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

Impact of road traffic noise on annoyance and preventable mortality in European cities: A health impact assessment

BACKGROUND

Road traffic is the main source of environmental noise in European cities and one of the main environmental risks to health and wellbeing. In this study we aimed to provide an in-depth assessment of available road traffic noise data and to estimate population exposure and health impacts for cities in Europe.

METHODS

We conducted the analysis for 724 cities and 25 greater cities in 25 European countries. We retrieved road traffic strategic noise maps delivered under the Environmental Noise Directive (END) or available from local sources. We assessed noise exposure using the 24 h day-evening-night noise level indicator (L_den) starting at exposure levels of 55 dB L_den - based on data availability - for the adult population aged 20 and over (n = 123,966,346). For the adults exposed to noise levels above 55 dB L_den we estimated the health impacts of compliance with the World Health Organization (WHO) recommendation of 53 dB L_den. Two primary health outcomes were assessed: high noise annoyance and Ischemic Heart Disease (IHD), using mortality from IHD causes as indicator. Exposure Response Functions (ERFs) relating road traffic noise exposure to annoyance and IHD mortality were retrieved from the literature. Uncertainties in input parameters were propagated using Monte Carlo simulations to obtain point estimates and empirical 95% Confidence Intervals (CIs). Lastly, the noise maps were categorized as high, moderate and low quality following a qualitative approach.

RESULTS

Strategic noise map data was delivered in three distinct formats (i.e. raster, polygon or polyline) and had distinct noise ranges and levels of categorization. The majority of noise maps (i.e. 83.2%) were considered of moderate or low quality. Based on the data provided, almost 60 million adults were exposed to road traffic noise levels above 55 dB L_den, equating to a median of 42% (Interquartile Range (IQR): 31.8-64.8) of the adult population across the analysed cities. We estimated that approximately 11 million adults were highly annoyed by road traffic noise and that 3608 deaths from IHD (95% CI: 843-6266) could be prevented annually with compliance of the WHO recommendation. The proportion of highly annoyed adults by city had a median value of 7.6% (IQR: 5.6-11.8) across the analysed cities, while the number preventable deaths had a median of 2.2 deaths per 100,000 population (IQR: 1.4-3.1).

CONCLUSIONS

Based on the provided strategic noise maps a considerable number of adults in European cities are exposed to road traffic noise levels harmful for health. Efforts to standardize the strategic noise maps and to increase noise and disease data availability at the city level are needed. These would allow for a more accurate and comprehensive assessment of the health impacts and further help local governments to address the adverse health effects of road traffic noise.

Estimating the harmful effects of environmental transport noise: An EU study

Annex III of the Environmental Noise Directive (END), referring to the provision of dose-effect relations for the assessment of harmful effects caused by environmental noise, has been recently amended with the ratification of Commission Directive (EU) 2020/367. It describes how harmful effects from environmental noise may be calculated for ischemic heart disease (IHD), high annoyance (HA), and high sleep disturbance (HSD) for road, rail, and aircraft noise for EU Member States (MS). Within this context, this analysis utilises the calculation procedures outlined in the Directive to undertake a case study of the quantification of environmental noise-induced harmful effects in Ireland. The study generates acoustic models for road traffic and railway noise using the new CNOSSOS-EU method instead of using national data submitted under the END and, to our knowledge, is the first EU study to do so. In the case of Ireland, the results indicate that 256 noise-induced IHD, 296,471 HA, and 109,951 HSD cases are attributable to transport (road, rail, aircraft) noise in Ireland. The results outline the scale of harmful effects from environmental noise from transport in Ireland and are instructive for other EU members states in terms of the approach utilised.

Investigation of Metrics for Assessing Human Response to Drone Noise

Novel electric air transportation is emerging as an industry that could help to improve the lives of people living in both metropolitan and rural areas through integration into infrastructure and services. However, as this new resource of accessibility increases in momentum, the need to investigate any potential adverse health impacts on the public becomes paramount. This paper details research investigating the effectiveness of available noise metrics and sound quality metrics (SQMs) for assessing perception of drone noise. A subjective experiment was undertaken to gather data on human response to a comprehensive set of drone sounds and to investigate the relationship between perceived annoyance, perceived loudness and perceived pitch and key psychoacoustic factors. Based on statistical analyses, subjective models were obtained for perceived annoyance, loudness and pitch of drone noise. These models provide understanding on key psychoacoustic features to consider in decision making in order to mitigate the impact of drone noise. For the drone sounds tested in this paper, the main contributors to perceived annoyance are perceived noise level (PNL) and sharpness; for perceived loudness are PNL and fluctuation strength; and for perceived pitch are sharpness, roughness and Aures tonality. Responses for the drone sounds tested were found to be highly sensitive to the distance between drone and receiver, measured in terms of height above ground level (HAGL). All these findings could inform the optimisation of drone operating conditions in order to mitigate community noise.

Redox Implications of Extreme Task Performance: The Case in Driver Athletes

Redox homeostasis and redox-mediated signaling mechanisms are fundamental elements of human biology. Physiological levels of reactive oxygen species (ROS) and reactive nitrogen species (RNS) modulate a range of functional processes at the cellular, tissue, and systemic levels in healthy humans. Conversely, excess ROS or RNS activity can disrupt function, impairing the performance of daily activities. This article analyzes the impact of redox mechanisms on extreme task performance. Such activities (a) require complex motor skills, (b) are physically demanding, (c) are performed in an extreme environment, (d) require high-level executive function, and (e) pose an imminent risk of injury or death. The current analysis utilizes race car driving as a representative example. The physiological challenges of this extreme task include physical exertion, g loading, vibration, heat exposure, dehydration, noise, mental demands, and emotional factors. Each of these challenges stimulates ROS signaling, RNS signaling, or both, alters redox homeostasis, and exerts pro-oxidant effects at either the tissue or systemic levels. These redox mechanisms appear to promote physiological stress during race car driving and impair the performance of driver athletes.

Traffic Flow Detection Using Camera Images and Machine Learning Methods in ITS for Noise Map and Action Plan Optimization

Noise maps and action plans represent the main tools in the fight against citizens’ exposure to noise, especially that produced by road traffic. The present and the future in smart traffic control is represented by Intelligent Transportation Systems (ITS), which however have not yet been sufficiently studied as possible noise-mitigation tools. However, ITS dedicated to traffic control rely on models and input data that are like those required for road traffic noise mapping. The present work developed an instrumentation based on low-cost cameras and a vehicle recognition and counting methodology using modern machine learning techniques, compliant with the requirements of the CNOSSOS-EU noise assessment model. The instrumentation and methodology could be integrated with existing ITS for traffic control in order to design an integrated method, which could also provide updated data over time for noise maps and action plans. The test was carried out as a follow up of the L.I.S.T. Port project, where an ITS was installed for road traffic management in the Italian port city of Piombino. The acoustic efficacy of the installation is evaluated by looking at the difference in the acoustic impact on the population before and after the ITS installation by means of the distribution of noise exposure, the evaluation of G_den and G_night, and the calculation of the number of highly annoyed and sleep-disturbed citizens. Finally, it is shown how the ITS system represents a valid solution to be integrated with targeted and more specific sound mitigation, such as the laying of low-emission asphalts.

Associations between indoor soundscapes, building services and window opening behaviour during the COVID-19 lockdown

Results of an online survey conducted during the COVID-19 lockdown among 848 home workers living in London (United Kingdom) and in Italy are reported with a focus on (1) the impacts of building services on the perception of the acoustic environment while working and relaxing at home and (2) the factors associated with window opening behaviour. The analyses showed no significant difference in soundscape appropriateness for relaxation depending on the heating, ventilation and cooling system typologies, and in soundscape appropriateness for working from home (WFH) based on the ventilation strategy. Higher soundscape appropriateness for WFH was associated with houses equipped only with radiant floors for heating in Italy and with air-cooling systems in London. In London, air systems resulted in higher perceived dominance of noise from building services compared to other systems. Overall, rooms with less dominant sounds from building services were evaluated as more appropriate for working and relaxing. The dominance of sky or buildings from the window view, outdoor noisiness, noise sensitivity, age and gender were not significantly associated with participants' window opening behaviour while WFH. Differently, participants viewing more vegetation from windows in Italy were more likely (odds ratio: 1.279) to keep the window open while WFH.

Pre-Sleep Cognitive Arousal Is Negatively Associated with Sleep Misperception in Healthy Sleepers during Habitual Environmental Noise Exposure: An Actigraphy Study

Specific noises (e.g., traffic or wind turbines) can disrupt sleep and potentially cause a mismatch between subjective sleep and objective sleep (i.e., “sleep misperception”). Some individuals are likely to be more vulnerable than others to noise-related sleep disturbances, potentially as a result of increased pre-sleep cognitive arousal. The aim of the present study was to examine the relationships between pre-sleep cognitive arousal and sleep misperception. Sixteen healthy sleepers participated in this naturalistic, observational study. Three nights of sleep were measured using actigraphy, and each 15-s epoch was classified as sleep or wake. Bedside noise was recorded, and each 15-s segment was classified as containing noise or no noise and matched to actigraphy. Participants completed measures of habitual pre-sleep cognitive and somatic arousal and noise sensitivity. Pre-sleep cognitive and somatic arousal levels were negatively associated with subjective−objective total sleep time discrepancy (p < 0.01). There was an association between sleep/wake and noise presence/absence in the first and last 90 min of sleep (p < 0.001). These results indicate that higher levels of habitual pre-sleep arousal are associated with a greater degree of sleep misperception, and even in healthy sleepers, objective sleep is vulnerable to habitual bedside noise.

Effects of nursing interventions to improve inpatients' sleep in intensive and non-intensive care units: Findings from an umbrella review

AIM

This review aimed to synthesise the available reviews on the effects of nursing interventions on sleep quality among patients hospitalised in intensive care and non-intensive care units.

BACKGROUND

Poor sleep quality is a common fact in hospitalised patients. Nurses can contribute to the improvement of patients' sleep quality and duration.

DESIGN

A review of intervention reviews was carried out and reported following the PRISMA guidelines and checklist.

METHODS

We systematically searched for reviews published from January 2009 to December 2019 in PubMed, CINAHL Plus, Scopus, Institute for Scientific Information Web of Science, Joanna Briggs Database of Systematic Reviews and Cochrane Central Register of Controlled Trials databases. Searches were repeated at 24 November 2020 to include the most recent evidence. A narrative synthesis of the results was conducted.

RESULTS

Nine reviews (representing 109 original papers) met the selection criteria and were included for critical appraisal. Overall, nursing interventions and sleep quality were poorly defined. We grouped the interventions into 3 categories (environmental, barrier and internal interventions) to provide a more comprehensive overview and examine effects of nursing interventions on inpatients sleep quality. Inconsistent results were obtained and low quality of the original articles was reported, making it difficult to establish absolute conclusions.

CONCLUSION

The impact of environmental changes on patients' sleep was positive but inconclusive, while use of earplugs and eye masks, music and acupuncture generally showed positive results with moderate quality of evidence, and no harmful effects were reported.

Empirical Study on Temperature Influence on Noise Measurements with the Statistical Pass-By Method

Road traffic noise measurements, such as the Statistical Pass-By method (SPB) described in ISO 11819-1, are pivotal in assessing this noise pollution problem. As temperature is a primary cause of uncertainty in tyre/road noise measurements, the SPB method results need to be temperature corrected. The ISO 11819-1 standard is currently being revised and will refer to ISO/DTS 13471-2:2021, also in the drafting stage, for a temperature-correction procedure that is not present in the current ISO 11819-1:1997 version. Compared to other methods, little research has evaluated the temperature influence using the SPB method. In this paper, 18 SPB measurements were performed at three locations, with dense asphalt concrete and SMA as the pavement type. In total, over 5700 vehicles were captured, covering the complete temperature range in ISO 11819-1. For passenger cars, a temperature coefficient of −0.103 dB/°C was obtained while no statistically significant proof was found that temperature influences the sound-pressure levels for heavy vehicles at the speeds in this study (45–65 km/h). In this speed range for heavy vehicles, not only the tyre/road noise is a significant source of pass-by vehicle noise but also the power unit noise, on which the temperature influence is more complicated. Additionally, the analysis of various temperatures (air, road and estimated tyre temperature) revealed that the air temperature appears to be best suited for the temperature correction procedure. In third-octave bands, no effect was observed in the low-frequency range for passenger cars, contradicting previous research. Negative correction coefficients were found in the middle and high-frequency range, although trends presented in other studies were not observed.

Exposure–Response Functions for the Effects of Traffic Noise on Self-Reported Annoyance and Sleep Disturbance in Finland: Effect of Exposure Estimation Method

Large variations in transportation noise tolerance have been reported between communities. In addition to population sensitivity, exposure–response functions (ERFs) for the effects of transportation noise depend on the exposure estimation method used. In the EU, the new CNOSSOS-EU method will change the estimations of exposure by changing the assignment of noise levels and populations to buildings. This method was officially used for the first time in the strategic noise mapping performed by Finnish authorities in 2017. Compared to the old method, the number of people exposed to traffic noise above 55 dB decreased by 50%. The main aim of this study, conducted in the Helsinki Capital Region, Finland, was to evaluate how the exposure estimation method affects ERFs for road traffic noise. As an example, with a façade road traffic noise level of 65 dB, the ERF based on the highest façade noise level of the residential building resulted in 5.1% being highly annoyed (HAV), while the ERF based on the exposure estimation method that is similar to the CNOSSOS-EU method resulted in 13.6%. Thus, the substantial increase in the health effect estimate compensates for the reduction in the number of highly exposed people. This demonstrates the need for purpose–fitted ERFs when the CNOSSOS-EU method is used to estimate exposure in the health impact assessment of transportation noise.

Community Response to Noise from Hot-Spots at a Major Road in Quito (Ecuador) and Its Application for Identification and Ranking These Areas

Environmental legislation in Ecuador is advancing with the legitimate aspiration of providing citizens with new standards of quality and environmental health. In the context of environmental noise, these legislative advances are based on the experience accumulated in other countries, which is an advantage that must be managed with caution by incorporating local factors into noise management procedures. This study advances two lines of work. The first is to survey the population about their attitude towards noise from a major road to try to detect local factors in the annoyance and sleep disturbances. The second uses this information to compare noise indicators for the detection and ranking of hot-spots from major roads. The interviewees exhibited a high level of annoyance and sleep disturbance due to noise compared with the results of other studies. Results show that there are small differences in the definition of hot-spots when using WHO’s dose–response curves for L_den ≥ 68 dB for and for L_night ≥ 58 dB, in comparison with the curves generated in this study (CS). Regarding the application of both dose–response curves (WHO vs. CS) to the estimation of the population at risk of the harmful effect of nighttime traffic noise (HSD), small oscillations are also observed even when L_night ≥ 58 dB and L_noche ≥ 60 dB are used.

Traffic noise-induced changes in wake-propensity measured with the Odds-Ratio Product (ORP)

Nocturnal traffic noise can disrupt sleep and impair physical and mental restoration, but classical sleep scoring techniques may not fully capture subtle yet clinically relevant alterations of sleep induced by noise. We used a validated continuous measure of sleep depth and quality based on automatic analysis of physiologic sleep data, termed Wake Propensity (WP), to investigate temporal changes of sleep in response to nocturnal noise events in 3-s epochs. Seventy-two healthy participants (mean age 40.3 years, range 18-71 years, 40 females, 32 males) slept for 11 nights in a laboratory, during which we measured sleep with polysomnography. In 8 nights, participants were exposed to 40, 80 or 120 road, rail and/or aircraft noise events with maximum noise levels of 45-65 dB L_AS,max during 8-h sleep opportunities. We analyzed sleep macrostructure and event-related change of WP during noise exposure with linear mixed models. Nocturnal traffic noise led to event-related shifts towards wakefulness and less deep, more unstable sleep (increase in WP relative to pre-noise baseline ranging from +29.5% at 45 dB to +38.3% at 65 dB; type III effect p < 0.0001). Sleep depth decreased dynamically with increasing noise level, peaking when L_AS,max was highest. This change in WP was stronger and occurred more quickly for events where the noise onset was more rapid (road and rail) compared to more gradually time-varying noise (aircraft). Sleep depth did not immediately recover to pre-noise WP, leading to decreased sleep stability across the night compared to quiet nights, which was greater with an increasing number of noise events (standardized β = 0.053, p = 0.003). Further, WP was more sensitive to noise than classical arousals. Results demonstrate the usefulness of WP as a measure of the effects of external stimuli on sleep, and show WP is a more sensitive measure of noise-induced sleep disruption than traditional methods of sleep analysis.

Incident hypertension in relation to aircraft noise exposure: results of the DEBATS longitudinal study in France

BACKGROUND

Although several cross-sectional studies have shown that aircraft noise exposure was associated with an increased risk of hypertension, a limited number of longitudinal studies have addressed this issue. This study is part of the DEBATS (Discussion on the health effect of aircraft noise) research programme and aimed to investigate the association between aircraft noise exposure and the incidence of hypertension.

METHODS

In 2013, 1244 adults living near three major French airports were included in this longitudinal study. Systolic and diastolic blood pressure, as well as demographic and lifestyle factors, were collected at baseline and after 2 and 4 years of follow-up during face-to-face interviews. Exposure to aircraft noise was estimated for each participant's home address using noise maps. Statistical analyses were performed using mixed Poisson and linear regression models adjusted for potential confounding factors.

RESULTS

A 10 dB(A) increase in aircraft noise levels in terms of L_den was associated with a higher incidence of hypertension (incidence rate ratio (IRR)=1.36, 95% CI 1.02 to 1.82). The association was also significant for L_day (IRR 1.41, 95% CI 1.07; to 1.85) and L_night (IRR 1.31, 95% CI 1.01 to 1.71). Systolic and diastolic blood pressure increased with all noise indicators.

CONCLUSION

These results strengthen those obtained from the cross-sectional analysis of the data collected at the time of inclusion in DEBATS, as well as those from previous studies conducted in other countries. Hence, they support the hypothesis that aircraft noise exposure may be considered as a risk factor for hypertension.

Experimental Study on the Effect of Urban Road Traffic Noise on Heart Rate Variability of Noise-Sensitive People

Epidemiological studies have confirmed that long-term exposure to road traffic noise can cause cardiovascular diseases (CDs), and when noise exposure reaches a certain level, the risk of related CDs significantly increases. Currently, a large number of Chinese residents are exposed to high noise exposure, which could greatly increase the risk of cardiovascular disease. On the other hand, relevant studies have found that people with high noise sensitivity are more susceptible to noise. And it is necessary to pay more attention to the high noise-sensitive people. This study investigated the acute physiological effect of different noise-sensitive groups by indoor-level noise stimulus experiments under laboratory conditions, by observing heart rate variability (HRV) indicators, including standard deviation of NN intervals (SDNN), low frequency/high frequency (LF/HF), and heart rate (HR). The results showed that (a) there was no significant difference in HRV between the high-sensitive group and the low-sensitive group at the physiological baseline and the different stimulating noise levels. (b) Then, based on the theory of cumulative effect of noise proposed by WHO Regional Office for Europe, non-significant but observable differences between groups were further discussed. By analyzing differences of the variation trends and the within-group significant changes of SDNN and HR between the two groups, the results tended to show that the high-sensitive group is more affected by road traffic noise. In addition, the values of SDNN and HR showed observable between-group differences at 55 dB (A) and 65 dB (A) which corresponding to the SPL associated with a significantly increased risk of cardiovascular disease concerned by epidemiological studies. According to the cumulative effect theory (WHO), these differences in HRV caused by short-term noise stimulation may have the potential to produce physiological response and lead to between-groups differences in prevalence after long-term recurrent effect, and deserve attention and further research.

Exploring the implications of autonomous vehicles: a comprehensive review

Over the last few years, a large emphasis has been devoted to autonomous vehicles (AVs), as vehicle automation promises a large number of benefits such as: improving mobility and minimization of energy and emissions. Additionally, AVs represent a major tool in the fight against pandemics as autonomous vehicles can be used to transport people while maintaining isolation and sterilization. Thus, manufacturers are racing to introduce AVs as fast as possible. However, laws and regulations are not yet ready for this change and the legal sector is following the development of autonomous vehicles instead of taking the lead. This paper provides a comprehensive review of the previous studies in the transportation field that involve AVs with the aim of exploring the implications of AVs on the safety, public behaviour, land use, economy, society and environment, public health, and benefits of autonomous vehicles in fighting pandemics.

Association between community noise and children's cognitive and behavioral development: A prospective cohort study

BACKGROUND

Noise exposure has been associated with adverse cognitive and behavioral outcomes in children, but evidence on longitudinal associations between community noise and child development in low- and middle-income countries is rare. We investigated associations between community noise and behavioral and cognitive development in preschool children in São Paulo.

METHODS

We linked child development data from the São Paulo Western Region Birth Cohort with average (Lden) and night-time (Lnight) community noise exposure at children's home, estimated by means of a land use regression model using various predictors (roads, schools, greenness, residential and informal settlements). Outcomes were the Strengths and Difficulties Questionnaire (SDQ) and Regional Project on Child Development Indicators (PRIDI) at 3 years of age and the Child Behavior Checklist (CBCL) and International Development and Early Learning Assessment (IDELA) at 6 years of age. We investigated the relationship between noise exposure and development using cross-sectional and longitudinal regression models.

RESULTS

Data from 3385 children at 3 years of age and 1546 children at 6 years of age were analysed. Mean Lden and Lnight levels were 70.3 dB and 61.2 dB, respectively. In cross-sectional analyses a 10 dB increase of Lden above 70 dB was associated with a 32% increase in the odds of borderline or abnormal SDQ total difficulties score (OR = 1.32, 95% CI: 1.04; 1.68) and 0.72 standard deviation (SD) increase in the CBCL total problems z-score (95% CI: 0.55; 0.88). No cross-sectional association was found for cognitive development. In longitudinal analyses, each 10 dB increase was associated with a 0.52 SD increase in behavioral problems (95% CI: 0.28; 0.77) and a 0.27 SD decrease in cognition (95%-CI: 0.55; 0.00). Results for Lnight above 60 dB were similar.

DISCUSSION

Our findings suggest that community noise exposure above Lden of 70 dB and Lnight of 60 dB may impair behavioral and cognitive development of preschool children.

Noise pollution and human cognition: An updated systematic review and meta-analysis of recent evidence

BACKGROUND

This systematic review provides a comprehensive synthesis of recent epidemiological evidence that environmental noise negatively impacts human cognition.

METHODS

We update a prior review with recent publications (PROSPERO CRD42019151923). The strength of evidence for associations was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework. We also conducted random-effects meta-analyses where suitable.

RESULTS

16 studies were identified and reviewed in tandem with 32 studies previously reviewed by Clark & Paunovic (2018). A meta-analysis from 3 studies found that reading comprehension scores in quiet classrooms were 0.80 (95% confidence interval: 0.40; 1.20) points higher than children in noisier classrooms. Meta-analysis of the impact of 1 dB (dB) increase in environmental noise on reading and language abilities gave a pooled beta coefficient of -0.11(95% confidence interval: -0.32; 0.10). A meta-analysis of Odds Ratios (OR) from 3 studies found higher odds of cognitive impairment in people aged 45 + with higher residential noise exposure (OR 1.40, 95% CI: 1.18;1.61). After qualitative synthesis of remaining studies, there was high quality evidence for an association between environmental noise and cognitive impairment in middle-to-older adults, moderate quality evidence for an association between aircraft noise and reading and language in children, and moderate quality evidence against an association between aircraft noise and executive functioning in children. Generally the literature was supportive for other cognitive outcomes, but with low or very low-quality evidence.

DISCUSSION

The evidence so far suggests that noise exposure is associated with cognition, but more good quality research using standardised methodology is required to corroborate these results and to allow for precise risk estimation by larger meta-analyses. There is also a need for more research with older teenagers and young-to-middle aged adults, on the synergistic effects of noise and air pollution, and in Africa, Central and South America, South Asia and Australasia.

Systematic review: auditory stimulation and sleep

STUDY OBJECTIVES

Auditory stimulation devices (white and pink noise) are used to mask sounds and facilitate relaxation and sleep; however, the effectiveness of this intervention is not well established. This systematic review examined the scientific literature for the effect of specific types of auditory stimulation on sleep outcomes in adults.

METHODS

The PRISMA Statement guided this review. Searches were conducted in nine databases for intervention studies that could easily be employed in clinical practice. We excluded other types of auditory stimulation (music alone, binaural tones, and synchronization). Two reviewers screened abstracts and full-text articles for eligibility, with conflicts resolved by a third reviewer, and extracted data. Risk of bias was assessed with the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies.

RESULTS

34 studies reported results of 1,103 persons participating in three categories of interventions: white noise (18), pink noise (11), and six multi-audio (some combination of white, pink, music, or silence). Nineteen studies had positive findings in terms of improving sleep outcomes: 6 white noise (33%), 9 pink noise (81.9%), and 4 multi-audio (66.7%). Multi-audio had the lowest (better) risk of bias (mean/SD: 1.67/0.82) compared to white (2.38/0.69) and pink noise (2.36/0.81).

CONCLUSIONS

Although there was no strong evidence to support use of auditory stimulation, none of the studies reported any adverse effects with short-term application of auditory stimulation during sleep. Future research needs to include confounding factors that can affect outcomes, including one's noise sensitivity, personality, and other conditions or medications that may affect sleep.

Environmental noise-induced cardiovascular responses during sleep

STUDY OBJECTIVES

This study was designed to test the utility of cardiovascular responses as markers of potentially different environmental noise disruption effects of wind farm compared to traffic noise exposure during sleep.

METHODS

Twenty participants underwent polysomnography. In random order, and at six sound pressure levels from 33 dBA to 48 dBA in 3 dB increments, three types of wind farm and two types of road traffic noise recordings of 20-sec duration were played during established N2 or deeper sleep, each separated by 20 seconds without noise. Each noise sequence also included a no-noise control. Electrocardiogram and finger pulse oximeter recorded pulse wave amplitude changes from the pre-noise onset baseline following each noise exposure and were assessed algorithmically to quantify the magnitude of heart rate and finger vasoconstriction responses to noise exposure.

RESULTS

Higher sound pressure levels were more likely to induce drops in pulse wave amplitude. Sound pressure levels as low as 39 dBA evoked a pulse wave amplitude response (Odds ratio [95% confidence interval]; 1.52 [1.15, 2.02]). Wind farm noise with amplitude modulation was less likely to evoke a pulse wave amplitude response than the other noise types, but warrants cautious interpretation given low numbers of replications within each noise type.

CONCLUSION

These preliminary data support that drops in pulse wave amplitude are a particularly sensitive marker of noise-induced cardiovascular responses during. Larger trials are clearly warranted to further assess relationships between recurrent cardiovascular activation responses to environmental noise and potential long-term health effects.

A Conceptual Framework Proposal for a Noise Modelling Service for Drones in U-Space Architecture

In recent years, there has been a rapid growth in the development and usage of flying drones due to their diverse capabilities worldwide. Public and private sectors will actively use drone technology in the logistics of goods and transporting passengers in the future. There are concerns regarding privacy and noise exposure in and around the rural and urban environment with the rapid expansion. Further, drone noise could affect human health. European Union has defined a service-orientated architecture to provide air traffic management for drones, called U-space. However, it lacks a noise modelling service (NMS). This paper proposes a conceptual framework for such a noise modelling service for drones with a use case scenario and verification method. The framework is conceptualized based on noise modelling from the aviation sector. The NMS can be used to model the noise to understand the accepted drone noise levels in different scenarios and take measures needed to reduce the noise impact on the community.

Noise Exposure and Quality of Life Among Nurses

BACKGROUND

The purpose of this study was to describe the relationship between noise exposure, selected health conditions, and well-being among nurses.

METHODS

A secondary analysis was performed on data obtained from 3,818 U.S. nurses who responded to a survey regarding noise exposure, health conditions, stress, professional quality of life, and workplace support.

FINDINGS

Those who reported high noise exposure reported more health conditions, higher stress and burnout scores, and lower supportive environments. High noise exposure was significantly associated with lower professional quality of life.

CONCLUSION/APPLICATION TO PRACTICE

Noise may impact the health and quality of professional life of nurses. Occupational health nurses should advocate for the regular monitoring of nurses' exposure to hazardous noise at work, compare it to OSHA permissible levels, and collaborate with the occupational health team to ensure safe noise levels are maintained. Occupational health nurses should advocate for expanded research on effects of noise on health.

Nachtlärminduzierte Schlafstörungen und Herz-Kreislauf-Risiko

Beeinträchtigungen des Schlafes im Sinne von Insomnien, d. h. Ein- und Durchschlafschwierigkeiten, frühmorgendliches Erwachen und ein chronisch unerholsamer Schlaf, sind weit verbreitet in der Bevölkerung und gehen mit einer Vielzahl von körperlichen und psychischen Gesundheitsstörungen einher. Die umweltbedingten Ursachen für Schlafstörungen umfassen eine ganze Reihe von Faktoren, wobei nächtlicher Lärm als eine wichtige Ursache gilt. Aktuelle Daten der Europäischen Umweltagentur zeigen, dass Umgebungslärm (Straßenverkehrs-, Schienen-, Flug- und Industrielärm) für starke Schlafstörungen bei 6,5 Millionen Personen in Europa sorgt. Neue epidemiologische und mechanistische Feldstudien zeigen, dass vor allem nächtlicher Verkehrslärm unter anderem zu einer eingeschränkten Gefäßfunktion, thromboinflammatorischen Veränderungen, einem Anstieg von Stresshormonen und einem erhöhten Blutdruck führen kann, die bedeutsame Risikofaktoren für Herz-Kreislauf-Erkrankungen darstellen. Gemäß der Europäischen Umweltagentur führt der Umgebungslärm jährlich zu 48000 zusätzlichen Fällen von ischämischen Herzerkrankungen sowie 12000 vorzeitigen Todesfällen.

Long-Term Exposure to Transportation Noise and Risk for Type 2 Diabetes in a Nationwide Cohort Study from Denmark

BACKGROUND

Epidemiologic studies have linked transportation noise to increased morbidity and mortality, particularly for cardiovascular outcomes. However, studies investigating metabolic outcomes such as diabetes are limited and have focused only on noise exposures estimated for the loudest residential façade.

OBJECTIVES

We aimed to examine the influence of long-term residential exposure to transportation noise at the loudest and quietest residential façades and the risk for type 2 diabetes.

METHODS

Road traffic and railway noise exposures (Lden) at the most and least exposed façades were estimated for all dwellings in Denmark during 1990-2017. Aircraft noise was estimated in 5-dB categories. Ten-year time-weighted mean noise exposures were estimated for 3.56 million individuals ≥35 years of age. From 2000 to 2017, 233,912 incident cases of type 2 diabetes were identified using hospital and prescription registries, with a mean follow-up of 12.9 y. We used Cox proportional hazards models adjusting for individual- and area-level covariates and long-term residential air pollution. The population-attributable fraction (PAF) was also computed.

RESULTS

Hazard ratios (HRs) and 95% confidence intervals (CIs) for type 2 diabetes in association with 10-dB increases in 10-y mean road traffic noise at the most and least exposed façades, respectively, were 1.05 (95% CI: 1.04, 1.05) and 1.09 (95% CI: 1.08, 1.10). Following subsequent adjustment for fine particulate matter [particulate matter ≤2.5μm in aerodynamic diameter] (10-y mean), the HRs (CIs) were 1.03 (95% CI: 1.03, 1.04) and 1.08 (95% CI: 1.07, 1.09), respectively. For railway noise, the HRs per 10-dB increase in 10-y mean exposure were 1.03 (95% CI: 1.02, 1.04) and 1.02 (95% CI: 1.01, 1.04) for the most and least exposed façades, respectively. Categorical models supported a linear exposure-outcome relationship for road traffic noise and, to a lesser extent, for railway noise. Aircraft noise >45 dB was associated with a 1-4% higher likelihood of type 2 diabetes compared with those who were unexposed. We found road traffic and railway noise associated with a PAF of 8.5% and 1.4%, respectively, of the diabetes cases.

DISCUSSION

Long-term exposure to road, railway, and possibly aircraft traffic noise was associated with an increased risk of type 2 diabetes in a nationwide cohort of Danish adults. Our findings suggest that diabetes should be included when estimating the burden of disease due to transportation noise. https://doi.org/10.1289/EHP9146.

A survey of bedroom ventilation types and the subjective sleep quality associated with them in Danish housing

We performed a survey of the types of bedroom ventilation in Danish dwellings (January-February 2020) and the associated subjective sleep quality. Five hundred and seventeen people responded. Their median age was 33 years old and 55.4% of them were males. We used an online questionnaire and collected information on the type of bedroom ventilation, bedroom airing behaviour by the respondents, the bedroom environment, building surroundings and location, and sleep disturbance caused by stuffy air, noise, and the thermal environment. Subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI); its median among respondents was >5 indicating reduced sleep quality. 35.4% of the bedrooms had mechanical, 24.6% exhaust, and 40.0% natural ventilation. Sleeping in a bedroom with mechanical ventilation tended to reduce sleep disturbance. The absence of mechanical ventilation and the presence of carpet in the bedroom were all associated with stuffy air causing sleep disturbance, which was the second most sleep disturbing factor. PSQI increased significantly with increased sleep disturbance. People who reported that their sleep was disturbed by stuffy air or "too warm" conditions opened windows frequently during the day or night, but no association was found between PSQI and bedroom airing behaviours. Our results are valid for the heating season and the survey would have to be repeated in the non-heating season to permit generalization of the findings. The results present associations and are qualitative, so field measurements are necessary to validate the present observations and provide further explanations.

Environmental noise at library learning commons affects student performance and electrophysiological functioning

Environmental noise (EN) refers to unpleasant harmful sounds that deteriorates living conditions. Therefore, this study aims to investigate how EN affects students at learning commons, where EN increases between 70 and 90 dBA, and which levels disturb psycho-physiologically. For this purpose, 16 students of Tecnologico de Monterrey were recruited: nine men and seven women. They were divided into four groups, and were involved in two activities: to solve a puzzle of 300 pieces without and with EN at 75 dBA. In both activities, a summative evaluation based on the level of puzzle completeness, and the electrophysiological monitoring of heart and blink rate, and neural electrical activity were conducted. Results showed that student performance was 4% higher in a quiet room than in learning commons. EN increased heart rate in 3.48%, and blink rate in 22.91%, and neural electrical activity was reduced at least in 3%, regardless of task demands. The findings of the present study suggest that academic work is difficult to undertake in learning commons when EN is above the permissible limit, and what diminishes the performance of students and alters their electrophysiological functioning.

A study on the assessment of traffic noise induced annoyance and awareness levels about the potential health effects among residents living around a noise-sensitive area

The present cross-sectional study aimed to evaluate the risk factors for traffic noise-induced annoyance and also assess the awareness levels among the exposed population concerning the health impacts caused by traffic noise. Field measurements were made to validate the application of the standard noise models, which were later used to present the acoustical environment and assess the exposure level around a super-speciality hospital surrounded by a residential zone. Results from the noise maps and façade maps revealed that the area was exposed to noise levels exceeding the upper safe limits by more than 10 dB(A). The effect of exposure in the form of annoyance and the awareness level were evaluated using a questionnaire survey in a sample of 565 residents. Attention questions were incorporated in the questionnaire, and the awareness level was evaluated using the mean awareness index score. Respondents living in noisy areas were having a higher risk for annoyance as compared to those living in quiet areas (OR = 4.06; 95% CI = 2.79-5.88). Reporting poor sleep quality, being sensitive to noise, and noise perception at home were the significant risk factors for annoyance. Most of the respondents were classified as having no/little awareness about serious health ailments caused by traffic noise. Lower awareness levels, despite a higher literacy rate and a higher percentage of the young population, imply that there is a need for undertaking mass awareness programmes so that the impacts can be reduced to a minimum, if not eliminated.

New and Emerging Approaches to Better Define Sleep Disruption and Its Consequences

Current approaches to quantify and diagnose sleep disorders and circadian rhythm disruption are imprecise, laborious, and often do not relate well to key clinical and health outcomes. Newer emerging approaches that aim to overcome the practical and technical constraints of current sleep metrics have considerable potential to better explain sleep disorder pathophysiology and thus to more precisely align diagnostic, treatment and management approaches to underlying pathology. These include more fine-grained and continuous EEG signal feature detection and novel oxygenation metrics to better encapsulate hypoxia duration, frequency, and magnitude readily possible via more advanced data acquisition and scoring algorithm approaches. Recent technological advances may also soon facilitate simple assessment of circadian rhythm physiology at home to enable sleep disorder diagnostics even for “non-circadian rhythm” sleep disorders, such as chronic insomnia and sleep apnea, which in many cases also include a circadian disruption component. Bringing these novel approaches into the clinic and the home settings should be a priority for the field. Modern sleep tracking technology can also further facilitate the transition of sleep diagnostics from the laboratory to the home, where environmental factors such as noise and light could usefully inform clinical decision-making. The “endpoint” of these new and emerging assessments will be better targeted therapies that directly address underlying sleep disorder pathophysiology via an individualized, precision medicine approach. This review outlines the current state-of-the-art in sleep and circadian monitoring and diagnostics and covers several new and emerging approaches to better define sleep disruption and its consequences.

Long-Term Exposures to Urban Noise and Blood Pressure Levels and Control Among Older Adults

[Figure: see text].

Road traffic noise and cognitive function in older adults: a cross-sectional investigation of The Irish Longitudinal Study on Ageing

Background

The World Health Organization published updated Environmental Noise Guidelines in 2018. Included are recommended limit values for environmental noise exposure based on systematic reviews for a range of health outcomes, including cognitive impairment. There is emerging evidence in the literature that chronic exposure to road traffic noise may affect cognitive function in older adults, but this relationship is not well established. This study spatially linked nationally representative health microdata from The Irish Longitudinal Study on Ageing to building-level modelled noise data for two cities in the Republic of Ireland. This was used to investigate associations between exposure to road traffic noise and cognitive function in a sample of older adults, independent of a range of socio-demographic and behavioural characteristics, as well as exposure to air pollution.

Methods

We used the Predictor-LimA Advanced V2019.02 software package to estimate noise originating from road traffic for the cities of Dublin and Cork in Ireland according to the new common noise assessment methodology for the European Union (CNOSSOS-EU). Noise exposure values were calculated for each building and spatially linked with geo-coded TILDA microdata for 1706 individuals aged 54 and over in the two cities. Ordinary least squares linear regression models were estimated for eight standardised cognitive tests including noise exposure as an independent variable, with standard errors clustered at the household level. Models were adjusted for individual sociodemographic, behavioural and environmental characteristics.

Results

We find some evidence that road traffic noise exposure is negatively associated with executive function, as measured by the Animal Naming Test, among our sample of older adults. This association appears to be accounted for by exposure to air pollution when focusing on a sub-sample. We do not find evidence of an association between noise exposure and memory or processing speed.

Conclusions

Long term exposure to road traffic noise may be negatively associated with executive function among older adults.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11853-y.

Environmental risk factors and cardiovascular diseases: a comprehensive review

Noncommunicable diseases (NCDs) are fatal for more than 38 million people each year and are thus the main contributors to the global burden of disease accounting for 70% of mortality. The majority of these deaths are caused by cardiovascular disease. The risk of NCDs is strongly associated with exposure to environmental stressors such as pollutants in the air, noise exposure, artificial light at night and climate change, including heat extremes, desert storms and wildfires. In addition to the traditional risk factors for cardiovascular disease such as diabetes, arterial hypertension, smoking, hypercholesterolemia and genetic predisposition, there is a growing body of evidence showing that physicochemical factors in the environment contribute significantly to the high NCD numbers. Furthermore, urbanization is associated with accumulation and intensification of these stressors. This comprehensive expert review will summarize the epidemiology and pathophysiology of environmental stressors with a focus on cardiovascular NCDs. We will also discuss solutions and mitigation measures to lower the impact of environmental risk factors with focus on cardiovascular disease.

Calculation of the physiologically developed nighttime noise index from existing noise indices

Background:

The effects of noise on sleep and health have been evaluated in earlier studies using noise indices chosen on the basis of practical considerations and not on the physiologic mechanisms of sleep disturbance due to noise exposure. We investigated the neurophysiologic mechanisms of sleep and found that the arithmetic mean of the sound levels above a threshold () may be used effectively to evaluate the effects of nighttime noise exposure. However, the efficacy of using has only been confirmed in a specific setting; therefore, the reliability of in other situations should be investigated by applying it in epidemiologic studies. In this study, we aimed to obtain an alternative equation for calculating from existing noise indices, given that detailed information on fluctuations in sound levels, needed to calculate according to the definition, is not readily available.

Materials and Methods:

We examined statistical relationships among noise indices namely , the number of noise events above 60 and 70 dB (N₆₀ and N₇₀), and the night equivalent sound level (L_night). The study area was around the Kadena military airfield, where the sound levels were recorded at noise monitoring stations.

Results:

showed a very strong correlation with N₆₀ and N₇₀ but not with L_night. Among regression equations, an equation representing N₆₀ and the interaction between N₆₀ and L_night, which is equivalent to the product of N₆₀ and a linear expression of L_night, showed the highest prediction capability.

Conclusion:

We obtained a regression equation to calculate from N₆₀ and L_night. Although this alternative equation for is only applicable for military aircraft noise, it will aid the re-analysis of existing epidemiologic studies as well as further investigations on the relationship between noise exposure and health effects.

Urban noise assessment and its nonauditory health effects on the residents of Chiniot and Jhang, Punjab, Pakistan

Elevated noise level is an emerging global problem. Therefore, the present work is conducted that can improve, increase, and integrate the already known issue in literature with new information coming from an emerging country such as Pakistan. The objectives of this study were (i) to assess the urban noise levels and traffic density of Chiniot and Jhang and (ii) to determine nonauditory health effects of noise levels on the residents of both cities. Noise levels were examined from 181 locations (103 from Jhang and 78 from Chiniot) and categorized into hospitals, educational, religious and recreational, residential, industrial areas, and traffic intersections. A-weighted noise level measurements were taken using an integrated sound level meter which recorded short-term road traffic noise continuously for 15 min at each location (LA_eq15). The urban noise data showed 82% of the sites in Jhang (LA_max = 103 dB) and 95% in Chiniot (LA_max = 120 dB) exceeded the noise limits set by the National Environment Quality Standard of Pakistan (NEQS-Pak) and World Health Organization (WHO). Moreover, higher intensity of noise levels (LA_eq15 ≥ 100 dB) was recorded in Chiniot (17 sites) than in Jhang (1 site). Regression analysis showed a relatively strong relationship of traffic density with noise at Chiniot (R² = 0.48) compared to Jhang (R² = 0.31). However, spatial variability of noise with traffic density was observed in both cities. Survey study revealed that all the respondents in Jhang and Chiniot suffered from many noise-related health problems such as annoyance (53 and 51%), depression (45 and 47%), dizziness (61 and 65%), headache (67 and 64%), hypertension (71 and 56%), hearing loss (53 and 56%), physiological stress (65 and 65%), sleeplessness (81 and 84%), and tinnitus (70 and 62%) due to noise, respectively. We conclude that noise levels are higher in Chiniot primarily due to high road traffic and secondarily due to high population density. It is recommended that vehicle maintenance and family and urban planning could be effective measures to reduce urban noise levels.

Relationship Between Chronic Noise Exposure, Cognitive Impairment, and Degenerative Dementia: Update on the Experimental and Epidemiological Evidence and Prospects for Further Research

Degenerative dementia, of which Alzheimer's disease is the most common form, is characterized by the gradual deterioration of cognitive function. The events that trigger and promote degenerative dementia are not clear, and treatment options are limited. Experimental and epidemiological studies have revealed chronic noise exposure (CNE) as a potential risk factor for cognitive impairment and degenerative dementia. Experimental studies have indicated that long-term exposure to noise might accelerate cognitive dysfunction, amyloid-β deposition, and tau hyperphosphorylation in different brain regions such as the hippocampus and cortex. Epidemiological studies are increasingly examining the possible association between external noise exposure and dementia. In this review, we sought to construct a comprehensive summary of the relationship between CNE, cognitive dysfunction, and degenerative dementia. We also present the limitations of existing evidence as a guide regarding important prospects for future research.

Residential exposure to transportation noise in Denmark and incidence of dementia: national cohort study

OBJECTIVE

To investigate the association between long term residential exposure to road traffic and railway noise and risk of incident dementia.

DESIGN

Nationwide prospective register based cohort study.

SETTING

Denmark.

PARTICIPANTS

1 938 994 adults aged ≥60 years living in Denmark between 1 January 2004 and 31 December 2017.

MAIN OUTCOME MEASURES

Incident cases of all cause dementia and dementia subtypes (Alzheimer's disease, vascular dementia, and Parkinson's disease related dementia), identified from national hospital and prescription registries.

RESULTS

The study population included 103 500 participants with incident dementia, and of those, 31 219 received a diagnosis of Alzheimer's disease, 8664 of vascular dementia, and 2192 of Parkinson's disease related dementia. Using Cox regression models, 10 year mean exposure to road traffic and railway noise at the most (L_denmax) and least (L_denmin) exposed façades of buildings were associated with a higher risk of all cause dementia. These associations showed a general pattern of higher hazard ratios with higher noise exposure, but with a levelling off or even small declines in risk at higher noise levels. In subtype analyses, both road traffic noise and railway noise were associated with a higher risk of Alzheimer's disease, with hazard ratios of 1.16 (95% confidence interval 1.11 to 1.22) for road L_denmax ≥65 dB compared with <45 dB, 1.27 (1.22 to 1.34) for road L_denmin ≥55 dB compared with <40 dB, 1.16 (1.10 to 1.23) for railway L_denmax ≥60 dB compared with <40 dB, and 1.24 (1.17 to 1.30) for railway L_denmin ≥50 dB compared with <40 dB. Road traffic, but not railway, noise was associated with an increased risk of vascular dementia. Results indicated associations between road traffic L_denmin and Parkinson's disease related dementia.

CONCLUSIONS

This nationwide cohort study found transportation noise to be associated with a higher risk of all cause dementia and dementia subtypes, especially Alzheimer's disease.

The Burden of Disease Due to Road Traffic Noise in Hesse, Germany

Road-traffic-noise exposition is widespread in Germany and can have harmful health effects. As guidance for informed decision-making, we estimated the environmental burden of disease attributable to road-traffic noise in Hesse, Germany as disability-adjusted life-years (DALYs). Using detailed road-traffic-noise exposure data provided by the Hessian Agency for Nature Conservation, Environment, and Geology (HLNUG), we calculated the DALYs due to road-traffic noise > 40 dB(A) L_24h (unweighted average 24 h noise level) and other noise metrics for endpoints with known dose-response functions and evidence in the literature (NORAH-study on disease risks and WHO reviews): cardiovascular disease, depressive disorders, road-traffic annoyance, and sleep disturbance. We calculated the population-attributable fractions (PAF) for road-noise-related cardiovascular disease (hypertensive heart disease, ischemic heart disease, and stroke) and depressive disorders in the population using published relative risk estimates. We multiplied the PAFs with the Hessian proportion of the 2015 WHO DALY estimates for Germany in people aged ≥ 40 years. For high annoyance and high sleep disturbance, we used published dose-response functions to determine the burden for residents of all ages. For Hesse, we found a total of 26,501 DALYs attributable to road-traffic noise or 435 DALY per 100,000 persons for the reference year, 2015. Further, we estimated that a hypothetic uniform road-traffic-noise reduction of 3 dB would prevent 23% of this burden of disease.

Transportation noise and risk for colorectal cancer: a nationwide study covering Denmark

PURPOSE

Few studies have suggested that traffic noise is a risk factor for cancer, but evidence is inconclusive. We aimed to investigate whether road traffic and railway noise are associated with risk of colorectal cancer.

METHODS

We obtained address history for all 3.5 million people above 40 years of age and living in Denmark for the period 1990-2017 and estimated road traffic and railway noise (L_den) at the most and least exposed facades of all addresses as well as air pollution (PM_2.5). During follow-up (2000-2017), 35,881 persons developed colon cancer and 19,755 developed rectal cancer. Information on individual and area-level demographic and socioeconomic variables was collected from Danish registries. We analyzed data using Cox proportional hazards models, including traffic noise as time-varying 10-year average exposure.

RESULTS

Exposure to road traffic noise at the most exposed façade was associated with an incidence rate ratio and 95% confidence interval for proximal colon cancer of 1.018 (0.999-1.038) per 10 dB higher noise. We observed no associations for road traffic noise at the least exposed façade or for railway noise in relation to proximal colon cancer. Also, we found no association between road traffic or railway noise and risk for distal colon cancer or rectal cancer.

CONCLUSION

Traffic noise did not seem associated with higher risk for colorectal cancer, although the suggestion of a slightly higher risk of proximal colon cancer following exposure to road traffic noise warrants further research.

Transportation noise pollution and cardiovascular disease

Epidemiological studies have found that transportation noise increases the risk of cardiovascular morbidity and mortality, with high-quality evidence for ischaemic heart disease. According to the WHO, ≥1.6 million healthy life-years are lost annually from traffic-related noise in Western Europe. Traffic noise at night causes fragmentation and shortening of sleep, elevation of stress hormone levels, and increased oxidative stress in the vasculature and the brain. These factors can promote vascular dysfunction, inflammation and hypertension, thereby elevating the risk of cardiovascular disease. In this Review, we focus on the indirect, non-auditory cardiovascular health effects of transportation noise. We provide an updated overview of epidemiological research on the effects of transportation noise on cardiovascular risk factors and disease, discuss the mechanistic insights from the latest clinical and experimental studies, and propose new risk markers to address noise-induced cardiovascular effects in the general population. We also explain, in detail, the potential effects of noise on alterations of gene networks, epigenetic pathways, gut microbiota, circadian rhythm, signal transduction along the neuronal-cardiovascular axis, oxidative stress, inflammation and metabolism. Lastly, we describe current and future noise-mitigation strategies and evaluate the status of the existing evidence on noise as a cardiovascular risk factor.

Effect of COVID-19 lockdown on noise pollution levels in an Indian city: a case study of Kanpur

Noise pollution is an emerging environmental threat, prolonged exposure of which can cause annoyance, sleep disturbance, hypertension, psychiatric disorders, and also hormonal dysfunction. Among all the sources of noise pollution, the noise generated by road vehicle traffic significantly affects the quality of urban environments. Concerning the recent imposition of COVID-19 societal lockdown, this study attempts to investigate the impacts of COVID-19 lockdown on the changes in noise pollution levels before, during, and after lockdown phase in different residential, commercial, industrial, and silence zones of the city of Kanpur, India. Utilizing data collected from portable environmental sensors, the average noise levels before lockdown and during lockdown were found to be in the range of 44.85 dB to 79.57 dB and 38.55 dB to 57.79 dB, respectively, for different zones. Although a significant reduction in the noise levels was observed during lockdown, except for commercial zone, all other monitoring stations had reported sound levels quite higher than the recommended noise limits set by the Central Pollution Control Board (CPCB) of India. Results further indicated that the impact of road traffic noise on risk of high annoyance and sleep disturbance was found to be lower during lockdown as compared to that of pre-lockdown and unlock phase. While the annoyance level in residential (86.23%), industrial (87.44%), and silence (84.47%) was higher in pre-lockdown period, it reduced to 41.25, 50.28, and 43.07% in the lockdown phase. Even the risk of sleep disturbance in the residential zone was found to reduce from 37.96% during pre-lockdown to 14.72% during lockdown phase. Several noise mitigation strategies are also proposed, which may indeed pave the way for devising noise control measures in the local and regional level.

The prevalence of occupational exposure to noise: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury

BACKGROUND

The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of individual experts. Evidence from mechanistic and human data suggests that occupational exposure to noise may cause cardiovascular disease. In this paper, we present a systematic review and meta-analysis of the prevalence of occupational exposure to noise for estimating (if feasible) the number of deaths and disability-adjusted life years from cardiovascular disease that are attributable to exposure to this risk factor, for the development of the WHO/ILO Joint Estimates.

OBJECTIVES

We aimed to systematically review and meta-analyse estimates of the prevalence of occupational exposure to noise.

DATA SOURCES

We searched electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and CISDOC. We also searched electronic grey literature databases, Internet search engines, and organizational websites; hand-searched reference list of previous systematic reviews and included study records; and consulted additional experts.

STUDY ELIGIBILITY AND CRITERIA

We included working-age (≥15 years) workers in the formal and informal economies in any WHO Member and/or ILO member State, but excluded children (<15 years) and unpaid domestic workers. We included all study types with an estimate of the prevalence of occupational exposure to noise, categorized into two levels: no (low) occupational exposure to noise (<85dBA) and any (high) occupational exposure to noise (≥85dBA).

STUDY APPRAISAL AND SYNTHESIS METHODS

At least two review authors independently screened titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. We combined prevalence estimates using random-effect meta-analysis. Two or more review authors assessed the risk of bias and the quality of evidence, using the RoB-SPEO tool and QoE-SPEO approach developed specifically for the WHO/ILO Joint Estimates.

RESULTS

Sixty-five studies (56 cross-sectional studies and nine cohort studies) met the inclusion criteria, comprising 157,370 participants (15,369 females) across 28 countries and all six WHO regions (Africa, Americas, Eastern Mediterranean, Europe, South-East Asia, and Western Pacific). For the main analyses, we prioritized the four included studies that surveyed national probability samples of general populations of workers over the 58 studies of workers in industrial sectors and/or occupations with relatively high occupational exposure to noise. The exposure was generally assessed with dosimetry, sound level meter, or official or company records; in the population-based studies, it was assessed with validated questions. Estimates of the prevalence of occupational exposure to noise are presented for all 65 included studies, by country, sex, 5-year age group, industrial sector, and occupation where feasible. The pooled prevalence of any (high) occupational exposure to noise (≥85dBA) among the general population of workers was 0.17 (95% confidence interval 0.16 to 0.19, 4 studies, 108,256 participants, 38 countries, two WHO regions, I2 98%, low quality of evidence). Subgroup analyses showed that pooled prevalence differed substantially by WHO region, sex, industrial sector, and occupation.

CONCLUSIONS

Our systematic review and meta-analysis found that occupational exposure to noise is prevalent among general populations of workers. The current body of evidence is, however, of low quality, due to serious concerns for risk of bias and indirectness. Producing estimates of occupational exposure to noise nevertheless appears evidence-based, and the pooled effect estimates presented in this systematic review are suitable as input data for the WHO/ILO Joint Estimates (if feasible). Protocol identifier: 10.1016/j.envint.2018.09.040 PROSPERO registration number: CRD42018092272.

Effects of Exposure to Road, Railway, Airport and Recreational Noise on Blood Pressure and Hypertension

Noise is one of the most diffused environmental stressors affecting modern life. As such, the scientific community is committed to studying the main emission and transmission mechanisms aiming at reducing citizens' exposure, but is also actively studying the effects that noise has on health. However, scientific literature lacks data on multiple sources of noise and cardiovascular outcomes. The present cross-sectional study aims to evaluate the impact that different types of noise source (road, railway, airport and recreational) in an urban context have on blood pressure variations and hypertension. 517 citizens of Pisa, Italy, were subjected to a structured questionnaire and five measures of blood pressure in one day. Participants were living in the same building for at least 5 years, were aged from 37 to 72 years old and were exposed to one or more noise sources among air traffic, road traffic, railway and recreational noise. Logistic and multivariate linear regression models have been applied in order to assess the association between exposures and health outcomes. The analyses showed that prevalence of high levels of diastolic blood pressure (DBP) is consistent with an increase of 5 dB (A) of night-time noise (β = 0.50 95% CI: 0.18-0.81). Furthermore, increased DBP is also positively associated with more noise sensitive subjects, older than 65 years old, without domestic noise protection, or who never close windows. Among the various noise sources, railway noise was found to be the most associated with DBP (β = 0.68; 95% CI: -1.36, 2.72). The obtained relation between DBP and night-time noise levels reinforces current knowledge.

Health Effects Related to Wind Turbine Sound: An Update

Commissioned by the Swiss Federal Office for the Environment, an update of an earlier narrative review was prepared for the literature published between 2017 and mid-2020 about the effects of wind turbine sound on the health of local residents. Specific attention was hereby given to the health effects of low-frequency sound and infrasound. The Netherlands Institute for Public Health and the Environment and Mundonovo sound research collected the scientific literature on the effect of wind turbines on annoyance, sleep disturbance, cardiovascular disease, and metabolic effects, as well as mental and cognitive impacts. It also investigated what is known about annoyance from visual aspects of wind turbines and other non-acoustic factors, such as the local decision-making process. From the literature study, annoyance again came forward as the most important consequence of sound: the louder the sound (in dB) of wind turbines, the stronger the annoyance response was. The literature did not show that "low-frequency sound" (sound with a low pitch) results in extra annoyance on top of normal sound. Results of scientific research for other health effects are either not available or inconsistent, and we can conclude that a clear association with wind turbine related sound levels cannot be confirmed. There is evidence that long-term effects are related to the annoyance people experience. These results confirm earlier conclusions. There is increasing evidence that annoyance is lower when people can participate in the siting process. Worries of residents should be addressed in an early stage, by involving them in the process of planning and decision making.

Heart healthy cities: genetics loads the gun but the environment pulls the trigger

The world's population is estimated to reach 10 billion by 2050 and 75% of this population will live in cities. Two-third of the European population already live in urban areas and this proportion continues to grow. Between 60% and 80% of the global energy use is consumed by urban areas, with 70% of the greenhouse gas emissions produced within urban areas. The World Health Organization states that city planning is now recognized as a critical part of a comprehensive solution to tackle adverse health outcomes. In the present review, we address non-communicable diseases with a focus on cardiovascular disease and the urbanization process in relation to environmental risk exposures including noise, air pollution, temperature, and outdoor light. The present review reports why heat islands develop in urban areas, and how greening of cities can improve public health, and address climate concerns, sustainability, and liveability. In addition, we discuss urban planning, transport interventions, and novel technologies to assess external environmental exposures, e.g. using digital technologies, to promote heart healthy cities in the future. Lastly, we highlight new paradigms of integrative thinking such as the exposome and planetary health, challenging the one-exposure-one-health-outcome association and expand our understanding of the totality of human environmental exposures.

Community daytime noise pollution and socioeconomic differences in Chicago, IL

Environmental noise may affect hearing and a variety of non-auditory disease processes. There is some evidence that, like other environmental hazards, noise may be differentially distributed across communities based on socioeconomic status. We aimed to a) predict daytime noise pollution levels and b) assess disparities in daytime noise exposure in Chicago, Illinois. We measured 5-minute daytime noise levels (L_{eq, 5-min}) at 75 randomly selected sites in Chicago in March, 2019. Geographically-based variables thought to be associated with noise were obtained, and used to fit a noise land-use regression model to estimate the daytime environmental noise level at the centroid of the census blocks. Demographic and socioeconomic data were obtained from the City of Chicago for the 77 community areas, and associations with daytime noise levels were assessed using spatial autoregressive models. Mean sampled noise level (L_{eq, 5-min}) was 60.6 dBA. The adjusted R² and root mean square error of the noise land use regression model and the validation model were 0.60 and 4.67 dBA and 0.51 and 5.90 dBA, respectively. Nearly 75% of city blocks and 85% of city communities have predicted daytime noise level higher than 55 dBA. Of the socioeconomic variables explored, only community per capita income was associated with mean community predicted noise levels, and was highest for communities with incomes in the 2^nd quartile. Both the noise measurements and land-use regression modeling demonstrate that Chicago has levels of environmental noise likely contributing to the total burden of environmental stressors. Noise is not uniformly distributed across Chicago; it is associated with proximity to roads and public transportation, and is higher among communities with mid-to-low incomes per capita, which highlights how socially and economically disadvantaged communities may be disproportionately impacted by this environmental exposure.

Long-Term Exposure to Road Traffic Noise and Air Pollution, and Incident Atrial Fibrillation in the Danish Nurse Cohort

BACKGROUND

Associations between long-term exposure to air pollution and road traffic noise have been established for ischemic heart disease, but findings have been mixed for atrial fibrillation (AF).

OBJECTIVES

The goal of the study was to examine associations of long-term exposure to road traffic noise and air pollution with AF.

METHODS

Time-varying Cox regression models were used to estimate associations of 1-, 3-, and 23-y mean road traffic noise and air pollution exposures with AF incidence in 23,528 women enrolled in the Danish Nurse Cohort (age >44y at baseline in 1993 or 1999). AF diagnoses were ascertained via the Danish National Patient Register. Annual mean weighted 24-h average road traffic noise levels (Lden) at the nurses' residences, since 1970, were estimated using the Nord2000 model, and annual mean levels of particulate matter with a diameter <2.5μm (PM2.5) and nitrogen dioxide (NO2) were estimated using the DEHM/UBM/AirGIS model.

RESULTS

Of 23,528 nurses with no prior AF diagnosis at the cohort baseline, 1,522 developed AF during follow-up. In a fully adjusted model (including PM2.5), the estimated risk of AF was 18% higher [hazard ratio (HR); 95% confidence interval (CI): 1.18; 1.02, 1.36] in nurses with residential 3-y mean Lden levels >58 dB vs. <48 dB, with similar findings for 1-y mean exposures. A 3.9-μg/m3 increase in 3-y mean PM2.5 was associated with incident AF before and after adjustment for concurrent exposure to road traffic noise (HR 1.09; 95% CI: 1.00, 1.20 and 1.08; 95% CI: 0.97, 1.19, respectively). Associations with 1-y mean PM2.5 exposures were positive but closer to the null and not significant. Associations with NO2 were null for all time periods before and after adjustment for road traffic noise and inverse when adjusted for concurrent PM2.5.

CONCLUSION

Our analysis of prospective data from a cohort of Danish female nurses followed for up to 14 y provided suggestive evidence of independent associations between incident AF and 1- and 3-y exposures to road traffic noise and PM2.5. https://doi.org/10.1289/EHP8090.

Influence of the SARS-CoV-2 pandemic: a review from the climate change perspective

Ever since the global outbreak of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2/COVID-19) in the early part of 2020, there is no doubt that the SARS-CoV-2 pandemic has placed great tension globally and has affected almost all aspects of human endeavors. There are presently several research studies on the atmospheric environmental and economic effects of this dreaded virus. Supposedly, the responses ought to have also present innovations that would advance scientific research to mitigate its impacts since most of the ensuing consequences impact the atmospheric climatic conditions. Even when it appears that economic events would possibly return in no time, the circumstances will change. Specifically, from the existing literature, it appears that not much has been done to study the influence of the SARS-CoV-2 pandemic on climate change. Hence, this present review article will explore the possible connection between the SARS-CoV-2 pandemic and climate change. The utilization of various scientific domains for climate change studies during the SARS-CoV-2 pandemic and exploring the positive influences of the SARS-CoV-2 pandemic and measures to avoid the negative impacts on climate change owing to SARS-CoV-2 have also been discussed.

Toward inclusion of atmospheric effects in the aircraft community noise predictions

This paper presents an atmospheric propagation model, based on ray acoustics, that accounts for realistic weather conditions in the evaluation of the noise footprint of an aircraft. Noise sources, obtained using the Ffowcs Williams and Hawkings acoustic analogy applied to scale-resolved flow simulation data, are stored on a hemisphere surrounding the vehicle. These noise sources are propagated using a propagation model that takes into account the vertical variability of air temperature and wind velocity. The electric vertical takeoff and landing aircraft, presented by Casalino, van der Velden, and Romani [(2019). in Proceedings of the AIAA Scitech 2019 Forum, January 7-11, San Diego, CA, pp. 1834-1851], is used as a case study; noise footprints, obtained considering various vertically varying temperature and wind velocity distributions, are compared. It is shown that weather conditions in the acoustic wave propagation can contribute to mismatch up to 4 dBA in the illuminated zone and a significant drop in the refractive shadow zone caused by the vertical air temperature and wind velocity gradients. This work constitutes the first accomplishment in including realistic atmospheric effects in aircraft community noise prediction based on scale-resolved flow simulations.

Soundscape Evaluation Comparison of Outdoor Activity Space Between Gated and Open Communities

In communities, outdoor activity space is utilized most often by older adults and children, and the soundscape is very important for its quality. For different community planning modes, such as gated and open communities, focus should be on different soundscape enhancement strategies for outdoor spaces. In this paper, typical samples of activity spaces in a gated community and in an open community were used. The comparison was conducted through soundscape evaluation including an analysis of the dominance of various sound sources, noise annoyance, and the perceptual dimensions of soundscape. The results showed that noise annoyance in the gated community was significantly lower than in the open community, although the noise level was of no significance between the two communities. The community planning mode moderated the relationships among the soundscape perception parameters between the gated and open communities. To reduce noise annoyance in the gated communities, each sound source should be considered; in open communities, traffic noise only should be considered. In a gated community, adding natural sounds to reduce noise annoyance may be a feasible intervention; in an open community, this is not necessary. Besides, there was no relationship between noise annoyance and Eventfulness in an open community, indicating that noise annoyance was insufficient to explain the complex sound environment of the community. China’s community planning will gradually shift from a gated community to an open community, making the soundscape of outdoor activity spaces likely to change dramatically in the future. The findings will help urban designers and managers to adopt targeted strategies to improve the soundscape and quality of life of community-dwelling older adults and children.

Effects of exposure to surrounding green, air pollution and traffic noise with non-accidental and cause-specific mortality in the Dutch national cohort

BACKGROUND

Everyday people are exposed to multiple environmental factors, such as surrounding green, air pollution and traffic noise. These exposures are generally spatially correlated. Hence, when estimating associations of surrounding green, air pollution or traffic noise with health outcomes, the other exposures should be taken into account. The aim of this study was to evaluate associations of long-term residential exposure to surrounding green, air pollution and traffic noise with mortality.

METHODS

We followed approximately 10.5 million adults (aged ≥ 30 years) living in the Netherlands from 1 January 2013 until 31 December 2018. We used Cox proportional hazard models to evaluate associations of residential surrounding green (including the average Normalized Difference Vegetation Index (NDVI) in buffers of 300 and 1000 m), annual average ambient air pollutant concentrations [including particulate matter (PM2.5), nitrogen dioxide (NO2)] and traffic noise with non-accidental and cause-specific mortality, adjusting for potential confounders.

RESULTS

In single-exposure models, surrounding green was negatively associated with all mortality outcomes, while air pollution was positively associated with all outcomes. In two-exposure models, associations of surrounding green and air pollution attenuated but remained. For respiratory mortality, in a two-exposure model with NO2 and NDVI 300 m, the HR of NO2 was 1.040 (95%CI: 1.022, 1.059) per IQR increase (8.3 µg/m3) and the HR of NDVI 300 m was 0.964 (95%CI: 0.952, 0.976) per IQR increase (0.14). Road-traffic noise was positively associated with lung cancer mortality only, also after adjustment for air pollution or surrounding green.

CONCLUSIONS

Lower surrounding green and higher air pollution were associated with a higher risk of non-accidental and cause-specific mortality. Studies including only one of these correlated exposures may overestimate the associations with mortality of that exposure.

Aircraft Noise Distribution as a Fairness Dilemma-A Review of Aircraft Noise through the Lens of Social Justice Research

Aircraft noise exposure is a health risk and there is evidence that noise annoyance partly mediates the association between noise exposure and stress-related health risks. Thus, approaches to reduce annoyance may be beneficial for health. Annoyance is influenced by manifold non-acoustic factors and perceiving a fair and trustful relationship between the airport and its residents may be one of them. The distribution of aircraft noise exposure can be regarded as a fairness dilemma: while residents living near an airport may seem to have some advantages, the majority of residents living under certain flight routes or in their immediate proximity suffer from the disadvantages of the airport, especially the noise. Moreover, a dilemma exists between the airport’s beneficial economic impact for a region and the physical and psychological integrity of residents. Aircraft noise exposure through the lens of social justice research can help to improve our understanding of noise annoyance. Research indicates that the fairness perceptions of the parties involved can be enhanced by (a) improving individual cost–benefit ratios, (b) providing a fair procedure for deciding upon the noise distribution, and (c) implementing fair social interaction with residents. Based on the review of evidence from social justice research, we derive recommendations on how fairness aspects can be integrated into aircraft noise management with the purpose of improving the relationship between the airport and its residents, to reduce annoyance, and to enhance the acceptance of local aviation and the airport as a neighbor.