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

Association between residential proximity to major roadways and chronic multimorbidity among Chinese older adults: a nationwide cross-sectional study

BACKGROUND

Multiple negative health outcomes were linked to residential proximity to major roadways. Nevertheless, there is limited knowledge regarding the association between residential proximity to major roadways and chronic multimorbidity.

METHODS

We used data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, which included 12,214 individuals aged ≥ 60. We derived the residential proximity to major roadways from self-reported data, defining chronic multimorbidity as the presence of two or more concurrent chronic diseases. A binary logistic regression model was utilized to investigate the association between residential proximity to major roadways and chronic multimorbidity. The model accounted for some demographic features, socioeconomic conditions, social participation, and health conditions. Subsequently, we conducted subgroup analyses to examine potential interaction effects.

RESULTS

Residential proximity to major roadways was associated with chronic multimorbidity, even after adjusting for confounding factors. Compared with those living > 300 m from major roadways, the OR for those living 201-300 m, 101-200 m, 50-100 m, and < 50 m were increased. When subgroup analyses were conducted using a cutoff point of 200 m, the risk of chronic multimorbidity associated with residential proximity to major roadways was stronger in participants with education levels > 6 years (P = 0.017).

CONCLUSION

Our findings provide important implications for improving residential area siting, transportation policies, and environmental regulations to reduce the risk of chronic multimorbidity caused by traffic-related exposure.

Occupational and Environmental Noise Exposure and Extra-Auditory Effects on Humans: A Systematic Literature Review

Noise is a common harmful factor in our work and the environment. Most studies have investigated the auditory effects of noise exposure; however, few studies have focused on the extra-auditory effects of exposure to occupational or environmental noise. This study aimed to systematically review published studies on the extra-auditory effects of noise exposure. We reviewed literature from PubMed and Google Scholar databases up to July 2022, using the Patient, Intervention, Comparison, and Outcome criteria and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify studies that reported extra-auditory effects of occupational or environmental noise exposure. Studies were evaluated utilizing validated reporting tools (CONSORT, STROBE) appropriate to study design. A total of 263 articles were identified, of which 36 were finally selected and reviewed. Upon conducting a review of the articles, exposure to noise can elicit a variety of extra-auditory effects on humans. These effects include circulatory effects linked to higher risk of cardiovascular disease and decreased endothelial function, nervous system effects correlated with sleep disturbance, cognitive impairment, and mental health problems, immunological and endocrinal effects connected to increased physiological stress response and metabolic disorders, oncological and respiratory effects associated with an elevated risk of acoustic neuroma and respiratory disorders, gastrointestinal effects linked to an increased risk of gastric or duodenal ulcer, and obstetric effects connected to the risk of preterm birth. Our review suggests that there are numerous extra-auditory effects of noise exposure on human, and further investigations are needed to fully understand these effects.

Measured effects of workload and auditory feedback on remote pilot task performance

Absent or reduced sensory cueing can deprive pilots operating remotely piloted aircraft beyond visual line of sight (BVLOS) of vital information necessary for safe flight. The present study tested the effects of real-time auditory feedback on remote pilot perception and decision-making task performance in an automated BVLOS flight, under three levels of workload (Low, Moderate and High). Results from 36 participants revealed workload and auditory feedback influenced perception task performance in terms of error type count, with misses more frequent than wrong identifications. In terms of performance in the decision-making task, under low and moderate levels of workload, auditory feedback was found to improve performance. Conversely, under high workloads, an inflexion or tipping point occurred whereby auditory feedback became detrimental to task performance. These results correspond with the expected behavioural responses to external stressors as predicted by the Arousal and Maximal Adaptability theory, and build upon previous findings related to workload, auditory feedback and remote pilot task performance. Practitioner summary: This study tested the effect of real-time auditory feedback and dynamic workloads on remote pilots' task performance. Auditory feedback and workload each influenced the perception tasks in terms of error types committed. Auditory feedback improved decision-making task performance under low and moderate workloads, and reduced performance under high workloads. These results may benefit practitioners by considering the nuanced effects of auditory feedback on human task performance within sensory deprived working environments, including those utilising teleoperated systems.

Road traffic noise impacts sleep continuity in suburban residents: Exposure-response quantification of noise-induced awakenings from vehicle pass-bys at night

Nocturnal traffic noise has been associated with adverse health outcomes in exposed residents. Precise quantification of traffic noise effects on sleep is thus of great importance. Here we establish an exposure-response relationship for the awakening probability due to intermittent road traffic noise in suburban residents. We conducted a field study in residential areas where road traffic was the dominant noise source, and noise events were attributable to separate vehicle pass-bys. Forty healthy participants underwent polysomnography for five consecutive nights at their homes. A total of 11,003 road traffic noises derived from simultaneous acoustic measurements at the sleepers' ears were included in an event-related analysis of awakenings. Logistic regression analysis revealed that the awakening probability due to road traffic noise increased with the maximum sound pressure level (SPL) and the maximum slope of the increasing SPL of a vehicle pass-by, as well as the age of the exposed individual. Compared to sleep stage 2, the awakening probability was higher in rapid eye movement sleep (REMS) and lower in slow wave sleep (SWS). The protective effect of both stage 2 and SWS against awakenings decreased with age, whereas no age-dependent change was observed for REMS. When adjusting for other contributing factors, the probability of a noise-induced awakening ranged from 0% at a maximum SPL of 27.1 dB(A) to 2.0% at 70 dB(A). Road traffic noise at night - even in suburban areas with moderate traffic density - negatively impacts residents' sleep continuity. Exposure-response quantification for traffic noise-induced awakenings may serve as a basis for noise protection efforts by regulators and policy makers.

Bottom-Up and Top-Down Attention Impairment Induced by Long-Term Exposure to Noise in the Absence of Threshold Shifts

Objective

We aimed to assess the effect of noise exposure on bottom-up and top-down attention functions in industrial workers based on behavioral and brain responses recorded by the multichannel electroencephalogram (EEG).

Method

In this cross-sectional study, 563 shipyard noise-exposed workers with clinical normal hearing were recruited for cognitive testing. Personal cumulative noise exposure (CNE) was calculated with the long-term equivalent noise level and employment duration. The performance of cognitive tests was compared between the high CNE group (H-CNE, >92.2) and the low CNE group; additionally, brain responses were recorded with a 256-channel EEG from a subgroup of 20 noise-exposed (NG) workers, who were selected from the cohort with a pure tone threshold <25 dB HL from 0.25 to 16 kHz and 20 healthy controls matched for age, sex, and education. P300 and mismatch negativity (MMN) evoked by auditory stimuli were obtained to evaluate the top-down and bottom-up attention functions. The sources of P300 and MMN were investigated using GeoSource.

Results

The total score of the cognitive test (24.55 ± 3.71 vs. 25.32 ± 2.62, p < 0.01) and the subscale of attention score (5.43 ± 1.02 vs. 5.62 ± 0.67, p < 0.001) were significantly lower in the H-CNE group than in the L-CNE group. The attention score has the fastest decline of all the cognitive domain dimensions (slope = -0.03 in individuals under 40 years old, p < 0.001; slope = -0.06 in individuals older than 40 years old, p < 0.001). When NG was compared with controls, the P300 amplitude was significantly decreased in NG at Cz (3.9 ± 2.1 vs. 6.7 ± 2.3 μV, p < 0.001). In addition, the latency of P300 (390.7 ± 12.1 vs. 369.4 ± 7.5 ms, p < 0.001) and MMN (172.8 ± 15.5 vs. 157.8 ± 10.5 ms, p < 0.01) was significantly prolonged in NG compared with controls. The source for MMN for controls was in the left BA11, whereas the noise exposure group's source was lateralized to the BA20.

Conclusion

Long-term exposure to noise deteriorated the bottom-up and top-down attention functions even in the absence of threshold shifts, as evidenced by behavioral and brain responses.

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.

The effects of psychological risk factors at work on cognitive failures through the accident proneness

BACKGROUND

Various agents such as psychosocial items and accident proneness can affect cognitive failures through different paths. The probable paths are the direct effects of workplace psychosocial items on cognitive failures and their indirect effects on cognitive failures through the mediator variable of accident proneness, which has not yet been studied by others. Thus, the present study aimed to investigate these paths.

METHODS

This cross-sectional study was conducted on 164 male employees of Karoon Sugar Company in 2018. The participants were asked to complete a background and demographic questionnaire, Broadbent cognitive failures scale, accident proneness questionnaire, and Copenhagen psychosocial questionnaire. Obtained data were analyzed and modeled using the statistical descriptive method, ANOVA, independent t-test, Pearson correlation test, and path analysis in the SPSS and AMOS software.

RESULTS

The results of the path analysis showed that, not only, some psychosocial risk items had a significant direct effect on cognitive failures, but also, they could affect cognitive failures through the accident proneness, indirectly. Work-family conflict and social support from supervisors by coefficients of 0.188 and - 0.187 had the highest direct effects, respectively. The highest indirect effects belonged to justice and respect, and work-family conflict by coefficients of - 0.220 and 0.199, respectively. The highest total effects were also related to the work-family conflict and justice and respect by coefficients of 0.387 and - 0.381, respectively.

CONCLUSIONS

In total, our results showed that some psychological items could, directly and indirectly, increase cognitive failure through accident proneness.

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.

The role of depressive symptoms within the association of long-term exposure to indoor and outdoor traffic noise and cognitive function - Results from the Heinz Nixdorf Recall study

OBJECTIVES

Traffic noise is negatively associated with cognitive function, and its perception can differ between depressed and non-depressed people. We studied the role of depressive symptoms in the association between traffic noise and cognitive function. We studied the role of depressive symptoms in the association between traffic noise and cognitive function.

METHODS

During the first follow-up examination (2006-2008) of the German Heinz Nixdorf Recall study, cognitive function (five subtests and an additive global summary score, GCS) and depressive symptoms (CES-D score) were assessed in 2745 participants (aged 50-80, 49.8% women). Mild cognitive impairment (MCI) was diagnosed according to the Petersen criteria in 380 participants. Long-term exposure to traffic noise was modeled as weighted 24-h mean (L_DEN) and night-time mean (L_NIGHT) at the façade of the baseline addresses, and was corrected for indoors (L_{DEN_IN} and L_{NIGHT_IN}). We developed multiple linear and logistic regression models adjusted for individual-level characteristics to investigate cross-sectionally the role of depressive symptoms in the association of traffic noise with cognitive function.

RESULTS

Overall, 8.6% participants had depressive symptoms. The median noise values were L_DEN 52.1 dB(A) and L_{DEN_IN} 34.7 dB(A). Associations were slightly stronger for cognitive subtests in those with severe depression (CES-D>21), i.e., per 10 dB(A) L_DEN and verbal fluency: β = -0.04 [-0.11; 0.03] for CES-D≤21 and β = -0.09 [-0.24; -0.06] for CES-D>21. Additional adjustment of the main model for CES-D did not change the association between noise and cognitive outcomes. Estimates using indoor noise exposure were generally stronger and more precise.

CONCLUSIONS

Depressed people may be more susceptible to adverse effects of noise than non-depressed. Modeled estimates of indoor noise exposure is possibly a more appropriate measure of exposure.

Adrenergic alpha-2 receptor antagonists cease augmented oxidation of plasma proteins and anxiety of rats caused by chronic noise exposure

BACKGROUND

Noise is one of the environmental factors, which is considered as a powerful stressor for the organism. Generally, the acoustic stress affects the behavior and physiological state of humans and animals.

AIMS

The goal of this study is to investigate the relationship between chronic noise exposure and the effects of adrenergic alpha-2 receptor antagonists, beditin and mesedin, on the anxiety and oxidation of plasma proteins and fibrinogen in rats.

METHODS

The experiments were carried out on non-linear albino male rats, divided into four groups (six animals in each): 1. Healthy controls 2. Exposed to noise of a level 91 dB(A), eight hours daily, during 7, 30 and 60 days; 3. Injected with 2 mg/kg of beditin (2-(2-amino-4-thiazolyl)-1,4-benzodioxane hydrochloride)); 4. Injected with 10 mg/kg mesedin (2-(2-methyl-amino-thiozolyl)-1,4-benzodioxane hydrochloride). For evaluating the cognitive impairment, the Any-maze test was applied. The level of carbonylation of proteins was assessed by reaction with 2,4-dinitrophenylhydrazine, spectrophotometrically.

RESULTS

Chronic noise decreased locomotor activity and increased anxiety and oxidation of plasma protein and fibrinogen. Intensity of these changes were dependent on the duration of noise exposure.

CONCLUSION

The Alpha 2 adrenoblockers alleviate oxidative modification of plasma proteins and reduce the cognitive impairment caused by chronic exposure to noise.

The Effect of Noise Exposure on Cognitive Performance and Brain Activity Patterns

BACKGROUND

It seems qualitative measurements of subjective reactions are not appropriate indicators to assess the effect of noise on cognitive performance.

AIM

In this study, quantitative and combined indicators were applied to study the effect of noise on cognitive performance.

MATERIAL AND METHODS

A total of 54 young subjects were included in this experimental study. The participants' mental workload and attention were evaluated under different levels of noise exposure including, background noise, 75, 85 and 95 dBA noise levels. The study subject's EEG signals were recorded for 10 minutes while they were performing the IVA test. The EEG signals were used to estimate the relative power of their brain frequency bands.

RESULTS

Results revealed that mental workload and visual/auditory attention is significantly reduced when the participants are exposed to noise at 95 dBA level (P < 0.05). Results also showed that with the rise in noise levels, the relative power of the Alpha band increases while the relative power of the Beta band decreases as compared to background noise. The most prominent change in the relative power of the Alpha and Beta bands occurs in the occipital and frontal regions of the brain respectively.

CONCLUSION

The application of new indicators, including brain signal analysis and power spectral density analysis, is strongly recommended in the assessment of cognitive performance during noise exposure. Further studies are suggested regarding the effects of other psychoacoustic parameters such as tonality, noise pitch (treble or bass) at extended exposure levels.

Road Traffic Noise at the Residence, Annoyance, and Cognitive Function in Elderly Women

The detrimental effects of traffic noise on cognition in children are well documented. Not much is known about the health effects in adults. We investigated the association of residential exposure to road traffic noise and annoyance due to road traffic noise with cognitive function in a cohort of 288 elderly women from the longitudinal Study on the influence of Air pollution on Lung function, Inflammation and Aging (SALIA) in Germany. Residential noise levels-weighted 24-h mean (LDEN) and nighttime noise (LNIGHT)-were modeled for the most exposed facade of dwellings and dichotomized at ≥50 dB(A). Traffic noise annoyance (day and night) was estimated by questionnaire. Cognitive function was assessed using the Consortium to Establish a Registry on Alzheimer's Disease (CERAD-Plus) Neuropsychological Assessment Battery. The modeled noise levels were associated with impaired total cognition and the constructional praxis domain, independently of air pollution. Self-reported noise annoyance was associated with better performance in semantic memory and constructional praxis domains. This finding should be interpreted with caution since we could not control for potential confounding by hearing loss. Noise levels and annoyance were associated, but their health effects seemed mutually independent.

Comparing the Effects of Road, Railway, and Aircraft Noise on Sleep: Exposure⁻Response Relationships from Pooled Data of Three Laboratory Studies

Objectives: Air, road, and railway traffic, the three major sources of traffic noise, have been reported to differently impact on annoyance. However, these findings may not be transferable to physiological reactions during sleep which are considered to decrease nighttime recovery and might mediate long-term negative health effects. Studies on awakenings from sleep indicate that railway noise, while having the least impact on annoyance, may have the most disturbing properties on sleep compared to aircraft noise. This study presents a comparison between the three major traffic modes and their probability to cause awakenings. In combining acoustical and polysomnographical data from three laboratory studies sample size and generalizability of the findings were increased. Methods: Data from three laboratory studies were pooled, conducted at two sites in Germany (German Aerospace Center, Cologne, and Leibniz Research Centre for Working Environment and Human Factors, Dortmund). In total, the impact of 109,836 noise events on polysomnographically assessed awakenings was analyzed in 237 subjects using a random intercept logistic regression model. Results: The best model fit according to the Akaike Information Criterion (AIC) included different acoustical and sleep parameters. After adjusting for these moderators results showed that the probability to wake up from equal maximum A-weighted sound pressure levels (SPL) increased in the order aircraft < road < railway noise, the awakening probability from road and railway noise being not significantly different (p = 0.988). At 70 dB SPL, it was more than 7% less probable to wake up due to aircraft noise than due to railway noise. Conclusions: The three major traffic noise sources differ in their impact on sleep. The order with which their impact increased was inversed compared to the order that was found in annoyance surveys. It is thus important to choose the correct concept for noise legislation, i.e., physiological sleep metrics in addition to noise annoyance for nighttime noise protection.

The effect of aircraft, road, and railway traffic noise on stroke - results of a case-control study based on secondary data

AIM

To examine the stroke risks associated with aircraft, road traffic, and railway noise exposure in a large case-control study.

MATERIALS AND METHODS

All people aged ≥40 years living around the Frankfurt airport that were insured by one of three large statutory health insurance funds between 2005 and 2010 were included in the study (n = 1,026,670). Address-specific exposure to aircraft, road, and railway traffic noise was estimated for 2005. We used insurance claim data to identify 25,495 newly diagnosed cases of stroke between 2006 and 2010 and compared them with 827,601 control participants. Logistic regression analysis was used to calculate the odds ratios adjusted for age, sex, local proportion of people receiving unemployment benefits, and if available individual indicators of socioeconomic status (education, occupation).

RESULTS

For 24-h continuous aircraft noise exposure, neither increased risk estimates nor a positive linear exposure-risk relation was found. However, stroke risk was statistically significantly increased by 7% [95% confidence intervals (95%CI): 2-13%] for people who were exposed to <40 dB of 24-h continuous aircraft noise, but ≥6 events of maximum nightly sound pressure levels ≥50 dB. For road and railway traffic noise, there was a positive linear exposure-risk relation: Per 10 dB the stroke risk increased by 1.7% (95%CI: 0.3-3.2%) for road traffic noise and by 1.8% (95%CI: 0.1-3.3%) for railway traffic noise. The maximum risk increase of 7% (95%CI: 0-14%) for road traffic noise and 18% (95%CI: 2-38%) for railway traffic noise was found in the exposure category ≥65 to <70 dB.

CONCLUSION

This large case-control study indicates that traffic noise exposure may lead to an increase in stroke risk. It furthermore suggests that maximum aircraft noise levels at night increase the stroke risk even when continuous noise exposure is low, and thus highlights the relevance of maximum noise levels for research and policies on noise protection.

The Adverse Effects of Environmental Noise Exposure on Oxidative Stress and Cardiovascular Risk

Epidemiological studies have provided evidence that traffic noise exposure is linked to cardiovascular diseases such as arterial hypertension, myocardial infarction, and stroke. Noise is a nonspecific stressor that activates the autonomous nervous system and endocrine signaling. According to the noise reaction model introduced by Babisch and colleagues, chronic low levels of noise can cause so-called nonauditory effects, such as disturbances of activity, sleep, and communication, which can trigger a number of emotional responses, including annoyance and subsequent stress. Chronic stress in turn is associated with cardiovascular risk factors, comprising increased blood pressure and dyslipidemia, increased blood viscosity and blood glucose, and activation of blood clotting factors, in animal models and humans. Persistent chronic noise exposure increases the risk of cardiometabolic diseases, including arterial hypertension, coronary artery disease, diabetes mellitus type 2, and stroke. Recently, we demonstrated that aircraft noise exposure during nighttime can induce endothelial dysfunction in healthy subjects and is even more pronounced in coronary artery disease patients. Importantly, impaired endothelial function was ameliorated by acute oral treatment with the antioxidant vitamin C, suggesting that excessive production of reactive oxygen species contributes to this phenomenon. More recently, we introduced a novel animal model of aircraft noise exposure characterizing the underlying molecular mechanisms leading to noise-dependent adverse oxidative stress-related effects on the vasculature. With the present review, we want to provide an overview of epidemiological, translational clinical, and preclinical noise research addressing the nonauditory, adverse effects of noise exposure with focus on oxidative stress. Antioxid. Redox Signal. 28, 873-908.

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

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

Environmental stressors and cardio-metabolic disease: part II-mechanistic insights

Environmental factors can act as facilitators of chronic non-communicable diseases. Ambient noise and air pollution collectively outrank all other environmental risk factors in importance, contributing to over 75% of the disease and disability burden associated with known environmental risk factors. In the first part of this review, we discussed the global burden and epidemiologic evidence supporting the importance of these novel risk factors as facilitators of cardiometabolic disease. In this part, we will discuss pathophysiological mechanisms responsible for noise and air pollution-mediated effects. Akin to traditional cardiovascular risk factors, a considerable body of evidence suggests that these environmental agents induce low-grade inflammation, oxidative stress, vascular dysfunction, and autonomic nervous system imbalance, thereby facilitating the development of diseases such as hypertension and diabetes. Through their impact on traditional risk factors and via additional novel mechanisms, environmental risk factors may have much larger impact on cardiovascular events than currently appreciated. In the second part of this review, we discuss deficiencies and gaps in knowledge and opportunities for new research.

Aviation Noise Impacts: State of the Science

Noise is defined as “unwanted sound.” Aircraft noise is one, if not the most detrimental environmental effect of aviation. It can cause community annoyance, disrupt sleep, adversely affect academic performance of children, and could increase the risk for cardiovascular disease of people living in the vicinity of airports. In some airports, noise constrains air traffic growth. This consensus paper was prepared by the Impacts of Science Group of the Committee for Aviation Environmental Protection of the International Civil Aviation Organization and summarizes the state of the science of noise effects research in the areas of noise measurement and prediction, community annoyance, children’s learning, sleep disturbance, and health. It also briefly discusses civilian supersonic aircraft as a future source of aviation noise.

A Population-Based Study on Nighttime Road Traffic Noise and Insomnia

Study Objectives

The aims of the present study were to investigate how nighttime road traffic noise relates to self-reported symptoms of insomnia and sleep medication use.

Methods

We used questionnaire data from the population-based study Health and Environment in Oslo (HELMILO) (2009-2010; n = 13019). The insomnia symptoms difficulties falling asleep, awakenings during the night, and waking up too early in the morning as well as self-reported sleep medication use were included as outcomes. Modeled noise levels (Lnight) were assigned to each participant's home address. For selecting covariates to the statistical model, we used a directed acyclic graph. The associations between noise and sleep were analyzed using logistic regression models.

Results

After adjustment for potential confounders, we found an odds ratio (OR) of 1.05 (95% confidence interval [CI]: 1.01-1.09) for the association between traffic noise and difficulties falling asleep, in the total study population. For the association between traffic noise and awakenings during the night, the OR was 1.04 (95% CI: 1.00-1.08) and for waking up too early, the OR was 1.06 (95% CI: 1.02-1.11). The effect estimates are given per 5-dB increase in traffic noise level (Lnight). Self-reported sleep medication use was not statistically significantly associated with traffic noise exposure.

Conclusions

In an adult population from Oslo, traffic noise was associated with difficulties falling asleep and waking up too early. These findings indicate that sleep quantity may be compromised for individuals living in areas highly exposed to nighttime traffic noise.

The influence of acoustical and non-acoustical factors on short-term annoyance due to aircraft noise in the field - The COSMA study

BACKGROUND

Air traffic has increased for the past decades and is forecasted to continue to grow. Noise due to current airport operations can impair the physical and psychological well-being of airport residents.

OBJECTIVES

The field study investigated aircraft noise-induced short-term (i.e., within hourly intervals) annoyance in local residents near a busy airport. We aimed at examining the contribution of acoustical and non-acoustical factors to the annoyance rating.

METHODS

Across four days from getting up till going to bed, 55 residents near Cologne/Bonn Airport (M=46years, SD=14years, 34 female) rated their annoyance due to aircraft noise at hourly intervals. For each participant and each hour, 26 noise metrics from outdoor measurements and further 6 individualized metrics that took into account the sound attenuation due to each person's whereabouts in and around their homes were obtained. Non-acoustical variables were differentiated into situational factors (time of day, performed activity during past hour, day of the week) and personal factors (e.g., sensitivity to noise, attitudes, domestic noise insulation). Generalized Estimation Equations were applied for the development of a prediction model for annoyance.

RESULTS

Acoustical factors explained only a small proportion (13.7%) of the variance in the annoyance ratings. The number of fly-overs predicted annoyance better than did equivalent and maximum sound pressure levels. The proportion of explained variance in annoyance rose considerably (to 27.6%) when individualized noise metrics as well as situational and personal variables were included in the prediction model.

CONCLUSIONS

Consideration of noise metrics related to the number of fly-overs and individual adjustment of noise metrics can improve the prediction of short-term annoyance compared to models using equivalent outdoor levels only. Non-acoustical factors have remarkable impact not only on long-term annoyance as shown before but also on short-term annoyance judged in the home environment.

The effects of different noise types on heart rate variability in men

PURPOSE

To determine the impact of noise on heart rate variability (HRV) in men, with a focus on the noise type rather than on noise intensity.

MATERIALS AND METHODS

Forty college-going male volunteers were enrolled in this study and were randomly divided into four groups according to the type of noise they were exposed to: background, traffic, speech, or mixed (traffic and speech) noise. All groups except the background group (35 dB) were exposed to 45 dB sound pressure levels. We collected data on age, smoking status, alcohol consumption, and disease status from responses to self-reported questionnaires and medical examinations. We also measured HRV parameters and blood pressure levels before and after exposure to noise. The HRV parameters were evaluated while patients remained seated for 5 minutes, and frequency and time domain analyses were then performed.

RESULTS

After noise exposure, only the speech noise group showed a reduced low frequency (LF) value, reflecting the activity of both the sympathetic and parasympathetic nervous systems. The low-to-high frequency (LF/HF) ratio, which reflected the activity of the autonomic nervous system (ANS), became more stable, decreasing from 5.21 to 1.37; however, this change was not statistically significant.

CONCLUSION

These results indicate that 45 dB(A) of noise, 10 dB(A) higher than background noise, affects the ANS. Additionally, the impact on HRV activity might differ according to the noise quality. Further studies will be required to ascertain the role of noise type.

Environmental noise and sleep disturbances: A threat to health?

Environmental noise, especially that caused by transportation means, is viewed as a significant cause of sleep disturbances. Poor sleep causes endocrine and metabolic measurable perturbations and is associated with a number of cardiometabolic, psychiatric and social negative outcomes both in adults and children. Nocturnal environmental noise also provokes measurable biological changes in the form of a stress response, and clearly affects sleep architecture, as well as subjective sleep quality. These sleep perturbations are similar in their nature to those observed in endogenous sleep disorders. Apart from these measurable effects and the subjective feeling of disturbed sleep, people who struggle with nocturnal environmental noise often also suffer the next day from daytime sleepiness and tiredness, annoyance, mood changes as well as decreased well-being and cognitive performance. But there is also emerging evidence that these short-term effects of environmental noise, particularly when the exposure is nocturnal, may be followed by long-term adverse cardiometabolic outcomes. Nocturnal environmental noise may be the most worrying form of noise pollution in terms of its health consequences because of its synergistic direct and indirect (through sleep disturbances acting as a mediator) influence on biological systems. Duration and quality of sleep should thus be regarded as risk factors or markers significantly influenced by the environment and possibly amenable to modification through both education and counseling as well as through measures of public health. One of the means that should be proposed is avoidance at all costs of sleep disruptions caused by environmental noise.

Effect of long-term outdoor air pollution and noise on cognitive and psychological functions in adults

It has been hypothesized that air pollution and ambient noise might impact neurocognitive function. Early studies mostly investigated the associations of air pollution and ambient noise exposure with cognitive development in children. More recently, several studies investigating associations with neurocognitive function, mood disorders, and neurodegenerative disease in adult populations were published, yielding inconsistent results. The purpose of this review is to summarize the current evidence on air pollution and noise effects on mental health in adults. We included studies in adult populations (≥18 years old) published in English language in peer-reviewed journals. Fifteen articles related to long-term effects of air pollution and eight articles on long-term effects of ambient noise were extracted. Both exposures were separately shown to be associated with one or several measures of global cognitive function, verbal and nonverbal learning and memory, activities of daily living, depressive symptoms, elevated anxiety, and nuisance. No study considered both exposures simultaneously and few studies investigated progression of neurocognitive decline or psychological factors. The existing evidence generally supports associations of environmental factors with mental health, but does not suffice for an overall conclusion about the independent effect of air pollution and noise. There is a need for studies investigating simultaneously air pollution and noise exposures in association mental health, for longitudinal studies to corroborate findings from cross-sectional analyses, and for parallel toxicological and epidemiological studies to elucidate mechanisms and pathways of action.

Effects of one night of induced night-wakings versus sleep restriction on sustained attention and mood: a pilot study

OBJECTIVE

Despite their high prevalence in daily life, repeated night-wakings and their cognitive and emotional consequences have received less research attention compared to other types of sleep disturbances. Our aim was to experimentally compare the effects of one night of induced infrequent night-wakings (of ∼15 min, each requiring a purposeful response) and sleep restriction on sustained attention and mood in young adults.

METHODS

In a within-between subjects counterbalanced design, 61 healthy adults (40 females; aged 20-29 years) underwent home assessments of sustained attention and self-reported mood at two times: after a normal (control) sleep night, and after a night of either sleep restriction (4h in bed) or induced night-wakings (four prolonged awakenings across 8h in bed). Sleep was monitored using actigraphy and sleep diaries. Sustained attention was assessed using an online continuous performance test (OCPT), and mood was reported online using the Profile of Mood States (POMS).

RESULTS

Actigraphic data revealed good compliance with experimental sleep requirements. Induced night-wakings and sleep restriction both resulted in more OCPT omission and commission errors, and in increased depression, fatigue and confusion levels and reduced vigor compared to the normal sleep night. Moreover, there were no significant differences between the consequences of induced awakenings and sleep restriction.

CONCLUSIONS

Our pilot study indicates that, similar to sleep restriction, one night of life-like repeated night-wakings negatively affects mood and sustained attention.

Auditory and non-auditory effects of noise on health

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

Cardiovascular effects of environmental noise exposure

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

Nocturnal air, road, and rail traffic noise and daytime cognitive performance and annoyance

Various studies indicate that at the same noise level and during the daytime, annoyance increases in the order of rail, road, and aircraft noise. The present study investigates if the same ranking can be found for annoyance to nocturnal exposure and next day cognitive performance. Annoyance ratings and performance change during combined noise exposure were also tested. In the laboratory 72 participants were exposed to air, road, or rail traffic noise and all combinations. The number of noise events and LAS,eq were kept constant. Each morning noise annoyance questionnaires and performance tasks were administered. Aircraft noise annoyance ranked first followed by railway and road noise. A possible explanation is the longer duration of aircraft noise events used in this study compared to road and railway noise events. In contrast to road and rail traffic, aircraft noise annoyance was higher after nights with combined exposure. Pooled noise exposure data showed small but significant impairments in reaction times (6 ms) compared to nights without noise. The noise sources did not have a differential impact on performance. Combined exposure to multiple traffic noise sources did not induce stronger impairments than a single noise source. This was reflected also in low workload ratings.

Aircraft noise, health, and residential sorting: evidence from two quasi-experiments

We explore two unexpected changes in flight regulations to estimate the causal effect of aircraft noise on health. Detailed measures of noise are linked with longitudinal data on individual health outcomes based on the exact address information. Controlling for individual heterogeneity and spatial sorting into different neighborhoods, we find that aircraft noise significantly increases sleeping problems and headaches. Models that do not control for such heterogeneity and sorting substantially underestimate the negative health effects, which suggests that individuals self-select into residence based on their unobserved sensitivity to noise. Our study demonstrates that the combination of quasi-experimental variation and panel data is very powerful for identifying causal effects in epidemiological field studies.

Effect of nighttime aircraft noise exposure on endothelial function and stress hormone release in healthy adults

AIMS

Aircraft noise disturbs sleep, and long-term exposure has been shown to be associated with increases in the prevalence of hypertension and an overall increased risk for myocardial infarction. The exact mechanisms responsible for these cardiovascular effects remain unclear.

METHODS AND RESULTS

We performed a blinded field study in 75 healthy volunteers (mean age 26 years), who were exposed at home, in random order, to one control pattern (no noise) and two different noise scenarios [30 or 60 aircraft noise events per night with an average maximum sound pressure level (SPL) of 60 dB(A)] for one night each. We performed polygraphy during each study night. Noise caused a worsening in sleep quality (P < 0.0001). Noise60, corresponding to equivalent continuous SPLs of 46.3 dB (Leq) and representing environmental noise levels associated with increased cardiovascular events, caused a blunting in FMD (P = 0.016). As well, although a direct comparison among the FMD values in the noise groups (control: 10.4 ± 3.8%; Noise30: 9.7 ± 4.1%; Noise60: 9.5 ± 4.3%, P = 0.052) did not reach significance, a monotone dose-dependent effect of noise level on FMD was shown (P = 0.020). Finally, there was a priming effect of noise, i.e. the blunting in FMD was particularly evident when subjects were exposed first to 30 and then to 60 noise events (P = 0.006). Noise-induced endothelial dysfunction (ED) was reversed by the administration of Vitamin C (P = 0.0171). Morning adrenaline concentration increased from 28.3 ± 10.9 to 33.2 ± 16.6 and 34.1 ± 19.3 ng/L (P = 0.0099). Pulse transit time, reflecting arterial stiffness, was also shorter after exposure to noise (P = 0.003).

CONCLUSION

In healthy adults, acute nighttime aircraft noise exposure dose-dependently impairs endothelial function and stimulates adrenaline release. Noise-induced ED may be in part due to increased production in reactive oxygen species and may thus be one mechanism contributing to the observed association of chronic noise exposure with cardiovascular disease.

Impact of wind turbine sound on annoyance, self-reported sleep disturbance and psychological distress

PURPOSE OF THE RESEARCH

The present government in the Netherlands intends to realize a substantial growth of wind energy before 2020, both onshore and offshore. Wind turbines, when positioned in the neighborhood of residents may cause visual annoyance and noise annoyance. Studies on other environmental sound sources, such as railway, road traffic, industry and aircraft noise show that (long-term) exposure to sound can have negative effects other than annoyance from noise. This study aims to elucidate the relation between exposure to the sound of wind turbines and annoyance, self-reported sleep disturbance and psychological distress of people that live in their vicinity. Data were gathered by questionnaire that was sent by mail to a representative sample of residents of the Netherlands living in the vicinity of wind turbines

PRINCIPAL RESULTS

A dose-response relationship was found between immission levels of wind turbine sound and selfreported noise annoyance. Sound exposure was also related to sleep disturbance and psychological distress among those who reported that they could hear the sound, however not directly but with noise annoyance acting as a mediator. Respondents living in areas with other background sounds were less affected than respondents in quiet areas.

MAJOR CONCLUSIONS

People living in the vicinity of wind turbines are at risk of being annoyed by the noise, an adverse effect in itself. Noise annoyance in turn could lead to sleep disturbance and psychological distress. No direct effects of wind turbine noise on sleep disturbance or psychological stress has been demonstrated, which means that residents, who do not hear the sound, or do not feel disturbed, are not adversely affected.

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

BACKGROUND

Traffic noise is interfering during day- and nighttime causing distress and adverse physiological reactions in large parts of the population. Railway noise proved less annoying than aircraft noise in surveys which were the bases for a so called 5 dB railway bonus regarding noise protection in many European countries.

OBJECTIVES

The present field study investigated railway noise-induced awakenings during sleep, nighttime annoyance and the impact on performance the following day. Comparing these results with those from a field study on aircraft noise allowed for a ranking of traffic modes concerning physiological and psychological reactions.

METHODS

33 participants (mean age 36.2 years ± 10.3 (SD); 22 females) living alongside railway tracks around Cologne/Bonn (Germany) were polysomnographically investigated. These data were pooled with data from a field study on aircraft noise (61 subjects) directly comparing the effects of railway and aircraft noise in one random subject effects logistic regression model. Annoyance was rated in the morning evaluating the previous night.

RESULTS

Probability of sleep stage changes to wake/S1 from railway noise increased significantly from 6.5% at 35 dB(A) to 20.5% at 80 dB(A) LAFmax. Rise time of noise events had a significant impact on awakening probability. Nocturnal railway noise led to significantly higher awakening probabilities than aircraft noise, partly explained by the different rise times, whereas the order was inversed for annoyance. Freight train noise compared to passenger train noise proved to have the most impact on awakening probability. Nocturnal railway noise had no effect on psychomotor vigilance.

CONCLUSIONS

Nocturnal freight train noise exposure in Germany was associated with increased awakening probabilities exceeding those for aircraft noise and contrasting the findings of many annoyance surveys and annoyance ratings of our study. During nighttime a bonus for railway noise seems not appropriate.

[Influence of environmental noise on sleep quality and sleeping disorders-implications for health]

Environmental noise is a well-known risk factor influencing sleep-wake behavior and sleep quality. Epidemiologic studies have shown that environmental noise is regarded as the most annoying environmental factor. Noise causes modifications in physiologic and mental functions and may result in health outcomes like elevated blood pressure and ischemic heart disease. Reactions to high sound levels during sleep are decreased sleep intensity, arousals, and increased stress hormone secretion. Effects of poor sleep quality are reduced cognitive performance, tiredness, and psychosomatic symptoms. Long-term consequences of recurrent sleep loss due to environmental noise may be heart disease and increased medication intake. Arousals occur especially due to single noise events and intermittent noise. Laboratory and field studies showed no habituation of physiologic parameters to high sound levels. Sleep is especially sensitive to noise; therefore, sound levels during nighttime should be much lower than during daytime.

Total sleep deprivation, chronic sleep restriction and sleep disruption

Sleep loss may result from total sleep deprivation (such as a shift worker might experience), chronic sleep restriction (due to work, medical conditions or lifestyle) or sleep disruption (which is common in sleep disorders such as sleep apnea or restless legs syndrome). Total sleep deprivation has been widely researched, and its effects have been well described. Chronic sleep restriction and sleep disruption (also known as sleep fragmentation) have received less experimental attention. Recently, there has been increasing interest in sleep restriction and disruption as it has been recognized that they have a similar impact on cognitive functioning as a period of total sleep deprivation. Sleep loss causes impairments in cognitive performance and simulated driving and induces sleepiness, fatigue and mood changes. This review examines recent research on the effects of sleep deprivation, restriction and disruption on cognition and neurophysiologic functioning in healthy adults, and contrasts the similarities and differences between these three modalities of sleep loss.