Auditory and non-auditory effects of noise on health

Noise is pervasive in everyday life and can cause both auditory and non-auditory health eff ects. Noise-induced hearing loss remains highly prevalent in occupational settings, and is increasingly caused by social noise exposure (eg, through personal music players). Our understanding of molecular mechanisms involved in noise-induced haircell and nerve damage has substantially increased, and preventive and therapeutic drugs will probably become available within 10 years. Evidence of the non-auditory eff ects of environmental noise exposure on public health is growing. Observational and experimental studies have shown that noise exposure leads to annoyance, disturbs sleep and causes daytime sleepiness, aff ects patient outcomes and staff performance in hospitals, increases the occurrence of hypertension and cardiovascular disease, and impairs cognitive performance in schoolchildren. In this Review, we stress the importance of adequate noise prevention and mitigation strategies for public health.

/pdf/auditory-and-non-auditory-eff-ects-of-noise-on-health-1ozea6l4sq.pdf

Auditory and non-auditory eff ects of noise on health

The interest in the systematic study of the circadian typology (CT) is relatively recent and has developed rapidly in the two last decades. All the existing data suggest that this individual difference affects our biological and psychological functioning, not only in health, but also in disease. In the present study, we review the current literature concerning the psychometric properties and validity of CT measures as well as individual, environmental and genetic factors that influence the CT. We present a brief overview of the biological markers that are used to define differences between CT groups (sleep-wake cycle, body temperature, cortisol and melatonin), and we assess the implications for CT and adjustment to shiftwork and jet lag. We also review the differences between CT in terms of cognitive abilities, personality traits and the incidence of psychiatric disorders. When necessary, we have emphasized the methodological limitations that exist today and suggested some future avenues of work in order to overcome these. This is a new field of interest to professionals in many different areas (research, labor, academic and clinical), and this review provides a state of the art discussion to allow professionals to integrate chronobiological aspects of human behavior into their daily practice.

Circadian typology: a comprehensive review.

Sleep and circadian rhythm disruption are frequently observed in patients with psychiatric disorders and neurodegenerative disease. The abnormal sleep that is experienced by these patients is largely assumed to be the product of medication or some other influence that is not well defined. However, normal brain function and the generation of sleep are linked by common neurotransmitter systems and regulatory pathways. Disruption of sleep alters sleep-wake timing, destabilizes physiology and promotes a range of pathologies (from cognitive to metabolic defects) that are rarely considered to be associated with abnormal sleep. We propose that brain disorders and abnormal sleep have a common mechanistic origin and that many co-morbid pathologies that are found in brain disease arise from a destabilization of sleep mechanisms. The stabilization of sleep may be a means by which to reduce the symptoms of--and permit early intervention of--psychiatric and neurodegenerative disease.

Sleep and circadian rhythm disruption in psychiatric and neurodegenerative disease

Melatonin is a ubiquitous molecule and widely distributed in nature, with functional activity occurring in unicellular organisms, plants, fungi and animals. In most vertebrates, including humans, melatonin is synthesized primarily in the pineal gland and is regulated by the environmental light/dark cycle via the suprachiasmatic nucleus. Pinealocytes function as 'neuroendocrine transducers' to secrete melatonin during the dark phase of the light/dark cycle and, consequently, melatonin is often called the 'hormone of darkness'. Melatonin is principally secreted at night and is centrally involved in sleep regulation, as well as in a number of other cyclical bodily activities. Melatonin is exclusively involved in signaling the 'time of day' and 'time of year' (hence considered to help both clock and calendar functions) to all tissues and is thus considered to be the body's chronological pacemaker or 'Zeitgeber'. Synthesis of melatonin also occurs in other areas of the body, including the retina, the gastrointestinal tract, skin, bone marrow and in lymphocytes, from which it may influence other physiological functions through paracrine signaling. Melatonin has also been extracted from the seeds and leaves of a number of plants and its concentration in some of this material is several orders of magnitude higher than its night-time plasma value in humans. Melatonin participates in diverse physiological functions. In addition to its timekeeping functions, melatonin is an effective antioxidant which scavenges free radicals and up-regulates several antioxidant enzymes. It also has a strong antiapoptotic signaling function, an effect which it exerts even during ischemia. Melatonin's cytoprotective properties have practical implications in the treatment of neurodegenerative diseases. Melatonin also has immune-enhancing and oncostatic properties. Its 'chronobiotic' properties have been shown to have value in treating various circadian rhythm sleep disorders, such as jet lag or shift-work sleep disorder. Melatonin acting as an 'internal sleep facilitator' promotes sleep, and melatonin's sleep-facilitating properties have been found to be useful for treating insomnia symptoms in elderly and depressive patients. A recently introduced melatonin analog, agomelatine, is also efficient for the treatment of major depressive disorder and bipolar affective disorder. Melatonin's role as a 'photoperiodic molecule' in seasonal reproduction has been established in photoperiodic species, although its regulatory influence in humans remains under investigation. Taken together, this evidence implicates melatonin in a broad range of effects with a significant regulatory influence over many of the body's physiological functions.

Melatonin: Nature's most versatile biological signal?

Limits of and possibilities to improve the IREQ cold stress model (ISO/TR 11079). A validation study in the field.

The Sleep Disturbance Index (SDI) is a novel index based on polysomnography describing sleep quality in a single score. It was developed and tested with young subjects in the context of research on the effects of noise on sleep. In this study, it is applied in a clinical setting for the first time. A total of 79 patients with suspected sleep apnea received diagnostic polysomnography and the SDI was calculated for these patients. SDI scores in this clinical sample were higher than those of normal young sleepers. They were normally distributed and showed a rather close relationship (r = 0.47) to the Apnea-Hypopnea Indices as measures of disease severity. Patients with more breathing disorders tend to have a higher SDI indicating more impaired sleep. An explorative comparison of SDI scores of this clinical group with SDI scores obtained in noise exposition studies showed higher SDI scores for the patient group. The SDI seems a promising approach to describe sleep in a single score and facilitate comparisons of the effects of, e. g. environmental and medical factors affecting sleep.

Disturbed sleep in obstructive sleep apnea expressed in a single index of sleep disturbance (SDI)

This paper concerns the influence of air temperature and of the direction of drafts on subjective and physiological responses. In three experimental series 58 healthy persons (50 men, 8 women, 20-29 yrs) were exposed to drafts in overall 446 experimental sessions. Drafts were applied either horizontally or vertically with mean air velocities of 0.1 to 0.3 m/s and a turbulence intensity of 50%. Air temperature was varied between 11 and 23 degrees C and metabolic rates between < 70 and 156 W/m2. These parameters were kept constant during the single one-hour sessions. The subjects were dressed for thermal neutrality. Draft-induced annoyance was registered every 5 minutes using a list of prescribed body parts and skin temperature was measured at the forearm and at the neck. Subjective and physiological responses were systematically related to air temperature. Draft-induced general annoyance, draft-induced local annoyance (neck, forearm) and the drop of the corresponding skin temperature were inversely related to air temperature. Concerning the direction horizontal drafts seem to cause somewhat stronger reactions. The predictive model developed by Toftum underestimates the percentage of persons annoyed. A modified version increases the predictive power significantly.

Drafts in cold environments--the significance of air temperature and direction.

The melatonin rhythm is arguably the best marker for the phase of the endogenous “biological clock.” Arylalkylamine N-acetyltransferase (AANAT) is known to catalyze the acetylation of serotonin, a rate-limiting process in melatonin synthesis. Different single-nucleotide polymorphisms (SNPs) in the AANAT gene were identified recently in the Japanese population, and one of the genes was significantly associated with the delayed sleep phase syndrome. Thus, 54 healthy Caucasian males were genotyped to investigate whether these SNPs in the AANAT gene affected melatonin levels. The endogenous melatonin levels were analyzed in saliva under standardized experimental conditions (“constant routines”) by radioimmunoassay. Despite the broad temporal variation of the human nocturnal melatonin profiles, none of the investigated SNPs were found in the AANAT gene in this study. These findings point to ethnic differences with respect to these SNPs, rather than time of day termed “morningness.” In summary, SNPs in the AANA...

Arylalkylamine N-acetyltransferase (AANAT) genotype as a personal trait in melatonin synthesis.

Melatonin synthesis occurs earlier in the morning than in the evening types who strictly adhere to their individual time schedule. This study tested whether melatonin profiles still separate between diurnal types who vary their individual rhythm or who are submitted to prescribed time schedules. Male and female students were observed during a constant routine in the laboratory (24-26 hours bed rest, 20 degrees C, <30 lux, hourly isocaloric diet) and soldiers who spent several days in a military hospital were observed during 12 hours (bed rest, <30 lux, normal meals). Salivary melatonin levels were determined hourly. In both studies, melatonin profiles occurred earlier in the morning than in the evening types. The difference was smaller in soldiers, thus conditioning contributes to the actual phase position but does not mask morningness. As morningness is related to the ability to cope with shift work, the melatonin onset can be used as a criterion when assigning a person to shift work.

Barbara Griefahn

Papers

Limits of and possibilities to improve the IREQ cold stress model (ISO/TR 11079). A validation study in the field.

Disturbed sleep in obstructive sleep apnea expressed in a single index of sleep disturbance (SDI)

Drafts in cold environments--the significance of air temperature and direction.

Arylalkylamine N-acetyltransferase (AANAT) genotype as a personal trait in melatonin synthesis.

The reliability of melatonin synthesis as an indicator of the individual circadian phase position.