Frontiers in public health · 2025
Environmental noise and self-rated health in older surgical patients undergoing general anesthesia: a cross-sectional study of anxiety as a behavioral pathway for healthy aging.
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Shen Jie, Ma Hui, Yang Xiaohui, Hu Mingcan, Tian Jieyin, Zhang Liting
Аннотация
BACKGROUND: Promoting healthy aging-a core public-health objective-demands hospital environments that support functional recovery and well-being. Excessive ward noise, however, is a modifiable environmental factor that may thwart this goal by amplifying anxiety and diminishing older adults' self-rated health, yet the magnitude and mechanism of this effect remain poorly quantified.
METHODOLOGY: We undertook a cross-sectional survey in March-August 2024 at a tertiary hospital in Hebei Province, China. Continuous bedside monitoring captured 24-h A-weighted equivalent sound levels (LAeq) for 270 surgical in-patients aged ≥ 60 years. Exposure was grouped into quartiles [≤ 45, 45.1-50, 50.1-55, > 55 dB(A)]. Poor self-rated health (SRH, scores 1-3/5) and anxiety (Generalized Anxiety Disorder-7) were assessed concurrently. Hierarchical logistic models estimated associations per 5 dB(A) increment; bias-corrected bootstrap mediation quantified the proportion of the noise-health relation transmitted through anxiety.
RESULTS: Median LAeq was 52.1 dB(A), well above the WHO daytime limit of 35 dB(A). The prevalence of poor SRH rose from 28% in the quietest quartile to 58% in the noisiest (p < 0.001). After adjustment for demographic, socioeconomic, clinical and ward factors, each 5 dB(A) increase in LAeq raised the odds of poor SRH by 16% (OR = 1.16, 95% CI 1.00-1.33, p = 0.047). Anxiety independently predicted poor SRH (OR = 1.10 per GAD-7 point) and mediated 23% of the total noise effect (indirect β = 0.048, 95% CI 0.019-0.086, p = 0.002).
CONCLUSION: Hospital sound levels substantially above international guidelines constitute a modifiable environmental barrier to healthy aging, deteriorating older adults' self-perceived health partly by intensifying anxiety. Integrating acoustic standards into hospital quality metrics and coupling noise reduction with early anxiety management represent feasible public-health strategies to support functional recovery and well-being in rapidly aging populations.
METHODOLOGY: We undertook a cross-sectional survey in March-August 2024 at a tertiary hospital in Hebei Province, China. Continuous bedside monitoring captured 24-h A-weighted equivalent sound levels (LAeq) for 270 surgical in-patients aged ≥ 60 years. Exposure was grouped into quartiles [≤ 45, 45.1-50, 50.1-55, > 55 dB(A)]. Poor self-rated health (SRH, scores 1-3/5) and anxiety (Generalized Anxiety Disorder-7) were assessed concurrently. Hierarchical logistic models estimated associations per 5 dB(A) increment; bias-corrected bootstrap mediation quantified the proportion of the noise-health relation transmitted through anxiety.
RESULTS: Median LAeq was 52.1 dB(A), well above the WHO daytime limit of 35 dB(A). The prevalence of poor SRH rose from 28% in the quietest quartile to 58% in the noisiest (p < 0.001). After adjustment for demographic, socioeconomic, clinical and ward factors, each 5 dB(A) increase in LAeq raised the odds of poor SRH by 16% (OR = 1.16, 95% CI 1.00-1.33, p = 0.047). Anxiety independently predicted poor SRH (OR = 1.10 per GAD-7 point) and mediated 23% of the total noise effect (indirect β = 0.048, 95% CI 0.019-0.086, p = 0.002).
CONCLUSION: Hospital sound levels substantially above international guidelines constitute a modifiable environmental barrier to healthy aging, deteriorating older adults' self-perceived health partly by intensifying anxiety. Integrating acoustic standards into hospital quality metrics and coupling noise reduction with early anxiety management represent feasible public-health strategies to support functional recovery and well-being in rapidly aging populations.