THE CHINESE UNIVERSITY OF HONG KONG FINAL REPORT FOR THE PROVISION OF SERVICE FOR THE STUDY OF HEALTH EFFECTS OF TRANSPORTATION NOISE IN HONG KONG ENVIRONMENTAL PROTECTION DEPARTMENT, HKSAR GOVERNMENT TENDER REF. AN 08-047 Submitted by Professor Kin Che Lam on behalf of the Centre for Environmental Policy and Resource Management of the Chinese University of Hong Kong January 2012 DISCLAIMER This report was prepared by the consultancy team of the Centre for Environmental Policy and Resource Management of the Chinese University of Hong Kong for general reference only for the Environmental Protection Department of the Government of the Hong Kong Special Administrative Region with all reasonable skills, care and diligence in accordance with the terms laid down in the Tender Ref. AN 08-047. The Chinese University of Hong Kong, its employees and its consultancy team for this study shall not be under any liability whatsoever for or in respect of any loss, damage, injury or death resulting from the use of information contained in this report. Principal Investigator: Noise: Professor Kin Che Lam1 Co-investigators: Noise (international): Professor Lex Brown2 Medical: Professor Tze Wai Wong3 Epidemiology (international): Dr. Irene van Kamp4 Statistical: Professor Ying Keung Chan5 1Department of Geography and Resource Management, The Chinese University of Hong Kong 2Griffith School of Environment, Griffith University, Australia 3Division of Occupational and Environmental Health, The Chinese University of Hong Kong 4The National Institute of Public Health and the Environment, The Netherlands 5Department of Sociology, The Chinese University of Hong Kong ACKNOWLEDGEMENTS The consultancy team would like to thank all those who have assisted in the preparation and production of this report, particularly Ms. Yi-tak Teresa Chung (Research Officer and Project Coordinator), Mr. Chor Hei Tsang Byford, Mr. Wai Fung Wong and Mr. King Lam Chung. i CONTENTS Executive summary x Chapter One: Introduction 1 1.1 Background 1 1.2 Objectives 1 Chapter Two: Methodology 2 2.1 Desktop study 2 2.1.1 Literature review 2 2.1.1 Previous studies 2 2.2 Household survey 2 2.2.1 Sampling 3 2.2.1.1 Sampling design 3 2.2.1.2 Sample size 4 2.2.2 Questionnaire design 4 2.2.2.1 Construction of questionnaire 4 2.2.2.2 The questionnaire 8 2.2.2.3 Language and wordings of questionnaire 11 2.2.3 Pilot studies 12 2.2.4 Conducting the household survey 12 2.2.5 Validation and quality check 12 2.3 Noise exposure estimation 13 2.4 Exposure-effect curve 14 2.5 Statistical analysis 15 2.5.1 Tabulations of individual responses and composite scores 15 2.5.2 Frequency tabulations and plots 15 2.5.3 Comparison of exposure-effect curves 15 2.5.4 Binary logistic ordinal regression 16 ii Chapter Three: Summary of scientific understanding of the effects of transportation noise on annoyance, sleep disturbance and cardiovascular diseases 17 3.1 Annoyance effects with transportation noise 17 3.2 Sleep disturbance effects with transportation noise 20 3.3 Cardiovascular effects with transportation noise 24 Chapter Four: Background information of the Hong Kong population according to the survey 26 4.1 Demographic characteristics of the sample in comparison with Hong Kong population 26 4.1.1 Socio-economic profile of the respondents 26 4.1.2 Shift workers 30 4.2 Characteristics of living environment 31 4.2.1 Dwelling unit conditions 31 4.2.1.1 Distributions of public/ private housing 31 4.2.1.2 Length of residence 31 4.2.1.3 Number of rooms in the dwelling 32 4.2.1.4 Crowdedness 33 4.2.1.5 Dwellings with bedrooms not directly facing a road/ rail (access to quiet room) 35 4.2.1.6 Air-conditioning in living room and bedroom 36 4.2.1.7 Closing windows 36 4.2.1.8 Coping behaviors 37 4.2.2 Noise sensitivity 38 Chapter Five: Noise sources, noise annoyance, sleep disturbance and other effects in Hong Kong 40 5.1 Noise sources and extent of annoyance in Hong Kong 40 5.1.1 The importance of noise/ sound in urban living 40 5.2 Annoyance responses to a specific list of noise sources 42 5.2.1 Annoyance reaction 42 5.2.2 Annoyance response on a 5-point scale 44 5.2.3 Supplementary questions as to which noise sources that bother 44 5.3 Sleep patterns, sleep quality, sleep disturbance and night time annoyance 45 5.3.1 Sleep pattern 45 5.3.2 Sleep quality 48 5.3.3 Sleep disturbance 49 iii 5.4 Self-reported health status, health-related well-being and diagnosed diseases diagnosed 51 5.4.1 Self-reported health status 51 5.4.2 Health-related quality of life 51 5.4.3 Diagnosed diseases which may be related to noise/ annoyance 52 Chapter Six: Findings: Effects of transportation noise on human annoyance and sleep disturbance in Hong Kong 60 6.1 Exposure of the Hong Kong population to road traffic noise 60 6.2 Urban form, noise exposure and noise sources 67 6.3 Response to road traffic noise 73 6.4 Exposure-effect relationship for road traffic noise in Hong Kong 74 6.4.1 Exposure-effect curve based on L10 74 6.4.2 Exposure-effect curve based on LDEN 76 6.5 Comparison with other studies 78 6.6 Factors affecting annoyance and sleep disturbance effects in Hong Kong 80 6.7 Discussions of findings 85 Chapter Seven: Conclusions and recommendations 88 References 91 List of appendices v List of tables vi List of figures viii Appendices iv List of appendices Appendix 1 Working paper on a review of annoyance effects with transportation noise Appendix 2 Working paper on a review of sleep disturbance effects with transportation noise Appendix 3 Working paper on a review of cardiovascular effects with transportation noise Appendix 4 Procedures of thematic household survey Appendix 5 Trial study Appendix 6 Technical issues related to establishing exposure-effect relationships with respect to transportation noise in Hong Kong Appendix 7 The relationship between urban form and acoustic environment in Hong Kong Appendix 8 Questionnaire and show cards in English and Cantonese v List of tables Table 4.1: Age proportion Table 4.2: Distribution of the type of housing Table 4.3: Highest education level attained of respondents in public/ private housing Table 4.4: Types of occupation of respondents in public/ private housing with reference to Hong Kong 2006 population by-census Table 4.5: Average monthly household income of respondents in public/ private housing with reference to Hong Kong 2006 population by-census Table 4.6: Employment status (Source: This Study) Table 4.7: Distribution of the level of satisfaction with the estate/ street block as a place to live Table 4.8: Distribution of the total number of rooms of dwellings in public/ private housing Table 4.9: Number of rooms (bedrooms/ maidrooms) per person in public/ private housing Table 4.10: Number of rooms (bedrooms/ maidrooms and study rooms/ store rooms) per person in public/ private housing Table 4.11: Distribution of dwellings with or without a quiet room in public/ private housing Table 4.12: Distribution of dwellings with air-conditioning in the living room/ dining room and bedroom in public/ private housing Table 4.13: Distribution of respondents who slept with windows closed in public/ private housing Table 4.14: Distribution of respondents who kept the windows closed during the day time when there are people at home in public/ private housing Table 4.15: Distribution of respondents who switched on the air-conditioner while bothered by outside noise at home in the past twelve months in public/ private housing Table 4.16: Distribution of respondents who closed the windows while bothered by outside noise at home in the past twelve months in public/ private housing Table 4.17: Distribution of noise sensitivity scores of respondents in public/ private housing Table 5.1: Distribution of three negative aspects of living in the estate/ street block Table 5.2: Distribution of three positive aspects of living in the estate/ street block Table 5.3: Percentages of respondents highly annoyed, highly annoyed at night and sleep highly disturbed by different noise sources Table 5.4: Distribution of noise sources from outside home that bother, disturb or annoy the respondent Table 5.5: Distribution of sleep quality scores of respondents in public/ private housing Table 5.6: Correlation analysis of road traffic, aircraft and neighbors noises on night time annoyance with sleep disturbance on a 0-10 numeric scale Table 5.7: Health status Table 5.8: Current health status compared to one year ago Table 5.9: Consulted a GP or local doctor about respondent’s health in the last two weeks Table 5.10: Whether the respondent was hospitalized in the past two years Table 5.11: Whether the respondent has been diagnosed with different diseases and regularly treated for a particular disease in the past one month Table 5.12: Percentage and frequency of medication use in the past one month vi Table 5.13: Distribution of respondents highly annoyed and those who have been diagnosed with different diseases and taking medication Table 5.14: Distribution of respondents highly annoyed at night and those who have been diagnosed with different diseases and taking medication Table 5.15: Distribution of respondents highly sleep disturbed and those who have been diagnosed with different diseases and taking medication Table 5.16: Distribution of respondents with sleep quality scores (10-12) (worst 25%) and those who have been diagnosed with different diseases and taking medication Table 6.1: Correlation matrix of six noise metrics Table 6.2: Percentage of respondent reporting noise sources that bother, disturb