En i onmen al Resea ch 242 (2024) 117642
A ailable online 22 No embe 2023
0013-9351/© 2023 The Au ho s. Published by Else ie Inc. This is an open access a icle unde he CC BY license (h p://c ea i ecommons.o g/licenses/by/4.0/).
Childhood sound dis u bance and sleep p oblems in Alpine alleys wi h
high le els o a ic exposu es and g eenspace
Angel M. Dzhambo
a
,
b
,
c
,
d
,
*
,
1
, Pe e Le che
b
,
1
, Dick Bo eldoo en
e
a
En i onmen al Heal h Di ision, Resea ch Ins i u e a Medical Uni e si y o Plo di , Bulga ia
b
Ins i u e o Highway Enginee ing and T anspo Planning, G az Uni e si y o Technology, Aus ia
c
Resea ch G oup “Heal h and Quali y o Li e in a G een and Sus ainable En i onmen ”, S a egic Resea ch and Inno a ion P og am o he De elopmen o MU - Plo di ,
Medical Uni e si y o Plo di , Bulga ia
d
Depa men o Hygiene, Facul y o Public Heal h, Medical Uni e si y o Plo di , Bulga ia
e
Depa men o In o ma ion Technology, Resea ch G oup WAVES, Ghen Uni e si y, Belgium
ARTICLE INFO
Keywo ds:
Ai pollu ion
Exposome
Ga den
G eenness
Res o a i e quali y
T a ic noise
ABSTRACT
Sound dis u bance and sleep p oblems a e ega ded as he mos common ad e se e ec s o en i onmen al noise
bu e idence o he ole o ai pollu ion and g eenspace is scan . This is especially ue o child en who ind
hemsel es in a sensi i e de elopmen al pe iod and expe ience hei en i onmen di e en ly han adul s. This
s udy examined he join e ec s o a ic exposu es and esiden ial g eenspace on child sound dis u bance and
sleep p oblems ia pe cep ions o neighbo hood quali y. We used c oss-sec ional da a o 1251 schoolchild en
(8–12 yea s) in he Ty ol egion o Aus ia/I aly. Ques ionnai es p o ided in o ma ion on sociodemog aphic and
housing ac o s, pe cei ed neighbo hood quali y, sound dis u bance in di e en si ua ions, and sleep p oblems.
Modelled acous ic indica o s included day-e ening-nigh sound le els and he highes pe cen ile le el, and nigh -
ime sound le el and a bespoke sleep dis u bance index. Ni ogen dioxide se ed as a p oxy o a ic- ela ed ai
pollu ion. The no malized di e ence ege a ion index was calcula ed as a measu e o esiden ial g eenspace, and
p esence o a domes ic ga den was sel - epo ed. Resul s showed ha highe le el o a ic- ela ed exposu es was
posi i ely associa ed wi h sound dis u bance and sleep p oblems, while li ing in a g eene a ea, especially in a
house wi h a ga den, was associa ed wi h lowe sound dis u bance and less sleep p oblems e en in he p esence
o a ic. T a ic exposu es con ibu ed o mo e un a o able, and g eenspace o mo e posi i e pe cep ions in
e ms o a ic- ela ed s esso s, oppo uni ies o ou doo ec ea ion, and gene al sa is ac ion wi h he neigh-
bo hood. This indi ec pa h seemed mo e impo an o g eenspace han o a ic exposu es. In conclusion, i
seems ad an ageous o combine a ic- ela ed mi iga ion wi h imp o ing access o g eenspace in in e en ions
o suppo ing he acous ic com o o child en du ing day and nigh ime. E en highly na u e-domina ed en i-
onmen s could s ill bene i om p oximal g een in as uc u e, especially om domes ic ga dens.
1. In oduc ion
Annoyance and sleep dis u bance a e ega ded as he mos common
ad e se e ec s o en i onmen al noise exposu e (WHO Regional O ice
o Eu ope, 2018). Though so ou comes hemsel es, hey ac as pa h-
ways o poo men al and physical heal h (WHO Regional O ice o
Eu ope, 2018). In Eu ope alone, 22 million people su e om ch onic
high annoyance and 6.5 million om ch onic high sleep dis u bance due
o noise (Eu opean En i onmen Agency, 2020). Ye , su p isingly li le is
known abou hese impac s on child en. Child en ind hemsel es in a
sensi i e de elopmen al pe iod when a ious s esso s can ad e sely
shi he ajec o y o hei la e heal h (Smi h and Pollak, 2020; Pe son
Waye e al., 2023). They ha e a numbe o cha ac e is ic ulne abili ies
o en i onmen al ha ms such as spending mo e ime ou doo s han
adul s, meaning hey a e exposed o longe pe iods o ime (G ela
e al., 2016). Child en also ha e a mo e limi ed coping epe oi e,
especially owa ds ch onic cumula i e s esso s, which can unde mine
sel - egula o y p ocesses and consequen ly impai adap i e capaci ies
(B uni e al., 2011; E ans and Kim, 2013; Bilo a e al., 2018). Tha is,
child en may no ecognize en i onmen al h ea s o hei heal h, no
* Co esponding au ho . Depa men o Hygiene, Facul y o Public Heal h, Medical Uni e si y o Plo di , 15A Vassil Ap ilo Bl d., 4000, Plo di , Bulga ia.
E-mail add esses: [email p o ec ed], [email p o ec ed], [email p o ec ed] (A.M. Dzhambo ).
1
These wo au ho s con ibu ed equally.
Con en s lis s a ailable a ScienceDi ec
En i onmen al Resea ch
jou nal homepage: www.else ie .com/loca e/en es
h ps://doi.o g/10.1016/j.en es.2023.117642
Recei ed 8 Oc obe 2023; Accep ed 9 No embe 2023
En i onmen al Resea ch 242 (2024) 117642
2
enjoy he same beha io al lexibili y as adul s in mee ing adap i e
challenges and h ea s om he en i onmen (e.g., h ough
window-opening habi s, a oidance o a pa icula se ing o si ua ion).
Fu he mo e, om a me hodological s ance, single-i em noise annoy-
ance measu emen s adop ed om adul s udies may no su icien ly
cha ac e ize he e ec s o noise on child en, as ew s udies ha e shown
(Le che e al., 2000; Haines e al., 2003; Pe sson Waye e al., 2011).
Such a na ow app oach dis ega ds o he po en ially posi i e app aisals
and coping oppo uni ies p o ided by he o e all physical en i onmen .
Beyond annoyance, exposu e o a ic noise a nigh is a p ominen
s esso unde mining no mal sleep, acco ding o mul iple expe imen al
and obse a ional s udies in adul s (Wo ld Heal h O ganiza ion, 2009;
Basne and McGui e, 2018) and ewe s udies in child en (B uni e al.,
2011; Quehl e al., 2021). Quali y sleep is essen ial o he eco e y o
child en om psychological wea and ea expe ienced in hei daily
li e, as well as om en i onmen al and social demands and p essu es in
he esiden ial and school se ings. Al hough ea lie s udies ha e shown
lowe awakening a es in child en (Ebe ha d , 1988; ¨
Oh s ¨
om e al.,
2006), s ess- ela ed ca dio ascula eac ions a e mo e p onounced in
hem (Muze , 2007). A ecen e iew unde lines ha dis up ion o
no mal sleep o child en can con ibu e o a b oad spec um o ad e se
heal h e ec s, such as non-speci ic symp oms, poo academic pe o -
mance, neu ode elopmen al p oblems, and soma ic diso de s like high
blood p essu e and adiposi y (Ma icciani e al., 2019). Howe e , mos
s udies on noise- ela ed sleep p oblems ha e elied on acous ic in-
dica o s based on he a e age sound ene gy o e a pe iod o ime, e en
hough al e na i e indica o s e lec ing dis u bing and dis ac ing
e en s in a soundscape con ex may be be e p edic o s o sleep ou -
comes (De Coensel e al., 2009; Bo eldoo en e al., 2015; F edianelli
e al., 2022; Le che and Dzhambo , 2023). Hi he o, hese al e na i e
acous ic app aisals ha e no been applied in s udies ela ed o child en’s
annoyance and sleep.
Ano he c i ical gap in he noise and child sleep li e a u e is ha
noise was s udied p ima ily as a s and-alone exposu e (e.g., Tiesle e al.,
2013; Weyde e al., 2017; Rudolph e al., 2019; Quehl e al., 2021).
Howe e , he e is a b oad spec um o ele an ac o s in luencing sleep
quali y (Philippens e al., 2022). Among hose, he e idence o an as-
socia ion be ween ai pollu ion and sleep diso de s in child en is
g owing (e.g., Law ence e al., 2018; S´
anchez e al., 2019), bu mos o
hese s udies did no accoun o co-exposu e o noise (Liu e al., 2020).
While noise ac s as a s esso ac i a ing subco ical s uc u es in he
b ain and leads o a ousal o he ege a i e ne ous sys em and elease
o s ess ho mones (Basne e al., 2018), ai pollu ion is belie ed o a ec
sleep ia neu ochemical changes (e.g., se o onin neu ochemis y),
impai ed neu ode elopmen o b ain s uc u es in ol ed in ci cadian
hy hm egula ion, and sleep diso de ed b ea hing (Liu e al., 2020). In
addi ion, ai pollu ion has been ound o con ibu e o noise annoyance
since pe cep ions o a ic noise and ai pollu ion can be in e wined
(F ei e al., 2014; Oiamo e al., 2015; Le che , 2019).
As a coun e pa o hese s esso s, esiden ial g eenspace migh be
p o ec i e agains sleep p oblems, o se ing some o he mechanisms
leading o poo sleep. G eenspace, which encompasses home ga dens,
s ee ees, pa ks, and ege a ion domina ed landscapes in gene al, can
mi iga e noise (Van Ren e ghem e al., 2015) and ai pollu ion (Nowak
e al., 2006). Mo eo e , lowe noise annoyance and mo e a o able
app aisals o he acous ic en i onmen ha e been obse ed in he
p esence o g een in as uc u e like g een sound ba ie s o h ough
g een window iews (Van Ren e ghem, 2019; Sch¨
a e e al., 2020).
G eenspace also p o ides oppo uni ies o elaxa ion, egaining
deple ed neu ocogni i e adap i e esou ces, and suppo ing
heal h-enhancing beha io s in child en (Ma ke ych e al., 2017). A
g eene en i onmen can be conduci e o g ea e le els o ou doo
physical ac i i y and he eo be e sleep (Dzhambo e al., 2023). The
e idence in child en is mixed bu in gene al, physical ac i i y du ing
day ime can imp o e sleep quali y by suppo ing no mal body weigh
and espi a o y unc ion, coun e ac ing he e ec s o
neu oin lamma ion and s ess ho mones, and dampening psychological
s ess (An czak e al., 2020). A hand ul o s udies in adul s ha e al eady
indica ed ha people li ing in g eene neighbo hoods, especially
domina ed by ees, ha e longe and be e sleep (As ell-Bu e al.,
2013; Johnson e al., 2018; As ell-Bu and Feng, 2019; Li e al., 2022;
S en o s e al., 2023). Some o hese s udies accoun ed o co-exposu e o
ai pollu ion (Li e al., 2022) o noise (Johnson e al., 2018). Howe e , as
wi h he o he causal links discussed so a , he e idence in child en is
sca ce. One s udy did no suppo such a p o ec i e associa ion despi e
he abo e-men ioned indings in adul popula ions (Feng e al., 2020),
while ano he s udy ound a bo de line signi ican associa ion be ween
g eenspace and longe sleep du a ion, which was media ed by pe cei ed
s ess (Zhong e al., 2023).
In ligh o he pauci y o e idence on hese associa ions in child en,
in he cu en s udy, we endea o ed o examine he join e ec s o a ic
exposu es and esiden ial g eenspace on child sound dis u bance and
sleep p oblems. We hypo hesized ha highe noise and ai pollu ion
le els would ela e o un a o able pe cep ions o neighbo hood quali y,
sound dis u bance, and sleep- ela ed p oblems, while g eenspace would
wo k in he opposi e di ec ion. Mo eo e , we an icipa ed ha highe
le els o g eenspace would weaken he e ec s o en i onmen al
s esso s. To es hese hypo heses, we employed a sui e o acous ic, ai
pollu ion, and g eenspace indica o s, as well as measu es o pe cei ed
neighbo hood cha ac e is ics ele an o sleep.
2. Me hods
2.1. S udy design and se ing
This s udy used da a p e iously collec ed o he B enne Base
Tunnel S udy in 2004–2005. De ailed desc ip ion o he design and
sampling has been epo ed elsewhe e (Dzhambo e al., 2019). B ie ly,
1251 8–12 yea s old child en we e ec ui ed om 49 schools in he Ty ol
egion o Aus ia and I aly. The mo he s o hese child en illed ou a
ques ionnai e abou sociodemog aphic and housing ac o s, while chil-
d en we e asked abou pe cep ions o hei esiden ial en i onmen ,
sound dis u bance, and sleep p oblems. E hical app o al was ob ained
om he E hics commi ee o he Medical Uni e si y Innsb uck (E hics
commission numbe 2105/2004).
Child en we e sampled om he Lowe Inn, Wipp, and side alleys.
The a ea is dis inc i e in ha i b ings oge he well-de eloped a ic
in as uc u e and ich na u al ea u es. The Lowe Inn and Wipp alleys
ep esen majo anspo a ion ou es h ough he Alps, wi h small
esiden ial illages loca ed along hem. T a ic lines s e ch along he
alley loo c ea ing un a o able acous ic condi ions wi h sound wa e
p opaga ing o e g ea dis ances o he slopes, mee ing ew obs acles.
While he me eo ology and opog aphy o he Lowe Inn alley a o he
build-up o ai pollu ion, owa ds he sou h he alleys a e be e
en ila ed and ai pollu ion le els end o be lowe . In con as , he
Alpine landscape in he a ea o e s scenic na u e iews wi h lush ege-
a ion, p o iding mul iple oppo uni ies o ou doo ec ea ion.
2.2. Sleep p oblems and sound dis u bance
Child en answe ed ques ions on di e en aspec s o hei nigh - ime
sleep. Sepa a e i ems asked abou ecen ime p oblems alling asleep,
uneasy sleep, and eeling i ed in he mo ning. Answe s we e p o ided
on a 5-poin scale (1 =ne e , 2 =seldom, 3 =some imes, 4 =o en, o 5
= e y o en). The sum o he h ee i ems ep esen ed a sleep p oblems
scale whe e highe alues indica ed mo e sleep p oblems.
Nine i ems we e used o measu e dis u bance by di e en sounds and
in di e en si ua ions. The ag eemen wi h each s a emen on pe cei ed
dis u bance was a ed on a scale om 1 o 4 (1 =no igh a all, 2 =
a he w ong, 3 = a he co ec , o 4 =exac ly igh ). Speci ically,
child en epo ed hei dis u bance by (1) ca , (2) uck, and (3) ailway
noise, (4) gene al noisiness o he neighbo hood, as well as dis u bance
A.M. Dzhambo e al.
En i onmen al Resea ch 242 (2024) 117642
3
by a ic noise du ing (5) doing homewo k, (6) elaxa ion, (7) wa ching
TV, (8) being ou doo s, and (9) ying o all asleep. We summed e-
sponses o hese nine i ems in o a sound dis u bance scale, wi h highe
dis u bance indica ed by highe alues.
2.3. Pe cei ed neighbo hood quali y
We cons uc ed a summa y pe cei ed neighbo hood quali y scale,
which was ea ed as a media o . Pe cei ed neighbo hood quali y was
measu ed wi h se en i ems co e ing di e en neighbo hood cha ac e -
is ics ha could be in luenced by a ic exposu es and g eenspace.
Child en we e asked, on a scale om 1 o 4 ( he same as o pe cei ed
dis u bance in Sec ion 2.2), i hei neighbo hood (1) had a lo o space
o play, (2) meadows and ees, and (3) clean ai , i i was (4) quie , i (5)
child en we e allowed o un a ound, i (6) people we e help ul o
child en, and (7) i child en gene ally enjoyed li ing he e.
2.4. Noise and ai pollu ion by a ic
The main sou ces o a ic noise in he a ea unde in es iga ion
include oad a ic on he highway in he cen al alley, o he oad
a ic, and ail a ic including an impo an con ibu ion o eigh on
he ail oad ha belongs o he T ans Eu opean Ne wo k. We calcula ed
day-e ening-nigh sound le els (L
den
) a each add ess (see Dzhambo
e al., 2019 o de ailed calcula ion no es). In addi ion o he mos
common noise exposu e indica o s, L
den
and nigh - ime sound le el
(L
nigh
), mo e explo a i e indica o s ha migh be ele an o sleep
dis u bance we e added.
To accoun o he loudes e en s, se e al indica o s ha e been
p oposed (Can e al., 2015; Can e al., 2016). He e, he highes pe cen ile
le el (L
01
) o e he day o all sou ces combined was also used. This
indica o e lec ed he le el du ing he 864 loudes seconds o he day. I
was modelled by augmen ing L
den
a he mos exposed açade o he
dwelling wi h an expec ed 1-s ime se ies. To calcula e his augmen a-
ion, he dis ance o he highway, main oads, and he ailway we e
conside ed while assuming ee ield p opaga ion, neglec ing buildings
and e ain. An o e all backg ound le el wi h mean alue o 37 dB A was
added. The sou ce dis ibu ion o gene a ing he ime se ies was based
on he known a ic in ensi y and a Poisson dis ibu ion o a ic.
Fu he analysis o he L
01
showed ha alues abo e 80 dB A we e ob-
ained only nea ailway acks while he con ibu ion o he main oad
was mo e e enly sp ead o e all loca ions ye emains lowe han abou
80 dB A.
In an a emp o ake as much o he exis ing knowledge on sleep
p oblems in child en in o accoun , a new indica o ha was modelled ab
ini io is in oduced, he sleep dis u bance index (SDI). This indica o
was based on de ec able indoo noise e en s exp essed in A-weigh ed
le el. Dwelling sound insula ion (seen as a o m o coping) was assumed
o depend on a e age ou doo le els (Loche e al., 2018). Fo each
de ec ed e en , he p obabili y o an e ec on sleep pa e n was es i-
ma ed based on he as amoun o li e a u e epo ing sleep changes in
lab du ing noise e en s (G ie ahn e al., 2008; Basne e al., 2011). In
addi ion o he le el i sel , also ise ime was accoun ed o . O e all, he
p obabili y o sleep changes due o noise is gi en by PSD = (N,dN),
whe e N is he loudness o he e en and dN is he ini ial inc ease in
loudness. The unc ion was modelled as a linea unc ion unca ed by
ze o and 1, and i s e ec h eshold was adap ed o he age o he child o
accoun o a lowe sensi i i y a young age (Lopez-Po eda, 2014;
¨
Oh s ¨
om e al., 2006). The single e en esponse was hen u he
agg ega ed o e 10-min sleep epochs assuming independence o
dis u bances:
PSD,Tk =∑
Tk
i=1
PSD,i∏
i−1
j=1(1−PSD,j)
whe e T
k
is he du a ion o he sleep epoch.
Finally, a weigh ed a e age, s essing mo ning hou s, o he p oba-
bili y o dis u bed sleep epochs o e he nigh was aken. This a e age
accoun ed o he longe sleeping ime o young child en.
To calcula e SDI, he empo al e olu ion o he sound le el should be
known. Typical oad a ic noise models do no accoun o his.
De ailed a ic models can p oduce his empo al in o ma ion, ye hei
deploymen in la ge a eas is ime consuming mainly because o he
se up- ime o he mic o- a ic simula ion. The e o e, he same model
ha was used o calcula ing L
01
was also used he e. A backg ound le el
o 35 dB A was assumed. Gi en sound sou ces in he Alpine a ea unde
s udy, a o al SDI sco e including highway, majo oad, and ailway
noise was calcula ed. The same model was also used o es ima e L
nigh
.
Mean annual concen a ions o ni ogen dioxide (NO
2
) we e used as
a p oxy o long- e m exposu e o a ic- ela ed ai pollu ion. NO
2
was
de i ed by he me eo ological model G az Mesoscale Model a a ho i-
zon al esolu ion o 10 ×10 m and a e ical esolu ion o 2 m (see
Dzhambo e al., 2019). Modelled NO
2
le els we e assigned o child en’s
home add ess.
Since noise and ai pollu ion indica o s can lead o dis u bance and
sleep p oblems ia di e en mechanisms, bu a e also highly co ela ed,
hey we e analyzed bo h indi idually and as a combined a ic expo-
su es ac o .
2.5. G eenspace
The no malized di e ence ege a ion index (NDVI) was used as a
measu e o esiden ial g eenspace (Tucke , 1979). I was calcula ed a a
30 ×30 m esolu ion using sa elli e da a (cloud ee images om
July–Augus 2003) om he Landsa 4–5 Thema ic Mappe . The a e age
NDVI alue in 100-m, 500-m, and 1000-m ci cula bu e s a ound
child’s home ep esen ed gene al ege a ion le el, whe e alues close
o +1 indica e high g eenness and alues close o −1 indica e build-up
land co e and wa e . NDVI
100-m
was used as he main g eenspace in-
dica o , since immedia e g eenspace in he icini y o he home is
heo e ically mo e ele an o child heal h ou comes and has been
ound o co ela e wi h sleep di icul ies in adul s s onge han mo e
dis an g eenspace (S en o s e al., 2023). S ill, we epo
single-exposu e sensi i i y analyses wi h NDVI in he 500-m and 1000-m
bu e s, which suppo ed he choice o he 100-m bu e .
Mo he s also epo ed whe he hei house had a ga den. By ga den,
we b oadly mean p i a e g eenspace, g een ya ds, o cha ds, lo al
ga dens, o ege able ga dens.
2.6. Con ounde s and e ec modi ie s
Addi ional po en ially in luen ial a iables we e a ailable a bo h
he indi idual and a ea-le els. Child’s age, sex, and ma e nal educa ion
we e epo ed by he mo he . Ma e nal educa ion se ed as a p oxy o
he amily’s socioeconomic s a us (basic o ≤9 yea s o school, skilled
labou , oca ional, o highe /A-le el). Indoo c owding, which is also
ela ed o a amily’s socioeconomic s a us and may a ec dis u bance,
was calcula ed as people/ ooms a io.
Dwelling ype could e lec non-acous ic cha ac e is ics o he
dwelling ele an o noise exposu e and dis u bance. Dwelling ypes
we e single amily de ached house, ow house, o mul iple dwelling.
Gi en s uc u al di e ences in opog aphy, me eo ology, and a ic
exposu es ac oss he alleys in he s udy a ea, whe e child en li ed was
also o in e es . The alleys in he s udy we e Lowe Inn alley, side
Wipp alley no h, side Wipp alley sou h, main Wipp alley no h, and
main Wipp alley sou h.
2.7. S a is ical analysis
The da ase was examined o missing alues and a iable dis ibu-
ions. Due o missing da a, some s a is ical es s used a smalle analysis
sample (i.e., 1017 obse a ions in he main analysis), bu he missing
A.M. Dzhambo e al.
En i onmen al Resea ch 242 (2024) 117642
4
da a on any gi en a iable did no exceed 10%. Following desc ip i e
analyses, bi a ia e associa ions be ween he co e a iables in he s udy
we e es ed using Spea man co ela ions. Due o i s dis ibu ion
(Figu e S1), he SDI a iable was dicho omized as equal o ze o o
g ea e .
Sepa a e linea eg ession models we e i ed o examine he asso-
cia ions be ween L
den
, L
nigh
, L
01
, SDI, NO
2
, NDVI
100-m
, and ga den, on
he one hand, and sound dis u bance and sleep p oblems, on he o he .
The models we e adjus ed o child’s sex and age, and ma e nal edu-
ca ion, which we e iden i ied as he minimum adjus men se o a oid
o e i ing. Tole ance (>0.2) and Va iance In la ion Fac o (<5.0) s a-
is ics sugges ed ha hese models did no su e om mul icollinea i y.
We hen es ed a s uc u al equa ion model (SEM) including he join
associa ions be ween exposu es (L
den
, L
01
, SDI, L
nigh
, NO
2
, NDVI
100-m
,
and ga den) and ou comes (sound dis u bance and sleep p oblems), as
media ed by pe cei ed neighbo hood quali y (Fig. 1). As con ol a i-
ables, we also included child’s sex and age, ma e nal educa ion, and
c owding. L
den
, L
01
, SDI, L
nigh
NO
2
we e assumed o load on o he same
la en cons uc ha we called a ic exposu es. The decision o g oup
all a ic- ela ed indica o s was based on model i compa ison and he
a iance explained in hem by he la en cons uc . A p io i, we assumed
co a iances be ween he exposu e a iables as shown in Fig. 1.
Besides di ec and indi ec e ec s o he exposu es, we we e in e -
es ed in po en ial e ec modi ica ion (mode a ion) by child sex, dwell-
ing ype, and p esence o a home ga den. We in es iga ed whe he hese
ca ego ical a iables modi ied he di ec and indi ec pa hs o in e es
wi h he mul ig oup SEM app oach. Fi s , we es ima ed a mul ig oup
model allowing he pa hs o be es ima ed sepa a ely and eely ac oss
he ca ego ies o he pu a i e modi ie (e.g., sepa a ely o boys and
gi ls, when he modi ie unde s udy was sex). Nex , we es ima ed a
educed model, which imposed equali y cons ain s on he pa hs o in-
e es (i.e., cons aining hem o be equal ac oss subg oups). We used a
chi-squa e di e ence es o compa e he uncons ained and cons ained
models. A signi ican di e ence in chi-squa e o hese nes ed models was
aken as an indica ion ha he model wi h mo e eely es ima ed pa-
ame e s i ed he da a be e , i.e., ha he cons ained pa hs di e ed
signi ican ly ac oss di e en subg oups.
To es ima e hese models, we employed he diagonally weigh ed
leas squa es (DWLS) es ima ion me hod wi h obus s anda d e o s. All
a iables we e s anda dized o easie in e p e a ion o he pa h es i-
ma es. Indi ec e ec s we e compu ed as he p oduc o he eg ession
weigh s associa ed wi h hei cons i uen pa hs, and s anda d e o s o
hese de ined pa ame e s we e compu ed using boo s apping (1000
d aws), excep o mul i-g oup models, whe e he Del a me hod was
used o e iciency ins ead. The e m “e ec ” is used o consis ency wi h
he accep ed language in he SEM li e a u e bu bea s no claims o
causali y. As a sensi i i y analysis, we also ende ed he main model
wi h a ull-in o ma ion maximum likelihood (FIML) es ima o and
boo s apping o impu e missing alues.
We e alua ed goodness-o - i using indices o accep able model i
sugges ed by Hu and Ben le (1999): non-signi ican
χ
2
(p >0.05); CFI
≥0.95; RMSEA ≤0.06 wi h a 90% CI ≤0.06; and SRMSR ≤0.08. The
pa simony no med i index (PNFI) was also assessed, as i akes in o
accoun model complexi y. PNFI was expec ed o be >0.50 (Iacobucci,
2010).
S uc u al equa ion modeling was conduc ed wi h he package la -
aan . 0.6–10 (Rosseel, 2012) in R . 4.1.2. (R Co e Team (2021). R: A
language and en i onmen o s a is ical compu ing. R Founda ion o
S a is ical Compu ing, Vienna, Aus ia.). All o he analyses we e con-
duc ed wi h S a a MP . 18 (S a aCo p. 2023. S a a S a is ical So wa e:
Release 18. College S a ion, TX: S a aCo p LLC.). A p- alue o <0.05 was
conside ed s a is ically signi ican .
3. Resul s
3.1. Desc ip i e analyses and bi a ia e associa ions
The s udy included 1251 child en wi h a mean age o abou 9 yea s
and sligh ly highe p e alence o gi ls. Cha ac e is ics o he s udy
sample a e p o ided in Table 1. On a e age, child en epo ed mode a e
sound dis u bance and sleep p oblems. Mos child en we e exposed o
ela i ely low noise and ai pollu ion le els, while g eenspace le els
we e gene ally high (Figu e S1), and mos child en li ed in a home wi h
a ga den.
Bi a ia e associa ions be ween he cen al a iables in he s udy a e
gi en in Table S1. A mode a ely s ong posi i e co ela ion exis ed be-
ween sound dis u bance and sleep p oblems and hese a iables we e
nega i ely co ela ed wi h pe cei ed neighbo hood quali y. Highe
noise and ai pollu ion le els we e associa ed wi h highe sound
dis u bance and mo e sleep p oblems hough he co ela ions wi h sleep
p oblems we e weak. Con e sely, highe NDVI
100 m
and home ga den
we e in e sely associa ed wi h sound dis u bance and mo e sleep
p oblems, again wi h he co ela ion wi h sound dis u bance being
s onge . The exposu es we e ela ed o each o he in line wi h heo y,
wi h noise and ai pollu ion indica o s being posi i ely co ela ed be-
ween hem and nega i ely wi h NDVI
100 m
and home ga den.
Fig. 1. Concep ual model o he pa hs linking a ic exposu es and g eenspace o sound dis u bance and sleep p oblems. No es: G een lines ep esen posi i e
associa ions, while o ange lines ep esen nega i e (in e se) associa ions. Abb e ia ions: L
den
– day-e ening-nigh sound le els; L
01
– sound le el exceeded o 1% o
he ime o he measu emen du a ion; L
nigh
– nigh - ime sound le el; NDVI – no malized di e ence ege a ion index; NO
2
– ni ogen dioxide; SDI – sleep
dis u bance index.
A.M. Dzhambo e al.
En i onmen al Resea ch 242 (2024) 117642
5
F om Table 2, sound dis u bance was highe wi h highe noise and
ai pollu ion le els, while NDVI and home ga den we e associa ed wi h
lowe dis u bance. Simila ly, he acous ic indica o s we e posi i ely
associa ed wi h sleep p oblems, while g eenspace was associa ed wi h
less sleep p oblems. As expec ed, NDVI in he 100-m bu e was a
s onge p edic o han NDVI in he la ge bu e s.
3.2. Main s uc u al equa ion model
The SEM con e ged no mally in 43 i e a ions and was easonably
consis en wi h he da a:
χ
2 (56)
=238.19, p <0.001; CFI =0.97, PNFI =
0.59; RMSEA =0.06 (90% CI: 0.05, 0.06); SRMR =0.05. Fig. 2 shows
he es ima ed signi ican pa hways in he model (See Figu e S2 o he
ull pa h diag am). Sound dis u bance and sleep p oblems we e posi-
i ely co ela ed. The model explained 29% o he a iance in sound
dis u bance, as opposed o only 5% in sleep p oblems. Highe a ic
exposu es and lowe neighbo hood quali y we e he mos in luen ial
p edic o s o bo h ou comes. In addi ion, lowe a ic exposu es, ha ing
a ga den, highe NDVI
100-m
, and highe ma e nal educa ion we e
associa ed wi h highe pe cei ed neighbo hood quali y, which was
explained a 14%.
All hypo hesized indi ec e ec s we e suppo ed in he es ima ed
model (Table 3). Tha is, highe a ic exposu es we e associa ed wi h
lowe pe cei ed neighbo hood quali y, and hen wi h highe sound
dis u bance and mo e sleep p oblems. On he o he hand, highe NDVI
100-m
and ga den ela ed o highe pe cei ed neighbo hood quali y, and
in u n, o lowe sound dis ance and less sleep p oblems. Mos o al e -
ec s also wen in he expec ed di ec ion excep o he null e ec o
NDVI
100 m
on sleep p oblems.
When missing alues we e conside ed in he es ima ion o make use
o he ull da ase using FIML, he model i was sligh ly wo se. The only
ma e ially impo an di e ence in he o e all associa ions was ha he
o al e ec o ga den on sound dis u bance was no longe signi ican ,
hough in he same di ec ion, and ha o NDVI
100-m
on sleep p oblems
became signi ican (Figu e S3).
3.3. Mul i-g oup s uc u al equa ion modeling
Table S2 shows he esul s o mul ig oup SEMs in es iga ing di e -
ences in he s eng hs o he pa hs om en i onmen al exposu es o
pe cei ed neighbo hood quali y and hen o he wo ou comes. Signi i-
can chi-squa e di e ences be ween he uncons ained and co e-
sponding cons ained models p o ided s a is ical suppo o e ec
modi ica ion by sex, dwelling ype, and ga den. Indi ec and o al e ec s
om hese mul ig oup models a e shown in Tables S3–S5.
In boys, he o al e ec s o a ic exposu es, NDVI
100 m
, and ga den
we e mo e p onounced. In gi ls, by con as , he only o al e ec
obse ed was om a ic exposu es o sound dis u bance.
S a i ica ion by p esence o a home ga den e ealed ha he o al
e ec o a ic exposu es on sound dis u bance was s onge in homes
wi h a ga den, and he e ec on sleep p oblems was only p esen in hose
homes. NDVI
100-m
was associa ed wi h lowe sound dis u bance mo e
s ongly in hose homes ha did no ha e a ga den.
Depending on dwelling ype, a ic exposu es we e associa ed wi h
sound dis u bance mo e s ongly in ow houses and single- amily homes
as opposed o mul iple dwellings. In addi ion, in ow houses, NDVI
100-m
was almos associa ed wi h less sleep p oblems, while o ga dens, an
in e se associa ion wi h sleep p oblems was obse ed only in single
amily homes.
4. Discussion
4.1. Gene al indings
This s udy sugges ed ha a ic exposu es and g eenspace could
wo k simul aneously bu in opposi e di ec ions as de e minan s o sound
Table 1
S udy popula ion cha ac e is ics (N =1251).
Cha ac e is ics Desc ip i es Missing
Socio-demog aphics
Age [yea s] (Mean ±SD) 9.36 ±0.65 0%
Boy (N, %) 623 (49.80) 0%
Ma e nal educa ion (N, %) 3.36%
Basic 279 (22.30)
Skilled labo 396 (31.65)
Voca ional 287 (22.94)
A-le el 247 (19.74)
Sound dis u bance (Median, 25 h – 75 h) 15.00
(12.00–19.00)
3.12%
Sleep p oblems (Median, 25 h – 75 h) 4.00 (1.00–6.00) 0.72%
Pe cei ed neighbo hood quali y (Median, 25 h
– 75 h)
24.00
(22.00–26.00)
2.88%
En i onmen al exposu es
L
den
[dBA] (Median, 25 h – 75 h) 49.89
(42.54–59.54)
0.00%
L
nigh
[dBA] (Median, 25 h – 75 h) 41.95
(35.68–52.62)
0.32%
L
01
[dBA] (Median, 25 h – 75 h) 52.10
(41.96–62.84)
0.00%
SDI >0 (N, %) 410 (32.77) 0.00%
NO
2
[
μ
g/m
3
] (Median, 25 h – 75 h) 12.68 (9.73–18.53) 9.11%
NDVI
100 m
(Median, 25 h – 75 h) 0.43 (0.33–0.53) 0.00%
Home ga den (N, %) 927 (74.10) 0.96%
O he cha ac e is ics
C owding [people/ ooms] (Median, 25 h – 75 h) 1.00 (0.80–1.25) 1.60%
Valley (N, %) 0.00%
Inn alley 251 (20.06)
Side Wipp alley no h 326 (26.06)
Side Wipp alley sou h 133 (10.63)
Main Wipp alley no h 326 (26.06)
Main Wipp alley sou h 215 (17.19)
Dwelling ype (N, %) 0.00%
Single amily a ached 780 (62.35)
Row house 176 (14.07)
Mul iple dwelling 295 (23.58)
No es: Depending on hei dis ibu ion, we epo mean and s anda d de ia ion
(SD) o no mally-dis ibu ed a iables, median and pe cen iles o non-
no mali y dis ibu ed a iables, and numbe o cases and pe cen age ac oss
ca ego ies o ca ego ical and o dinal a iables. Abb e ia ions: L
den
– day-
e ening-nigh sound le els; L
01
– sound le el exceeded o 1% o he ime o
he measu emen du a ion; L
nigh
– nigh - ime sound le el; NDVI – no malized
di e ence ege a ion index; NO
2
– ni ogen dioxide; SDI – sleep dis u bance
index.
Table 2
Single-exposu e models es ing he associa ions o a ic exposu es and g een-
space wi h sound dis u bance and sleep p oblems.
Exposu e indica o Sound dis u bance Sleep p oblems
β p β P
L
den
0.29 <0.001 0.12 <0.001
L
nigh
0.28 <0.001 0.11 <0.001
L
01
0.27 <0.001 0.12 <0.001
SDI 0.23 <0.001 0.09 0.002
NO
2
0.24 <0.001 0.06 0.029
NDVI
100-m
−0.22 <0.001 −0.09 0.001
NDVI
500-m
−0.18 <0.001 −0.07 0.015
NDVI
1000-m
−0.14 <0.001 −0.04 0.227
Ga den −0.13 <0.001 −0.09 0.001
Coe icien s shown a e s anda dized linea eg ession coe icien s (β) wi h co -
esponding signi icance alues (p- alue). Exposu e indica o s a e es ed one-a -
a- ime in sepa a e models. All models a e adjus ed o child age, sex, and
ma e nal educa ion.
Abb e ia ions: L
01
– a ic sound le el exceeded o 1% o he day; L
den
– day-
e ening-nigh sound le els; L
nigh
– nigh - ime oad a ic sound le el; NDVI –
no malized di e ence ege a ion index; NO
2
– ni ogen dioxide; SDI – sleep
dis u bance index.
A.M. Dzhambo e al.
En i onmen al Resea ch 242 (2024) 117642
6
dis u bance and sleep quali y in schoolchild en. While highe le els o
a ic noise and ai pollu ion we e posi i ely associa ed wi h sound
dis u bance and sleep p oblems, li ing in a g eene a ea, especially in a
house wi h a ga den, was associa ed wi h lowe sound dis u bance and
less sleep p oblems e en in he p esence o a ic. The unde lining
mechanism o which he e was s a is ical suppo in he cu en s udy
was child en’s pe cep ion o hei neighbo hood’s cha ac e is ics. Tha
is, a ic exposu es con ibu ed o mo e un a o able, and g eenspace o
mo e posi i e pe cep ions in e ms o a ic- ela ed s esso s, oppo u-
ni ies o ou doo ec ea ion, and gene al sa is ac ion wi h he neigh-
bo hood. This indi ec pa h seemed mo e impo an o g eenspace
because i s o e all e ec was mos ly ealized h ough pe cei ed neigh-
bo hood quali y. Con e sely, a ic exposu es had con incing di ec
e ec s.
We se ou o cha ac e ize he in e wea ing o posi i e and nega i e,
as well as objec i ely-measu ed and pe cei ed, aspec s o he neigh-
bo hood en i onmen . In addi ion o sleep, i was necessa y o conside
sound dis u bance as a sepa a e ou come a he han i s p ecu so , since
in ou c oss-sec ional s udy, i was no s aigh o wa d o asce ain i
annoyance concep ually p eceded sleep p oblems o he o he way
a ound. Mo eo e , child en may spend hei play ime in he same oom
whe e hey sleep, so he sel - epo s o hese wo cons uc s could
o e lap (c . G ela e al., 2016). We decided o go beyond con en ional
noise annoyance ope a ionaliza ion employed in mos s udies among
adul s (c . Guski e al., 2017; Nguyen and Yano, 2023). Though i is
unde s ood ha a ic noise is a s esso o child en causing annoyance
and a ange o ad e se emo ional esponses (Haines e al., 2003) and
ha childhood is a c i ical pe iod o de eloping coping skills and
cogni i e schemas needed o adap a ion o social and en i onmen al
ad e si ies (c . B uni e al., 2011; E ans and Kim, 2013; Bilo a e al.,
2018), empi ical esea ch s ill la gely elies on single i ems o measu e
noise annoyance in child en (Le che e al., 2000; Haines e al., 2003;
Pe sson Waye e al., 2011). In ea lie s udies on adul s a b oade noise
eac ion app oach was suppo ed (Job e al., 2001), and mo e ecen
a emp s poin in he same di ec ion (K oesen and Sch eckenbe g,
2011). Howe e , he body o e idence in child en is limi ed and s an-
da d scales used in adul s may no cap u e he a ie y o si ua ions and
eac ions ela ed o child en’s noise dis u bance (c . Le che e al., 2000;
Haines e al., 2003; Pe sson Waye e al., 2011). In ou s udy, we con-
s uc ed a mul i-i em sound dis u bance scale, mo i a ed by he ac ha
child en engage in a ange o ac i i ies, bo h in and ou o doo s, ypical
o hei age g oup bu no co e ed in classic noise annoyance scales
de eloped o adul s. Mul i-i em scales also gene ally ou pe o m single
i ems in e ms o p edic i e alidi y o a cons uc (Diaman opoulos
e al., 2012). Al hough no shown he e, associa ion be ween
a ic- ela ed exposu es and a single a ic-dis u bance i em we e
weake han wi h ou mul i-i em dis u bance scale.
Fu he , as in e mi en and e en single sound e en s a e su icien o
cause a ousal and sleep agmen a ion (Basne and McGui e, 2018), we
specula ed ha using only s anda d acous ic indica o s, which ep esen
he a e age sound ene gy du ing day o nigh ime, would no be sen-
si i e enough. To de ec he in luence on sleep o bo h con inuous sound
le els and in e mi en acous ic e en s o eme gences abo e back-
g ound, we employed L
den
, L
nigh
, L
01
, and SDI as a se , which we
conside ed concep ually ele an o bo h dis u bance and sleep
Fig. 2. S uc u al equa ion model showing es ima ed pa hs linking a ic exposu es and g eenspace o sound dis u bance and sleep p oblems (N =1020). No es:
Solid lines a e associa ed wi h s a is ically signi ican s anda dized eg ession es ima es a p <0.05, while dashed lines co espond o non-signi ican es ima es.
Obse ed a iables ha e ec angula ou line and la en a iables ha e o al ou line. Pe cen ages indica e he a iance explained in endogenous a iables. Con ol
a iables (child’s sex, age, ma e nal educa ion, and c owding), co a iances, and e o s e ms a e no displayed o enhance eadabili y. Abb e ia ions: L
01
– a ic
sound le el exceeded o 1% o he day; L
den
– day-e ening-nigh sound le els; L
nigh
– nigh - ime oad a ic sound le el; NDVI – no malized di e ence ege a ion
index; NO
2
– ni ogen dioxide; SDI – sleep dis u bance index.
Table 3
Es ima ed pa hs om a ic exposu es and g eenspace o sound dis u bance and
sleep p oblems in he s uc u al equa ion model (N =1020).
Pa hs S anda dized es ima e
(95% CI)
p- alue
Indi ec e ec s
T a ic exposu es → Neighbo hood quali y →
Sound dis u bance
0.07 (0.04, 0.11) <0.001
T a ic exposu es → Neighbo hood quali y →
Sleep p oblems
0.03 (0.01, 0.04) 0.004
NDVI
100 m
→ Neighbo hood quali y →
Sound dis u bance
−0.10 (−0.13, −0.07) <0.001
NDVI
100 m
→ Neighbo hood quali y → Sleep
p oblems
−0.04 (−0.06, −0.02) <0.001
Ga den → Neighbo hood quali y → Sound
dis u bance
−0.05 (−0.08, −0.02) 0.002
Ga den → Neighbo hood quali y → Sleep
p oblems
−0.02 (−0.03, −0.01) 0.005
To al e ec s
T a ic exposu es → Sound dis u bance 0.27 (0.19, 0.35) <0.001
T a ic exposu es → Sleep p oblems 0.11 (0.04, 0.18) 0.002
NDVI
100 m
→ Sound dis u bance −0.13 (−0.20, −0.13) <0.001
NDVI
100 m
→ Sleep p oblems −0.03 (−0.10, 0.04) 0.397
Ga den → Sound dis u bance −0.09 (−0.16, −0.03) 0.007
Ga den → Sleep p oblems −0.09 (−0.16, −0.02) 0.010
Abb e ia ions: NDVI – no malized di e ence ege a ion index.
A.M. Dzhambo e al.
En i onmen al Resea ch 242 (2024) 117642
7
ou comes (c . F edianelli e al., 2022; Sanok e al., 2022). Wi h hei
help, we ound associa ions in line wi h ou hypo hesis. These acous ic
indica o s di e ed no only in hei de ini ion bu also in he way hey
we e modelled. L
01,
ook in o accoun all a ic noise sou ces and s a s
by adding expec ed empo al luc ua ions o he o e all L
den
. I did so by
conside ing he dis ance o he h ee main a ic noise sou ces in he
a ea: he highway, he main oad, and he ailway. The calcula ion o
L
nigh
and SDI was based on he same simpli ied a ic model. In con as
o he commonly used L
nigh
, SDI ep esen ed he p obabili y o sleep
dis u bance, whe e sleep dis u bance was de ined as any change in sleep
pa e n. In i s calcula ion, we conside ed ha child en ha e inc eased
beha io al ole ance o noise du ing sleep (Aeschbach, 2021; A egi
e al., 2022) and longe sleep du a ion. I should be no ed hough ha
SDI should be mo e ele an o au onomous esponse and long- e m
heal h e ec s han o sel - epo ed sleep dis u bance. Tha could
explain why we obse ed weake associa ions wi h SDI han wi h L
den
.
Thus, oge he wi h L
den
, which e lec ed he acous ic si ua ion du ing
he en i e day and hus was ele an o sound dis u bance and o e all
neighbo hood quali y, hese indica o s we e associa ed wi h sound
dis u bance bo h di ec ly and indi ec ly ia pe cei ed neighbo hood
quali y. Fu u e e inemen o he SDI should ca e ully selec sleep
ou come measu es o which i would be mo e in o ma i e.
Much less e idence is a ailable ha li ing in a g eene en i onmen
can mi iga e sound dis u bance (Lug en e al., 2018) and e en less
suppo ed is he con ibu ion o g eenspace o be e sleep. S udies in
adul s ha e obse ed ha ha ing iews o g een landscapes o simply
li ing in a g een neighbo hood and close o g eenspace ela es o lowe
noise annoyance, e en a e accoun ing o objec i e sound le els (Van
Ren e ghem and Bo eldoo en, 2016; Dzhambo , 2017; Van Ren -
e ghem, 2019). Howe e , we a e unawa e o any p e ious s udy ha has
demons a ed o e en in es iga ed he associa ions be ween g eenspace
and sound dis u bance eac ions in child en. The e is also ambiguous
e idence o associa ion be ween g een space and sleep quali y in chil-
d en (Feng e al., 2020). One ecen s udy in adolescen s showed ha
lowe s ess media ed he associa ion be ween g eenspace and sleep
du a ion (Zhong e al., 2023). Ou s udy o e s suppo o one po en ial
mechanism in ol ing gene al app ecia ion o he li ing en i onmen
media ing he associa ion be ween g eenspace and sound dis u bance.
Upon close inspec ion o he i ems ha we used o cons uc ou
pe cei ed neighbo hood quali y scale, one can see ha hey la gely
apped dimensions consis en wi h scales on pe cei ed es o a i e
quali y (Bago , 2004; Han, 2018), such as ela i e absence o s esso -
s/nuisances, oppo uni ies o ou doo ec ea ion, and hence es o a i e
expe iences. In ha , ou s udy seems o add o a g owing body o e i-
dence ha pe cei ed es o a i e quali y is a cen al link be ween na u al
en i onmen s and be e psychological well-being (Collado e al., 2017;
Dzhambo e al., 2017, 2023).
Rega ding NO
2
, he e we e g ounds o including i in ou se o
a ic exposu e indica o s, as ai pollu ion has been shown o con ibu e
o a ings o noise annoyance beyond noise le els, due o sha ed
pe cep ual a ibu es (F ei e al., 2014; Oiamo e al., 2015; Le che ,
2019). I is also biologically plausible ha ai pollu ion could lead o
sleep p oblems h ough espi a o y symp oms and by a ec ing b ain
chemis y o e ime (Liu e al., 2020). And ye , ou indings o NO
2
should be ega ded cau iously, since he co ela ion be ween NO
2
and
a ic noise in ou da a could explain he associa ions ound in single
exposu e models wi h sound dis u bance and sleep p oblems, i.e., NO
2
could ha e ac ed as a p oxy o a ic noise. Acco ding o a sys ema ic
e iew, mos s udies conside ing he ole o ai pollu ion in child en
in es iga ed as ou comes p ima ily b ea hing diso de s du ing sleep (Liu
e al., 2020). Ou sleep p oblems scale was gene ic and ela ed o
insomnia only and he e o e did no ap espi a o y symp oms ela ed o
ai quali y. Fu he , we used NO
2
as a p oxy o a ic- ela ed ai
pollu ion, bu pa icula e ma e has been ound o be mo e s ongly
associa ed wi h sleep diso de symp oms (Law ence e al., 2018).
By showing ha a ic exposu es we e in e sely ela ed o pe cei ed
neighbo hood quali y, we eplica ed a p e iously obse ed mechanism
in adul s ( on Linde n e al., 2016) and adolescen s (Dzhambo e al.,
2017), whe e a ic noise and ai pollu ion seemed o cons ain he
pe cei ed es o a i e quali y o he li ing en i onmen ia annoyance
and he eby led o wo se men al heal h. O no e, a bidi ec ional ela-
ionship be ween sa is ac ion wi h he li ing en i onmen and noise
annoyance is plausible. Fo ins ance, a s udy in F ench child en showed
he ole o esiden ial sa is ac ion in lowe child noise annoyance om
di e en sound sou ces (G ela e al., 2016). Longi udinal da ase s can
be used o es which is he s onge p edic o o e epea ed measu e-
men s o i in ac a bidi ec ional ela ionship is e ealed o e ime.
4.2. E ec modi ica ion
To unde s and whe he g eenspace no only wo ked in he opposi e
di ec ion o a ic exposu es bu could bu e hei e ec s, we compa ed
he pa hways o in e es in he SEM be ween child en li ing in a home
wi h and wi hou a ga den. We p e e ed o s a i y he model by ga den
as i was no so s ongly spa ially co ela ed wi h a ic sou ces like he
NDVI. Mo eo e , ga dens ep esen eadily accessible g eenspace whe e
child en can play and elax. To ou su p ise, highe a ic exposu es
we e associa ed wi h s onge sound dis u bance when he child’s home
had a ga den, and he e was no nega i e e ec o a ic on sleep in
child en li ing in a home wi hou a ga den. We do no mean o sugges
ha ga dens enhance he e ec s o noise, a he hey may e lec un-
measu ed aspec s o local con ex . Fo ins ance, single- amily homes in
hese a eas wi h a ga den migh be less p o ec ed agains noise
compa ed wi h la ge apa men homes. This emains a conjec u e
hough. Likewise, he di e ences in e ec s obse ed be ween child en
li ing in di e en dwelling ypes could be explained by he di e en
con igu a ion o hose.
The pa h om NDVI
100 m
also di e ed depending on he p esence o
a home ga den. I was no ha unexpec ed ha highe NDVI was asso-
cia ed wi h lowe sound dis u bance only in he absence o a ga den,
since child en wi hou access o a ga den we e a guably elying mo e on
a ailable g eenspace in hei neighbo hood, while a ga den would
supplan he need o use mo e dis an g eenspace. Mos e idence on
posi i e g eenspace e ec s on heal h is de i ed om highly u banized
coun ies/ egions (Ye e al., 2022) whe e home ga dens a e no so
common ea u es as in ou s udy a ea. In one o he ew s udies in
child en examining bo h u ban and u al a eas, he amoun o g een-
ness, pa k, and wa e showed signi ican ela ionships wi h quali y o
li e only in u ban/subu ban popula ions bu no in u al a eas (Tillmann
e al., 2018). Bu ha s udy, as many o he s, did no include noise and
ai pollu ion. Ano he s udy ha did measu e ai pollu ion showed
posi i e e ec s o g eenspace on quali y o li e ega dless o
as hma- hini is s a us (Boudie e al., 2022). Ou indings con ibu e o
he small e idence base ha g eenspace, especially ga dens, may ha e
posi i e e ec s also in u al a eas, in spi e o he ypically abundan
backg ound ege a ion and he p esence o noise and ai pollu ion.
Rega ding sex, mos associa ions we ound we e s onge in boys and
we specula e ha his may be a ibu ed o boys being mo e physically
ac i e ou doo s, which would esul in g ea e impo ance o he ou -
doo en i onmen . We a e unawa e o exis ing li e a u e on he subjec
o child gende di e ences o he ou comes o in e es in ou s udy.
P e ious s udies in adul s ha e gene ally poin ed o s onge associa-
ions be ween g eenspace and physical heal h ou comes in women
(Sillman e al., 2022).
4.3. Implica ions
Childhood men al diso de s (Ba ican e al., 2022) a e o en seen in
schoolchild en who ace a ious axing demands in hei social and
academic en i onmen . Social challenges in he amily and iend
sphe es, in o ma ion o e load a school, high pa en al expec a ions, and
excessi e media consump ion a e common s esso s o child en (Basu
A.M. Dzhambo e al.
En i onmen al Resea ch 242 (2024) 117642
8
and Bane jee, 2020). In his company, physical en i onmen exposu es
may no be key de e minan s o childhood men al heal h on he indi-
idual le el, bu modi ica ions o he li ing en i onmen ha e he po-
en ial o bene i he child popula ion as a whole (Ye e al., 2022).
Howe e , along wi h mi iga ion o s esso s like noise, in e en ions
should conside imp o ing access o g eenspace a he same ime. Mos
g eenspace and heal h esea ch has aken place in u ban and subu ban
a eas; he e o e, we need o know mo e abou he bene i s o g eenspace
in u al con ex . E en hough ou s udy was unde aken in an a ea wi h
ela i ely high le els o g eenspace, associa ions be ween g eenspace
and mo e a o able ou comes we e s ill ound. This sugges s ha e en
highly na u e-domina ed esiden ial en i onmen s could s ill bene i
om de elopmen o p oximal g een in as uc u e, especially om
domes ic ga dens and ya ds.
Ou indings a e speci ically ele an o esiden s o he s udy a ea,
as high le els o oad and ailway a ic we e a majo sou ce o en i-
onmen al nuisance a he ime o da a collec ion o his su ey, and
e en nowadays he a eas a e exposed o he same amoun o a ic
noise. E o s o add ess his acous ic si ua ion depend on he as e
implemen a ion o he WHO-noise guidelines (WHO Regional O ice o
Eu ope, 2018).
4.4. Limi a ions
As wi h o he c oss-sec ional s udies, causali y canno be es ablished
in his s udy. We acknowledge ha al e na i e di ec ions o some e-
la ionships obse ed in ou model a e plausible. To add ess he unce -
ain causali y be ween sound dis u bance and sleep p oblems, we
assumed a co ela ional a he han causal ela ionship be ween hem.
Ne e heless, in o he ins ances, we made judgemen calls, as wi h he
posi ioning o pe cei ed neighbo hood quali y in concep ual space
be o e sound dis u bance. One can app ecia e how, in e e se, nega i e
app aisal o he acous ic si ua ion can e ode gene al sa is ac ion wi h
o he aspec s o an a ea (c . Le che and Dzhambo , 2023).
Ou model included a pa simonious se o psychosocial and beha -
io al de e minan s o sound dis u bance and sleep p oblems. Fo
ins ance, we did no use in o ma ion on media use and sc een ime,
ou doo physical ac i i y, o heal h s a us e en hough hese a iables
could be modi ie s o media o s o he exposu es unde s udy (Whi ing
e al., 2021). I hey conside hese, u u e s udies may be able o explain
sleep p oblems o a g ea e deg ee han we could.
Symp oms o ouble alling asleep, s aying asleep, o eeling
es o ed in he mo ning a e commonly used o ope a ionalize insomnia
in child en and adolescen s (Owens, 2005). Howe e , he ag eemen
be ween sel - epo ed and objec i ely measu ed sleep quali y is no ideal
(Ma hews e al., 2018).
C i ics may also a gue agains he concep ualiza ion o he la en
“ a ic exposu es” a iable as i combines annual a e age indica o s
wi h e en -based and day ime-speci ic indica o s. Ou decision on hese
indica o s was based on model pe o mance e alua ion, which indica ed
ha , o example, ha ing SDI as a s and-alone p edic o o he ou comes
in he SEM did no esul in be e model i . On he o he hand, i was
explained o a easonable deg ee by he la en a iable.
Fu he , exposu e misclassi ica ion is ano he possibili y since we did
no accoun o child en’s ime-ac i i y pa e ns and ac ual exposu e o
a ic o g eenspace. T acking pa icipan s’ mo emen s ac oss mic o-
en i onmen s can p o ide be e es ima es o accumula ed exposu e
(Almanza e al., 2012), bu was echnically no easible a he ime o
da a collec ion. We did no use land use/land co e da a o ex ac in-
dica o s o g eenspace access, as he s udy a ea is u al and public pa ks
a e no a ele an ype o g eenspace exposu e.
Rega ding he acous ic indica o s used, one migh no ice ha L
nigh
and SDI pe o med simila ly o wo se han L
den
as p edic o s o sound
dis u bance and sleep p oblems in he linea models. This may lead one
o ques ion he u ili y o hose indica o s i hey did no p o ide supe io
p edic ion. This implies ha nonmono onic ela ionships may exis wi h
said ou comes. Howe e , all hese indica o s con ibu ed o he la en
a iable in ou model. A his poin , u he de elopmen and es ing o
he SDI is indica ed.
5. Conclusions
Highe le els o a ic exposu es we e posi i ely associa ed wi h
sound dis u bance and sleep p oblems, and li ing in a g eene a ea was
associa ed wi h lowe sound dis u bance and less sleep p oblems e en in
he p esence o a ic. T a ic exposu es con ibu ed o mo e un a o -
able, and g eenspace o mo e posi i e pe cep ions in e ms o a ic-
ela ed s esso s, oppo uni ies o ou doo ec ea ion, and gene al
sa is ac ion wi h he neighbo hood. This indi ec pa h seemed mo e
impo an o g eenspace han o a ic.
Ou indings sugges ha mi iga ion o a ic- ela ed exposu es
should be coupled wi h imp o ing access o g eenspace, in in e en ions
o suppo ing he acous ic com o o child en du ing day and nigh -
ime. E en highly na u e-domina ed en i onmen s could s ill bene i
om p oximal g een in as uc u e, especially om domes ic ga dens.
C edi au ho s a emen
Angel M. Dzhambo : Concep ualiza ion, Me hodology, So wa e,
Fo mal analysis, In es iga ion, W i ing – o iginal d a , W i ing – e iew
& edi ing. Pe e Le che : Concep ualiza ion, Me hodology, In es iga-
ion, W i ing – e iew & edi ing, P ojec adminis a ion. Dick Bo el-
doo en: Me hodology, So wa e, In es iga ion, W i ing – e iew &
edi ing.
Decla a ion o compe ing in e es
The au ho s decla e ha hey ha e no known compe ing inancial
in e es s o pe sonal ela ionships ha could ha e appea ed o in luence
he wo k epo ed in his pape .
Da a a ailabili y
The au ho s do no ha e pe mission o sha e da a.
Acknowledgemen s
We wan o hank he inhabi an s o he Lowe Inn and Wipp alleys.
Ou hanks also go o he Aus ian Minis y o Science and T ans-
po a ion o unding he amewo k o he En i onmen al Heal h
Impac Assessmen (EHIA), he go e nmen o he Ty ol egion o
p o iding GIS da a and in o ma ional suppo om he BEG (B enne
Eisenbahn Gesellscha ). The BBT su ey go suppo om he BBT
company wi hin a legally equi ed EHIA h ough EU-suppo . The noise
mapping was done by Ghen Uni e si y, and he ai pollu ion assessmen
by an I alian-Aus ian conso ium. We also hank he la ge EHIA- eams
in bo h s udies who did he ieldwo k. Finally, we hank Iana Ma ke ych
and Ma hew B owning o calcula ing he no malized di e ence ege-
a ion index.
This p ojec has ecei ed unding om he Eu opean Union’s Ho i-
zon 2020 esea ch and inno a ion p og am unde g an ag eemen No
874724. Equal-Li e is membe o he Eu opean Human Exposome
Ne wo k which b ings oge he nine esea ch p ojec s, ecei ing o e
€
100 million om Ho izon 2020, he EU’s amewo k p og am o
esea ch and inno a ion.
Appendix A. Supplemen a y da a
Supplemen a y da a o his a icle can be ound online a h ps://doi.
o g/10.1016/j.en es.2023.117642.
A.M. Dzhambo e al.
En i onmen al Resea ch 242 (2024) 117642
9
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