Transportation noise exposure and anxiety: A systematic review and meta-analysis

Abstract

Background Exposure to transportation noise is hypothesized to contribute to anxiety, but consistent associations have not been established. Objective To provide a comprehensive synthesis of the literature by examining associations between traffic-related noise (i.e., road traffic noise, railway noise, aircraft noise and mixed traffic noise) and anxiety. Methods We systematically searched Web of Science, Scopus, Embase, PubMed, and PsycINFO for English-language observational studies published up to February 2020 reporting on the traffic noise-anxiety association. We appraised the risk of bias using an assessment tool and the quality of evidence following established guidelines. A random-effects meta-analysis was performed for pooled and separated traffic-related noise sources. Results Of the 3575 studies identified, 11 fulfilled the inclusion criteria and 9 studies were appropriate for meta-analysis. For the pooled overall effect size between transport noise and anxiety, we found 9% higher odds of anxiety associated with a 10 dB(A) increase in day-evening-night noise level (Lden), with moderate heterogeneity (OR = 1.09, 95% CI: [0.97; 1.23], I2 = 70%). The association was more likely to be significant with more severe anxiety (OR = 1.08, 95% CI: [1.01; 1.15], I2 = 48%). Sub-group analysis revealed that the effects of different noise sources on anxiety were inconsistent and insignificant. The quality of evidence was rated as very low to low. Conclusions Our findings support the hypothesis of an association between traffic noise and more severe anxiety. More high-quality studies are needed to confirm associations between different noise types and anxiety, as well as to better understand underlying mechanisms.