Suicide and Transportation Noise: A Prospective Cohort Study from Switzerland
Abstract
Background: Although plausible from a pathophysiological point of view, robust evidence for effects of transportation noise on mental health remains scarce. Meanwhile, psychiatric diseases are among the most prevalent noncommunicable diseases worldwide, and suicide as a mortality outcome highly connected to mental disorders presents a pressing public health issue. The aim of this study was to investigate the association between source-specific transportation noise, particulate matter (PM) air pollution, residential greenness, and suicide by means of a nationwide cohort study. Methods: Road traffic, railway and aircraft noise exposure as well as exposure to air pollution [PM with aerodynamic diameter ≤2.5μm (PM2.5)] and greenness [normalized difference vegetation index (NDVI)] were linked to 5.1 million adults (age 15 y and older) in the Swiss National Cohort, accounting for their address history. Mean noise exposure in 5-y periods was calculated. Individuals were followed for up to 15 y (2001–2015). Time-varying Cox regression models were applied to deaths by suicide (excluding assisted suicide). Models included all three noise sources, PM2.5, and NDVI plus individual and spatial covariates, including socioeconomic status. Effect modification by sex, age, socioeconomic indicators, and degree of urbanization was explored. Results: During the follow-up, there were 11,265 suicide deaths (10.4% poisoning, 33.3% hanging, 28.7% firearms, 14.7% falls). Road traffic and railway…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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