (autumn vs. spring) on reported road traffic noise annoyance was investigated in a postal survey with a stratified random sample of 2386 Swiss residents. Our results showed that early appearance of annoyance questions was significantly associated with higher annoyance scores. Questionnaires filled out in autumn were associated with a significantly higher annoyance rating than in the springtime. No effect was found for the order of response alternatives. Standardized average annoyance scores were slightly higher using the 11-point numerical scale whereas the percentage of highly annoyed respondents was higher based on the 5-point scale, using common cutoff points. In conclusion, placement and presentation of annoyance questions within a questionnaire, as well as the time of the year a survey is carried out, have small but demonstrable effects on the degree of self-reported noise annoyance., Competing Interests: The authors declare no conflicts of interest.

Most environmental epidemiology studies model health effects of noise by regressing on acoustic exposure metrics that are based on the concept of average energetic dose over longer time periods (i.e. the L eq and related measures). Regarding noise effects on health and wellbeing, average measures often cannot satisfactorily predict annoyance and somatic health effects of noise, particularly sleep disturbances. It has been hypothesized that effects of noise can be better explained when also considering the variation of the level over time and the frequency distribution of event-related acoustic measures, such as for example, the maximum sound pressure level. However, it is unclear how this is best parametrized in a metric that is not correlated with the L eq , but takes into account the frequency distribution of events and their emergence from background. In this paper, a calculation method is presented that produces a metric which reflects the intermittency of road, rail and aircraft noise exposure situations. The metric termed intermittency ratio (IR) expresses the proportion of the acoustical energy contribution in the total energetic dose that is created by individual noise events above a certain threshold. To calculate the metric, it is shown how to estimate the distribution of maximum pass-by levels from information on geometry (distance and angle), traffic flow (number and speed) and single-event pass-by levels per vehicle category. On the basis of noise maps that simultaneously visualize L eq , as well as IR, the differences of both metrics are discussed.

Little is known about the real everyday exposure of children in Europe to extremely low-frequency magnetic fields (ELF-MFs). The aims of this study are to (i) assess personal ELF-MF exposure in children; (ii) to identify factors determining personal and bedroom ELF-MF exposure measurements in children; (iii) to evaluate the reproducibility of exposure summary measures; and (iv) to compare personal with bedroom measurements. In Switzerland and Italy, 172 children aged between 5 and 13 years were equipped with ELF-MF measurement devices (EMDEX II, measuring 40-800 Hz) during 24-72 h twice, in the warm and the cold season. In addition, 24-h measurements were taken in the bedroom of children. In our study, sample geometric mean ELF-MF exposure was 0.04 μT for personal and 0.05 μT for bedroom measurements. Living within 100 m of a highest voltage power line increased geometric mean personal exposure by a factor of 3.3, and bedroom measurements by a factor 6.8 compared to a control group. Repeated measurements within the same subject showed high reproducibility for the geometric mean (Spearman's correlation 0.78 for personal and 0.86 for bedroom measurements) but less for the 95th and 99th percentile of the personal measurements (≤0.42). Spearman's correlation between bedroom and personal exposure was 0.86 for the geometric mean but considerably lower for the 95th and 99th percentiles (≤0.60). Most previous studies on ELF-MF childhood leukaemia used mean bedroom exposure. Our study demonstrates that geometric mean bedroom measurements is well correlated with personal geometric mean exposure, and has high temporal reproducibility.

Background: There is public concern regarding potential health effects of radiofrequency electromagnetic fields (RF-EMF) emitted by fixed site transmitters. We therefore investigated whether self-reported general well-being in adolescents is affected by RF-EMF exposure from mobile phone base stations (downlink) and broadcast transmitters (TV and radio)., Methods: In a prospective cohort study, 439 study participants aged 12-17 years, completed questionnaires about their self-reported well-being and possible confounding factors at baseline and one year later. Exposure from fixed site transmitters at home and school was calculated by using a geospatial propagation model. Data were analysed using a mixed-logistic cross-sectional model of a combined dataset consisting of baseline and follow-up data and a longitudinal approach where we investigated whether exposure at baseline (cohort analysis) or changes in exposure between baseline and follow-up (change analysis) were related to a new onset of a symptom between baseline and follow-up. All analyses were adjusted for relevant confounders., Results: Mean exposure (median; 75(th)) for broadcast transmitters, downlink and total exposure at baseline were 1.9 μW/m(2) (1.0 μW/m(2); 2.8 μW/m(2)), 14.4 μW/m(2) (3.8 μW/m(2); 11.0 μW/m(2)) and 16.3 μW/m(2) (5.8 μW/m(2); 13.4 μW/m(2)), respectively. In cross-sectional analyses no associations were observed between any symptom and RF-EMF exposure from fixed site transmitters. In the cohort and change analyses only a few significant associations were observed including an increased OR for tiredness (2.94, 95%CI: 1.43 to 6.05) for participants in the top 25(th) percentile of total RF-EMF exposure from fixed site transmitters at baseline, in comparison to participants exposed below the median and a decreased OR for exhaustibility (0.50, 95%CI: 0.27 to 0.93) for participants with an exposure increase between baseline and follow-up., Conclusions: In this cohort study, using a geospatial propagation model, RF-EMF exposure from fixed site transmitters was not consistently associated with self-reported symptoms in Swiss adolescents. The few observed associations have to be interpreted with caution and might represent chance findings.

Extremely low frequency magnetic fields (ELF-MFs) exposure is still a topic of concern due to their possible impact on children's health. Although epidemiological studies claimed an evidence of a possible association between ELF-MF above 0.4 μT and childhood leukemia, biological mechanisms able to support a causal relationship between ELF-MF and this disease were not found yet. To provide further knowledge about children's ELF-MF exposure correlated to children's daily activities, a measurement study was conducted in Milan (Italy). Eighty-six children were recruited, 52 of whom were specifically chosen with respect to the distance to power lines and built-in transformers to oversample potentially highly exposed children. Personal and bedroom measurements were performed for each child in two different seasons. The major outcomes of this study are: (1) median values over 24-h personal and bedroom measurements were <3 μT established by the Italian law as the quality target; (2) geometric mean values over 24-h bedroom measurements were mostly <0.4 μT; (3) seasonal variations did not significantly influence personal and bedroom measurements; (4) the highest average MF levels were mostly found at home during the day and outdoors; (5) no significant differences were found in the median and geometric mean values between personal and bedroom measurements, but were found in the arithmetic mean.

Background: Analysis of the association between exposure to electromagnetic fields of non-ionising radiation (EMF-NIR) and health in children and adolescents is hindered by the limited availability of data, mainly due to the difficulties on the exposure assessment. This study protocol describes the methodologies used for characterising exposure of children to EMF-NIR in the INMA (INfancia y Medio Ambiente- Environment and Childhood) Project, a prospective cohort study., Methods/design: Indirect (proximity to emission sources, questionnaires on sources use and geospatial propagation models) and direct methods (spot and fixed longer-term measurements and personal measurements) were conducted in order to assess exposure levels of study participants aged between 7 and 18 years old. The methodology used varies depending on the frequency of the EMF-NIR and the environment (homes, schools and parks). Questionnaires assessed the use of sources contributing both to Extremely Low Frequency (ELF) and Radiofrequency (RF) exposure levels. Geospatial propagation models (NISMap) are implemented and validated for environmental outdoor sources of RFs using spot measurements. Spot and fixed longer-term ELF and RF measurements were done in the environments where children spend most of the time. Moreover, personal measurements were taken in order to assess individual exposure to RF. The exposure data are used to explore their relationships with proximity and/or use of EMF-NIR sources., Discussion: Characterisation of the EMF-NIR exposure by this combination of methods is intended to overcome problems encountered in other research. The assessment of exposure of INMA cohort children and adolescents living in different regions of Spain to the full frequency range of EMF-NIR extends the characterisation of environmental exposures in this cohort. Together with other data obtained in the project, on socioeconomic and family characteristics and development of the children and adolescents, this will enable to evaluate the complex interaction between health outcomes in children and adolescents and the various environmental factors that surround them.

Background: There is growing evidence that chronic exposure to transportation related noise and air pollution affects human health. However, health burden to a country of these two pollutants have been rarely compared., Aims: As an input for external cost quantification, we estimated the cardiorespiratory health burden from transportation related noise and air pollution in Switzerland, incorporating the most recent findings related to the health effects of noise., Methods: Spatially resolved noise and air pollution models for the year 2010 were derived for road, rail and aircraft sources. Average day-evening-night sound level (Lden) and particulate matter (PM10) were selected as indicators, and population-weighted exposures derived by transportation source. Cause-specific exposure-response functions were derived from a meta-analysis for noise and literature review for PM10. Years of life lost (YLL) were calculated using life table methods; population attributable fraction was used for deriving attributable cases for hospitalisations, respiratory illnesses, visits to general practitioners and restricted activity days., Results: The mean population weighted exposure above a threshold of 48dB(A) was 8.74dB(A), 1.89dB(A) and 0.37dB(A) for road, rail and aircraft noise. Corresponding mean exposure contributions were 4.4, 0.54, 0.12μg/m(3) for PM10. We estimated that in 2010 in Switzerland transportation caused 6000 and 14,000 YLL from noise and air pollution exposure, respectively. While there were a total of 8700 cardiorespiratory hospital days attributed to air pollution exposure, estimated burden due to noise alone amounted to 22,500 hospital days., Conclusions: YLL due to transportation related pollution in Switzerland is dominated by air pollution from road traffic, whereas consequences for morbidity and indicators of quality of life are dominated by noise. In terms of total external costs the burden of noise equals that of air pollution., (Copyright © 2015 Elsevier GmbH. All rights reserved.)

Exposure assessment is a crucial part in studying potential effects of RF-EMF. Using data from the HERMES study on adolescents, we developed an integrative exposure surrogate combining near-field and far-field RF-EMF exposure in a single brain and whole-body exposure measure. Contributions from far-field sources were modelled by propagation modelling and multivariable regression modelling using personal measurements. Contributions from near-field sources were assessed from both, questionnaires and mobile phone operator records. Mean cumulative brain and whole-body doses were 1559.7 mJ/kg and 339.9 mJ/kg per day, respectively. 98.4% of the brain dose originated from near-field sources, mainly from GSM mobile phone calls (93.1%) and from DECT phone calls (4.8%). Main contributors to the whole-body dose were GSM mobile phone calls (69.0%), use of computer, laptop and tablet connected to WLAN (12.2%) and data traffic on the mobile phone via WLAN (6.5%). The exposure from mobile phone base stations contributed 1.8% to the whole-body dose, while uplink exposure from other people's mobile phones contributed 3.6%. In conclusion, the proposed approach is considered useful to combine near-field and far-field exposure to an integrative exposure surrogate for exposure assessment in epidemiologic studies. However, substantial uncertainties remain about exposure contributions from various near-field and far-field sources.

Background: There is a growing body of evidence that exposure to transportation related noise can adversely affect health and wellbeing. More recently, research on cardiovascular disease has specifically explored the hypothesis that exposure to transportation noise increases the risk for ischemic heart disease (IHD). Our objective was to review and conduct a meta-analysis to obtain an overall exposure-response association., Methods and Results: We conducted a systematic review and retained published studies on incident cases of IHD using sources of transportation noise as exposure. Study-specific results were transformed into risk estimates per 10dB increase in exposure. Subsequently we conducted a random effects meta-analysis to pool the estimates. We identified 10 studies on road and aircraft noise exposure conducted since the mid-1990s, providing a total of 12 risk estimates. Pooled relative risk for IHD was 1.06 (1.03-1.09) per 10dB increase in noise exposure with the linear exposure-response starting at 50dB. Based on a small number of studies, subgroup analyses were suggestive of higher risk for IHD for males compared to females (p=0.14), and for persons over 65 years of age compared to under (p=0.22). Air pollution adjustment, explored only in a subset of four studies, did not substantially attenuate the association between noise exposure and IHD., Conclusions: The evidence for an effect of transportation noise with IHD necessitates further research into the threshold and the shape of the exposure-response association, potential sources of heterogeneity and effect modification. Research in different cultural contexts is also important to derive regional and local estimates for the contribution of transportation noise to the global burden of disease., (Copyright © 2015 Elsevier Inc. All rights reserved.)

The aim of this study is to investigate the relationships between road traffic noise exposure, annoyance caused by different noise sources and validated health indicators in a cohort of 1375 adults from the region of Basel, Switzerland. Road traffic noise exposure for each study participant was determined using modelling, and annoyance from various noise sources was inquired by means of a four-point Likert scale. Regression parameters from multivariable regression models for the von Zerssen score of somatic symptoms (point symptom score increase per annoyance category) showed strongest associations with annoyance from industry noise (2.36, 95% CI: 1.54, 3.17), neighbour noise (1.62, 95% CI: 1.17, 2.06) and road traffic noise (1.53, 95% CI: 1.09, 1.96). Increase in modelled noise exposure by 10 dB(A) resulted in a von Zerssen symptom score increase of 0.47 (95% CI: -0.01, 0.95) units. Subsequent structural equation modelling revealed that the association between physical noise exposure and health-related quality of life (HRQOL) is strongly mediated by annoyance and sleep disturbance. This study elucidates the complex interplay of different factors for the association between physical noise exposure and HRQOL.