Acute effects of military aircraft noise on sedative and analgesic drug administrations in psychiatric patients: A case-time series analysis

• Published in: Environment international Vol. 185; p. 108501
• Main Authors: Wicki, Benedikt, Vienneau, Danielle, Schäffer, Beat, Müller, Thomas J, Raub, Ulrich, Widrig, Jonin, Pervilhac, Charlotte, Röösli, Martin
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-03-2024; Elsevier
• Subjects: Aircraft Noise; Case Time Series; Medication; Mental Health; Psychiatry; Case Time Series; Medication; Aircraft Noise; Mental Health; Psychiatry
• ISSN: 0160-4120; 1873-6750
• DOI: 10.1016/j.envint.2024.108501

•Application of the case time series design in a natural experiment setting.•Fighter jet noise was associated with drug administrations in a psychiatric clinic.•Results support that noise can exacerbate symptoms in psychiatric patients.•The study design and setting ensure robustness and low risk for bias or confounding.
Existing evidence suggests that psychiatric patients are highly noise sensitive, and that noise exposure increases the risk for adverse mental health outcomes, such as psychiatric hospitalizations and even suicide. To investigate acute effects of noise in this vulnerable population, we assessed short-term associations between fighter jet noise and on-demand sedative and analgesic drug administrations in a psychiatric clinic located close to a military airfield in Switzerland.
We applied a case time series analysis with an hourly time resolution using distributed-lag models. Analysis was adjusted for long-term and seasonal trends, day of week, time of day, time-varying weather conditions and the week of stay. Noise exposure (hourly A-weighted equivalent continuous sound pressure levels (LAeq)) was modelled using detailed flight plans and noise footprints for different fighter jet and route combinations. Outcome data were available from the clinic’s records.
During the study period (06/2016–12/2021), 23,486 flights occurred. 5,968 clinical stays with a median length of 41 days (IQR: 28d, 50d) were recorded. The odds ratio (OR) for medication administration over the lag period of 3 hours after exposure was 1.016 (95 %CI: 1.006, 1.026) per 10 dB LAeq for sedatives and 1.032 (95 %CI: 1.016, 1.048) per 10 dB for analgesics. Effects were larger in multimorbid patients.
Case time series analysis is a novel method to investigate transient associations in observational data while minimizing risk of bias. Using an objectively recorded outcome measure, our results demonstrate that psychiatric patients are a vulnerable population, in which noise exposure can lead to symptom exacerbations and adverse events.