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@ARTICLE{Slesinski:309612,
      author       = {S. C. Slesinski and G. Bolte and S. Zhuang and T. Lakes and
                      E. Rehfuess and J. Staab and F. Bamberg and H. Baurecht and
                      H. Becher and H. Brenner$^*$ and N. Glaser and K. H.
                      Greiser$^*$ and K. Günther and V. Harth and J.-K. Heise and
                      T. Keil and C. J. Klett-Tammen and M. Leitzmann and W. Lieb
                      and C. Meinke-Franze and R. Mikolajczyk and I. Moreno
                      Velásquez and U. Mueller and R. Nagrani and N. Obi and C.
                      Övermöhle and T. Pischon and T. Schikowski and S. Schipf
                      and C. L. Schlett and B. Schmidt and M. B. Schulze and T.
                      Tönnies and S. N. Willich and A. Peters and A. Schneider
                      and K. Wolf},
      title        = {{T}ransportation noise and self-rated health: {E}vidence
                      from the {G}erman {N}ational {C}ohort ({NAKO}).},
      journal      = {Environmental research},
      volume       = {nn},
      issn         = {0013-9351},
      address      = {San Diego, Calif.},
      publisher    = {Elsevier},
      reportid     = {DKFZ-2026-00262},
      pages        = {123885},
      year         = {2026},
      abstract     = {A large proportion of Europeans are exposed to high levels
                      of transportation noise, which can cause physiological and
                      psychological stress, leading to negative health impacts.
                      Few studies have examined the association between
                      transportation noise and self-rated health (SRH), a summary
                      indicator of morbidity.We aimed to assess the associations
                      of SRH with both annual average road traffic noise exposure
                      and nighttime transportation noise annoyance, examine
                      geographic differences, evaluate potential effect
                      modification and interaction by sex, and investigate whether
                      annoyance mediates the relationship between road traffic
                      noise and self-rated health.Using NAKO baseline data (n =
                      174,956), we implemented a cross-sectional study using
                      logistic regression to analyze associations of road traffic
                      noise ≥ 55 dB(A) and nighttime transportation noise
                      annoyance with poor SRH, adjusting for relevant
                      sociodemographic characteristics and environmental
                      co-exposures, including air pollution and greenness. We
                      examined geographic differences, tested for effect
                      modification by sex, and used path analysis to assess
                      mediation by annoyance.Road traffic noise ≥55 dB(A) (OR
                      1.06, $95\%$ CI 1.01-1.10), and moderate (OR 1.28,
                      1.23-1.32) and strong nighttime transportation noise
                      annoyance (OR 1.73, 1.65-1.81) were associated with higher
                      odds of poor SRH. Associations were similar for males and
                      females, but varied across study regions. The path analysis
                      revealed that road traffic noise was associated with higher
                      odds of poor SRH indirectly via nighttime transportation
                      noise annoyance (indirect effect).In our study, nighttime
                      transportation noise annoyance was more strongly and
                      consistently associated with poor SRH than road traffic
                      noise. Reducing both transportation noise and related
                      annoyance could help protect population health.},
      keywords     = {environmental noise exposure (Other) / mediation analysis
                      (Other) / noise annoyance (Other) / population-based cohort
                      (Other) / traffic noise (Other) / wellbeing (Other)},
      cin          = {C070 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C020-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41611060},
      doi          = {10.1016/j.envres.2026.123885},
      url          = {https://inrepo02.dkfz.de/record/309612},
}