Biochemical effects of chronic exposure to noise in man

Impact of Noise Exposure on Risk of Developing Stress-Related Metabolic Effects: A Systematic Review and Meta-Analysis

Background

Exposure to noise can increase biological stress reactions, which may increase adverse health effects, including metabolic disorders; however, the certainty in the association between exposure to noise and metabolic outcomes has not been widely explored. The objective of this review is to evaluate the evidence between noise exposures and metabolic effects.

Materials and Methods

A systematic review of English and comparative studies available in PubMed, Cochrane Central, EMBASE, and CINAHL databases between January 1, 1980 and December 29, 2021 was performed. Risk of Bias of Nonrandomized Studies of Exposures was used to assess risk of bias of individual studies and certainty of the body of evidence for each outcome was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.

Results

Fifty-six primary studies reporting on cortisol, cholesterol levels, waist circumference, glucose levels, and adrenaline and/or noradrenaline were identified. Although meta-analyses suggested that there may be an increase in waist circumference and adrenaline with increased noise exposure, the certainty in the evidence is very low. Overall, the certainty in the evidence of an effect of increased noise on all the outcomes were low to very low due to concerns with risk of bias, inconsistency across exposure sources, populations, and studies, and imprecision in the estimates of effects.

Conclusions

The certainty of the evidence of increased noise on metabolic effects was low to very low, which likely reflects the inability to compare across the totality of the evidence for each outcome. The findings from this review may be used to inform policies involving noise reduction and mitigation strategies, and to direct further research in areas that currently have limited evidence available.

Non-auditory effects of industrial chronic noise exposure on workers; change in salivary cortisol pattern

Background

Noise has different auditory and non-auditory effects on human. In noisy environments, noise as a non-specific stressor can activates the hypothalamic-pituitary-adrenal axis (HPA, cortisol). The aim of this study was to evaluate the effect of chronic exposure to noise on salivary cortisol on industrial workers.

Methods

This cross-sectional study had a case/control design. 136 male workers (68 workers were exposed to chronic industrial noise, and 68 other workers were exposed to background noise) voluntarily enrolled in the study. The equivalent noise level was measured at workstations and salivary cortisol for both case and control groups was measured at the beginning (6 AM) and also at the end of work shift (4 PM). The amount of change in the average of the values of the two groups were compared with each other.

Results

The measured Leq_8h (equivalent continuous sound level) in case and control groups were 87.43 dB-A and 67.6 dB-A, respectively. Comparison of salivary cortisol levels change in groups shows a significant differences in control groups for salivary cortisol in the morning and in the evening samples (p < 0.05); but not in the case group (p = 0.052). Also, comparison of salivary cortisol levels changes with noise exposure experience in the case subgroups revealed no significant difference (p > 0.05).

Conclusion

This study showed that chronic exposure to industrial noise can lead to a change in pattern of salivary cortisol secretion especially in the evening (at the end of the work shift), in a way that instead of its normal decrease, an increase happened.

Ambient and at-the-ear occupational noise exposure and serum lipid levels

OBJECTIVES

Occupational and residential noise exposure has been related to increased risk of cardiovascular disease. Alteration of serum lipid levels has been proposed as a possible causal pathway. The objective of this study was to investigate the relation between ambient and at-the-ear occupational noise exposure and serum levels of total cholesterol, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides when accounting for well-established predictors of lipid levels.

METHODS

This cross-sectional study included 424 industrial workers and 84 financial workers to obtain contrast in noise exposure levels. They provided a serum sample and wore portable dosimeters that every 5-s recorded ambient noise exposure levels during a 24-h period. We extracted measurements obtained during work and calculated the full-shift mean ambient noise level. For 331 workers who kept a diary on the use of a hearing protection device (HPD), we subtracted 10 dB from every noise recording obtained during HPD use and estimated the mean full-shift noise exposure level at the ear.

RESULTS

Mean ambient noise level was 79.9 dB (A) [range 55.0-98.9] and the mean estimated level at the ear 77.8 dB (A) [range 55.0-94.2]. Ambient and at-the-ear noise levels were strongly associated with increasing levels of triglycerides, cholesterol-HDL ratio, and decreasing levels of HDL-cholesterol, but only in unadjusted analyses that did not account for HPD use and other risk factors.

CONCLUSION

No associations between ambient or at-the-ear occupational noise exposure and serum lipid levels were observed. This indicates that a causal pathway between occupational and residential noise exposure and cardiovascular disease does not include alteration of lipid levels.

Recent and long-term occupational noise exposure and salivary cortisol level

Environmental and occupational noise exposure have been related to increased risk of cardiovascular disease, hypothetically mediated by stress-activation of the hypothalamic-pituitary-adrenal (HPA) axis. The objective of this study was to investigate the relation between recent and long-term occupational noise exposure and cortisol level measured off work to assess a possible sustained HPA-axis effect. We included 501 industrial, finance, and service workers who were followed for 24h during work, leisure, and sleep. Ambient occupational noise exposure levels were recorded every 5s by personal dosimeters and we calculated the full-shift LAEq value and estimated duration and cumulative exposure based on their work histories since 1980. For 332 workers who kept a log-book on the use of hearing protection devices (HPD), we subtracted 10 dB from every noise recording obtained during HPD use and estimated the noise level at the ear. Salivary cortisol concentration was measured at 20.00 h, the following day at awakening, and 30 min after awakening on average 5, 14 and 14.5h after finishing work. The mean ambient noise exposure level was 79.9 dB(A) [range: 55.0-98.9] and the mean estimated level at the ear 77.7 dB(A) [range: 55.0-94.2]. In linear and mixed regression models that adjusted for age, sex, current smoking, heavy alcohol consumption, personal income, BMI, leisure-time noise exposure level, time since occupational noise exposure ceased, awakening time, and time of saliva sampling, we observed no statistically significant exposure response relation between recent, or long-term ambient occupational noise exposure level and any cortisol parameter off work. This was neither the case for recent noise level at the ear. To conclude, neither recent nor long-term occupational noise exposure levels were associated with increased cortisol level off work. Thus, our results do not indicate that a sustained activation of the HPA axis, as measured by cortisol, is involved in the causal pathway between occupational noise exposure and cardiovascular disease.

Towards a general framework for including noise impacts in LCA

PURPOSE

Several damages have been associated with the exposure of human beings to noise. These include auditory effects, i.e., hearing impairment, but also non-auditory physiological ones such as hypertension and ischemic heart disease, or psychological ones such as annoyance, depression, sleep disturbance, limited performance of cognitive tasks or inadequate cognitive development. Noise can also interfere with intended activities, both in daytime and nighttime. ISO 14'040 also indicated the necessity of introducing noise, together with other less developed impact categories, in a complete LCA study, possibly changing the results of many LCA studies already available. The attempts available in the literature focused on the integration of transportation noise in LCA. Although being considered the most frequent source of intrusive impact, transportation noise is not the only type of noise that can have a malign impact on public health. Several other sources of noise such as industrial or occupational need to be taken into account to have a complete consideration of noise into LCA. Major life cycle inventories (LCI) typically do not contain data on noise emissions yet and characterisation factors are not yet clearly defined. The aim of the present paper is to briefly review what is already available in the field and propose a new framework for the consideration of human health impacts of any type of noise that could be of interest in the LCA practice, providing indications for the introduction of noise in LCI and analysing what data is already available and, in the form of a research agenda, what other resources would be needed to reach a complete coverage of the problem.

MAIN FEATURES

The literature production related to the impacts of noise on human health has been analysed, with considerations of impacts caused by transportation noise as well as occupational and industrial noise. The analysis of the specialist medical literature allowed for a better understanding of how to deal with the epidemiological findings from an LCA perspective and identify areas still missing dose-response relations. A short review of the state-of-science in the field of noise and LCA is presented with an expansion to other contributions in the field subsequent to the comprehensive work by Althaus et al. (2009a; 2009b). Focusing on the analogy between toxicological analysis of pollutants and noise impact evaluation, an alternative approach is suggested, which is oriented to the consideration of any type of noise in LCA and not solely of transportation noise. A multi-step framework is presented as a method for the inclusion of noise impacts on human health in LCA.

RESULTS AND DISCUSSION

A theoretical structural framework for the inclusion of noise impacts in LCA is provided as a basis for future modelling expansions in the field. Rather than evaluating traffic/transportation noise, the method focuses on the consideration of the noise level and its impact on human health, regardless of the source producing the noise in an analogous manner as considered in the fields of toxicology and common noise evaluation practices combined. The resulting framework will constitute the basis for the development of a more detailed mathematical model for the inclusion of noise in LCA. The toxicological background and the experience of the analysis of the release of chemicals in LCA seem to provide sufficient ground for the inclusion of noise in LCA: taken into account the physical differences and the uniqueness of noise as an impact, the procedure applied to the release of chemicals during a product life cycle is key for a valuable inclusion of noise in the LCA logic.

CONCLUSIONS

It is fundamental for the development of research in the field of LCA and noise to consider any type of noise. Further studies are needed to contribute to the inclusion of noise sources and noise impacts in LCA. In this paper, a structure is proposed that will be expanded and adapted in the future and which forms the basic framework for the successive modelling phase.

Occupational noise exposure in small scale hand tools manufacturing (forging) industry (SSI) in Northern India

Occupational noise has been recognized as hazardous for the human beings. A high noise level in forging shops is considered to lower the labour productivity and cause illness however occupational noise is being accepted as an integral part of the job. The present study has been carried out in 5 small scale hand tool forging units (SSI) of different sizes in Northern India in Punjab. Noise levels at various sections were measured. OSHA norms for hearing conservation has been incorporated which includes an exchange rate of 5 dB (A), criterion level at 90 dB (A), criterion time of 8 h, threshold level=80 dB (A), upper limit=140 dB (A) and with F/S response rate. Equivalent sound pressure level (L(eq)) has been measured in various sections of these plants. Noise at various sections like hammer section, cutting presses, punching, grinding and barrelling process was found to be >90 dB (A), which is greater than OSHA norms. A cross-sectional study on the basis of questionnaire has been carried out. The results of which revealed that 68% of the workers are not wearing ear protective equipments out of these 50% were not provided with PPE by the company. About 95% of the workers were suffering speech interference though high noise annoyance was reported by only 20%. It has been established that the maximum noise exposure is being taken by the workers as they are working more than 8h a day for six days per week. More than 90% workers are working 12 to 24 h over time per week which lead to very high noise exposure i.e. 50 to 80% per week higher than exposure time/week in USA or European countries(15, 16)).

A physiological correlate for the intolerance to both internal and external sounds

The notion that stress can induce chronic tinnitus, or increase its intensity, is predominant in the literature on tinnitus. However, there is little empirical support for this claim, since previous studies rely merely on subjective reports. In the present study, we used an objective physiological measure of stress (i.e., basal secretion of the stress hormone cortisol), in order to assess the relationship between tinnitus and stress. We hypothesized that tinnitus, a permanent internal sound, should behave as a stressor and should be accompanied by chronically elevated cortisol levels in individuals with severe tinnitus. In addition, we hypothesized that suffering from severe tinnitus should generalize to an intolerance towards external sounds. Two groups each comprised of 18 participants (with and without tinnitus) matched on education and health status participated in the study. Tinnitus severity, as assessed by tinnitus-related distress, was high in half of the tinnitus participants, and low in the other half. Basal cortisol levels were measured using saliva samples (five saliva samples per day for 3 days within a week) taken in the participant's natural environment. Intolerance to external sounds was assessed psychometrically. The high tinnitus-related distress group had chronic cortisol levels greater than both the low tinnitus-related distress and control groups, and also displayed greater intolerance to external sounds. The low tinnitus-related distress and control groups did not differ from each other on either of these measures. Our study thus provides the first physiological and empirical evidence of a link between intolerance to both internal (tinnitus) and external sounds in persons with tinnitus, and is compatible with the clinical observation that severe tinnitus is associated with high stress levels.

Industrial noise exposure, noise annoyance, and serum lipid levels in blue-collar workers--the CORDIS Study

Chronic noise exposure may constitute a risk factor for cardiovascular disease, but the exact mechanism is unclear. The authors studied the association between industrial noise exposure, noise annoyance, and serum lipid/lipoprotein levels in male (n = 1,455) and female (n = 624) blue-collar workers. The authors found that young men (i.e., < or = 44 y of age) exposed to high noise levels (> or = 80 dB[A]) had higher total levels of cholesterol (p = .023) and triglycerides (p = .001), as well as a higher cholesterol ratio (p = .038), than men exposed to low noise levels, even after controlling for confounding variables. In women or in older (> 45 y) men, noise did not affect serum lipid/lipoprotein levels. The authors found no interaction between noise exposure level and noise annoyance (except for high-density lipoprotein in women). However, noise annoyance covaried independently with total cholesterol (p = .022) and high-density lipoprotein (p = .0039) levels in young men and with total cholesterol (p = .035), triglyceride (p = .035), and high-density lipoprotein levels in women (under high noise exposure conditions)(p = .048) levels in women. Noise annoyance and noise exposure levels had an additive effect on cholesterol levels. Young men who scored high on both variables had a 15-mg/dl higher mean cholesterol level (95 % confidence interval [CI] = 7.2, 22.8; p = .0003) than those who scored low on both variables; in women, the corresponding difference was 23 mg/dl (95% CI = 1.5, 42.9; p = .019). The authors concluded that the examination of serum lipid/lipoprotein levels may be useful in studies of the health effects of noise, and particular attention should be paid to noise-annoyed individuals.

The effects of chronic industrial noise exposure on urinary cortisol, fatigue and irritability: a controlled field experiment

This quasiexperimental field study explored the effect of noise attenuation on urinary cortisol excretion (sampled three times, at 6:30 and 10:30 AM and 1:30 PM) and reported fatigue and postwork irritability among 35 healthy industrial workers chronically exposed to high ambient noise levels (> 85 dB [A]) without using ear protectors. The results indicated that under conditions of chronic noise exposure the cortisol level at the end of the workshift was high and almost reached the morning level. This elevation in cortisol excretion was accompanied by high levels of accumulated fatigue and postwork irritability. Attenuating the noise reaching the eardrum by 30 to 33 dB, by fitting the same workers with earmuffs for a period of 7 working days, resulted in a significant improvement in both psychological and physiological stress reactions. Besides decreasing noise intensity, no other changes were made, either to ongoing work activities or to the other characteristics of the ambient noise. The cortisol level declined steadily during the workshift and exhibited the normal cortisol diurnal rhythm. At the end of the workshift, this level was significantly lower (P < .05) than that observed under the chronic noise-exposure condition. There was also a concomitant reduction in reported fatigue (P < .05) and postwork irritability (P < .01). These findings demonstrate the "net" contribution of ambient noise to elevating stress reactions to regular work demands.

Associação da perda auditiva induzida pelo ruído com o tempo acumulado de trabalho entre motoristas e cobradores

Através da técnica da regressão linear múltipla, estudou-se a relação existente entre a perda auditiva induzida pelo ruído e as variáveis "tempo total acumulado de trabalho como condutor de veículos coletivos urbanos", "pressão arterial diastólica" e "idade", em uma população de 278 motoristas e cobradores usuários de um serviço de saúde ocupacional da cidade de Campinas, estado de São Paulo (Brasil). Os principais resultados encontrados foram uma associação positiva entre a perda auditiva e o tempo acumulado de trabalho, bem como a existência de uma interação entre esta variável e a idade dos condutores.

Lipids in psychological research: the last decade

We review the recent literature examining lipid changes during stressful experiences, and the psychological and constitutional differences that influence lipid levels at rest and that may modulate lipid response to stress. Mild forms of chronic or episodic stress are apparently not associated with alterations in lipids and lipoproteins, but severe forms of real or perceived stress do appear to alter lipid levels. Acute laboratory stress is frequently associated with short-term alterations in lipids and lipoproteins, but the significance of these changes is unclear. Several individual characteristics, such as heightened neuroendocrine or autonomic reactivity to stressors, Type A component behavior, and other aspects of personality, appear to be associated with an atherogenic lipid profile. Stress may influence lipid concentrations and metabolism through a variety of physiological and behavioral mechanisms, but none have been clearly elucidated. Future research should concentrate on understanding these mechanisms.

Is there a relationship between hypercholesterolaemia and noise-induced hearing loss?

Many investigators who have analysed the possible correlation between hearing loss and high serum cholesterol levels have found that hearing appears to be influenced by high blood lipids. Noise, as is well known, also influences hearing, particularly at high frequencies. It increases serum cholesterol levels during short-term experiments. The present investigation addresses the question of a possibly increased ototraumatic influence by the combination of high serum cholesterol levels and occupational noise exposure. Seventy-eight 50-year-old men with high serum cholesterol levels from a WHO study were compared with 75 50-year-old men who were randomly selected from the same WHO material. Group mean audiograms showed that hearing was similar in both groups, with a moderate high frequency hearing loss having a configuration suggestive of a noise-induced hearing loss. Analysis of the individual histories and the pure-tone audiograms showed that noise was the most predominant factor influencing hearing at any specific frequency or combination of frequencies. There was a statistically significant tendency for the high-cholesterol group that had suffered the most noise exposure, to have a high-frequency hearing loss. There was also a tendency for the low-cholesterol group to have a high-frequency loss if they had been excessively exposed to occupational noise. No further correlations were found. The present results indicate a slightly increased risk of acquiring a high-frequency sensorineural hearing loss for people who work in noisy environments and have high serum cholesterol levels.