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.

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Auditory and non-auditory eff ects of noise on health

The health impacts of environmental noise are a growing concern. At least one million healthy life years are lost every year from traffic-related noise in the western part of Europe. This publication summarises the evidence on the relationship between environmental noise and health effects, including cardiovascular disease, cognitive impairment, sleep disturbance, tinnitus, and annoyance. For each one, the environmental burden of disease methodology, based on exposure-response relationship, exposure distribution, background prevalence of disease and disability weights of the outcome, is applied to calculate the burden of disease in terms of disability-adjusted life-years. Data are still lacking for the rest of the WHO European Region. This publication provides policy-makers and their advisers with technical support in their quantitative risk assessment of environmental noise. International, national and local authorities can use the procedure for estimating burdens presented here to prioritize and plan environmental and public health policies.

Burden of Disease from Environmental Noise: Quantification of Healthy Life Years Lost in Europe

The role of noise as an environmental pollutant and its impact on health are being increasingly recognized. Beyond its effects on the auditory system, noise causes annoyance and disturbs sleep, and it impairs cognitive performance. Furthermore, evidence from epidemiologic studies demonstrates that environmental noise is associated with an increased incidence of arterial hypertension, myocardial infarction, and stroke. Both observational and experimental studies indicate that in particular night-time noise can cause disruptions of sleep structure, vegetative arousals (e.g. increases of blood pressure and heart rate) and increases in stress hormone levels and oxidative stress, which in turn may result in endothelial dysfunction and arterial hypertension. This review focuses on the cardiovascular consequences of environmental noise exposure and stresses the importance of noise mitigation strategies for public health.

https://www.klein-winternheim.de/lokale-agenda/d43d5e550c96630fc05d6c66ec88f0f4_Elsner-eurheartj.ehu030.full.pdf

Cardiovascular effects of environmental noise exposure

To evaluate the quality of available evidence on the effects of environmental noise exposure on sleep a systematic review was conducted. The databases PSYCINFO, PubMed, Science Direct, Scopus, Web of Science and the TNO Repository were searched for non-laboratory studies on the effects of environmental noise on sleep with measured or predicted noise levels and published in or after the year 2000. The quality of the evidence was assessed using GRADE criteria. Seventy four studies predominately conducted between 2000 and 2015 were included in the review. A meta-analysis of surveys linking road, rail, and aircraft noise exposure to self-reports of sleep disturbance was conducted. The odds ratio for the percent highly sleep disturbed for a 10 dB increase in Lnight was significant for aircraft (1.94; 95% CI 1.61–2.3), road (2.13; 95% CI 1.82–2.48), and rail (3.06; 95% CI 2.38–3.93) noise when the question referred to noise, but non-significant for aircraft (1.17; 95% CI 0.54–2.53), road (1.09; 95% CI 0.94–1.27), and rail (1.27; 95% CI 0.89–1.81) noise when the question did not refer to noise. A pooled analysis of polysomnographic studies on the acute effects of transportation noise on sleep was also conducted and the unadjusted odds ratio for the probability of awakening for a 10 dBA increase in the indoor Lmax was significant for aircraft (1.35; 95% CI 1.22–1.50), road (1.36; 95% CI 1.19–1.55), and rail (1.35; 95% CI 1.21–1.52) noise. Due to a limited number of studies and the use of different outcome measures, a narrative review only was conducted for motility, cardiac and blood pressure outcomes, and for children’s sleep. The effect of wind turbine and hospital noise on sleep was also assessed. Based on the available evidence, transportation noise affects objectively measured sleep physiology and subjectively assessed sleep disturbance in adults. For other outcome measures and noise sources the examined evidence was conflicting or only emerging. According to GRADE criteria, the quality of the evidence was moderate for cortical awakenings and self-reported sleep disturbance (for questions that referred to noise) induced by traffic noise, low for motility measures of traffic noise induced sleep disturbance, and very low for all other noise sources and investigated sleep outcomes.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Effects on Sleep.

Examining nocturnal railway noise and aircraft noise in the field: Sleep, psychomotor performance, and annoyance☆☆☆

Nocturnal aircraft noise disturbs sleep and impairs recuperation. We investigated in laboratory and field studies whether noise-induced sleep fragmentation is associated with performance impairments in a psychomotor vigilance task (PVT) and a memory search task. In the laboratory, 112 participants were exposed to aircraft noise during 9 consecutive nights. In the field, 64 participants were examined during 9 consecutive nights in the vicinity of Cologne/Bonn airport. Reaction time, signal detection performance and subjective task load were recorded. Dose–response relationships showed significant, linear impairments in reaction times. In the laboratory, reaction time in PVT increased with 0.13 ms/dB equivalent noise level (LAeq) plus 0.02 ms/noise event. In the field study, reaction time increased with 0.3 ms/dB LAeq. Participants worked significantly less accurate after nocturnal noise exposure. Influences of LAeq and number of noise events on daytime performance were small but consistent and significant, stressing the potential public health impact of nocturnal noise exposure.

Effects of nocturnal aircraft noise on cognitive performance in the following morning: dose-response relationships in laboratory and field.

Annoyance from nocturnal aircraft noise exposure: Laboratory and field-specific dose–response curves

The effects of cabin noise on subjective comfort assessments were systematically investigated in order to reveal optimisation potentials for an improved passenger noise acceptance. Two aircraft simulation studies were conducted. An acoustic laboratory test facility provided with loudspeaker systems for realistic sound presentations and an aircraft cabin simulator (Dornier Do 728) with a high degree of ecological validity were used. Subjects were exposed to nine different noise patterns (three noise levels ranging from 66 to 78 dB(A) combined with three different frequency spectra). Regression analysis demonstrated a significant increase of passengers' acceptance with lower noise levels and significant effects of different frequency spectra determined by seat position in the aircraft cabin (front, middle, rear). Acoustic cabin design should therefore consider measures beyond noise level reduction altering noise characteristics to improve passengers' comfort and well-being in the aircraft cabin. Practitione...

Effects of aircraft cabin noise on passenger comfort.

INTRODUCTION: It is a well known fact that noise annoyance depends on the traffic mode. Much less is known about differences in physiological effects, especially on combined effects. Therefore, we investigated the effects of air (AI), road (RO) and rail (RA) traffic noise on sleep in the AIRORA study. METHODS: 72 subjects (40 ± 13 years, 32 male) were polysomnographically investigated during 11 consecutive nights in the laboratory. Electrophysiological signals included EEG, EOG, EMG, EKG, respiratory movements and finger pulse amplitude. Cortisol and noradrenalin were measured in nocturnal urine samples. Each traffic mode consisted of five noise categories (maximum SPL 45, 50, 55, 60 and 65 dBA) with 8 different noise events, i.e. 40 noise events in total. Therefore, between 40 and 120 noise events were realistically played back during single (AI, RO, RA, RORO), double (AIRO, AIRA, RORA) and triple (AIRORA) exposure nights. The design was complemented with a noise-free control night and carefully balanced. RESULTS: Annoyance due to aircraft noise was stronger compared to both rail and road traffic noise. However, according to multvariable random subject effect logistic regression models, awakening probability increased in the order AI, RO, RA (AI<RO, AI<RA, both p<0.0001; RO<RA, p=0.513). Cumulative effects in double and triple exposure nights were both lower (S1, SWS) and higher (Wake, REM) compared to expectations based on single exposure nights. Nocturnal traffic noise exposure had no influence on stress hormone excretion rates. CONCLUSIONS: Traffic modes differ in their noise effects on sleep. Field studies are needed to validate our results.

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J. Quehl

Papers

Examining nocturnal railway noise and aircraft noise in the field: Sleep, psychomotor performance, and annoyance☆☆☆

Effects of nocturnal aircraft noise on cognitive performance in the following morning: dose-response relationships in laboratory and field.

Annoyance from nocturnal aircraft noise exposure: Laboratory and field-specific dose–response curves

Effects of aircraft cabin noise on passenger comfort.

Single and combined effects of air, road and rail traffic noise on sleep