[Show abstract][Hide abstract] ABSTRACT: Previous studies suggest that pregnant women and children are particularly vulnerable to the adverse effects of air pollution. A prospective cohort study in pregnant women and their children enables identification of the specific effects and critical periods. This paper describes the design of air pollution exposure assessment for participants of the Generation R Study, a population-based prospective cohort study from early pregnancy onwards in 9778 women in The Netherlands. Individual exposures to PM10 and NO2 levels at the home address were estimated for mothers and children, using a combination of advanced dispersion modelling and continuous monitoring data, taking into account the spatial and temporal variation in air pollution concentrations. Full residential history was considered. We observed substantial spatial and temporal variation in air pollution exposure levels. The Generation R Study provides unique possibilities to examine effects of short- and long-term air pollution exposure on various maternal and childhood outcomes and to identify potential critical windows of exposure.
Environmental Health 02/2012; 11:9. · 2.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Exposure to air pollution has been associated with higher C-reactive protein (CRP) levels, suggesting an inflammatory response. Not much is known about this association in pregnancy.
We investigated the associations of air pollution exposure during pregnancy with maternal and fetal CRP levels in a population-based cohort study in the Netherlands.
Particulate matter (PM) with an aerodynamic diameter ≤ 10 μm (PM10) and nitrogen dioxide (NO2) levels were estimated at the home address using dispersion modeling for different averaging periods preceding the blood sampling (1 week, 2 weeks, 4 weeks, and total pregnancy). High-sensitivity CRP levels were measured in maternal blood samples in early pregnancy (n = 5,067) and in fetal cord blood samples at birth (n = 4,450).
Compared with the lowest quartile, higher PM10 exposure levels for the prior 1 and 2 weeks were associated with elevated maternal CRP levels (> 8 mg/L) in the first trimester [fourth PM10 quartile for the prior week: odds ratio (OR), 1.32; 95% confidence interval (CI): 1.08, 1.61; third PM10 quartile for the prior 2 weeks: OR, 1.28; 95% CI: 1.06, 1.56]; however, no clear dose-response relationships were observed. PM10 and NO2 exposure levels for 1, 2, and 4 weeks preceding delivery were not consistently associated with fetal CRP levels at delivery. Higher long-term PM10 and NO2 exposure levels (total pregnancy) were associated with elevated fetal CRP levels (> 1 mg/L) at delivery (fourth quartile PM10: OR, 2.18; 95% CI: 1.08, 4.38; fourth quartile NO2: OR, 3.42; 95% CI: 1.36, 8.58; p-values for trend < 0.05).
Our results suggest that exposure to air pollution during pregnancy may lead to maternal and fetal inflammatory responses.
Environmental Health Perspectives 02/2012; 120(5):746-51. · 7.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Air pollution exposure during pregnancy might have trimester-specific effects on fetal growth.
We prospectively evaluated the associations of maternal air pollution exposure with fetal growth characteristics and adverse birth outcomes in 7,772 subjects in the Netherlands.
Particulate matter with an aerodynamic diameter < 10 μm (PM10) and nitrogen dioxide (NO2) levels were estimated using dispersion modeling at the home address. Fetal head circumference, length, and weight were estimated in each trimester by ultrasound. Information on birth outcomes was obtained from medical records.
In cross-sectional analyses, NO2 levels were inversely associated with fetal femur length in the second and third trimester, and PM10 and NO2 levels both were associated with smaller fetal head circumference in the third trimester [-0.18 mm, 95% confidence interval (CI): -0.24, -0.12 mm; and -0.12 mm, 95% CI: -0.17, -0.06 mm per 1-μg/m3 increase in PM10 and NO2, respectively]. Average PM10 and NO2 levels during pregnancy were not associated with head circumference and length at birth or neonatally, but were inversely associated with birth weight (-3.6 g, 95% CI: -6.7, -0.4 g; and -3.4 g, 95% CI: -6.2, -0.6 g, respectively). Longitudinal analyses showed similar patterns for head circumference and weight, but no associations with length. The third and fourth quartiles of PM10 exposure were associated with preterm birth [odds ratio (OR) = 1.40, 95% CI: 1.03, 1.89; and OR = 1.32; 95% CI: 0.96, 1.79, relative to the first quartile]. The third quartile of PM10 exposure, but not the fourth, was associated with small size for gestational age at birth (SGA) (OR = 1.38; 95% CI: 1.00, 1.90). No consistent associations were observed for NO2 levels and adverse birth outcomes.
Results suggest that maternal air pollution exposure is inversely associated with fetal growth during the second and third trimester and with weight at birth. PM10 exposure was positively associated with preterm birth and SGA.
Environmental Health Perspectives 01/2012; 120(1):150-6. · 7.26 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Road traffic noise in urban areas is a major source of annoyance. A quiet façade has been hypothesized to beneficially affect annoyance. However, only a limited number of studies investigated this hypothesis, and further quantification is needed. This study investigates the effect of a relatively quiet façade on the annoyance response. Logistic regression was performed in a large population based study (GLOBE, N~18,000), to study the association between road traffic noise exposure at the most exposed dwelling façade (L(den)) and annoyance in: (1) The subgroup with a relatively quiet façade (large difference in road traffic noise level between most and least exposed façade (Q>10 dB); (2) the subgroup without a relatively quiet façade (Q<10 dB). Questionnaire data were linked to individual exposure assessment based on detailed spatial data (GIS) and standard modeling techniques. Annoyance was less likely (OR(Q) (>10)<OR(Q) (<10)) in the subgroup with relatively quiet façade compared to the subgroup without relatively quiet façade. The difference in response between groups seemed to increase with increasing Q and L(den). Results indicate that residents may benefit from a quiet façade to the dwelling.
The Journal of the Acoustical Society of America 10/2011; 130(4):1936-42. · 1.65 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Recently, it has been suggested that the annoyance of residents at a given aircraft noise exposure level increases over the years. The objective of the present study was to verify the hypothesized trend and to identify its possible causes. To this end, the large database used to establish earlier exposure-response relationships on aircraft noise was updated with original data from several recent surveys, yielding a database with data from 34 separate airports. Multilevel grouped regression was used to determine the annoyance response per airport, after which meta-regression was used to investigate whether study characteristics could explain the heterogeneity in annoyance response between airports. A significant increase over the years was observed in annoyance at a given level of aircraft noise exposure. Furthermore, the type of annoyance scale, the type of contact, and the response percentage were found to be sources of heterogeneity. Of these, only the scale factor could statistically account for the trend, although other findings rule it out as a satisfactory explanation. No evidence was found for increased self-reported noise sensitivity. The results are of importance to the applicability of current exposure-annoyance relationships for aircraft noise and provide a basis for decisions on whether these need to be updated.
The Journal of the Acoustical Society of America 04/2011; 129(4):1953-62. · 1.65 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Exposure to air pollution is associated with elevated blood pressure and cardiovascular disease. We assessed the associations of exposure to particulate matter (PM(10)) and nitrogen dioxide (NO(2)) levels with blood pressure measured in each trimester of pregnancy and the risks of pregnancy-induced hypertension and preeclampsia in 7006 women participating in a prospective cohort study in the Netherlands. Information on gestational hypertensive disorders was obtained from medical records. PM(10) exposure was not associated with first trimester systolic and diastolic blood pressure, but a 10-μg/m(3) increase in PM(10) levels was associated with a 1.11-mm Hg (95% confidence interval [CI] 0.43 to 1.79) and 2.11-mm Hg (95% CI 1.34 to 2.89) increase in systolic blood pressure in the second and third trimester, respectively. Longitudinal analyses showed that elevated PM(10) exposure levels were associated with a steeper increase in systolic blood pressure throughout pregnancy (P<0.01), but not with diastolic blood pressure patterns. Elevated NO(2) exposure was associated with higher systolic blood pressure levels in the first, second, and third trimester (P<0.05), and with a more gradual increase when analyzed longitudinally (P<0.01). PM(10) exposure, but not NO(2) exposure, was associated with an increased risk of pregnancy-induced hypertension (odds ratio 1.72 [95% CI 1.12 to 2.63] per 10-μg/m(3) increase). In conclusion, our results suggest that air pollution may affect maternal cardiovascular health during pregnancy. The effects might be small but relevant on a population level.
[Show abstract][Hide abstract] ABSTRACT: This study assesses the effects of aircraft noise on residential satisfaction, an important indicator of subjective well-being. A structural equation model is specified that estimates the relationships between objective variables, noise annoyance variables and residential satisfaction. Secondary data-analysis is used to estimate the model. The survey was conducted in 1996/1997 among the population living within a 25-km radius of Amsterdam Schiphol, the largest airport in the Netherlands. The effect of aircraft noise annoyance is found to be relatively small. In addition, the objective level of aircraft noise exposure is found to be a better predictor of residential satisfaction than its subjective counterpart. The most important determinants of residential satisfaction are found to be road traffic noise annoyance, age and neighbor noise annoyance.
Transportation Research Part D: Transport and Environment. 01/2010;
[Show abstract][Hide abstract] ABSTRACT: The effects of ambient air pollution on pregnancy outcomes are under debate. Previous studies have used different air pollution exposure assessment methods. The considerable traffic-related intra-urban spatial variation needs to be considered in exposure assessment. Residential proximity to traffic is a proxy for traffic-related exposures that takes into account within-city contrasts.
We investigated the association between residential proximity to traffic and various birth and pregnancy outcomes in 7,339 pregnant women and their children participating in a population-based cohort study. Residential proximity to traffic was defined as 1) distance-weighted traffic density in a 150 meter radius, and 2) proximity to a major road. We estimated associations of these exposures with birth weight, and with the risks of preterm birth and small size for gestational age at birth. Additionally, we examined associations with pregnancy-induced hypertension, (pre)eclampsia, and gestational diabetes.
There was considerable variation in distance-weighted traffic density. Almost fifteen percent of the participants lived within 50 m of a major road. Residential proximity to traffic was not associated with birth and pregnancy outcomes in the main analysis and in various sensitivity analyses.
Mothers exposed to residential traffic had no higher risk of adverse birth outcomes or pregnancy complications in this study. Future studies may be refined by taking both temporal and spatial variation in air pollution exposure into account.
Environmental Health 12/2009; 8:59. · 2.71 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A computational study of road traffic noise in cities is presented. Based on numerical boundary-element calculations of canyon-to-canyon propagation, an efficient engineering algorithm is developed to calculate the effect of multiple reflections in street canyons. The algorithm is supported by a room-acoustical analysis of the reverberant sound fields in the source and receiver canyons. Using the algorithm, a simple model for traffic noise in cities is developed. Noise maps and exposure distributions of the city of Amsterdam are calculated with the model, and for comparison also with an engineering model that is currently used for traffic noise impact assessments in cities. Considerable differences between the two model predictions are found for shielded buildings with day-evening-night levels of 40-60 dB at the facades. Further, an analysis is presented of level differences between the most and the least exposed facades of buildings. Large level differences are found for buildings directly exposed to traffic noise from nearby roads. It is shown that by a redistribution of traffic flow around these buildings, one can achieve low sound levels at quiet sides and a corresponding reduction in the percentage of highly annoyed inhabitants from typically 23% to 18%.
The Journal of the Acoustical Society of America 11/2009; 126(5):2340-9. · 1.65 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate and explain sex differences in subjective and actigraphic sleep parameters in community-dwelling elderly persons.
The study was embedded in the Rotterdam Study, a population-based study.
Nine hundred fifty-six participants aged 59 to 97 years.
Participants wore an actigraph and kept a sleep diary for an average of 6 consecutive nights. Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index. Unadjusted sex differences in sleep parameters were assessed with t tests. Women reported shorter total sleep time, a less favorable sleep-onset latency, lower sleep efficiency, and worse global sleep quality, as compared with men. When assessed with actigraphy, however, women were found to have longer and less-fragmented sleep than men. Sex differences in diary-reported sleep duration and other subjective sleep parameters were attenuated by adjustment for marital status, the use of sleep medication, and other covariates, but all sex differences remained significant in a multivariate-adjusted model. Sex differences in actigraphic sleep parameters were barely attenuated by multivariate adjustment, although the shorter actigraphically measured sleep duration in men was partly explained by their higher alcohol consumption. Some covariates (eg, sleep medication) had a different relationship with diary-reported or actigraphic total sleep time in men and women.
If assessed by diary or interview, elderly women consistently reported shorter and poorer sleep than elderly men. In contrast, actigraphic sleep measures showed poorer sleep in men. These discrepancies are partly explained by determinants of sleep duration, such as sleep medication use and alcohol consumption.
[Show abstract][Hide abstract] ABSTRACT: Curvilinear effects of age on self-reported annoyance from environmental noise were investigated in a pooled international and a Dutch sample of in total 62,983 individuals aged between 15 and 102 years. All respondents were frequently exposed to varying levels of transportation noise (i.e., aircraft, road traffic, and railway noise). Results reveal an inverted U-shaped pattern, where the largest number of highly annoyed individuals was found in the middle-aged segment of the sample (peaking around 45 years) while the lowest number was found in the youngest and oldest age segments. This pattern was independent of noise exposure level and self-reported noise sensitivity. The inverted U-shape explains the absence of linear age effects in previous studies. The results are discussed in light of theories predicting an age-related vulnerability to noise.
The Journal of the Acoustical Society of America 08/2009; 126(1):187-94. · 1.65 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study investigates the association between night time road traffic noise exposure (L(night)) and self-reported sleep problems. Logistic regression was performed in a large population based cohort study (GLOBE), including over 18 000 subjects, to study the association between exposure at the dwelling facade and sleep problems. Measures of sleep problems were collected by questionnaire with two questions: "Do you in general get up tired and not well rested in the morning?" and "Do you often use sleep medication or tranquilizers?" After adjustment for potential confounders, a significant association was found between noise exposure and the risk of getting up tired and not rested in the morning. Although prevalence of medication use was higher at higher noise levels compared to the reference category (L(night)<35 dB), after adjustment for covariates this association was not significant. Long-term road traffic noise exposure is associated with increased risk of getting up tired and not rested in the morning in the general population. This result extends the earlier established relationship between long-term noise exposure and self-reported sleep disturbance assessed with questions that explicitly referred to noise and indicates that road traffic noise exposure during the night may have day-after effects.
The Journal of the Acoustical Society of America 08/2009; 126(2):626-33. · 1.65 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Walking is an important source of outdoor physical activity among elderly people. In order to devise measures aimed at encouraging walking among the elderly it is important to understand how the local environment influences the walking behaviour of elderly people. Here, a model describing the influence of environmental street characteristics on the walking route choice of elderly people is presented. Techniques adapted from the field of transportation research were employed within the model. Data concerning the walking route choice to specific destinations reported by 364 independently living elderly residents (55–80 years) from three Dutch urban districts were collected. Route choice was modelled within a ‘Geographic Information System’ (GIS) database by using ‘resistance factors’ to describe the resistance to walking of street sections (i.e. links) within the street network. These factors were optimized by minimizing the difference between the estimated and the reported number of trips along each link. This is, to the authors' knowledge the first time that this technique has been applied within this context. The influence of link characteristics on link resistance was investigated by multivariate linear regression. The first results of the route choice model and the influence of street characteristics on route choice are reported and discussed.
Journal of Environmental Psychology - J ENVIRON PSYCHOL. 01/2009; 29(4):477-484.
[Show abstract][Hide abstract] ABSTRACT: The relationships between road and rail traffic noise with pre-ejection period (PEP) and with respiratory sinus arrhythmia (RSA) during sleep, as indices of cardiac sympathetic and parasympathetic nervous system tone, were investigated in the field (36 subjects, with 188 and 192 valid subject nights for PEP and RSA, respectively). Two analyses were conducted. The first analysis investigated the overall relationships across the entire sleep period. A second analysis investigated differences in the relationships between the first and second halves of the sleep period. Separate multilevel linear regression models for PEP and RSA were employed. Potential covariates for each model were selected from the same pool of variables, which included: gender, age, body-mass index, education level, traffic noise source type, intake of medication, caffeine, alcohol and cigarette smoke, and hindrance during sleep due to the ambulatory recordings. RSA models were adjusted for respiration rate. Mean indoor traffic noise exposure was negatively related to mean RSA during the sleep period, specifically during the second half of the sleep period. Both respiration rate and age were negatively associated with RSA. No significant relationships were observed for PEP. The results indicate that higher indoor traffic noise exposure levels may lead to cardiac parasympathetic withdrawal during sleep, specifically during the second half of the sleep period. No effect of indoor traffic noise on cardiac sympathetic tone was observed.
International journal of psychophysiology: official journal of the International Organization of Psychophysiology 01/2009; 72(2):179-86. · 3.05 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Epidemiological studies have repeatedly found increased mortality associated with both habitual short and long sleep duration. The mechanisms behind these associations are unclear. We investigated whether objectively measured sleep duration, time in bed, and sleep fragmentation were associated with total cholesterol and high density lipoprotein (HDL) cholesterol in community-dwelling elderly.
This cross-sectional study was conducted among 768 participants of the Rotterdam Study, aged 57 to 97 years. Sleep parameters were assessed with actigraphy, a validated method that infers wakefulness and sleep from arm movement. Cholesterol levels in serum were determined in fasting blood samples. All regression analyses were adjusted for age, gender, body mass index, smoking, depressive symptoms, and heart failure.
Sleep duration was positively associated with total cholesterol level: beta = 0.11 (95% confidence interval = 0.03-0.18) mmol/l per hour of sleep. Persons who slept longer, and spent more time in bed, also had a higher total/HDL cholesterol ratio. A less fragmented sleep was also associated with higher total cholesterol. Some of these associations showed significant interactions with age. The association between time in bed and total/HDL ratio was mainly driven by persons aged <65, whereas the relationship between sleep fragmentation and total cholesterol level was most prominent in persons aged >or=70.
A longer sleep duration was related to higher total cholesterol level and a higher total/HDL cholesterol ratio. Two separate mechanisms, a longer time in bed and sleep fragmentation, seem to explain these associations in different age categories.
Psychosomatic Medicine 10/2008; 70(9):1005-11. · 4.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The epidemiological evidence for the association between sleep duration and obesity in the elderly is inconsistent and has not been investigated with objective measures. Furthermore, the role of sleep fragmentation in this relationship is unknown. Our aim was to investigate the association of sleep measures with body mass index (BMI) and obesity in a normal elderly population.
A total of 983 community-dwelling elderly (mean age 68.4+/-6.9 years, range, 57-97).
Weight and height were measured, and sleep duration and fragmentation were assessed with on average six nights of actigraphy.
A quadratic model adequately described the association between continuous measures of sleep duration and BMI. Actigraphic sleep duration had a significant U-shaped relationship with BMI (beta of quadratic term=0.30, 95% confidence interval (CI): 0.08, 0.52). Both short sleepers (<5 h: OR, 2.76 (95% CI: 1.38, 5.49), 5 to <6 h: OR, 1.97 (95% CI: 1.26, 3.08)) and long sleepers (>or=8 h: OR, 2.93 (95% CI: 1.39, 6.16)) were more likely to be obese, compared to participants who slept 7 to <8 h. BMI increased with 0.59 kg m(-2) per standard deviation of sleep fragmentation (95% CI: 0.34, 0.84). After adjustment for sleep fragmentation, the association between short sleep and obesity was no longer significant. Exclusion of participants with probable sleep apnea only marginally changed these associations. Self-reported habitual sleep duration was not associated with BMI or obesity.
Sleep duration, as measured with actigraphy, had a U-shaped relationship with BMI and obesity in an elderly population. A highly fragmented sleep is associated with a higher BMI and a higher risk of obesity, and may explain why short sleep is related to obesity. To preclude bias that can be introduced by self-report measures of sleep duration, using multiple measures of sleep parameters is recommended in future research.
International journal of obesity (2005) 08/2008; 32(7):1083-90. · 5.22 Impact Factor