- Email: [email protected]
The effects of aircraft noise exposure on objective sleep quality: The results of the DEBATS study in France
S330
European Congress of Epidemiology / Revue d’Épidémiologie et de Santé Publique 66S (2018) S277–S437
years. Analysts should be aware that the choice of method may influence HLE estimates.
of noise indicators. In front of this nuisance, adaptation mechanisms to sleep deprivation could be observed.
Disclosure of interest est.
Disclosure of interest est.
The authors declare that they have no competing inter-
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.247
https://doi.org/10.1016/j.respe.2018.05.248
Session 4 - Epidemiology and environment (climate change, disasters, environmental health, injury)
Trauma brain injury following a road traffic accident: Data from the Rhône Register, France
P4-2
P4-1
The effects of aircraft noise exposure on objective sleep quality: The results of the DEBATS study in France A.M. Nassur a,∗ , M. Lefevre a , D. Leger c , B. Laumon d , A.-S. Evrard a , Bruitparif Noise Observatory in Île-de-Franceb a Umrestte, Ifsttar, Bron, France b Bruitparif, Saint-Denis, France c Centre du sommeil et de la vigilance, EA 7330 VIFASOM, AP–HP, Hôtel-Dieu de Paris, Paris, France d Transport, Health and Safety, Ifsttar, Bron, France ∗ Corresponding author. E-mail address: [email protected] (A.M. Nassur) Background Noise in the areas near airports is considered as a public health issue. Exposure to aircraft noise has been shown to have adverse effects on health and particularly on sleep. Sleep disturbances are the most investigated health effects related to environmental noise. Many studies support that noise at night can affect subjective and objective sleep quality. If habituation to noise can be observed for subjective sleep quality, no habituation has been shown with objective sleep quality. However, few studies have evaluated the effects of aircraft noise on sleep quality with objective measurements at home. No such studies have been performed around French airports. Objectives The aim of the present study was to investigate the association between aircraft noise exposure and objective sleep quality in the population living near airports in France. Methods Our study includes 112 people living around Paris-CDG and Toulouse-Blagnac airports. Actimetric measurements were performed during eight nights to objectively evaluate the sleep quality of the participants in terms of sleep onset latency, wake time, total sleep time and sleep efficiency. Simultaneously, acoustic measurements were performed inside and outside (at the fac¸ade) the participants’ bedroom in order to measure aircraft noise levels. Thus, integrated (that is related to energetic average for a given period of time) as well as noise event indicators (that is the number of events that exceeds a given threshold) were estimated. Logistic regression models taking into account measurements repetition were used with adjustment for potential confounders: age, gender, marital status, education and body mass index (BMI). Results and discussion Integrated indicators as well as noise event indicators were significantly associated with objective sleep quality. Increased levels of aircraft noise or increased numbers of aircraft noise events increased time to fall asleep, total wake time and decreased sleep efficiency. Unexpectedly, noise indicators also increased total sleep time, time in bed and delayed get up time. These latter results can be interpreted as an adaptation mechanism to sleep deprivation. If a deterioration of the sleep quality has been observed with an increase in time to fall asleep and in total wake time, a process of recovery and sleep maintenance has been shown with an increase in total sleep time. Noise event indicators have been shown to be more often associated with sleep disturbances than integrated indicators. Increased numbers of noise events during the sleep period have been found to degrade objective sleep quality. Conclusion The present study is the first one to investigate the effects of aircraft noise exposure around French airports on sleep quality evaluated with objective measurements. The findings contribute to the overall evidence suggesting that aircraft noise exposure at nighttime may decrease objective quality of sleep. Aircraft noise exposure affects objective sleep quality whatever the type
A. Ndiaye a,∗ , H. Tardy a , G. Pédrono b , L.-M. Paget b , B. Thélot b , B. Gadegbeku a a Umrestte, Ifsttar, Bron, France b Unité traumatismes, Direction des maladies non transmissibles et des traumatismes, Santé publique France, Saint-Maurice, France ∗ Corresponding author. E-mail address: [email protected] (A. Ndiaye) Introduction Road accidents cause serious cranial lesions and affect a young population. They constitute a major public health problem in terms of mortality and morbidity. The objective is to describe the cranial trauma resulting from a road accident according to the accidental and individual characteristics of the casualties, the severity of injuries and evolution in time. Methods The data come from the Rhône Register of victims from road traffic accidents. It is a permanent and exhaustive collection of any person killed or injured as a result of an accident occurring in the Rhône area. It has its source in the health environment. The information collected concerns the victim, his accident, his injuries and outcome. The lesions are coded according to the Abbreviated Injury Scale (AIS), which has six levels of severity ranging from 1 (minor) to 6 (fatal). The selected victims are those with cranio-encephalic lesions, injured during the period 2005–2014. Results Over the 2005–2014 period, the Registry counted 4913 victims with traumatic brain injuries. The average annual incidence is 28.5 traumatic brain injuries per 100,000 population. The sex ratio is 2.6. There is a shift in the peak of incidence between men and women, earlier and more marked in men (15–19 years) than women (20–24 years). Victims with traumatic brain injuries are mainly motorists (36%), followed by motorized two-wheelers (24%), pedestrians and cyclists (17% each). The lethality is 7.7%. Severe head injuries (AIS ≥ 3) were less observed in two-wheeled motorized helmet users: 26% versus 37% for those who did not wear a helmet. The base of the skull is more often injured than the vault. The most frequent intra-cranial lesions are, in order of frequency, subarachnoid hemorrhages (15%), brain contusions (8%), subdural haematomas (7%), cerebral edemas (6%), intracerebral haematomas (3%), and finally the extra-durals (3%). The injuries of cerebellum (2%) of brainstem (1%) and vascular nervous system (1%) are less frequent. The type of lesion varies according to the types of users: subdural haematomas are frequent in pedestrians; extra-dural haematomas are more common in motorized and non-motorized two-wheelers users; brain contusions are mostly observed in car occupants. Since 2005 there has been a decrease in head injuries (−48%) for motorists, (−38%) for pedestrians, (−20%) for motorized two-wheelers. It is less pronounced for the cyclists (−11%). This noticeable decline among motorists is due to the road safety policies implemented in France since 2002. Cyclists are hardly affected by this decline due to their increase in numbers, due to the introduction of self-service bikes and due to the fact that wearing the helmet are not mandatory. Conclusion Head injuries have almost divided by two among motorists, but efforts need to be made for vulnerable road users. An effective strategy for all types of users must prevail. A first measure taken in France in March 2017, making the use of bicycle helmets mandatory for children under twelve, could be evaluated in the following years on the incidence of head trauma. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.249
European Congress of Epidemiology / Revue d’Épidémiologie et de Santé Publique 66S (2018) S277–S437
years. Analysts should be aware that the choice of method may influence HLE estimates.
of noise indicators. In front of this nuisance, adaptation mechanisms to sleep deprivation could be observed.
Disclosure of interest est.
Disclosure of interest est.
The authors declare that they have no competing inter-
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.247
https://doi.org/10.1016/j.respe.2018.05.248
Session 4 - Epidemiology and environment (climate change, disasters, environmental health, injury)
Trauma brain injury following a road traffic accident: Data from the Rhône Register, France
P4-2
P4-1
The effects of aircraft noise exposure on objective sleep quality: The results of the DEBATS study in France A.M. Nassur a,∗ , M. Lefevre a , D. Leger c , B. Laumon d , A.-S. Evrard a , Bruitparif Noise Observatory in Île-de-Franceb a Umrestte, Ifsttar, Bron, France b Bruitparif, Saint-Denis, France c Centre du sommeil et de la vigilance, EA 7330 VIFASOM, AP–HP, Hôtel-Dieu de Paris, Paris, France d Transport, Health and Safety, Ifsttar, Bron, France ∗ Corresponding author. E-mail address: [email protected] (A.M. Nassur) Background Noise in the areas near airports is considered as a public health issue. Exposure to aircraft noise has been shown to have adverse effects on health and particularly on sleep. Sleep disturbances are the most investigated health effects related to environmental noise. Many studies support that noise at night can affect subjective and objective sleep quality. If habituation to noise can be observed for subjective sleep quality, no habituation has been shown with objective sleep quality. However, few studies have evaluated the effects of aircraft noise on sleep quality with objective measurements at home. No such studies have been performed around French airports. Objectives The aim of the present study was to investigate the association between aircraft noise exposure and objective sleep quality in the population living near airports in France. Methods Our study includes 112 people living around Paris-CDG and Toulouse-Blagnac airports. Actimetric measurements were performed during eight nights to objectively evaluate the sleep quality of the participants in terms of sleep onset latency, wake time, total sleep time and sleep efficiency. Simultaneously, acoustic measurements were performed inside and outside (at the fac¸ade) the participants’ bedroom in order to measure aircraft noise levels. Thus, integrated (that is related to energetic average for a given period of time) as well as noise event indicators (that is the number of events that exceeds a given threshold) were estimated. Logistic regression models taking into account measurements repetition were used with adjustment for potential confounders: age, gender, marital status, education and body mass index (BMI). Results and discussion Integrated indicators as well as noise event indicators were significantly associated with objective sleep quality. Increased levels of aircraft noise or increased numbers of aircraft noise events increased time to fall asleep, total wake time and decreased sleep efficiency. Unexpectedly, noise indicators also increased total sleep time, time in bed and delayed get up time. These latter results can be interpreted as an adaptation mechanism to sleep deprivation. If a deterioration of the sleep quality has been observed with an increase in time to fall asleep and in total wake time, a process of recovery and sleep maintenance has been shown with an increase in total sleep time. Noise event indicators have been shown to be more often associated with sleep disturbances than integrated indicators. Increased numbers of noise events during the sleep period have been found to degrade objective sleep quality. Conclusion The present study is the first one to investigate the effects of aircraft noise exposure around French airports on sleep quality evaluated with objective measurements. The findings contribute to the overall evidence suggesting that aircraft noise exposure at nighttime may decrease objective quality of sleep. Aircraft noise exposure affects objective sleep quality whatever the type
A. Ndiaye a,∗ , H. Tardy a , G. Pédrono b , L.-M. Paget b , B. Thélot b , B. Gadegbeku a a Umrestte, Ifsttar, Bron, France b Unité traumatismes, Direction des maladies non transmissibles et des traumatismes, Santé publique France, Saint-Maurice, France ∗ Corresponding author. E-mail address: [email protected] (A. Ndiaye) Introduction Road accidents cause serious cranial lesions and affect a young population. They constitute a major public health problem in terms of mortality and morbidity. The objective is to describe the cranial trauma resulting from a road accident according to the accidental and individual characteristics of the casualties, the severity of injuries and evolution in time. Methods The data come from the Rhône Register of victims from road traffic accidents. It is a permanent and exhaustive collection of any person killed or injured as a result of an accident occurring in the Rhône area. It has its source in the health environment. The information collected concerns the victim, his accident, his injuries and outcome. The lesions are coded according to the Abbreviated Injury Scale (AIS), which has six levels of severity ranging from 1 (minor) to 6 (fatal). The selected victims are those with cranio-encephalic lesions, injured during the period 2005–2014. Results Over the 2005–2014 period, the Registry counted 4913 victims with traumatic brain injuries. The average annual incidence is 28.5 traumatic brain injuries per 100,000 population. The sex ratio is 2.6. There is a shift in the peak of incidence between men and women, earlier and more marked in men (15–19 years) than women (20–24 years). Victims with traumatic brain injuries are mainly motorists (36%), followed by motorized two-wheelers (24%), pedestrians and cyclists (17% each). The lethality is 7.7%. Severe head injuries (AIS ≥ 3) were less observed in two-wheeled motorized helmet users: 26% versus 37% for those who did not wear a helmet. The base of the skull is more often injured than the vault. The most frequent intra-cranial lesions are, in order of frequency, subarachnoid hemorrhages (15%), brain contusions (8%), subdural haematomas (7%), cerebral edemas (6%), intracerebral haematomas (3%), and finally the extra-durals (3%). The injuries of cerebellum (2%) of brainstem (1%) and vascular nervous system (1%) are less frequent. The type of lesion varies according to the types of users: subdural haematomas are frequent in pedestrians; extra-dural haematomas are more common in motorized and non-motorized two-wheelers users; brain contusions are mostly observed in car occupants. Since 2005 there has been a decrease in head injuries (−48%) for motorists, (−38%) for pedestrians, (−20%) for motorized two-wheelers. It is less pronounced for the cyclists (−11%). This noticeable decline among motorists is due to the road safety policies implemented in France since 2002. Cyclists are hardly affected by this decline due to their increase in numbers, due to the introduction of self-service bikes and due to the fact that wearing the helmet are not mandatory. Conclusion Head injuries have almost divided by two among motorists, but efforts need to be made for vulnerable road users. An effective strategy for all types of users must prevail. A first measure taken in France in March 2017, making the use of bicycle helmets mandatory for children under twelve, could be evaluated in the following years on the incidence of head trauma. Disclosure of interest est.
The authors declare that they have no competing inter-
https://doi.org/10.1016/j.respe.2018.05.249