A1. Classification and Description of Medications
Supplemental material
A1. Classification and Description of Medications
Medication Group ATC code ATC class
Antihypertensives C02A Antiadrenergic agents, centrally acting
C02C Antiadrenergic agents, peripherally acting
C02D Arteriolar smooth muscle, agents acting on
C02N Combinations of antihypertensives in ATC-group C02
C03A Low-ceiling diuretics, thiazides
C03B Low-ceiling diuretics, excluding thiazides
C03C High-ceiling diuretics
C03E Diuretics and potassium-sparing agents in combination
C07 Beta blocking agents
C08 Calcium channel blockers
C09A ACE inhibitors, plain
C09B ACE inhibitors, combinations
C09C Angiotensin II antagonists, plain
C09D Angiotensin II antagonists, combinations
Antacids A02A Antacids
A02B Drugs for peptic ulcer and gastro-oesophageal reflux disease
Anxiolytics N05B Anxiolytics
Hypnotics N05C Hypnotics and sedatives
Antidepressants N06A Antidepressants
Antasthmatics R03 Drugs for obstructive airway diseases
Description of Medication Types:
Antihypertensives are a range of drugs aimed at lowering blood pressure thus decreasing the risk of stroke, coronary events, heart failure and renal failure; antacids are a group of drugs used to relieve symptoms of ulcer dyspepsia and of non-erosive gastro-oesophageal reflux as well as non-ulcer dyspepsia; anxiolytics can be prescribed to alleviate anxiety states through sedation; hypnotics are used to induce sleep; antidepressants are used in the treatment of depression and antasthmatics are used in the management of asthma and chronic obstructive pulmonary disease.
A2. HYENA study population characteristics stratified by exposure to night-time aircraft noise (Lnight). Percentages are calculated within each band of exposure.
Lnight Aircraft (dB)
30-39.9 40-49.9 50-59.9 >=60 Total
Population Characteristics
N 2290 1396 862 93 4641
Females (%) 50.0 50.9 51.6 37.7 50.3
Age (mean ± sd) 57.7 ±7.0 58.0 ±7.3 57.5±7.0 57.9±6.5 57.7 ±7.1
BMI (mean ± sd) 26.9 ±4.6 27.2 ±4.5 27.3 ±4.7 28.4 ±4.9 27.1 ±4.6
Alcohol units/wk (mean ± sd) 6.8±9.5 5.9±8.3 6.2±9.1 5.7±9.7 6.4±9.1
Physical activity <once a wk (%) 30.7 32.9 31.7 48.4 31.9
Education highest quartile (%) 28.0 24.3 15.2 12.9 24.2
Non-smokers (%) 39.6 40.8 41.1 57.0 40.6
Highly annoyed by aircraft noise night (%) 9.0 26.8 27.2 44.1 18.4
Country (% within each exposure band)
UK (%) 5.8 9.5 27.3 91.4 12.6
Germany (%) 22.5 14.8 28.4 4.3 20.9
Netherlands (%) 18.0 14.4 29.5 4.3 18.8
Sweden (%) 26.5 19.1 13.5 0 21.3
Greece (%) 8.0 30.3 0.9 0 13.3
Italy (%) 19.3 12.0 0.5 0 13.2
Total (%) 100.1 100.1 100.1 100.0 100.1
sd: standard deviation
A3. HYENA study population characteristics stratified by exposure to 24hr road traffic noise (LAeq,24h). Percentages are calculated within each band of exposure.
LAeq,24h Road traffic (dB)
45-54.9 55 – 64.9 >=65 Total
Population Characteristics
N 3060 1176 406 4642
Females (%) 50.2 51.5 47.8 50.3
Age (mean ± sd) 57.7 ±7.1 57.7 ±7.2 57.6±7.0 57.7±7.1
BMI (mean ± sd) 27.2 ±4.5 27.0 ±4.7 27.0 ±4.8 27.1 ±4.6
Alcohol units/wk (mean ± sd) 6.2±8.6 6.9±10.0 6.8±9.7 6.4±9.1
Physical activity <once a wk (%) 31.9 30.4 36.7 31.9
Education highest quartile (%) 25.7 21.0 22.2 24.2
Non-smokers (%) 42.0 38.1 37.2 40.6
Highly annoyed by road traffic noise (%) 5.8 16.9 37.7 11.4
Country (% within each exposure band)
UK (%) 15.4 9.4 0.7 12.6
Germany (%) 13.9 31.6 42.4 20.9
Netherlands (%) 17.0 24.3 16.3 18.8
Sweden (%) 25.8 15.0 6.7 21.4
Greece (%) 18.1 4.2 3.0 13.3
Italy (%) 9.9 15.6 31.0 13.2
Total (%) 100.1 100.1 100.1 100.2
sd: standard deviation
A4. Comparison of country-specific ORs (95% CIs) for antihypertensive use in relation to aircraft noise (LAeq,16h and Lnight) between highly annoyed and not highly annoyed groups.
Medication Group Noise Source Country Annoyance OR 95% CI N
(with aircraft noise in day)
Antihypertensives LAeq,16h Aircraft UK Highly annoyed 1.63 (1.15, 2.33) 215
Not highly annoyed 1.12 (0.93, 1.35) 385
Germany Highly annoyed 1.16 (0.81, 1.67) 217
Not highly annoyed 1.02 (0.89, 1.18) 755
Netherlands Highly annoyed 1.67 (0.97, 2.87) 164
Not highly annoyed 0.96 (0.77, 1.18) 736
Sweden Highly annoyed 0.69 (0.34, 1.39) 246
Not highly annoyed 0.85 (0.73, 1.00) 757
Greece Highly annoyed 1.01 (0.66, 1.54) 337
Not highly annoyed 1.00 (0.80, 1.26) 301
Italy Highly annoyed 0.79 (0.51, 1.22) 209
Not highly annoyed 0.76 (0.64, 0.91) 544
(with aircraft noise at night)
Antihypertensives Lnight Aircraft UK Highly annoyed 1.49 (1.14, 1.94) 190
Not highly annoyed 1.14 (1.00, 1.31) 410
Germany Highly annoyed 1.04 (0.76, 1.41) 142
Not highly annoyed 1.01 (0.91, 1.11) 830
Netherlands Highly annoyed 1.29 (0.95, 1.75) 102
Not highly annoyed 1.13 (1.01, 1.26) 798
Sweden Highly annoyed 1.25 (0.88, 1.79) 89
Not highly annoyed 1.05 (0.95, 1.17) 914
Greece Highly annoyed 1.13 (0.85, 1.52) 242
Not highly annoyed 1.02 (0.89, 1.16) 398
Italy Highly annoyed 0.99 (0.75, 1.31) 136
Not highly annoyed 0.91 (0.82, 1.01) 618
OR: odds ratio
95% CI: 95% confidence interval
The hierarchical structure of each logistic regression model assumed a random intercept that accounts for differences in the use of medication between countries and a random slope to account for differences between countries in the effect of aircraft noise on medication use, and adjustment was made for age, sex, BMI, alcohol intake, education, exercise and smoking status.
The odds ratios were calculated for two groups (highly annoyed and not highly annoyed by aircraft noise) by running each hierarchical model for each group.
For each of the aircraft noise models (LAeq,16h and Lnight), adjustment was made for exposure to road traffic noise (LAeq,24h).
A5. Comparison of ORs (95% CIs) for medication use (except antihypertensives) in relation to aircraft noise (LAeq,16h and Lnight) between highly annoyed and not highly annoyed groups.
Medication Group Noise Source Annoyance OR 95% CI N
(with aircraft noise in day)
Antacids LAeq,16h Aircraft Highly annoyed 1.26 (0.84, 1.90) 1331
Not highly annoyed 0.99 (0.85, 1.15) 3311
Anxiolytics or
Hypnotics LAeq,16h Aircraft Highly annoyed 1.25 (0.83, 1.90) 1331
Not highly annoyed 0.95 (0.78, 1.17) 3311
Anxiolytics LAeq,16h Aircraft Highly annoyed 1.17 (0.71, 1.94) 1331
Not highly annoyed 1.11 (0.85, 1.46) 3311
Hypnotics LAeq,16h Aircraft Highly annoyed 1.64 (0.80, 3.36) 1331
Not highly annoyed 0.80 (0.60, 1.06) 3311
Antidepressants LAeq,16h Aircraft Highly annoyed 1.04 (0.64, 1.71) 1331
Not highly annoyed 0.97 (0.79, 1.19) 3311
Antasthmatics LAeq,16h Aircraft Highly annoyed 1.13 (0.69, 1.87) 1331
Not highly annoyed 1.05 (0.87, 1.26) 3311
(with aircraft noise at night)
Antacids Lnight Aircraft Highly annoyed 1.60 (1.16, 2.22) 855
Not highly annoyed 1.04 (0.90, 1.21) 3784
Anxiolytics or
Hypnotics LAeq,16h Aircraft Highly annoyed 1.16 (0.79, 1.71) 855
Not highly annoyed 0.99 (0.81, 1.21) 3784
Anxiolytics Lnight Aircraft Highly annoyed 1.15 (0.69, 1.91) 855
Not highly annoyed 1.14 (0.88, 1.49) 3784
Hypnotics Lnight Aircraft Highly annoyed 1.29 (0.68, 2.44) 855
Not highly annoyed 0.78 (0.59, 1.04) 3784
Antidepressants Lnight Aircraft Highly annoyed 0.95 (0.60, 1.50) 855
Not highly annoyed 0.98 (0.81, 1.18) 3784
Antasthmatics Lnight Aircraft Highly annoyed 1.10 (0.75, 1.62) 855
Not highly annoyed 1.01 (0.85, 1.21) 3784
OR: odds ratio
95% CI: 95% confidence interval
The hierarchical structure of each logistic regression model assumed a random intercept that accounts for differences in the use of medication between countries and adjustment was made for age, sex, BMI, alcohol intake, education, exercise and smoking status.
The odds ratios were calculated for two groups (highly annoyed and not highly annoyed by aircraft noise) by running each hierarchical model for each group.
For each of the aircraft noise models (LAeq,16h and Lnight), adjustment was made for exposure to road traffic noise (LAeq,24h).