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   Abstract
  Introduction
  Methods
  Results
  Discussion
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ARTICLE  
Year : 2013  |  Volume : 15  |  Issue : 64  |  Page : 173-177
Stress and odor sensitivity in persons with noise sensitivity

1 Department of Psychology, UmeŚ University, UmeŚ, Sweden
2 Department of Psychology, UmeŚ University, UmeŚ, Sweden; School of Psychology, Cardiff University, United Kingdom

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Date of Web Publication21-May-2013
 
  Abstract 

Previous research has indicated that sensory sensitivity/intolerance to a specific modality may be part of a more general environmental hypersensitivity, and possibly mediated by stress. This study investigated the relationship between noise sensitivity, perceived stress, and odor sensitivity in a group of men. A quasi-experimental design was used. One-hundred and thirty-four male undergraduate students completed Weinstein's noise sensitivity scale from which a low-sensitivity group (n = 16) and a high-sensitivity (n = 16) group were formed. These two groups were screened for loss in auditory and olfactory detection sensitivity, and completed the perceived stress questionnaire (PSQ) and the chemical sensitivity scale (CSS). One-way analysis of variance and Spearman correlational analyses were performed. Significantly higher scores on the PSQ (P < 0.05) and the CSS (P < 0.05) were found in the high noise-sensitivity group compared to the low noise-sensitivity group. These findings raise the question of whether the relation between noise and odor sensitivity reflects a general environmental sensitivity.

Keywords: Chemical sensitivity, environmental annoyance, hypersensitivity, olfaction, sound

How to cite this article:
Nordin S, Ljungberg JK, Claeson AS, Neely G. Stress and odor sensitivity in persons with noise sensitivity. Noise Health 2013;15:173-7

How to cite this URL:
Nordin S, Ljungberg JK, Claeson AS, Neely G. Stress and odor sensitivity in persons with noise sensitivity. Noise Health [serial online] 2013 [cited 2019 Sep 15];15:173-7. Available from: http://www.noiseandhealth.org/text.asp?2013/15/64/173/112366

  Introduction Top


Individuals may differ considerably in their sensitivity to environmental noise. [1],[2] Hypersensitivity to noise can be described as an internal state that increases the degree of reactivity to noise in general. [3] It can cause considerable discomfort, with negative impact on quality of life. [4],[5] More specifically, the major consequences seem to be of attentional, behavioral, social, and emotional character. [6],[7] Noise sensitivity is a rather common condition and can be considered a public health problem. A population-based questionnaire study in Poland showed a prevalence of 15.2%, with a similar prevalence between men and women. [8] A Swedish population-based study found a prevalence of 8% when using a postal-based questionnaire and 9% when using an Internet-based questionnaire. [5]

In audiological clinical cases, noise sensitivity may be caused by sensory mechanisms resulting in elevated perceived sound intensity, with etiologies of both peripheral (e.g., Bell's palsy) and central (e.g., William's syndrome) nature. [9] However, the underlying mechanisms may, in many cases, be cognitive in origin, related to how sounds are perceived. Thus, persons who are sensitive to noise may be more likely to interpret sounds as threatening. Accordingly, hypersensitivity to noise has been found to be related to negative affect (e.g., anxiety and depression), [10],[11],[12] personality (e.g., neuroticism), [13],[14] and life events (e.g., post-traumatic stress disorder). [15]

It has been documented, from both laboratory [16] and field [17] settings, that noise is an environmental stressor. There are also indications of an association between stress intolerance (relatively strong emotional and physiological reaction to potential stressors) and sensitivity to noise. [18],[19] However, caution should be taken since the measurement of stress intolerance in these studies consisted of a single rating. Zimmer and Ellermeier [12] reported a modest correlation between recognition of stressors and noise sensitivity. Indirect support for an association between physiological reactions to potential stressors and noise sensitivity has been provided by studying neuroendocrine activity. Normal circadian decline in cortisol concentration has been found to be significantly attenuated in subjects with high noise sensitivity when exposed to low-frequency noise. [20] High noise sensitivity has also been shown to be associated with poor performance on cognitive tasks during noise exposure. [21]

It has been suggested that intrinsic sensitivity to noise can be conceived as a dispositional or vulnerability variable. [22] It seems reasonable that a vulnerable disposition would also result in an environmental hypersensitivity of a more general character. Such vulnerability variables may be perceived stress, anxiety, and depression that have been found to be associated with sensitivity attributed to electromagnetic fields [23] and chemical sensitivity. [24] Supporting this reasoning, there are indices of a more general environmental sensitivity in persons with noise sensitivity. Having participants' rate sensitivity to odor, touch, color, pain, and brightness, Stansfeld et al.[13] found that a total score of these ratings, representing general sensitivity, was associated with noise sensitivity. In a similar vein, Andersson et al.[5] reported relatively high frequencies of self-reported sensitivity to odor, touch, light/color, pain, and taste in persons with noise sensitivity. This provides support for the notion of a vulnerability to environmental stimuli in general among persons with noise sensitivity. However, again, sensitivity to each of these sensory modalities was assessed with a single question, calling for more careful investigation.

Among the five environmental sensitivities investigated by Andersson et al., [5] sensitivity to odors was most commonly reported. Odor sensitivity, including pungent substances mediated by chemosomatosensation, has considerable impact on quality of life. [25] Depending on definition, 9-33% of the general population report hypersensitivity to odors, and 0.5-6.3% fulfill criteria for a clinical diagnosis or report having been given a diagnosis such as multiple chemical sensitivity or sensory hyper-reactivity. [26],[27],[28]

The objective of this work was to study perceived stress, focused on emotional factors, and environmental odor sensitivity in persons with high sensitivity to noise in comparison with persons with low noise sensitivity. Reliable and valid questionnaire instruments were used to assess stress and odor sensitivity. It was hypothesized that persons with high noise sensitivity would show higher levels of both perceived stress and odor sensitivity compared to persons with low sensitivity. Furthermore, noise sensitivity was expected to correlate significantly with stress and odor sensitivity.


  Methods Top


Participants

Sixteen men (mean ± SD age = 23 ± 2.5 years) scoring high and 16 men (mean ± SD age = 24 ± 2.9) scoring low on a noise sensitivity questionnaire were selected for participation. The study was conducted within a larger project measuring perceived noise sensitivity, stress and cognitive performance of noise, and vibration exposure. [29],[30] Sensitivity category was based on results from Weinstein's Noise Sensitivity Scale (NSS). [31] The NSS consists of 21 statements that emphasize negative affective reactions to and behavioral disruptions caused by noise (e.g., "At movies, whispering and crinkling candy wrappers disturb me"), avoiding general inquiries about noise as an environmental problem. These statements are to be responded to on a five-point Likert scale, and summed to give an overall score that ranges from 1 to 105 (high score indicating high sensitivity). The NSS has demonstrated good test-retest reliability, [13],[31] split-half reliability, internal consistency, [18] predictive validity in field and laboratory studies, [22],[31],[32] and to generate approximately normal distributions. [18]

From among 134 male undergraduate university students who responded to the NSS, 67 men had an NSS score either in the upper or in the lower 25 percentile. Among those who reported being interested in further participation (n = 54), the participants with 30% highest and lowest scores formed the two groups, resulting in a total sample of 32 participants. Mean (SD) NSS score was 85.4 (7.5) for the high-sensitivity group and 55.2 (6.1) for the low-sensitivity group. None of the participants showed loss in auditory or olfactory sensitivity based on absolute detection thresholds, [33] and all reported good physical health. This study was reviewed by the local research ethics committee.

Perceived stress

Self-reported stress was assessed using The Perceived Stress Questionnaire (PSQ). [34] It consists of 30 statements (e.g., "You feel under pressure from deadlines") to be responded to on a four-point scale, and summed to give an overall index that ranges from 0 to 1 (high index indicating high stress level). The PSQ has good reliability and validity, and factorial analyses have identified the dimensions harassment, irritability, lack of joy, fatigue, worries, tension, and overload. [34]

Odor sensitivity

Assessment of odor sensitivity was conducted with the Chemical Sensitivity Scale (CSS). [19] As for the NSS, the CSS consists of 21 statements to respond to, emphasizing negative affective reactions to and behavioral disruptions caused by environmental odors (e.g., "At movies, other persons' perfume and aftershave disturb me"). The statements are to be responded to on a five-point Likert scale, and summed to give an overall score that ranges from 1 to 105 (high score indicating high sensitivity). The odorous/pungent situations to which the subject is to respond to in the CSS are analogous to the noise situations in the NSS, and the response alternatives in the two scales are identical, making the two scales directly comparable. The CSS has good test-retest reliability, internal consistency, predictive validity, and generates approximately normal distributions. [19],[35]

Statistical analysis

Statistical comparisons between the noise-sensitivity groups for the PSQ index and CSS score were conducted with one-way analysis of variance (ANOVA), and the correlational analyses were performed by calculating the Spearman correlation coefficient (due to bimodal distribution of NSS scores). The α-level was set at 0.05. The statistical analyses were performed using SPSS for Windows 18.0 (SPSS Inc., Chicago, IL, USA).


  Results Top


Mean PSQ index for the two noise-sensitivity groups is shown in the top half of [Figure 1], revealing higher stress scores in the high noise-sensitivity group compared to the low noise-sensitivity group. A one-way ANOVA yielded a significant difference in PSQ index between groups (F (1,30) = 5.19, P < 0.05, h 2 = 0.15). The bottom half of [Figure 1] depicts mean CSS scores for the two noise-sensitivity groups, with significantly higher CSS scores in the high noise-sensitivity group compared to the low noise-sensitivity group (one-way ANOVA: F (1,30) = 5.50, P < 0.05, h 2 = 0.16).
Figure 1: Mean (+SE) index on the perceived stress questionnaire (PSQ) (upper diagram) and score on the chemical sensitivity scale (CSS) (lower diagram) in participants with low and high scores on Weinstein's noise sensitivity scale (NSS). The high NSS‑score group differs significantly from the low NSS‑score group on both PSQ index and CSS score (P < 0.05)

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The Spearman correlation coefficient based on all 32 participants was 0.35 between NSS score and PSQ index (P < 0.05), 0.48 between NSS and CSS scores (P < 0.01), and 0.58 between PSQ index and CSS score (P < 0.001).


  Discussion Top


The objective of this study was to investigate whether sensitivity to environmental noise is associated with perceived stress and sensitivity to odors and pungent environmental substances. Indeed, the results provide support for the hypothesis of a relatively high stress level and high odor sensitivity in persons with high noise sensitivity. This was evidenced by both group comparisons and correlational analyses.

Locus of control, the extent to which individuals believe that they can control events that affect them, is an important aspect of perceived stress. An association between noise annoyance and low external locus of control has been reported. [36] Based on this, Stansfeld and associates [13] suggested that noise sensitive individuals may also consider themselves to be victims of their environment rather than in control of it. This is in agreement with Glass et al.[37] experiments that found that individuals lacking perceived control over unpredictable noise exposure showed greater noise after-effects in terms of degraded performance in a mental task. Furthermore, anxiety, depression, and neuroticism are known to be associated with hypersensitivity to noise, [10],[11],[12],[13],[14] and anxiety and depression with perceived stress, [38],[39] It is therefore, conceivable that noise sensitivity is secondary to endogenous influences that include anxiety, depression, and neuroticism. Associations with perceived stress have also been reported for other forms of sensitivity, such as sensitivity attributed to electromagnetic fields and dental fillings. [23],[40]

The association between noise and odor sensitivity is in concordance with prior studies suggesting concomitant conditions. Winneke et al.[41],[42] found that persons who reported being highly annoyed in their residential area by either noise or odor also reacted more strongly to both noise and unpleasant odor stimuli in a laboratory setting compared to persons who only reported being a little annoyed in their residential areas. Using either two or three questions to assess annoyance to electrical equipment, odors, and sounds in a large population-based survey, Carlsson et al. [43] identified certain individuals who report annoyance to all three sources. In another study, the prevalence of reporting disturbance from noise from neighbors, ventilation systems, and traffic as well as annoyance from car exhausts, tobacco smoke, although not street smells, was higher in individuals with symptoms attributed to electromagnetic fields. [44] In a recent study, using the NSS and CSS, persons with symptoms attributed to electromagnetic fields were found to score high on both noise and odor sensitivity. This study found a correlation also between odor sensitivity and perceived stress as well; providing even further support for an association between noise and odor sensitivity. These data raise the question of whether the relation between noise and odor sensitivity reflects a general environmental sensitivity that to some extent may be stress-induced.

Given that the environmental sensitivity to noise and odors underpins the same mechanisms, it may also be so that in the long run, exposure may not only affect subjective well-being in these persons, but also have consequences for behavior. Studies have demonstrated that noise sensitive subjects have degraded performance during noise exposure, [45] and during performance of a mental task, induced stress levels in terms of increased saliva cortisol, [20] while some studies have not found any effects on either saliva cortisol or performance., [29],[30] Furthermore, Ellermeier et al.[2] using signal-detection analysis, could not find a relationship between noise sensitivity and sensory input of auditory processing. Although participants in high and low noise-sensitive group had varied ratings of unpleasantness of the sound exposure, subjective noise sensitivity was more strongly related to subjective judgments than were perceptual components. Similarly, it has been concluded that there is no clear relationship between noise exposure and noise sensitivity. [46] The findings mentioned above show inconsistent outcomes, and include only measurements of noise sensitivity. Investigation of the impact of other physical exposures (odor and noise) and the mediating role of environmental sensitivity on behavior may be profitable, and a new interesting step for this research area.

Although we have been able to demonstrate that noise sensitivity is related to perceived stress and sensitivity to odors and pungent environmental substances, the study has limitations that suggest that further work would yield useful and interesting data. One possible limitation of the study is that the sample of participants is restricted to men. Although the prevalence of noise sensitivity appears to be similar between gender, [8],[31] and gender-specific underlying mechanism has so far not been identified, considerable caution should be taken when generalizing the present findings to the population of women. Another limitation is the cross-sectional design of the present study. Although it is reasonable to argue that high stress may contribute to noise sensitivity, [13] it is also possible that noise sensitivity contributes to perceived stress. Certainly, any follow-up work should study the associations between noise sensitivity, stress, and odor sensitivity and include women as well, and have a longitudinal design. Nevertheless, in conclusion, the present results support the hypothesis of noise sensitivity being associated with perceived stress and odor sensitivity.


  Acknowledgments Top


This study was supported by grants from the European territorial cooperation program Botnia-Atlantica, Region Västerbotten (Sweden), and the Regional Council of Ostrobothnia (Finland). We gratefully acknowledge Anders Körning for excellent assistance and Annika Glader for supervising the TEMA project of which this work was part.

 
  References Top

1.Griffiths ID, Delauzun FR. Individual differnces in sensitivity to traffic noise: An empirical study. J Sound Vibrat 1977;55:93-107.  Back to cited text no. 1
    
2.Ellermeier W, Eigenstetter M, Zimmer K. Psychoacoustic correlates of individual noise sensitivity. J Acoust Soc Am 2001;109:1464-73.  Back to cited text no. 2
    
3.Job RF. Noise sensitivity as a factor influencing human reaction to noise. Noise Health 1999;1:57-68.  Back to cited text no. 3
    
4.Anari M, Axelsson A, Eliasson A, Magnusson L. Hypersensitivity to sound - Questionnaire data, audiometry and classification. Scand Audiol 1999;28:219-30.  Back to cited text no. 4
    
5.Andersson G, Lindvall N, Hursti T, Carlbring P. Hypersensitivity to sound (hyperacusis): A prevalence study conducted via the Internet and post. Int J Audiol 2002;41:545-54.  Back to cited text no. 5
    
6.Khalfa S, Dubal S, Veuillet E, Perez-Seliaz F, Jouvent R, Collet L. Psychometric normalisation of a hyperacusis questionnaire. Otorhinolaryngol 2002;64:438-42.  Back to cited text no. 6
    
7.Nelting M, Rienhoff NK, Hesse G, Lamparter U. The assessment of subjective distress related to hyperacusis with a self-rating questionnaire on hypersensitivity to sound. Laryngorhinootologie 2002;81:32-4.  Back to cited text no. 7
    
8.Skarzyñski H, Rogowski M, Bartnik G, Fabijañska A. Organization of tinnitus management in Poland. Acta Otolaryngol 2000;120:225-6.  Back to cited text no. 8
    
9.Katzenall U, Segal S. Hyperacusis: Review and clincial guidelines. Otol Neurotol 2001;22:321-7.  Back to cited text no. 9
    
10.Carman JS. Imipramine in hyperacusic depression. Am J Psychiatry 1973;130:937.  Back to cited text no. 10
    
11.Marriage J, Barnes NM. Is central hyperacusis a symptom of 5-hydroxytryptamine (5-HT) dysfunction? J Laryngol Otol 1995;109: 915-21.  Back to cited text no. 11
    
12.Zimmer K, Ellermeier W. Psychometric properties of four measures of noise sensitivity: A comparison. J Environ Psychol 1999:19;295-302.  Back to cited text no. 12
    
13.Stansfeld SA, Clark CR, Jenkins LM, Tarnopolsky A. Sensitivity to noise in a community sample: I. Measurement of psychiatric disorder and personality. Psychol Med 1985;15:243-54.  Back to cited text no. 13
    
14.Ohrström E, Björkman M, Rylander R. Noise annoyance with regard to neurophysiological sensitivity, subjective noise sensitivity and personality variables. Psychol Med 1988;18:605-13.  Back to cited text no. 14
    
15.Baguley DM. Hyperacusis. J R Soc Med 2003;96:582-5.  Back to cited text no. 15
    
16.Glass DC, Siger JE, Friedman LN. Psychic cost of adaptation to an environmental stressor. J Pers Soc Psychol 1969;12:200-10.  Back to cited text no. 16
    
17.Cohen S, Evans GW, Krantz DS, Stokols D. Physiological, motivational, and cognitive effects of aircraft noise on children: Moving from the laboratory to the field. Am Psychol 1980;35:231-43.  Back to cited text no. 17
    
18.Ekehammar B, Dornic S. Weinstein's Noise Sensitivity Scale: Reliability and construct validity. Percept Mot Skills 1990;70:129-30.  Back to cited text no. 18
    
19.Nordin S, Millqvist E, Löwhagen O, Bende M. The chemical sensitivity scale: Psychometric properties and comparison with the noise sensitivity scale. J Environ Psychol 2003;23:357-65.  Back to cited text no. 19
    
20.Waye KP, Bengtsson J, Rylander R, Hucklebridge F, Evans P, Clow A. Low frequency noise enhances cortisol among noise sensitive subjects during work performance. Life Sci 2002;70:745-58.  Back to cited text no. 20
    
21.Sandrock S, Schütte M, Griefahn B. Impairing effects of noise in high and low noise sensitive persons working on different mental tasks. Int Arch Occup Environ Health 2009;82:779-85.  Back to cited text no. 21
    
22.Topf M. Personal and environmental predictors of patient disturbance due to hospital noise. J Appl Psychol 1985;70:22-8.  Back to cited text no. 22
    
23.Johansson A, Nordin S, Heiden M, Sandström M. Symptoms, personality traits, and stress in people with mobile phone-related symptoms and electromagnetic hypersensitivity. J Psychosom Res 2010;68:37-45.  Back to cited text no. 23
    
24.Staudenmayer H. Idiopathic environmental intolerances (IEI): Myth and reality. Toxicol Lett 2001;120:333-42.  Back to cited text no. 24
    
25.Söderholm A, Söderberg A, Nordin S. The experience of living with sensory hyperreactivity-accessibility, financial security, and social relationships. Health Care Women Int 2011;32:686-707.  Back to cited text no. 25
    
26.Caress SM, Steinemann AC. A national population study of the prevalence of multiple chemical sensitivity. Arch Environ Health 2004;59:300-5.  Back to cited text no. 26
    
27.Hausteiner C, Bornschein S, Hansen J, Zilker T, Förstl H. Self-reported chemical sensitivity in Germany: A population-based survey. Int J Hyg Environ Health 2005;208:271-8.  Back to cited text no. 27
    
28.Johansson A, Brämerson A, Millqvist E, Nordin S, Bende M. Prevalence and risk factors for self-reported odour intolerance: The Skövde population-based study. Int Arch Occup Environ Health 2005;78:559-64.  Back to cited text no. 28
    
29.Ljungberg JK, Neely G. Cognitive after-effects of vibration and noise exposure and the role of subjective noise sensitivity. J Occup Health 2007;49:111-6.  Back to cited text no. 29
    
30.Ljungberg KJ, Neely G. Stress, subjective experience and cognitive performance during exposure to noise and vibration. J Environ Psychol 2007;27:44-54.  Back to cited text no. 30
    
31.Weinstein ND. Individual differences in reactions to noise: A longitudinal study in a college dormitory. J Appl Psychol 1978;63:458-66.  Back to cited text no. 31
    
32.Dornic S, Laaksonen T, Ekehammar B. Noise sensitivity: General self-report versus noise effect in laboratory situations. Reports from the Department of Psychology 1990, Stockholm University, No. 716.  Back to cited text no. 32
    
33.Cain WS. Testing olfaction in a clinical setting. Ear Nose Throat J 1989;68:78-86.  Back to cited text no. 33
    
34.Levenstein S, Prantera C, Varvo V, Scribano ML, Berto E, Luzi C, et al. Development of the perceived stress questionnaire: A new tool for psychosomatic research. J Psychosom Res 1993;37:19-32.  Back to cited text no. 34
    
35.Nordin S, Bende M, Millqvist. Normative data of the Chemical Sensitivity Scale. J Environ Psychol 2004;24:399-403.  Back to cited text no. 35
    
36.Thomas JR, Jones DM. Individual differences in noise annoyance and the uncomfortable loudness level. J Sound Vibrat 1982;82:289-304.  Back to cited text no. 36
    
37.Glass DC, Singer JE, Leonard HS, Krantz D, Cohen S, Cummings H. Perceived control of aversive stimulation and the reduction of stress responses. J Pers 1973;41:577-95.  Back to cited text no. 37
    
38.Karasek R, Theorell T. Healthy work: Stress, productivity, and the reconstruction of working life. New York: Basic Books;1990.  Back to cited text no. 38
    
39.Rusli BN, Edimansyah BA, Naing L. Working conditions, self-perceived stress, anxiety, depression and quality of life: A structural equation modelling approach. BMC Public Health 2008;8:48.  Back to cited text no. 39
    
40.Bergdahl J, Bergdahl M. Environmental illness: Evaluation of salivary flow, symptoms, diseases, medications, and psychological factors. Acta Odontol Scand 2001;59:104-10.  Back to cited text no. 40
    
41.Winneke G, Neuf M. Psychological response to environmental stressors: Trait or state? Appl Psychol 1992;41:257-67.  Back to cited text no. 41
    
42.Winneke G, Neuf M, Steinheider B. Separating the impact of exposure and personality in annoyance response to environmental stressors, particularly odors. Environ Int 1996;22:73-81.  Back to cited text no. 42
    
43.Carlsson F, Karlson B, Ørbaek P, Osterberg K, Ostergren PO. Prevalence of annoyance attributed to electrical equipment and smells in a Swedish population, and relationship with subjective health and daily functioning. Public Health 2005;119:568-77.  Back to cited text no. 43
    
44.Hillert L, Berglind N, Arnetz BB, Bellander T. Prevalence of self-reported hypersensitivity to electric or magnetic fields in a population-based questionnaire survey. Scand J Work Environ Health 2002;28:33-41.  Back to cited text no. 44
    
45.Belojeviæ G, Ohrström E, Rylander R. Effects of noise on mental performance with regard to subjective noise sensitivity. Int Arch Occup Environ Health 1992;64:293-301.  Back to cited text no. 45
    
46.Miedema HM, Vos H. Noise sensitivity and reactions to noise and other environmental conditions. J Acoust Soc Am 2003;113:1492-504.  Back to cited text no. 46
    

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Correspondence Address:
Steven Nordin
Department of Psychology, UmeŚ University, SE-90187 UmeŚ, Sweden

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Source of Support: Grants from the European territorial cooperation program Botnia-Atlantica, Region Všsterbotten (Sweden), and the Regional Council of strobothnia (Finland), Conflict of Interest: None


DOI: 10.4103/1463-1741.112366

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