Ci a ion: Heinonen-Guzeje , M.;
Whipp, A.M.; Wang, Z.; Ranji , A.;
Pal iainen, T.; an Kamp, I.; Kap io, J.
Pe cei ed Occupa ional Noise
Exposu e and Dep ession in Young
Finnish Adul s. In . J. En i on. Res.
Public Heal h 2023,20, 4850. h ps://
doi.o g/10.3390/ije ph20064850
Academic Edi o s: Aidé
A acely Maldonado-Macías,
Yo dán Rod íguez and Juan
Luis He nández A ellano
Recei ed: 13 Janua y 2023
Re ised: 1 Ma ch 2023
Accep ed: 4 Ma ch 2023
Published: 9 Ma ch 2023
Copy igh : © 2023 by he au ho s.
Licensee MDPI, Basel, Swi ze land.
This a icle is an open access a icle
dis ibu ed unde he e ms and
condi ions o he C ea i e Commons
A ibu ion (CC BY) license (h ps://
c ea i ecommons.o g/licenses/by/
4.0/).
In e na ional Jou nal o
En i onmen al Resea ch
and Public Heal h
A icle
Pe cei ed Occupa ional Noise Exposu e and Dep ession in
Young Finnish Adul s
Ma ja Heinonen-Guzeje 1,* , Alyce M. Whipp 1,2 , Zhiyang Wang 2, Anu Ranji 1,2, Teemu Pal iainen 2,
I ene an Kamp 3and Jaakko Kap io 1,2
1Clinicum, Depa men o Public Heal h, Uni e si y o Helsinki, FI-00014 Helsinki, Finland
2Ins i u e o Molecula Medicine Finland (FIMM), Uni e si y o Helsinki, FI-00014 Helsinki, Finland
3
Cen e o Sus ainabili y, En i onmen and Heal h, Na ional Ins i u e o Public Heal h and he En i onmen
in he Ne he lands (RIVM), 3720 BA Bil ho en, The Ne he lands
*Co espondence: [email p o ec ed]
Abs ac :
We in es iga ed he associa ion be ween pe cei ed occupa ional noise exposu e and dep es-
si e symp oms in young Finnish adul s and whe he noise sensi i i y mode a es his associa ion. This
s udy was based on an ongoing longi udinal win s udy. We included hose who had been wo king
daily (n= 521) o weekly (n= 245) du ing he pas 12 mon hs (mean age 22.4, SD 0.7,
53% emale)
.
We asked abou occupa ional noise exposu e a age 22 and assessed dep essi e symp oms using he
Gene al Beha io In en o y (GBI) a age 17 and 22. Noise sensi i i y and co a ia es we e used in
linea eg ession models. Pe cei ed daily occupa ional noise exposu e was associa ed, as a s a is ically
independen main e ec wi h dep essi e symp oms a age 22 (be a 1.19; 95% CI 0.09, 2.29) among
all, and sepa a ely o emales (be a 2.22; 95% CI 0.34, 4.09) bu no males (be a 0.22; 95% CI
−
1.08,
1.52). Noise sensi i i y was independen ly associa ed wi h dep essi e symp oms among all (be a 1.35;
95% CI 0.54, 2.17), and sepa a ely o males (be a 1.96; 95% CI 0.68, 3.24) bu no emales (be a 1.05;
95 % CI
−
0.04, 2.13). Noise sensi i i y was independen o pe cei ed occupa ional noise exposu e.
P e-exis ing dep essi e symp oms a age 17 we e p edic i e o pe cei ed occupa ional noise exposu e,
sugges ing complex in e ac ions o noise and dep ession.
Keywo ds: occupa ional noise; noise sensi i i y; dep essi e symp oms; young adul s
1. In oduc ion
Acco ding o he Wo ld Heal h O ganiza ion (WHO), dep ession occu s among 1.1%
o adolescen s aged 10–14 yea s, and 2.8% o 15–19-yea -olds [
1
]. I is es ima ed ha , in
adul hood, wice as many emales as males a e dep essed [
2
]. In child en, he p e alence
o dep ession is below 1%, wi h no sex di e ences. The p e alence ises h oughou
adolescence [
2
]. The sex di e ences i s eme ge in he age ange o 11–14 [
3
]. The main
isk ac o s o dep ession in adolescence a e amily his o y o dep ession and exposu e o
psychosocial s ess [
4
]. Gene ic and de elopmen al ac o s, psychosocial ad e si y, and sex
ho mones in e ac and inc ease he isk o dep ession [
4
]. O he isk ac o s o dep ession in
you h a e a ec , cogni ion, and beha io [
5
]. S udies ha e shown ha dep essed adolescen s
main ain longe dep essi e a ec i e s a es [
6
]. Cogni i e mechanisms a leas pa ially
media e he ela ionship be ween pa en ing and dep essi e symp oms [
7
]. Pa en s can
model dep essi e beha io o hey may ail o model p oblem-sol ing, coping skills o
a ec egula ion [
5
]. All o hese isk ac o s a he indi idual and b oade con ex ual le els
in e ac , leading o he de elopmen o dep ession [5].
Exposu e o physical en i onmen al agen s and pe ina al, amilial and social ac o s
can ha e subs an ial e ec s on human de elopmen . The exposome is conside ed o consis
o a gene al ex e nal domain (e.g., u bani y, social capi al, and s ess), speci ic ex e nal
domains (e.g., die , smoking, in ec ions, pollu an s, and chemical exposu es), and in e nal
domains (e.g., gu mic obio a, oxida i e s ess, and me abolism) [
8
,
9
]. This s udy is pa o
In . J. En i on. Res. Public Heal h 2023,20, 4850. h ps://doi.o g/10.3390/ije ph20064850 h ps://www.mdpi.com/jou nal/ije ph
In . J. En i on. Res. Public Heal h 2023,20, 4850 2 o 18
he Equal-Li e p ojec , which con ibu es o he de elopmen o he exposome concep by
in eg a ing he in e nal, physical and social exposomes. We dis inguish be ween he ex e -
nal exposome, which is subdi ided in o he physical exposome (e.g., en i onmen al indoo
and ou doo quali y, such as noise exposu e), he social exposome (e.g., socie al con ex ,
socioeconomic, social, and psychosocial ac o s), and he in e nal exposome [
10
]. The gen-
e al exposome ac o has been associa ed wi h psychopa hology [11]. Genome–exposome
in e ac ions seem o con ibu e subs an ially o you h men al heal h symp oms [12].
Noise is an unwan ed sound ha may ad e sely a ec he heal h and well-being o
indi iduals. I is an en i onmen al s esso , which can also a ec men al heal h [
13
,
14
].
The e a e se e al s udies on he e ec s o en i onmen al noise on men al heal h and,
acco ding o a sys ema ic e iew by Cla k e al. (2020), he e is low quali y e idence ha
oad a ic noise may ha e ha m ul e ec s on in e iew-measu ed dep ession and anxie y
as well as on medica ion use [15].
Noise annoyance is a pe son’s indi idual ad e se eac ion o noise [
16
]. Acco ding
o ecen s udies, noise annoyance can be a media o be ween noise exposu e and men al
ill-heal h [
17
], especially dep ession [
18
]. Noise sensi i e indi iduals a e mo e a ec ed by
noise and noise sensi i i y p edic s noise annoyance [
19
]. Noise sensi i i y agg ega es in
amilies and p obably has a gene ic componen . The es ima e o he i abili y o noise sensi-
i i y is 36% [
20
]. Noise sensi i i y can be a mode a o o noise exposu e on psychological
ill-heal h [17,21,22].
S udies on occupa ional noise ha e mainly in es iga ed he audi o y e ec s o noise
and we ha e less in o ma ion on occupa ional noise and o he heal h ou comes, pa icula ly
men al heal h. We a e missing solid e idence om young people en e ing he wo k o ce.
Noise exposu e a wo k is one o he isk ac o s o a poo e quali y o li e [
23
]. Occupa-
ional noise annoyance has been signi ican ly ela ed o men al heal h, including dep essi e
symp oms and suicidal idea ion [
24
]. In a s udy o he e ec s o noise on he wo kload
and s ess le els o ope a ing oom s a , anxie y and wo kload sco es we e posi i ely
co ela ed wi h noise le els [
25
]. Noise is also one o he occupa ional haza ds a ec ing job
s ess [
26
]. In a s udy on wo kplace noise in an eme gency depa men , he pe o mance o
men al asks was main ained du ing noise exposu e, bu noise exposu e was associa ed
wi h signi ican deg ees o sel - epo ed dis ess [
27
]. In a s udy by Sjödin e al. (2012)
on noise and s ess e ec s on p eschool pe sonnel, he ad e se e ec s we e s udied using
ques ionnai es and sali a co isol samples. To measu e he subjec i e s ess and i s ela-
ion o he psychosocial wo k condi ions, he S ess–Ene gy adjec i e checklis was used.
S ess and ene gy ou pu we e p onounced. Abou 30% o he s a expe ienced s ong
bu nou symp oms ha we e associa ed wi h educed sleep quali y and inc eased mo ning
sleepiness. Men al eco e y a e wo k was low, which was indica ed by s ess le els
emaining high a e wo k. Co isol le els suppo ed he conclusion ega ding p onounced
ele a ed daily s ess le els [
28
]. In a s udy by an Dijk e al. (1987), abou wo- hi ds o
wo ke s epo ed noise annoyance. Consis en posi i e ela ionships we e ound be ween
symp oms o s ess and noise annoyance. Men ally s ess ul asks we e mos a ec ed by
noise [29].
This s udy was p epa ed as pa o he Equal-Li e p ojec , which s udies long- e m
e ec s o ea ly en i onmen al exposu es du ing childhood and adolescence on men al
heal h and cogni ion. We aimed o cha ac e ize he e ec s o pe cei ed occupa ional noise
exposu e on dep essi e symp oms among young adul s om he longi udinal win s udy
(FinnTwin12 coho ). We also assessed p e-exis ing dep essi e symp oms measu ed a age
14 and 17 o hei associa ion wi h u u e pe cei ed noise exposu e. Noise exposu e a
wo k a ha age would be minimal o absen , hus p o iding clues as o he di ec ion o
e ec s. Those wi h ea lie dep essi e symp oms could, e.g., epo he same noise le els as
loude han hose wi hou dep essi e symp oms, o he associa ion o p io dep ession wi h
occupa ional noise in he u u e could be one mani es a ion o a heal hy wo ke selec ion
e ec [
30
,
31
]. A seconda y aim o his s udy was o es ablish whe he noise sensi i i y
mode a es an associa ion be ween pe cei ed noise exposu e and dep essi e symp oms.
In . J. En i on. Res. Public Heal h 2023,20, 4850 3 o 18
2. Ma e ials and Me hods
This s udy was based on FinnTwin12 (FT12), an ongoing longi udinal win s udy
launched in 1994 o in es iga e he de elopmen al gene ic epidemiology o heal h- ela ed
beha io s. In 1994, 5600 wins we e en olled and hei amilies selec ed om na ion-wide
bi h coho s bo n om 1983–1987. In he i s phase, ques ionnai es we e sen o wins,
hei pa en s and eache s when he wins we e 11–12 yea s old, wi h wo ollow-ups a
ages 14 and 17.5 yea s [
32
,
33
]. Twins om 935 amilies we e in i ed o in-dep h assessmen s
a age 14, including psychia ic in e iews [
34
]. A age 14, 1852 wins pa icipa ed and
hey we e con ac ed again o pa icipa ion as young adul s (wa e 4). In he 2006–2009
wa e 4 s udy, da a collec ion in ol ed conduc ing s uc u ed psychia ic in e iews a
an a e age age o 21.9 (SD 0.8, ange 21–26) yea s, wi h neu opsychological assessmen s
and collec ion o DNA and se um samples ( o basic biochemis y and me abolomics) in
addi ion o comple ing ques ionnai es including i ems on wo k, wo k exposu es and wo k
condi ions. A o al o 1347 wins comple ed in e iews a age 22, while 1299 comple ed
ques ionnai es ela ed o wo k [35].
Inclusion c i e ia: We included hose who had been wo king du ing he pas 12 mon hs
(n= 766, 53% emale, age ange 20–26 yea s). Wo k du ing he pas 12 mon hs was assessed
using he ques ion “Du ing he las 12 mon hs ha e you been a wo k?” The esponse
choices we e as ollows: 1 “daily”, 2 “weekly”, 3 “mon hly”, 4 “ empo a y wo k”, 5 “I ha e
no wo ked a all o i has been e y occasional”. O hese pa icipan s, 521 had wo ked
daily and 245 weekly. We also asked abou s udying and wo king using he ques ion “Do
you go o school o a e you s udying a he momen ?” The esponse choices we e as ollows:
1 “No, I am no s udying anywhe e”, 2 “I’m s udying, no wo king a he same ime”,
3 “I’m s udying and also wo king ______ hou s pe week”. The o he 533 pa icipan s had
no wo ked o wo ked in equen ly o se e al easons (such as ull- ime s udy, pa en al
lea e, mili a y se ice o unemploymen ).
Exposu e da a: Pe cei ed occupa ional noise exposu e a age 22 (wa e 4) was de ined
by asking abou noise exposu e a wo k. We used he ques ion “How o en is he e such a
loud noise a you wo k ha you canno hea no mal speech wi hin a me e ’s dis ance?”
The esponse choices we e 1 “daily”, 2 “weekly”, 3 “occasionally”, 4 “ne e .” All ou
ca ego ies we e used in he analyses.
Co a ia es: We based ou selec ion o co a ia es on hei a ailabili y in he FT12 s udy
and hei use in p e ious s udies o ele ance o dep ession [
36
,
37
]. We included age, sex,
educa ion, economic si ua ion, wo k condi ions, and smoking s a us as ele an co a ia es.
Two noise-speci ic a iables we e included, i.e., noise sensi i i y and noise annoyance.
Noise annoyance is he mos p e alen communi y esponse in popula ions exposed
o en i onmen al noise [
38
]. Annoyance is ela ed o noise le el, bu noise sensi i i y is
no [
39
,
40
]. EU Di ec i e 2002/49/EC (1) ecommends e alua ing en i onmen al noise
exposu es on he basis o es ima ed noise annoyance [
41
]. Noise annoyance is assessed a
he le el o popula ions using a ques ionnai e. Noise annoyance was s udied using he
ques ion “Do he ollowing ac o s annoy you a wo k: noise?” The esponse al e na i es
we e 1 “no o does no bo he ”, 2 “bo he s somewha ”, 3 “bo he s qui e a lo ”, 4 “bo he s
e y much”. Pa icipan s answe ing “no o does no bo he ” we e classi ied as no epo ing
noise annoyance. Pa icipan s answe ing “bo he s somewha ” we e classi ied as epo ing
some annoyance. Pa icipan s answe ing “bo he s qui e a lo ” we e classi ied as epo ing
mode a e annoyance. Pa icipan s answe ing “bo he s e y much” we e classi ied as
epo ing high annoyance.
Noise sensi i i y e e s o physiological and psychological in e nal s a es o an indi id-
ual ha inc ease he deg ee o eac i i y o noise in gene al [
42
]. Noise sensi i e indi iduals
pay mo e a en ion o noise han less sensi i e ones. They ha e highe le els o onic physi-
ological a ousal and mo e s a le esponses o noise. In dep essed pa ien s, noise sensi i i y
sco es ha e been shown o be conside ably highe han in con ol pa icipan s [
19
]. Noise
sensi i i y is a po en ial mode a o o an associa ion be ween noise exposu e and dep es-
sion. Noise sensi i i y was s udied using he s a emen “An unexpec ed noise makes me
In . J. En i on. Res. Public Heal h 2023,20, 4850 4 o 18
jump and s a le.” The esponse choices we e “S ongly disag ee”, “Disag ee”, “Ag ee” o
“S ongly ag ee”. In he analyses, ou classes o noise sensi i i y we e e-ca ego ized in o
wo. Pe sons wi h noise sensi i i y we e hose answe ing “Ag ee” o “S ongly ag ee” and
pe sons wi hou noise sensi i i y we e hose answe ing “S ongly disag ee” o “Disag ee”.
Wo k condi ions we e s udied using he Ka asek Job Con ol, Demand and Sup-
po Scale, a well-es ablished ins umen o assess wo k condi ions du ing he pas 12
mon hs [
43
]. We o med he ollowing h ee ecognized subscales: Job Con ol, C onbach’s
alpha 0.82; Job Demand, alpha 0.70; and Job Suppo , alpha 0.75.
Ciga e e smoking is associa ed wi h subsequen dep ession, and hose su e ing om
dep ession a e mo e likely o s a smoking and become nico ine-
dependen [36,44–47]
.
Smoking s a us was s udied using he ques ion “Which o he ollowing al e na i es
desc ibes you cu en smoking beha io he bes ?” wi h esponse choices o 1 ”I smoke
daily 20 ciga e es o mo e”, 2 “I smoke daily 10 o 19 ciga e es”, 3 “I smoke daily 1 o
9 ciga e es”, 4 “I smoke once a week o mo e o en, no daily howe e ”, 5 “I smoke less
equen ly han once a week”, 6 “I ha e s opped o qui smoking”, 7 “I ha e ied smoking
bu I don’ smoke” and 8 “I ha e ne e e en ied”. We collapsed he ca ego ies in o cu en
daily smoke s, occasional smoke s, o me smoke s and ne e smoke s o he analyses
In you h, lowe socio-economic s a us has been associa ed wi h highe a es o de-
p essed mood and anxie y [
48
], and we used a ained educa ion as a measu e o socio-
economic s a us. Du ing he da a collec ion, in he Finnish educa ional sys em, compulso y
educa ion consis ed o 9 yea s o basic school (ending a age 16). Some imes an addi ional
10 h yea o he basic school was necessa y. A e ha , uppe seconda y educa ion was
di ided in o oca ional seconda y educa ion (non-academic) and academic seconda y
educa ion (academic high school wi h ma icula ion examina ion), which no mally ook
2 and 3 yea s
o comple e, espec i ely. Te ia y-le el educa ion was p o ided by poly-
echnic schools (poly echnic deg ee) and uni e si ies (academic deg ee), las ing no mally
3.5 and 5 yea s, espec i ely. Educa ion was s udied using he ques ion “Wha school-
ing/deg ees ha e you comple ed?” The esponse choices we e 1 “Senio g ades o he
basic school”, 2 “I ha e a deg ee om he 10 h class o he basic school“, 3 “I ha e passed
my ma icula ion examina ion”, 4 “I ha e a oca ional deg ee”, 5 “I ha e a poly echnic
deg ee”, 6 “I ha e an academic deg ee”, 7 “I ha e passed an app en iceship aining”, and
8 “I ha e passed a oca ional aining o oca ional cou se”. Based on hese i ems, we
classi ied he pa icipan s based on hei seconda y-le el educa ion as ha ing no seconda y
educa ion, ha ing an academic high school diploma o ha ing oca ional aining. Since
many pa icipan s we e s ill s udying, di e en ia ion in o hose wi h and hose wi hou a
e ia y deg ee was no possible. In Finland, a e ia y deg ee can be ob ained ega dless o
he kind o seconda y deg ee.
Men al heal h assessmen s: Dep essi e symp oms we e s udied a age 17 (wa e 3) and
a age 22 (wa e 4) using he Gene al Beha io In en o y (GBI). The GBI is a sel - epo ed
in en o y o mood- ela ed beha io s ha was i s de eloped by Depue in 1981 and was
designed o iden i y he p esence and se e i y o dep essi e and manic o hypomanic
symp oms and o assess o cyclo hymia [
49
,
50
]. We used he sho e sion o he GBI,
which has been used in p e ious analyses o da a om he FT12 sample [
36
,
37
,
50
,
51
]. This
scale consis s o 10 i ems inqui ing abou he occu ence o dep essi e symp oms, answe ed
on a 4-poin Like scale om 0 = ne e o 3 = e y o en, and he o al sum sco e anges
om 0–30. The coe icien alpha was 0.90 o GBI a wa e 3 (age 17) and 0.91 a wa e
4 (young adul ), indica ing excellen in e nal consis ency o he scale.
Valida ion o he 10-i em GBI a young adul age e sus majo dep essi e diso -
de DSM-IV diagnosis was pe o med. O he esponden s included in he analysis,
749 (17 (2.2%) missing) we e also success ully in e iewed, ei he in pe son o by ele-
phone using he Semi-S uc u ed Assessmen o Gene ics o Alcoholism psychia ic in-
e iew (Bucholz e al. 1994) o yield a diagnosis o li e ime Majo Dep essi e Diagnosis
based on DSM-IV [
52
]. A posi i e diagnosis was gi en by 86 pa icipan s (11.4% o e all,
among males 7.0% and among emales 15.3%). In a logis ic eg ession analysis, GBI a age
In . J. En i on. Res. Public Heal h 2023,20, 4850 5 o 18
22 s ongly p edic ed (p= 5.04
×
10
−23
, pseudo-R
2
= 21.7%) a diagnosis o majo dep ession,
wi h an ROC ( ecei e ope a ing cha ac e is ic) AUC (a ea unde cu e) o 0.831. This
demons a es ha he sho o m o he GBI has excellen alidi y when measu ed agains
a psychia ic diagnosis o majo dep ession, when ob ained by ained and expe ienced
in e iewe s using a alida ed and s uc u ed ins umen .
Ano he assessmen o dep essi e symp oms was ob ained using he modi ied Mul idi-
mensional Pee Nomina ion In en o y (MPNI). Dep essi e symp oms we e a ed a ages 17
(wa e 3) and 14 (wa e 2). The adolescen a ed him- o he sel a ages 14 and 17. The MPNI
includes 37 i ems co e ing majo domains o pe sonali y and beha io . The co e i ems o
he MPNI we e de eloped o ep esen a model o emo ional and beha io al egula ion.
The e a e subscales o agg ession, dep ession, hype ac i i y/impulsi i y, ina en ion, and
social anxie y [
53
,
54
]. A age 14, he e a e i e i ems o dep ession ques ions and, a age
17, wo i ems o dep ession [
55
]. The ROC AUC o MPNI dep essi e symp oms a ages
14 agains age 22 DSM-IV majo dep essi e diso de was unde 0.60, while he age 17
measu es (bo h MPNI and GBI) had AUCs a ound 0.68, compa ed o 0.83 o age 22 GBI
agains s uc u ed in e iew-based majo dep essi e diso de diagnosis.
Supplemen a y Ma e ial consis s o (1) he 17-yea -old win ques ionnai e including
MPNI and GBI ques ions, and (2) he 21–24-yea -old win home ques ionnai e including
wo k and noise ques ions.
S a is ical analyses: Linea eg ession analyses we e used o analyze he associa ion
o pe cei ed noise a wo k wi h dep essi e symp oms. Reg ession coe icien s (be a) and
95% con idence in e als (95% CIs) a e epo ed. The main analysis was o examine he
associa ions o pe cei ed occupa ional noise exposu e and dep essi e symp oms in young
adul hood, bo h a age 22. We hen examined whe he dep essi e symp oms on he same
scale (GBI) assessed a age 17 we e associa ed wi h la e pe cei ed noise exposu e a wo k
a age 22. Noise exposu e a wo k a age 17 would be minimal o absen , hus p o iding
clues as o he di ec ion o e ec s. Las ly, we used ano he measu e o dep essi e symp oms
( he MPNI assessed a ages 14 and 17) o see whe he he GBI and MPNI wo k simila ly a
age 17 and whe he ea ly adolescence dep essi e symp oms show any associa ion wi h
pe cei ed occupa ional noise exposu e yea s la e . Models wi h and wi hou co a ia es
we e used o assess he s a is ical independence o he associa ion. Fu he , we es ed
whe he noise sensi i i y and noise annoyance mode a ed he e ec o pe cei ed noise
exposu e h ough in e ac ion analyses. All s a is ical analyses we e conduc ed wi h S a a
( e sion 17, S a aCo p, College S a ion, TX, USA) [56].
3. Resul s
Table 1shows he ou comes and co a ia es by pe cei ed noise exposu e ca ego ies
(daily, weekly, occasionally, ne e ). The pa icipan s we e young adul s and hus only a
ew had comple ed a uni e si y o poly echnic deg ee. A signi ican p opo ion o high
school g adua es con inued o s udy. In con as , only a small p opo ion o oca ional
school a endees we e s udying. We included hose pa icipan s who had been wo king
daily (n= 521) o weekly (n= 245) du ing he pas 12 mon hs in u he analyses.
Males we e exposed o noise mo e han emales. O hose who we e exposed o noise
a wo k daily, 64.0% we e male, o weekly exposed, 67.0% we e male, and o occasionally
exposed, 53.2% we e male. O hose ne e exposed o noise a wo k, 68.6% we e emale
(Table 1).
O all pa icipan s, 32.1% we e noise sensi i e. Females we e mo e noise sensi i e
han males (40.4% o emales and 22.1% o males we e noise sensi i e). O e all, 51.9% o
he pa icipan s epo ed noise annoyance a wo k, o whom 37.4% epo ed low noise
annoyance, 8.8% mode a e annoyance and 5.8% high annoyance a wo k. Males epo ed
mo e annoyance han emales, wi h 60.2% o males and 44.4% o emales epo ing noise
annoyance a wo k. Mo e males (7.5%) han emales (4.2%) epo ed high noise annoyance
a wo k.
In . J. En i on. Res. Public Heal h 2023,20, 4850 6 o 18
Table 1.
Dis ibu ions o a iables (ou comes and co a ia es) by noise exposu e ca ego ies in young
adul hood among pa icipan s who had wo ked a leas weekly in he p io 12 mon hs.
Pe cei ed Noise Exposu e a Wo k
Daily Weekly Occasionally Ne e To al
N= 114 N= 97 N= 233 N= 322 N= 766
Sex (N, %)
Male 73 (64.0%) 65 (67.0%) 124 (53.2%) 101 (31.4%) 363 (47.4%)
Female 41 (36.0%) 32 (33.0%) 109 (46.8%) 221 (68.6%) 403 (52.6%)
Age a wa e 4 (yea s) (Mean, SD) 22.4 (0.7) 22.3 (0.7) 22.5 (0.7) 22.5 (0.8) 22.4 (0.7)
Seconda y educa ion (N, %)
None 7 (6.1%) 9 (9.3%) 21 (9.0%) 11 (3.4%) 48 (6.3%)
Voca ional 69 (60.5%) 44 (45.4%) 94 (40.3%) 93 (28.9%) 300 (39.2%)
Academic 38 (33.3%) 44 (45.4%) 118 (50.6%) 218 (67.7%) 418 (54.6%)
Smoking s a us (N, %)
Ne e 43 (37.7%) 37 (38.1%) 85 (36.6%) 153 (47.5%) 318 (41.6%)
Fo me 15 (13.2%) 13 (13.4%) 22 (9.5%) 30 (9.3%) 80 (10.5%)
Occasional 6 (5.3%) 7 (7.2%) 28 (12.1%) 40 (12.4%) 81 (10.6%)
Cu en 50 (43.9%) 40 (41.2%) 97 (41.8%) 99 (30.7%) 286 (37.4%)
Wo k condi ions (Mean, SD)
Job suppo 2.2 (0.9) 2.0 (0.8) 2.0 (0.7) 2.0 (0.8) 2.0 (0.8)
Job demand 0.3 (0.7) 0.3 (0.7) 0.4 (0.7) 0.6 (0.7) 0.4 (0.7)
Job con ol 1.5 (0.9) 1.4 (0.7) 1.5 (0.8) 1.6 (0.8) 1.5 (0.8)
Cu en s udy (N, %)
No 83 (73.5%) 70 (72.9%) 131 (57.7%) 147 (45.7%) 431 (56.9%)
Only s udy 14 (12.4%) 8 (8.3%) 24 (10.6%) 38 (11.8%) 84 (11.1%)
S udy&wo k 16 (14.2%) 18 (18.8%) 72 (31.7%) 137 (42.5%) 243 (32.1%)
GBI o age 22 (Mean, SD) 5.0 (4.8) 3.6 (3.5) 4.8 (4.5) 3.9 (4.2) 4.3 (4.3)
GBI o age 17 (Mean, SD) 5.5 (5.4) 4.1 (4.1) 5.3 (5.2) 4.7 (4.8) 4.9 (5.0)
Figu e 1p esen s he dis ibu ion o he GBI sco e a age 22 by sex and Figu e 2 he
dis ibu ion o he GBI sco e a age 22 by pe cei ed noise exposu e a wo k.
In . J. En i on. Res. Public Heal h 2023, 20, x FOR PEER REVIEW 7 o 19
Figu e 1. Dis ibu ion o he GBI sco e a age 22 by sex.
Figu e 2. Dis ibu ion o he GBI sco e a age 22 by pe cei ed noise exposu e a wo k.
3.1. Associa ion o Dep essi e Symp oms wi h Pe cei ed Occupa ional Noise Exposu e
Table 2 p o ides linea mul i a iable eg ession models ha we e used o in es iga e
he associa ion o dep essi e symp oms a age 22 wi h pe cei ed occupa ional noise ex-
posu e as young adul s (also a age 22). A age 22, in all pa icipan s in he age- and sex-
adjus ed model, daily noise exposu e a wo k was associa ed wi h dep essi e symp oms
(be a 1.56; 95% CI 0.54, 2.59), and also occasional noise exposu e a wo k was associa ed
wi h dep essi e symp oms (be a 1.17; 95% 0.43, 1.92), bu he e ec size o he associa ion
was smalle han in pe cei ed daily noise exposu e. In males, he e was no associa ion o
dep essi e symp oms wi h noise exposu e a wo k (be a 0.61; 95% CI −0.57, 1.78). In
Figu e 1. Dis ibu ion o he GBI sco e a age 22 by sex.
In . J. En i on. Res. Public Heal h 2023,20, 4850 7 o 18
In . J. En i on. Res. Public Heal h 2023, 20, x FOR PEER REVIEW 7 o 19
Figu e 1. Dis ibu ion o he GBI sco e a age 22 by sex.
Figu e 2. Dis ibu ion o he GBI sco e a age 22 by pe cei ed noise exposu e a wo k.
3.1. Associa ion o Dep essi e Symp oms wi h Pe cei ed Occupa ional Noise Exposu e
Table 2 p o ides linea mul i a iable eg ession models ha we e used o in es iga e
he associa ion o dep essi e symp oms a age 22 wi h pe cei ed occupa ional noise ex-
posu e as young adul s (also a age 22). A age 22, in all pa icipan s in he age- and sex-
adjus ed model, daily noise exposu e a wo k was associa ed wi h dep essi e symp oms
(be a 1.56; 95% CI 0.54, 2.59), and also occasional noise exposu e a wo k was associa ed
wi h dep essi e symp oms (be a 1.17; 95% 0.43, 1.92), bu he e ec size o he associa ion
was smalle han in pe cei ed daily noise exposu e. In males, he e was no associa ion o
dep essi e symp oms wi h noise exposu e a wo k (be a 0.61; 95% CI −0.57, 1.78). In
Figu e 2. Dis ibu ion o he GBI sco e a age 22 by pe cei ed noise exposu e a wo k.
3.1. Associa ion o Dep essi e Symp oms wi h Pe cei ed Occupa ional Noise Exposu e
Table 2p o ides linea mul i a iable eg ession models ha we e used o in es i-
ga e he associa ion o dep essi e symp oms a age 22 wi h pe cei ed occupa ional noise
exposu e as young adul s (also a age 22). A age 22, in all pa icipan s in he age- and sex-
adjus ed model, daily noise exposu e a wo k was associa ed wi h dep essi e symp oms
(be a 1.56; 95% CI 0.54, 2.59), and also occasional noise exposu e a wo k was associa ed
wi h dep essi e symp oms (be a 1.17; 95% 0.43, 1.92), bu he e ec size o he associa ion
was smalle han in pe cei ed daily noise exposu e. In males, he e was no associa ion o
dep essi e symp oms wi h noise exposu e a wo k (be a 0.61; 95% CI
−
0.57, 1.78). In e-
males, pe cei ed daily noise exposu e a wo k was associa ed wi h dep essi e symp oms
(be a 2.75; 95% CI 0.98, 4.51) (Table 2).
In linea eg ession mul i a iable models adjus ed o all non-noise co a ia es (age,
sex, educa ion, smoking, wo k condi ions), in all pa icipan s, pe cei ing daily noise
exposu e a wo k was associa ed wi h dep essi e symp oms (be a 1.20; 95% CI 0.19, 2.20).
In males and emales sepa a ely, he poin es ima es we e signi ican o emales (be a
2.07; 95% 0.37, 3.76) bu no o males (be a 0.42; 95% −0.82, 1.66). In he ull model, noise
sensi i i y was independen ly associa ed wi h dep essi e symp oms in all pa icipan s
(be a 1.35; 95% CI 0.54, 2.17)
and in males (be a 1.96; 95% CI 0.68, 3.24), bu no in emales
(be a 1.05; 95 % CI
−
0.04, 2.13) (Table 2). Noise sensi i i y was no associa ed wi h pe cei ed
occupa ional noise exposu e a wo k ( esul s no included in ables).
In a ull linea eg ession model adjus ed o all a iables, in all pa icipan s, daily
noise exposu e a wo k was associa ed wi h dep essi e symp oms (be a 1.19; 95% CI 0.09;
2.29). In males, he e was no associa ion o dep essi e symp oms wi h noise exposu e a
wo k (be a 0.22; 95% CI
−
1.08, 1.52), whe eas in emales, pe cei ed daily noise exposu e a
wo k was associa ed wi h dep essi e symp oms (be a 2.22; 95% CI 0.34, 4.09). (Table 2).
As an addi ional analysis, we also an he mul i a iable GBI model a age 22 by s a a
o educa ion (none, oca ional and academic high school) o emales, and he associa ion
o GBI a age 22 and pe cei ed occupa ional noise exposu e, con olled o all co a ia es,
was as s ong in all subg oups.
In . J. En i on. Res. Public Heal h 2023,20, 4850 8 o 18
Table 2.
Linea mul i a iable eg ession models o he associa ion o dep essi e symp oms a age 22 using he GBI scale wi h pe cei ed occupa ional noise exposu e
and selec ed co a ia es in young adul hood.
GBI Sco e a Age 22
Reg ession Coe icien Be a (95% CI)
All Male Female
Model a (n= 757) Model b (n= 756) Model c (n= 658) Model a (n= 360) Model b (n= 360) Model c (n= 302) Model a (n= 397) Model b (n= 396) Model c (n= 356)
R2 o he model 0.0468 0.1134 0.1362 0.0253 0.0826 0.1315 0.0360 0.131 0.1463
Pe cei ed noise a wo k
Ne e Re . Re . Re . Re . Re . Re . Re . Re . Re .
Daily 1.56 (0.54, 2.59) * 1.20 (0.19, 2.20) * 1.19 (0.09, 2.29) * 0.61 (−0.57, 1.78) 0.42 (−0.82, 1.66) 0.22 (−1.08, 1.52) 2.75 (0.98, 4.51) * 2.07 (0.37, 3.76) * 2.22 (0.34, 4.09) *
Weekly 0.30 (−0.55, 1.16) 0.06 (−0.78, 0.89) −0.12 (−1.05, 0.82) −0.25 (−1.28, 0.77) −0.39 (−1.39, 0.61) −0.44 (−1.55, 0.66) 0.88 (−0.63, 2.39) 0.42 (−0.99, 1.82) −0.02 (−1.58, 1.54)
Occasionally 1.17 (0.43, 1.92) * 0.94 (0.22, 1.66) * 1.01 (0.24, 1.77) 0.84 (−0.20, 1.88) 0.67 (−0.40, 1.75) 1.03 (−0.13, 2.18) 1.25 (0.19, 2.32) 1.01 (0.01, 2.00) * 0.82 (−0.25, 1.89)
Age a 22 yea s su ey 0.28 (−0.16, 0.71) 0.26 (−0.16, 0.68) 0.14 (−0.33, 0.60) 0.54 (−0.08, 1.16) 0.43 (−0.18, 1.05) 0.29 (−0.41, 0.99) 0.03 (−0.56, 0.62) 0.12 (−0.46, 0.70) 0.03 (−0.61, 0.67)
Seconda y educa ion
Academic Re . Re . Re . Re . Re . Re .
None 1.67 (0.13, 3.21) * 1.69 (−0.01, 3.39) 1.28 (−0.59, 3.15) 1.38 (−0.58, 3.34) 1.92 (−0.84, 4.68) 2.17 (−0.97, 5.31)
Voca ional −0.16 (−0.89, 0.58) −0.22 (−1.03, 0.59) −0.28 (−1.22, 0.67) −0.21 (−1.25, 0.84) −0.12 (−1.20, 0.96) −0.17 (−1.32, 0.98)
Smoking Ne e Re . Re . Re . Re . Re . Re .
Fo me 1.62 (0.42, 2.82) * 1.46 (0.11, 2.81) * 1.27 (−0.30, 2.85) 1.04 (−0.65, 2.74) 1.81 (−0.00, 3.63) 1.90 (−0.26, 4.05)
Occasional 0.03 (−0.82, 0.89) 0.06 (−0.84, 0.97) −1.40 (−2.43, −0.37) * −1.59 (−2.69, −0.49) * 1.04 (−0.20, 2.29) 1.05 (−0.23, 2.33)
Cu en 1.50 (0.75, 2.26) * 1.44 (0.58, 2.30) * 0.72 (−0.30, 1.75) 0.53 (−0.64, 1.71) 2.13 (1.02, 3.23) * 2.11 (0.89, 3.32) *
Wo k condi ions
Job suppo 0.56 (0.14, 0.98) * 0.75 (0.28, 1.23) * 0.06 (−0.50, 0.62) 0.32 (−0.37, 1.01) 0.86 (0.29, 1.43) * 0.96 (0.33, 1.58) *
Job demand −0.15 (−0.63, 0.32) −0.15 (−0.67, 0.37) −0.05 (−0.90, 0.80) −0.05 (−1.00, 0.90) −0.21 (−0.78, 0.35) −0.18 (−0.80, 0.44)
Job con ol 0.48 (0.01, 0.95) * 0.36 (−0.15, 0.86) 0.54 (−0.02, 1.10) 0.34 (−0.28, 0.97) 0.43 (−0.27, 1.13) 0.36 (−0.37, 1.09)
Noise sensi i i y
No Re . Re . Re .
Yes 1.35 (0.54, 2.17) * 1.96 (0.68, 3.24) * 1.05 (−0.04, 2.13)
a: Independen a iable: noise exposu e a wo k, age, and sex; b: Independen a iable: based on a, addi ional seconda y le el school, smoking s a us, job suppo , demand, and con ol;
c: Independen a iable: based on b, addi ional noise sensi i i y; * p< 0.05.
In . J. En i on. Res. Public Heal h 2023,20, 4850 9 o 18
In pos hoc analyses, we looked a he o e all in e ac ion es be ween ou ca ego ies
o pe cei ed noise exposu e and wo ca ego ies o noise sensi i i y in emales. I was no
signi ican (p= 0.275). I is in e es ing ha , among he se en combina ions o exposu e
and sensi i i y compa ed o non-exposed, non-sensi i e emales, emales who we e bo h
exposed o daily noise and who we e noise sensi i e had mo e dep essi e symp oms han
he non-sensi i e ones (nominal p= 0.037; be a 3.47; 95% CI 0.21, 6.75).
Noise annoyance and pe cei ed occupa ional noise exposu e we e highly co ela ed
( ho =
−
0.71). In a linea eg ession mul i a iable model adjus ed o pe cei ed occupa-
ional noise exposu e a wo k, educa ion, smoking, and wo k condi ions, annoyance was
no associa ed wi h dep essi e symp oms in all pa icipan s o in males o emales sepa-
a ely ( ables no included). Noise annoyance was associa ed wi h pe cei ed occupa ional
noise exposu e bu no wi h dep ession, and s a is ical adjus men o annoyance did no
emo e he associa ion o pe cei ed occupa ional noise exposu e wi h dep ession.
3.1.1. P e-Exis ing Dep essi e Symp oms (Using GBI) a Age 17 and Pe cei ed Noise
Exposu e a Wo k as Young Adul s
We also s udied he associa ion o p e-exis ing dep ession assessed using he GBI a
age 17 wi h he pe cei ed occupa ional noise exposu e a age 22. Table 3shows linea
mul i a iable eg ession models ha we e used o in es iga e he associa ion o p e-exis ing
dep essi e symp oms wi h pe cei ed occupa ional noise exposu e. In all pa icipan s, in
he age- and sex-adjus ed model, pe cei ed daily noise exposu e a wo k (be a 1.69; 95% CI
0.45, 2.92) and occasional noise exposu e a wo k (be a 1.10; 95% 0.19, 2.01) we e associa ed
wi h p e-exis ing dep essi e symp oms; he e ec size o he associa ion o pe cei ed
occasional noise exposu e was smalle han in pe cei ed daily noise exposu e. In emales,
in he age- and sex-adjus ed model, daily noise exposu e a wo k (a age 22) was associa ed
wi h p e-exis ing dep essi e symp oms (be a 3.02; 95% CI 0.70, 5.33), bu in males he e
was no associa ion (be a 0.53; 95% CI −0.72, 1.78) (Table 3).
In linea eg ession models adjus ed o all non-noise co a ia es, in all pa icipan s,
pe cei ing daily noise exposu e a wo k was associa ed wi h dep essi e symp oms a age
17 (be a 1.36; 95% CI 0.12, 2.60). In males and emales sepa a ely, he poin es ima es we e
highe o emales (be a 2.18; 95%
−
0.15, 4.51) han o males (be a 0.61; 95%
−
0.65, 1.86),
al hough nei he was s a is ically signi ican as he sample sizes dec eased (Table 3).
In a ull model adjus ed o all a iables, in all pa icipan s, pe cei ed daily noise
exposu e a wo k (a age 22) was associa ed wi h dep essi e symp oms a age 17 (be a
1.32; 95% CI 0.11; 2.53). In males, he e was no associa ion o dep essi e symp oms wi h
pe cei ed noise exposu e a wo k (be a 0.43; 95% CI
−
0.80, 1.67), whe eas in emales
pe cei ed daily noise exposu e a wo k was associa ed wi h dep essi e symp oms (be a
2.41; 95% CI 0.12, 4.70). Noise sensi i i y was independen ly associa ed wi h dep essi e
symp oms in all pa icipan s (be a 2.11; 95% CI 1.25, 2.97), and in males (be a 1.57; 95% CI
0.41, 2.74) and emales (be a 2.43; 95 % CI 1.24, 3.62) (Table 3).
In . J. En i on. Res. Public Heal h 2023,20, 4850 16 o 18
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