PROCEEDINGS of the
23rd International Congress on Acoustics
9 to 13 September 2019 in Aachen, Germany

Is noise annoyance from neighbours in multi-storey housing
associated with fatigue and sleeping problems?
Birgit RASMUSSEN1; Ola EKHOLM2
1
2

SBi, Aalborg University (AAU-CPH)

National Institute of Public Health, University of Southern Denmark

ABSTRACT
Danish Health and Morbidity Surveys including questions about neighbour noise and traffic noise have been
carried out each 3-5 years since year 2000, the latest one in 2017. In all five surveys, the neighbour noise
annoyance in multi-storey housing was higher than annoyance from traffic noise. In 2017, 14,022 respondents(response rate 56%) completed the self-administered questionnaire, out of which 3,893 adult Danes lived in
multi-storey houses. Noise annoyance was assessed by asking the respondent about noise annoyance fromneighbours and traffic, respectively, in their home during the past two weeks. Fatigue and sleeping problems
during the past two weeks were assessed with a checklist that included eight different health outcomes(including the two mentioned). In total, 36% reported having been very/slightly bothered by neighbour noiseand 22% by traffic noise. Noise annoyance from neighbours was strongly associated with both healthoutcomes. For example, individuals being very annoyed by noise from neighbours had 2.91 times higher odds
of being very bothered by fatigue. Similar associations were also observed for traffic noise annoyance.
Although causality cannot be established in the present cross-sectional study, it is concluded that noise
annoyance from neighbours is strongly associated with both fatigue and sleeping problems.
Keywords: Housing, Neighbour noise, Fatigue, Sleeping problems

1. INTRODUCTION
The adverse effects of noise has had the attention of WHO for decades, and several reports are published,e.g. an assessment report [1] addressing the environmental health inequalities in Europe and pointing
out noise exposure at home as one of the environmental health inequality indicato rs. Due to the
influence of noise on health, the European Environmental Agency (EEA) has analyzed the traffic noise
situation and published a report Noise in Europe 2014 [2] pointing out the severe adverse health
implications of traffic noise. A brief summary is found in [3]. The importance of protection from traffic noise
sources has been emphasized at the EU level, e.g. by EEA, and the EU Environmental Noise Directive(END), [4], requires national mapping of external noise and action plans every fifth year.
While health implications of traffic noise have been quite thoroughly investigated, neighbour noise
has mainly been considered a “social” problem. Nevertheless, sleep disturbances and other activity
disturbances by neighbours may be unhealthier than those caused by traffic, since the information
contents in neighbour noise is high, implying a high annoyance potential.
In Denmark, national health and morbidity studies have been carried out every 3-5 years since year
2000, see [5]. Comparison between neighbour and traffic noise annoyance is found in [3], and strong
associations between neighbour noise annoyance and poor mental health and perceived stress,
respectively, are found in [6]. The current paper deals with fatigue and sleeping problems.

2. NEIGHBOUR NOISE ANNOYANCE AND REACTIONS
Based on indications from the field, very low sound insulation between dwellings implies totallack of privacy leading to annoyance and to restraints on own activities. Examples of disturbing noises
and disturbed activities are found in Table 1, and reactions may go in different directions, e.g.
annoyance may develop to hatred and conflicts, and disturbance to tension, depression and tiredness,
1

bir@sbi.aau.dk

2

oek@si-folkesundhed.dk

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see e.g. description of the noise reaction process in [7]. Thus, it is necessary to increase awareness on
the importance of acoustic conditions for quality of life. In contrast to neighbour noise, traffic noise
exposure can be objectively quantified by physical parameters [4], and most studies investigating theimpact of noise on health outcomes use traffic noise as the environmental noise exposure. However,
the health consequences of neighbour noises have rarely been studied. Neighbour noises are more
complex and generally not quantifiable. Thus, individual and subjective perceptions of noise are assessedby means of surveys targeting noise annoyance. Based on results, there are good reasons to suspect thatneighbour noise annoyance affects health adversely. Health outcomes from noise are dealt with in the
WHO LARES study carried out in eight cities in Europe 2002-2003, see [8] and [9], and it is concluded
that that neighbour noise affects health via long lasting severe annoyance, [9]. In [8] sleep disturbancefrom neighbour noise is reported as almost on the same level as for traffic, while other noise sources
are far below. References to various other surveys are found in e.g. [10]. The far most extensive survey
has been made in UK, see [11], with very detailed interviews and reporting.
Table 1 – Examples of disturbing/annoying neighbour sounds and own activities being disturbed.
Disturbing/annoying neighbour noises
 Voices/shouting/arguments
 Dogs Radio, TV, music Parties
 Neighbours’ DYI

 Footsteps
 Children jumping/playing
 Doors banging
 Washing machines etc.

Own activities disturbed
 Sleeping Using every room in the house Listening to TV, radio, music Quiet activities: Reading, resting Having a conversation

3. MULTI-STOREY HOUSING IN DENMARKThe housing stock in Denmark consists of about 2.7 million dwellings in total, of these almost
1.1 million in multi-storey (MS) housing. In Figure 1 are found graphs for number of dwellings in MS
housing according to year of construction. Buildings from different periods have different construction
characteristics, and thus expectedly different sound insulation performance. More details are found in [1213] and [3] and in references in those publications. The building types may here be denoted E1, E2, E3
and NEW, and number of dwellings are a 500,000, up to 100,000, a 400,000 and a 65,000 (incl. estimate
for 2019). Figure 1 also includes small sketches of the four building types and expected acoustic classes
F, E, D, C according to [14]. The current Danish building regulations are found in [15], which refers
to class C in [14] as minimum acoustic performance. Acoustic requirements for other countries are foundin e.g. [16], [12] and [17]. Brief indications of constructions in Danish MS housing are as follows:
E1: Old brick-built buildings with timber floor constructions. Period: a 1850 to 1930/1950.
E2: Brick-built buildings with thin in-situ concrete slabs and wooden floors. Period: a 1930 to 1960.
E3: Concrete elements with wooden floors. Period: a 1960 to 2009.
NEW: Concrete elements with wooden floors (higher performance than E3). Period: From a 2010.

Figure 1 – Dwellings in multi-storey housing according to construction year [18].
Building types for various periods are illustrated and expected acoustic classes indicated.
Number of dwellings for 2019 estimated.

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4. DANISH HEALTH AND MORBIDITY SURVEYS 2000-2017 − METHODOLOGY
Data derives from the Danish health and morbidity surveys in 2000, 2005, 2010, 2013 and 2017[19]. The aim of the surveys is to describe the status and trends in health and morbidity in the adult
Danish population (16 years or older) and the factors that influence health status, including e.g. healthbehaviour and environmental and occupational health risks. The resul ts are used in national, regionaland municipal planning and monitoring as well as in research and analysis. All samples were drawn
at random from the adult Danish population using the Danish Civil Registration System [20]. It is
important to notice that the target population in 2010, 2013 and 2017 included all individuals living
in Denmark, whereas the target population in 2000 and 2005 only were Danish citizens. Data were in2000 and 2005 collected via face-to-face interview at the respondent’s home. However, in 2010, themode was changed from face-to-face interviews to self-administered questionnaires, [21]. The letterof introduction invited the selected individuals either to fill in the web questionnaire or to complete
the mailed questionnaire. In each survey wave, the questionnaire includes standard topics, e.g. morbidity,
health behaviour, health care utilization, consequences of morbidity and background information suchas sex, age, cohabitation status and education. In addition, the survey also aims to highlight several
specific topics, e.g. teeth status, violence and sexual assault and thought of suicide and suicide
attempts. The questionnaires from all waves can be downloaded from the website [5].
In all survey waves (since year 2000), noise annoyance was assessed by asking the respondent
whether they had been annoyed by noise from traffic or noise from neighbours, respectively, in theirhome during the past two weeks. The respondents were also asked about other indoor environment
exposures. The possible answer categories were ‘Yes, very annoyed’, ‘Yes, slightly annoyed’, and‘No’. Fatigue and sleeping problems (or insomnia) during the past two weeks were assessed with achecklist that included eight different health outcomes. There were three answer categories for eachhealth outcome: ‘Yes, very bothered’, ‘Yes, slightly bothered’, and ‘No’. This checklist has been
included in all survey waves since 1987.
Information on type of housing for each respondent was obtained from the Building and Housing
Register at the time of the survey in the latter three waves [22]. In 2000 and 2005, this information
was noted by the interviewer.
In all, the questionnaire in 2017 included 98 questions, out of which approximately 50% had
underlying items. Table 2 shows a brief overview of the survey waves, e.g. number of invited
individuals, response rates and brief indications of noise related questions.
Table 2 – Main characteristics for the Danish Health and Morbidity Surveys 2000-2017
and indication of noise questions.
No. ofSurvey Sample respondents/
Year
Questions on noise annoyance included in survey
mode
size response rate(%)
Noise from traffic; Noise from installations (e.g. pipe,
Face-to face
22,484 16,688 / 74% radiator, refrigerator); Noise from neighbours; Noise from2000
interviewnearby business activities; Infrasound or low frequency noise.
Noise from traffic; Noise from installations (e.g. pipe,
Face-to face
21,832 14,566 / 67% radiator, refrigerator); Noise from neighbours; Noise from2005
interviewnearby business activities.
Noise from traffic; Noise from service equipment (e.g. pipe,
Self25,000 15,165 / 61% radiator, refrigerator); Noise from neighbours; Noise from2010
administerednearby business activities.
SelfNoise from traffic;
25,000 14,265 / 57%2013
administered
Noise from neighbours.
Noise from traffic;
Self25,000 14,022 / 56% Noise from neighbours; If affirmative, the respondents were2017
administeredasked which kind of noise using a multiple-choice question.
The association between traffic noise annoyance and sleep ha s been examined in several studies,but studies examining the associations between neighbour noise annoyance and fatigue and/or
sleeping problems are rare, but is done in the current study. The prevalence of experiencing bothering
fatigue and sleeping problems, respectively, is presented as percentages. Multiple logistic regress ion

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models were used to examine the associations between traffic and neighbour noise annoyance,
respectively, and very bothering fatigue and sleeping problems, respectively, among individuals living
in multi-storey houses. The results are presented as odds ratios (ORs) with 95% confidence intervals(CI). An odds ratio is a measure of effect size, measuring the strength of association between two
variables [23]. An odds ratio greater than 1 indicates the group is more likely to report that healthoutcome (i.e. very bothering fatigue or sleeping problems, respectively) , while an odds ratio less than
1 indicates the group is less likely to report the health outcome. The ORs are adjusted for sex, age,education, marital status, degree of urbanisation, owner/tenant status, and ethnic background. The CIof the ORs are used to estimate the precision of the ORs. If the CI interval includes 1, then there is no
statistically significant difference between that specific group and the reference group.
Overview results related to housing conditions are found in [24] for the 2013 survey and in [25]for the 2017 survey. Detailed results are published separately.

5. NOISE RELATED SURVEY RESULTS 2017
In the 2017 survey, 3,893 respondents lived in multi-storey houses, cf. Table 3. The distribution by
construction year is displayed in Table 3. For example, the table shows that 14.0% of the study
population live in multi-storey houses that were constructed between 1960-1969 and 11.9% live in
multi-storey houses that were constructed between 1970-1979, i.e. about 1/4 of the study population
live in houses constructed during these two decades. Furthermore, the table shows that there were noclear associations between the year of building construction and the self-reported neighbour and traffic
annoyance, respectively, among individuals living in multi-storey housing. However, the prevalenceof being very or slightly annoyed by neighbour noise were relatively low among individuals living in
multi-storey houses constructed in the 2000’s.
Table 3 – Number of respondents living in multi-storey houses, distribution by year ofbuilding construction and percentage who were very or slightly annoyed in their homeduring the past two weeks by traffic and neighbour noise, respectively. Results from 2017.
Survey 2017
Traffic noise (%)
Neighbour noise (%)
Year ofbuilding
construction<1900

Respondents%
9.7

No. ofrespondents
399

4.0

‘Yes,
slightly
annoyed’
24.5

1900-1909

8.7

1910-1919

4.2

350

4.9

22.6

72.5

6.3

27.4

66.3

167

3.4

17.2

79.4

5.5

32.7

61.8

1920-1929
1930-1939

6.1

243

2.0

13.8

84.3

4.1

28.0

67.9

11.2

466

4.1

20.5

75.5

7.3

33.4

59.3

1940-1949
1950-1959

6.0

231

1.8

22.3

75.9

5.6

32.7

61.7

9.7

369

5.6

16.7

77.7

11.7

30.1

58.2

1960-1969

14.0

519

1.0

16.9

82.1

7.7

30.9

61.4

1970-1979

11.9

427

1.9

15.8

82.3

5.9

29.6

64.5

1980-1989

5.6

208

2.8

21.9

75.4

8.0

26.1

65.8

1990-1999

4.1

150

2.2

18.4

79.4

6.7

19.4

73.9

2000-2009

6.5

270

1.5

14.3

84.2

1.4

20.8

77.8

‘Yes, very
annoyed’‘No’‘Yes, very
annoyed’

71.5

7.7

‘Yes,
slightly
annoyed’
28.7

‘No’
63.6

≥2010

2.3

94

8.1

14.4

77.4

3.6

21.8

74.6

All

100.0

3.893

3.0

18.6

78.4

6.7

28.9

64.4

Table 4a shows that 2.8% of all respondents in 2017 reported being very annoyed by neighbour
noise within the past two weeks, whereas 13.8% had been slightly annoyed. Furthermore, the tableshows that 1.8% of the respondents in 2017 reported being very annoyed by traffic noise within thepast two weeks, whereas 12.2% had been slightly annoyed. The percentages are substantially higher
when the analyses are restricted to individuals living in multi storey housing, see Table 4b.

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Table 5 reveals that the prevalence of annoyance is strongly associated with the type of exposureand house types. For example, the prevalence who had been very or slightly annoyed by neighbour
noise within the past two weeks was 35.6% among individuals living in multi -storey housing and5.5% among individuals living one-family houses.
The prevalence of being very or slightly annoyed by traffic noise has increased from 6.3% in 2000
to 14.0% in 2017, see Table 6. Among individuals living in multi-storey houses, the corresponding
prevalences were 11.5% in 2000 and 21.6% in 2017. The prevalence of being very o r slightly annoyedby neighbour noise among individuals living in multi-storey houses has been stable in the period 2010(35.8%) to 2017 (35.6%). The change in mode of data collection in 2010 (i.e. from face-to-faceinterview to self-administered questionnaire) had a large effect on respondents’ reported neighbour
noise annoyance. Thus, the prevalence estimates for neighbour noise annoyance from 2000 and 2005
are not comparable with the prevalence estimates from 2010 and onwards.
Table 4a – Traffic and neighbour noise: Percentage who were very or slightly annoyedin their home during the past two weeks. All dwellings. Results from 2017.
‘Yes,
‘Yes,
Total
Type of noise‘No’
In allvery annoyed’ slightly annoyed’
Very or slightly annoyed
2.8
13.8
83.3
100.0
16.7
Neighbours
1.8
12.2
86.0
100.0
14.0
Traffic
Table 4b – Traffic and neighbour noise: Percentage who were very or slightly annoyed in their homeduring the past two weeks among individuals living in multi-storey housing. Results from 2017.
‘Yes,
‘Yes,
Total
Type of noise‘No’
In allvery annoyed’ slightly annoyed’
Very or slightly annoyed
6.7
28.9
64.4
100.0
35.6
Neighbours
3.0
18.6
78.4
100.0
21.6
Traffic
Table 5 – Percentage who were slightly or very annoyed in their home by various indoor environment
exposures within the past two weeks according to type of dwelling. Results from 2017.
One-family
Row andMulti-storey Other*
All
Exposurehousesdouble houses
housing
housing
Smell of mould
2.3
3.0
4.2
2.6
3.0
Noise from traffic
9.8
10.8
21.6
12.5
14.0
Noise from neighbours
5.5
11.8
35.6
21.8
16.7
Odour from nearby wood stoves
12.5
7.9
3.5
8.0
8.8
Smell of tobacco smoke from neighbours
1.7
4.5
17.3
8.5
7.4
* Other = e.g. nursing homes, institutions

Table 6 – Percentage who were annoyed in their home by traffic and neighbour noise, respectively,
during the past two weeks. Results from surveys in 2000-2017.
Traffic noise
Neighbour noise
One- Row and Multi- Other
OneRow and Multi- Other
Year Total family
Double storey
Total Family
Double storey
houseshouseshouseshouses2000 6.3
4.2
5.7
11.5
5.6
(7.7)*(2.6)(9.1)(19.1)* (10.9)
2005 8.1
5.2
7.5
15.6
7.2
(9.0)*(4.4)(9.8)(21.2)* (12.1)
2010 9.6
5.3
4.8
18.4
11.2
15.6
4.2
10.6
35.8
23.8
2013 9.6
5.9
6.4
16.4
11.2
15.4
3.8
12.2
34.4
26.5
2017 14.0
9.8
10.8
21.6
12.5
16.7
5.5
11.8
35.6
21.8
*Change in methodology suggests that pre-2010 survey estimates are not comparable to results from 2010, 2013 and 2017.
The prevalence of being very bothered by fatigue was substantially higher among those who havebeen very annoyed by noise from neighbours (33%) than among those who had not been annoyed bynoise from neighbours (14%), see Figure 2. The prevalence among those who had been slightly
annoyed was 20%. Correspondingly, the prevalence of being very bothered by sleeping problems was
substantially higher among those who have been very annoyed by noise from neighbours (25%) thanamong those who had not been annoyed by noise from neighbours (11%), see Figure 2. The prevalence

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among those, who had been slightly annoyed was 16%. The same associations are observed for noisefrom traffic, see Figure 3. The strong associations remained even after adjustment for potential
confounders, see Table 7. For example, individuals who had been very annoyed by noise fromneighbours during the past two weeks had 2.62 (95% CI: 1.86-3.69) times higher odds of being verybothered by sleeping problems than individuals who had not been annoyed by noise from neighbours.
The corresponding odds ratio for those who had been slightly annoyed was 1.46 (95% CI: 1.16-1.84).

Figure 2 – Prevalence of fatigue and sleeping problems, respectively, within the past two weeks by noise
annoyance from neighbours among individuals living in multi-storey housing in 2017. Percentages.

Figure 3 – Prevalence of fatigue and sleeping problems, respectively, within the past two weeks by noise
annoyance from traffic among individuals living in multi-storey housing in 2017. Percentages.

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Table 7 – The association between noise annoyance from neighbours and traffic, respectively, and verybothering fatigue and sleeping problems or insomnia, respectively, within the past two weeks amongindividuals living in multi-storey housing in 2017. Adjusted odds ratios1 (and 95% confidence intervals).
Annoyed by noise from neighbours
Yes, very annoyed
Yes, slightly annoyed
No
Fatigue
2.91 (2.14-3.98)
1.46 (1.18-1.79)
1Sleeping problems

2.62(1.86-3.69)

FatigueAnnoyed by noise from traffic
Yes, very annoyed
Yes, slightly annoyed
2.10 (1.39-3.18)
1.46 (1.11-1.92)

No
1Sleeping problems

2.60

1

(1.73-3.91)

1.46

1.58

(1.16-1.84)(1.20-2.09)

1

1

Adjusted for sex, age, marital status, education, degree of urbanization, owner/tenant status and ethnic background

6. CONCLUSIONSThe prevalence of being very or slightly annoyed by traffic noise increased markedly between 2013
and 2017. The reasons are not known, but might partly be increased traffic noise levels, see e.g. [26],partly higher awareness about traffic noise pollution among the general population. The prevalenceof being very or slightly annoyed by neighbour noise remained stable in the period 2010 to 2017. The
present study also showed that the prevalence of annoyance depends on the type of exposure andhousing. For example, as expected, noise annoyance from neighbours were most prevalent amongindividuals living in multi-storey housing.
The strong associations between neighbour noise annoyance and fatigue and sleeping problems,
respectively, among individuals living in multi-storey housing in Denmark seems reasonable due tothe unpredictable nature of noise from neighbours (often with a very high informational content)
and/or loud noises like e.g. neighbours’ footsteps, barking dogs, loud discussions, banging doors. Thisfinding is also in keeping with a previous Danish study, which found strong associations between
neighbour noise annoyance and poor mental health and perceived stress, resp ectively, [6].
The present study highlights the importance of studying the association between noise annoyance ,and fatigue and sleeping problems, respectively. However, future prospective studies are needed todetermine the direction of causality, since it’s not possible in a cross-sectional study to determine,whether people with fatigue and/or sleeping problems are more annoyed by noise, or opposite, if theannoyance leads to fatigue and/or sleeping problems. However, either way is relevant for evaluationof the health situation of the population and the quality of life.

ACKNOWLEDGEMENTS
This article is part of a project funded by Realdania, the Danish National Building Fund and Aaseand Ejnar Danielsen’s Fund.

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