The influence of stressors on biochemical reactions--a review of present scientific findings with noise

The Modern Environment: The New Secondary Cause of Hypertension?

The most important risk factor for cardiovascular disease, the leading cause of death worldwide, is hypertension. Although most cases of hypertension are thought to be essential, the multifactorial associations of the environmental influence on blood pressure seem to play an important role and should be more closely investigated. This review attempts to focus on the recent literature that examines the environmental effects on arterial blood pressure and its management. Seasonal variability and the role of ambient temperature, either occupational or recreational noise pollution, as well as obesity due to environment-caused dietary habits, are recognized as important risk factors, affecting the onset as well as the regulation of hypertension. Furthermore, the effects of seasonal fluctuations in blood pressure, noise pollution, and obesity seem to share a similar pathogenesis, and as such to all further react together, leading to increased blood pressure. The activation of the autonomous nervous system plays a key role and causes an increase in stress hormones that generates oxidative stress on the vascular system and, thus, vasoconstriction. In this review, by focusing on the association of the environmental impact with arterial blood pressure, we come to the question of whether most cases of hypertension-if not all-should, indeed, be considered primary or secondary.

Premature Triadic Music Therapy (PT-MT) for babies and their parents: a pilot study

OBJECTIVE

We aim to test the feasibility and effectiveness of Premature Triadic Music Therapy (PT-MT) in the premature baby unit.

METHODS

The design was a clinical pre-test-post-test trial with a convenience sample. Inclusion criteria were a gestational age higher than 28 weeks for preterm infants and the absence of shock or extreme distress for parents. Six preterm children (with a gestational age of 33 to 36 weeks) and their parents participated in the study. For the children, we measured heart rate, blood perfusion, and blood saturation at three different times (pre-PT-MT, during PT-MT, after PT-MT) as quantitative indicators of distress. Their parents completed the Edinburgh Postnatal Depression Scale (EPDS) before and after the PT-MT intervention.

RESULTS

We found a statistically significant lower heart rate and a marginally statistically significant higher blood perfusion during PT-MT, as compared to the baseline. However, these changes were not present at the end of PT-MT. The parents' EPDS scores were not statistically significantly lower at the post-test, although, the Medians of the scores did decrease.

CONCLUSIONS

PT-MT is a promising intervention for the reduction of distress in both parents and children. Further studies should include a higher number of sessions and participants.

Musical Enjoyment and Reward: From Hedonic Pleasure to Eudaimonic Listening

This article is a hypothesis and theory paper. It elaborates on the possible relation between music as a stimulus and its possible effects, with a focus on the question of why listeners are experiencing pleasure and reward. Though it is tempting to seek for a causal relationship, this has proven to be elusive given the many intermediary variables that intervene between the actual impingement on the senses and the reactions/responses by the listener. A distinction can be made, however, between three elements: (i) an objective description of the acoustic features of the music and their possible role as elicitors; (ii) a description of the possible modulating factors—both external/exogenous and internal/endogenous ones; and (iii) a continuous and real-time description of the responses by the listener, both in terms of their psychological reactions and their physiological correlates. Music listening, in this broadened view, can be considered as a multivariate phenomenon of biological, psychological, and cultural factors that, together, shape the overall, full-fledged experience. In addition to an overview of the current and extant research on musical enjoyment and reward, we draw attention to some key methodological problems that still complicate a full description of the musical experience. We further elaborate on how listening may entail both adaptive and maladaptive ways of coping with the sounds, with the former allowing a gentle transition from mere hedonic pleasure to eudaimonic enjoyment.

Noise induced human population annoyance in urban environment of city of Novi Sad (Serbia)

The objective of this paper is to estimate percent of the human population in the City of Novi Sad (CNS) annoyed by road traffic noise according to two methods (ISO 1996-1: 2016, and National norm from 2010). 24-hour noise measurements data in the area of the city center and city roads in the CNS from 2012 to 2016 are obtained from the Institute of Public Health of Vojvodina (IPHV). Both methods show similar results, although with varying precision within the different noise range. Night noise stands out as a problem due to the fact that the expert recognize it as a significant factor responsible for the non-auditory effects of noise on human health and because the results of measurements of the IPHV confirm that the night-time noise is increased by 98% of measurements in the city traffic area.

Occupational Noise and Hypertension Risk: A Systematic Review and Meta-Analysis

A number of epidemiological studies report an association between occupational noise exposure and arterial hypertension. Existing systematic reviews report conflicting results, so we conducted an updated systematic review with meta-analysis. We registered the review protocol with PROSPERO (registration no.: CRD 42019147923) and searched for observational epidemiological studies in literature databases (Medline, Embase, Scopus, Web of Science). Two independent reviewers screened the titles/abstracts and full texts of the studies. Two reviewers also did the quality assessment and data extraction. Studies without adequate information on recruitment, response, or without a comparison group that was exposed to occupational noise under 80 dB(A) were excluded. The literature search yielded 4583 studies, and 58 studies were found through hand searching. Twenty-four studies were included in the review. The meta-analysis found a pooled effect size (ES) for hypertension (systolic/diastolic blood pressure ≥140/90 mmHg) due to noise exposures ≥80 dB(A) of 1.81 (95% CI 1.51–2.18). There is no substantial risk difference between men and women, but data concerning this question are limited. We found a positive dose-response-relationship: ES = 1.21 (95% CI 0.78–1.87) ≤ 80 dB(A), ES = 1.77 (95% CI 1.36–2.29) > 80–≤85 dB(A), and ES = 3.50 (95% CI 1.56–7.86) > 85–≤90 dB(A). We found high quality of evidence that occupational noise exposure increases the risk of hypertension.

Music Listening as Coping Behavior: From Reactive Response to Sense-Making

Coping is a survival mechanism of living organisms. It is not merely reactive, but also involves making sense of the environment by rendering sensory information into percepts that have meaning in the context of an organism's cognitions. Music listening, on the other hand, is a complex task that embraces sensory, physiological, behavioral, and cognitive levels of processing. Being both a dispositional process that relies on our evolutionary toolkit for coping with the world and a more elaborated skill for sense-making, it goes beyond primitive action-reaction couplings by the introduction of higher-order intermediary variables between sensory input and effector reactions. Consideration of music-listening from the perspective of coping treats music as a sound environment and listening as a process that involves exploration of this environment as well as interactions with the sounds. Several issues are considered in this regard such as the conception of music as a possible stressor, the role of adaptive listening, the relation between coping and reward, the importance of self-regulation strategies in the selection of music, and the instrumental meaning of music in the sense that it can be used to modify the internal and external environment of the listener.

Music and Noise: Same or Different? What Our Body Tells Us

In this article, we consider music and noise in terms of vibrational and transferable energy as well as from the evolutionary significance of the hearing system of Homo sapiens. Music and sound impinge upon our body and our mind and we can react to both either positively or negatively. Much depends, in this regard, on the frequency spectrum and the level of the sound stimuli, which may sometimes make it possible to set music apart from noise. There are, however, two levels of description: the physical-acoustic description of the sound and the subjective-psychological reactions by the listeners. Starting from a vibrational approach to sound and music, we first investigate how sound may activate the sense of touch and the vestibular system of the inner ear besides the sense of hearing. We then touch upon distinct issues such as the relation between low-frequency sounds and annoyance, the harmful effect of loud sound and noise, the direct effects of overstimulation with sound, the indirect effects of unwanted sounds as related to auditory neurology, and the widespread phenomenon of liking loud sound and music, both from the point of view of behavioral and psychological aspects.

Full-time exposure to occupational noise during pregnancy was associated with reduced birth weight in a nationwide cohort study of Swedish women

Noise is a common exposure in the occupational work environment. Earlier studies of occupational noise and pregnancy outcome are few and show mixed results. To investigate if objectively assessed exposure to occupational noise during pregnancy is associated with reduced intrauterine growth and/or preterm birth a nationwide cohort study of 857,010 single births was initiated. Individual information on occupation and risk factors was retrieved from prenatal care interviews at pregnancy week 10. Occupational noise was classified into three exposure categories <75, 75-85, >85 dBA by a job exposure matrix. Odds ratios were adjusted for BMI, smoking, parity, education, physically strenuous work and low job control. Exposure to high (>85 dBA) levels of occupational noise throughout the pregnancy (full time workers) was associated with an increased risk of the child being born small for gestational age, OR 1.44 (95% CI 1.01 to 2.03) compared to noise exposure <75 dBA. A similar increase was seen for low birth weight OR 1.36 (95% CI 1.03 to 1.80) for high levels of noise. No clear association was seen for preterm birth. No consistent effects on birth outcome was observed in women who had worked part-time or were on leave of absence >21 days (median). In summary, full-time exposure to high levels of noise during pregnancy was associated with a slightly reduced fetal growth but not with preterm birth. The effect of intermediate occupational noise exposure (75-85 dBA) showed a small, but statistically increased risk for all studied birth outcomes. The study strengthens the evidence that pregnant women should not be long-term exposed to high levels >85 dBA of occupational noise during pregnancy. Intermediate exposure should be studied further.

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.

Road Traffic and Railway Noise Exposures and Adiposity in Adults: A Cross-Sectional Analysis of the Danish Diet, Cancer, and Health Cohort

BACKGROUND

Traffic noise has been associated with cardiovascular and metabolic disorders. Potential modes of action are through stress and sleep disturbance, which may lead to endocrine dysregulation and overweight.

OBJECTIVES

We aimed to investigate the relationship between residential traffic and railway noise and adiposity.

METHODS

In this cross-sectional study of 57,053 middle-aged people, height, weight, waist circumference, and bioelectrical impedance were measured at enrollment (1993-1997). Body mass index (BMI), body fat mass index (BFMI), and lean body mass index (LBMI) were calculated. Residential exposure to road and railway traffic noise exposure was calculated using the Nordic prediction method. Associations between traffic noise and anthropometric measures at enrollment were analyzed using general linear models and logistic regression adjusted for demographic and lifestyle factors.

RESULTS

Linear regression models adjusted for age, sex, and socioeconomic factors showed that 5-year mean road traffic noise exposure preceding enrollment was associated with a 0.35-cm wider waist circumference (95% CI: 0.21, 0.50) and a 0.18-point higher BMI (95% CI: 0.12, 0.23) per 10 dB. Small, significant increases were also found for BFMI and LBMI. All associations followed linear exposure-response relationships. Exposure to railway noise was not linearly associated with adiposity measures. However, exposure > 60 dB was associated with a 0.71-cm wider waist circumference (95% CI: 0.23, 1.19) and a 0.19-point higher BMI (95% CI: 0.0072, 0.37) compared with unexposed participants (0-20 dB).

CONCLUSIONS

The present study finds positive associations between residential exposure to road traffic and railway noise and adiposity.

Long-term exposure to residential traffic noise and changes in body weight and waist circumference: A cohort study

BACKGROUND

Traffic noise can act as a stressor and disturb sleep, and has been associated with cardiovascular disease. Recent studies suggest a possible association to metabolic outcomes and adiposity through biological mechanisms related to physiological stress and sleep disturbance.

OBJECTIVES

We aimed to investigate the association between long-term residential traffic noise and changes in adiposity.

MATERIALS AND METHODS

The study was based on 39,720 middle-aged Danish men and women from a cohort, with information on weight and waist circumference at two points in time. Residential exposure to traffic noise was calculated for all participants' present and historical addresses using the Nordic prediction method. The associations between traffic noise and changes in adiposity measures after a mean follow-up of 5.3 years were analyzed by linear and logistic regression with adjustments for age, sex, socioeconomic position and lifestyle factors in three models with increasing adjustment.

RESULTS

In linear models adjusted for sex, age, socioeconomic position and competing noise sources we found road traffic noise to be significantly associated with small gains in both weight and waist circumference. For example, time-weighted mean exposure 5-years preceding follow-up was associated with a yearly weight gain of 15.4 g (95% confidence interval (CI): 2.14; 28.7) and a yearly increase in waist circumference of 0.22 mm (95% CI: 0.018; 0.43) per 10dB. Similarly, in Poisson regression models we found an 10% increased risk for gaining more than 5 kg body weight during follow-up (95% CI: 1.04; 1.15) per 10 dB higher 5 years exposure preceding follow-up. Exposure to railway noise above 55 dB was associated with weight gain (39.9 g/year (95% CI: 10.2; 69.6)), but not with a significant change in waist circumference. We found baseline BMI (p<0.001) and waist circumference (p=0.001) to be significant effect modifiers for the association between road traffic noise and waist circumference, with gain in waist circumference only among the obese (BMI≥30) participants (1.20 mm/year (95% CI: 0.68; 1.72)) and participants with a large waist circumference (0.83 mm/year (95% CI: 0.42; 1.23)).

CONCLUSION

The findings supports previous studies suggesting that traffic noise may be associated with development of adiposity. However, the potential effects are small and suggest an effect mainly among obese participants.

Music as environment: an ecological and biosemiotic approach

This paper provides an attempt to conceive of music in terms of a sounding environment. Starting from a definition of music as a collection of vibrational events, it introduces the distinction between discrete-symbolic representations as against analog-continuous representations of the sounds. The former makes it possible to conceive of music in terms of a Humboldt system, the latter in terms of an experiential approach. Both approaches, further, are not opposed to each other, but are complementary to some extent. There is, however, a distinction to be drawn between the bottom-up approach to auditory processing of environmental sounds and music, which is continuous and proceeding in real time, as against the top-down approach, which is proceeding at a level of mental representation by applying discrete symbolic labels to vibrational events. The distinction is discussed against the background of phylogenetic and ontogenetic claims, with a major focus on the innate auditory capabilities of the fetus and neonate and the gradual evolution from mere sensory perception of sound to sense-making and musical meaning. The latter, finally, is elaborated on the basis of the operational concepts of affordance and functional tone, thus bringing together some older contributions from ecology and biosemiotics.

Thoracic bioelectrical impedance assessment of the hemodynamic reactions to recorded road-traffic noise in young adults

Noise exposure increases blood pressure in both experimental and field studies. The underlying mechanisms may be evaluated by thoracic bioelectrical impedance. The aim of this experimental study was to assess changes in blood pressure, cardiac and hemodynamic parameters provoked by recorded traffic noise in young adults. The study included 130 participants (42 men and 88 women), aged 24.88±2.67 years. Thoracic electrical bioimpedance device was applied to monitor cardiac parameters, hemodynamic parameters, heart rate variability, blood pressure and heart rate. The testing procedure consisted of three phases. Participants were exposed to recorded road-traffic noise (Leq=89dBA) for 10min and relaxed in quiet conditions (Leq=40dBA) before and after noise exposure. Listening to recorded noise resulted in significant decrease of stroke volume and cardiac output, and an increase of vascular resistance. Heart rate variability and the overall sympathovagal balance remained similar through all experimental conditions. During noise exposure, systolic pressure increased by 2mmHg among women (95% confidence interval=0.97-2.73mmHg), and by 4mmHg among men (95% confidence interval=2.16-5.00mmHg). Similarly, diastolic pressure increased by 2mmHg among women (95% confidence interval=0.95-2.47mmHg), and by 4mmHg among men (95% confidence interval=2.46-5.28mmHg). Once noise ceased, both pressures returned to pre-exposure levels. Experimental exposure to recorded road-traffic noise of 89dBA for 10min provoked significant hemodynamic changes in young adults, including vasoconstriction (increase of vascular resistance), and hypodynamics (decrease of global heart flow). The interaction of these effects resulted in the elevation of blood pressure during noise exposure.

Exposure to aircraft and road traffic noise and associations with heart disease and stroke in six European countries: a cross-sectional study

BACKGROUND

Although a number of studies have found an association between aircraft noise and hypertension, there is a lack of evidence on associations with other cardiovascular disease. For road traffic noise, more studies are available but the extent of possible confounding by air pollution has not been established.

METHODS

This study used data from the Hypertension and Environmental Noise near Airports (HYENA) study. Cross-sectional associations between self-reported 'heart disease and stroke' and aircraft noise and road traffic noise were examined using data collected between 2004 and 2006 on 4712 participants (276 cases), who lived near airports in six European countries (UK, Germany, Netherlands, Sweden, Greece, Italy). Data were available to assess potential confounding by NO2 air pollution in a subsample of three countries (UK, Netherlands, Sweden).

RESULTS

An association between night-time average aircraft noise and 'heart disease and stroke' was found after adjustment for socio-demographic confounders for participants who had lived in the same place for ≥ 20 years (odds ratio (OR): 1.25 (95% confidence interval (CI) 1.03, 1.51) per 10 dB (A)); this association was robust to adjustment for exposure to air pollution in the subsample. 24 hour average road traffic noise exposure was associated with 'heart disease and stroke' (OR: 1.19 (95% CI 1.00, 1.41), but adjustment for air pollution in the subsample suggested this may have been due to confounding by air pollution. Statistical assessment (correlations and variance inflation factor) suggested only modest collinearity between noise and NO2 exposures.

CONCLUSIONS

Exposure to aircraft noise over many years may increase risks of heart disease and stroke, although more studies are needed to establish how much the risks associated with road traffic noise may be explained by air pollution.

Music therapy research in the NICU: an updated meta-analysis

PURPOSE

To provide an overview of developmental and medical benefits of music therapy for preterm infants.

DESIGN

Meta-analysis.

SAMPLE

Empirical music studies with preterm infants in the neonatal intensive care unit (NICU).

MAIN OUTCOME

Evidence-based NICU music therapy (NICU -MT ) was highly beneficial with an overall large significant effect size (Cohen's d = 0.82). Effects because of music were consistently in a positive direction.

RESULTS

Results of the current analysis replicated findings of a prior meta-analysis and included extended use of music.(1) Benefits were greatest for live music therapy (MT ) and for use early in the infant's NICU stay (birth weight <1,000 g, birth postmenstrual age <28 weeks). Results justify strong consideration for the inclusion of the following evidence-based NICU -MT protocols in best practice standards for NICU treatment of preterm infants: music listening for pacification, music reinforcement of sucking, and music pacification as the basis for multilayered, multimodal stimulation.

Work-related cardiovascular disease risk factors using a socioecological approach: implications for practice and research

BACKGROUND

Cardiovascular disease (CVD) is a leading cause of mortality. Numerous investigations have linked occupational factors and CVD. Occupational factors such as overtime work have an enormous effect on the CVD risk of industrial workers. However, risk factors for CVD are not systematically reviewed in the workplace. The purpose of the paper is to review work-related risk factors for CVD.

METHODS

A systematic review of work-related CVD risk factors was performed, yielding 180 articles. All articles were assessed in relation to inclusion and exclusion criteria, resulting in 44 articles being reviewed. The sole inclusion criteria was work-related environmental factors and intra/inter-personal factors (psychosocial factors), which is based on the socioecological perspective. The articles were also assessed regarding the quality of each study using the scoring methods developed by Cesario et al. and Brown et al.

CONCLUSION

The literature review demonstrated that work environment factors such as shift work, overtime work, and noise and chemical exposures; and psychosocial factors such as job stress, social support, and socioeconomic status cannot be explained or intervened by one single risk factor. Furthermore, certain occupational factors were shown to aggravate or attenuate other risk factors. The implication of these findings is to incorporate work-related environmental and psychosocial factors into assessment of the patient's CVD risks and intervention plan. Future research should also incorporate a well-defined conceptual framework to address the effects of work-related environmental and psychosocial factors on CVD among CVD patients.

Epidemiological studies on noise and blood pressure in children: Observations and suggestions

OBJECTIVE

The goal of this review was to investigate methodological differences in studies on the effects of aircraft or road-traffic noise on blood pressure (BP) of urban children, emphasizing the similarities and differences in blood pressure measurements.

METHODS

A literature search has identified eight peer-reviewed studies, four conference proceedings and one PhD thesis on the effects of aircraft or road-traffic noise on children's blood pressure published in English in the last 30 years. Most of the studies were cross-sectional, and four studies were longitudinal, with follow-up period from one to three years. The studies were analyzed according to the following methodological issues: study design, children's characteristics, noise exposure assessment and blood pressure measurements. The effects of noise on systolic and diastolic pressure were presented in detail.

RESULTS

Studies on aircraft noise had more uniform methodology, indicating a slight tendency towards a positive relationship between aircraft noise exposure and BP in children. The studies on road-traffic noise were methodologically diverse, but compared to aircraft noise studies they showed a more uniform trend in the direction of a positive relationship with systolic BP. The time, place and number of BP measurements, as well as the devices and cuff sizes varied among the studies. Children's age, gender, body composition and ethnicity, and socio-economic status remain the greatest source of diversity in BP values.

CONCLUSIONS

The reviewed studies were methodologically diverse concerning noise exposure assessment, BP measurement, study design and control for confounders. In spite of this, they indicate a tendency toward positive association between noise exposure and children's blood pressure. We recommended strategies that might help researchers adopt similar procedures when measuring BP in future field studies.

Transportation noise and exposed population of an urban area in the Republic of Korea

Using noise prediction models, we explored the transportation noise levels of Youngdeungpo-gu, an urbanized area of Seoul Metropolitan City in the Republic of Korea. In addition, we estimated the population exposed to transportation noise levels and determined how many people are vulnerable to noise levels that would cause serious annoyance and sleep disturbance. Compared with the World Health Organization [WHO] recommended levels, the daytime and nighttime transportation noise levels were still high enough to have the two psychosocial effects on people when considering the recommended levels of the World Health Organization (WHO; 55 decibels [dB[A]] and 40 dB[A] for daytime and nighttime, respectively). Particularly, nighttime transportation noise was discovered to be harmful to a wider area and more people than daytime noise. Approximately 91% of the Youngdeungpo-gu area experienced nighttime transportation noise levels exceeding those recommended by WHO. It was estimated that as much as 80% of the people in the study area were exposed to transportation noise levels >40 dB[A] during nighttime. Taking this into account, there is an urgent need to control and reduce transportation noise levels in Seoul, to protect residents against the potential ill health effects caused by urban transportation.

Road traffic noise and stroke: a prospective cohort study

AIMS

Epidemiological studies suggest that long-term exposure to road traffic noise increases the risk of cardiovascular disorders. The aim of this study was to investigate the relation between exposure to road traffic noise and risk for stroke, which has not been studied before.

METHODS AND RESULTS

In a population-based cohort of 57,053 people, we identified 1881 cases of first-ever stroke in a national hospital register between 1993-1997 and 2006. Exposure to road traffic noise and air pollution during the same period was estimated for all cohort members from residential address history. Associations between exposure to road traffic noise and stroke incidence were analysed in a Cox regression model with stratification for gender and calendar-year and adjustment for air pollution and other potential confounders. We found an incidence rate ratio (IRR) of 1.14 for stroke [95% confidence interval (CI): 1.03-1.25] per 10 dB higher level of road traffic noise (L(den)). There was a statistically significant interaction with age (P < 0.001), with a strong association between road traffic noise and stroke among cases over 64.5 years (IRR: 1.27; 95% CI: 1.13-1.43) and no association for those under 64.5 years (IRR: 1.02; 95% CI: 0.91-1.14).

CONCLUSION

Exposure to residential road traffic noise was associated with a higher risk for stroke among people older than 64.5 years of age.

Associations between chronic community noise exposure and blood pressure at rest and during acute noise and non-noise stressors among urban school children in India

The present study builds on prior research that has examined the association between children's chronic exposure to community noise and resting blood pressure and blood pressure dysregulation during exposure to acute stressors. A novel contribution of the study is that it examines how chronic noise exposure relates to blood pressure responses during exposure to both noise and non-noise acute stressors. The acute noise stressor was recorded street noise and the non-noise stressor was mental arithmetic. The sample consisted of 189 3rd and 6th grade children (51.9% percent boys; 52.9% 3rd graders) from a noisy (n = 95) or relatively quiet (n = 94) public school in the city of Pune, India. There were no statistically significant differences between chronic noise levels and resting blood pressure levels. However, relative to quiet-school children, noisy-school children had significantly lower increases in blood pressure when exposed to either an acute noise or non-noise stressor. This finding suggests that chronic noise exposure may result in hypo-reactivity to a variety of stressors and not just habituation to noise stressors.

Community response to environmental noise and the impact on cardiovascular risk score

OBJECTIVE

The objective of our study was to investigate and evaluate the relationship between road traffic noise and cardiovascular risk.

METHODS

The study sample (n=659; 36.9% male, 63.1% female university students, mean age 22.83+/-1.58 years) included a group exposed to road traffic noise (n=280, L(eq,24h)=67+/-2dB(A)) and a control group (n=379, L(eq,24h)=58.7+/-6dB(A)). Subjective response was determined by a validated noise annoyance questionnaire. The ten year risk of developing a coronary heart disease event was quantified as an evaluation of cardiovascular risk (SCORE60, Framingham 10-year risk estimation and projection to the age of 60, relative risk SCORE chart).

RESULTS

Cardiovascular risk scores were significantly higher in the exposed group based on the Framingham scores projected to the age of 60, SCORE60 (AOR=2.72 (95% CI=1.21-6.15)) and the relative risk SCORE chart (AOR=2.81 (1.46-5.41)).

CONCLUSIONS

These findings highlight the association between road traffic noise and cardiovascular risk.

The spatial relationship between traffic-generated air pollution and noise in 2 US cities

Traffic-generated air pollution and noise have both been linked to cardiovascular morbidity. Since traffic is a shared source, there is potential for correlated exposures that may lead to confounding in epidemiologic studies. As part of the Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air), 2-week NO and NO(2) concentrations were measured at up to 105 locations, selected primarily to characterize gradients near major roads, in each of 9 US communities. We measured 5-min A-weighted equivalent continuous sound pressure levels (L(eq)) and ultrafine particle (UFP) counts at a subset of these NO/NO(2) monitoring locations in Chicago, IL (N=69 in December 2006; N=36 in April 2007) and Riverside County, CA (N=46 in April 2007). L(eq) and UFP were measured during non-"rush hour" periods (10:00-16:00) to maximize comparability between measurements. We evaluated roadway proximity exposure surrogates in relation to the measured levels, estimated noise-air pollution correlation coefficients, and evaluated the impact of regional-scale pollution gradients, wind direction, and roadway proximity on the correlations. Five-minute L(eq) measurements in December 2006 and April 2007 were highly correlated (r=0.84), and measurements made at different times of day were similar (coefficients of variation: 0.5-13%), indicating that 5-min measurements are representative of long-term L(eq). Binary and continuous roadway proximity metrics characterized L(eq) as well or better than NO or NO(2). We found strong regional-scale gradients in NO and NO(2), particularly in Chicago, but only weak regional-scale gradients in L(eq) and UFP. L(eq) was most consistently correlated with NO, but the correlations were moderate (0.20-0.60). After removing the influence of regional-scale gradients the correlations generally increased (L(eq)-NO: r=0.49-0.62), and correlations downwind of major roads (L(eq)-NO: r=0.53-0.74) were consistently higher than those upwind (0.35-0.65). There was not a consistent effect of roadway proximity on the correlations. In conclusion, roadway proximity variables are not unique exposure surrogates in studies of endpoints hypothesized to be related to both air pollution and noise. Moderate correlations between traffic-generated air pollution and noise suggest the possibility of confounding, which might be minimized by considering regional pollution gradients and/or prevailing wind direction(s) in epidemiologic studies.

Music as a nursing intervention for preterm infants in the NICU

Although there is general agreement that noise in the neonatal intensive care unit should be reduced, there is controversy about the use of music as a developmental care strategy with prererm infants. Much literature supports using music with preterm infants, indicating that it enhances physiologic and neurobehavioral functioning, but some experts worry that music is overstimulating. This article presents evidence supporting the use of music with preterm infants as well as criticism of same. Recommendations for music interventions with preterm infants are discussed, although fUrther research is needed before specific guidelines can he established.

Urban road-traffic noise and blood pressure and heart rate in preschool children

Night time noise exposure has very rarely been used in previous studies on the relationship between community noise and children's blood pressure, although children spend a larger part of their night time sleeping at home than adults. For this reason, we focused on night time noise exposure at children's residences and daytime noise at kindergartens. The aim of this study was to investigate the effects of urban road-traffic noise on children's blood pressure and heart rate. A cross-sectional study was performed on 328 preschool children (174 boys and 154 girls) aged 3-7 years, who attended 10 public kindergartens in Belgrade. Equivalent noise levels (Leq) were measured during night in front of children's residences and during day in front of kindergartens. A residence was regarded noisy if Leq exceeded 45 dB (A) during night and quiet if the Leq was < or =45 dB (A). Noisy and quiet kindergartens were those with daily Leq>60 dB (A) and < or =60 dB (A), respectively. Children's blood pressure was measured with mercury sphygmomanometer. Heart rate was counted by radial artery palpitation for 1 min. The prevalence of children with hypertensive values of blood pressure was 3.96% (13 children, including 8 boys and 5 girls) with higher prevalence in children from noisy residences (5.70%), compared to children from quiet residences (1.48%). The difference was borderline significant (p=0.054). Systolic pressure was significantly higher (5 mm Hg on average) among children from noisy residences and kindergartens, compared to children from both quiet environments (p<0.01). Heart rate was significantly higher (2 beats/min on average) in children from noisy residences, compared to children from quiet residences (p<0.05). Multiple regression, after allowing for possible confounders, showed a significant correlation between noise exposure and children's systolic pressure (B=1.056; p=0.009).

Nível de ruído em unidade de terapia intensiva neonatal

OBJETIVO: Verificar o nível de ruído da Unidade de Terapia Intensiva Neonatal e identificar suas fontes. MÉTODOS: Estudo quantitativo, descritivo e exploratório, conduzido em uma Unidade de Terapia Intensiva Neonatal de São Paulo. A coleta de dados ocorreu de abril a maio de 2005, utilizando um dosímetro para 96 horas de registro do nível de pressão sonora e 9 horas de observação, para identificar as fontes de ruído. RESULTADOS: Registrou-se Leq entre 61,3 a 66,6 dBA, sendo maior nos dias do final de semana. Os valores dos picos variaram de 90,8 a 123,4 dBC, sendo mais elevados no período noturno. As principais fontes foram: alarme dos ventiladores, dos oxímetros, conversa entre profissionais e pais e outros. CONCLUSÃO: Considerando os efeitos deletérios do nível elevado de ruído sobre neonatos e equipe de saúde, os resultados demonstram a necessidade de intervenções em algumas rotinas e na conduta dos profissionais e familiares.

Impact of background noise on reaction time and brain DC potential changes of VDT-based spatial attention

Background noise is often discussed in terms of mental costs. In this study the effect of background noise on brain activity as reflected by the direct coupled (DC) potential was investigated by a within design in ten participants. During two successive blocks of 7 min each, participants performed 156 trials of a visual display terminal (VDT)-based visual-spatial attention task without noise and two blocks with a mixture of the environmental noises of barking dogs, traffic noise and irrelevant speech of 60 dBA. Brain DC potentials were recorded along the midline and analysed for change by time on task. For noise conditions, reaction time was prolonged and the DC-potential shifted towards positivity, contrary to control condition, independent of block and location. Results suggest reduced cortical resources by widespread inhibitory activation through background noise. It can be concluded that even low intensity background noise is associated with energy consumption and with impaired performance in spatial attention.

Influence of intensive coronary care acoustics on the quality of care and physiological state of patients

AIM OF THE STUDY

To evaluate the possible role of room acoustics on patients with coronary artery disease and to test the hypothesis that a poor acoustics environment is likely to produce a bad work environment resulting in unwanted sound that could adversely affect the patients.

METHODS AND RESULTS

A total of 94 patients admitted to the intensive coronary heart unit at Huddinge University Hospital for evaluation of chest pain were included in the study. Patient groups were recruited during bad and good acoustics, respectively. Acoustics were altered during the study period by changing the ceiling tiles throughout the CCU from sound-reflecting tiles (bad acoustics) to sound-absorbing tiles (good acoustics) of similar appearance. Patients were monitored with regard to blood pressure including pulse amplitude, heart rate and heart rate variability. The patients were asked to fill in a questionnaire about the quality of the care, and a follow-up of rehospitalization and mortality was made at 1 and 3 months, respectively. There were significant differences between good and bad acoustics with regard to pulse amplitude in the acute myocardial infarction and unstable angina pectoris groups, with lower values during the good acoustics period during the night. The incidence of rehospitalization was higher for the bad acoustics group. Patients treated during the good acoustics period considered the staff attitude to be much better than during the bad acoustics period.

CONCLUSION

A bad acoustics environment during acute illness may have important detrimental physiological effects on rehabilitation.

Deleterious effects of an environmental noise on sleep and contribution of its physical components in a rat model

Sleep disturbances induced by environmental noise (EN) exposure are now well admitted. However, many contradictory conclusions and discrepancies have been reported, resulting from uncontrolled human factors or the use of artificial noises (pure tone). Thus, the development of an animal model appears to be a useful strategy for determining whether EN is deleterious to sleep. The aims of this study were: (i) to confirm the effects of noise on sleep in a rat model; and (ii) to determine the most deleterious physical component of noise regarding sleep structure. For this purpose, rats were exposed during 24 h either to EN or to artificial broad-band noises [either continuous broad-band noise (CBBN) or intermittent broad-band noise (IBBN)]. All the noises decrease both slow wave sleep (SWS) and paradoxical sleep (PS) amounts during the first hours of exposure. However, CBBN acts indirectly on PS through a reduction of SWS bout duration, whereas IBBN and EN disturb directly and more strongly both SWS and PS. Finally, EN fragments SWS and decreases PS amount during the dark period, whereas IBBN only fragments PS. These results demonstrate the validity and suitability of a rodent model for studying the effects of noise on sleep and definitively show that sleep is disturbed by EN exposure. Two physical factors seem to be implicated: the intermittency and the frequency spectrum of the noise events, which both induce long-lasting sleep disturbances. An additive effect of frequency spectrum to intermittency tends to abolish all possible adaptations to EN exposure. Since sleep is involved in cognitive processes, such disturbances could lead to cognitive deficits.

Health status as a potential effect modifier of the relation between noise annoyance and incidence of ischaemic heart disease

AIMS

Traffic noise is a psychosocial stressor. Epidemiological studies suggest chronic noise stress to be a risk factor for cardiovascular disorders.

METHODS

In a prospective cohort study, the association between annoyance and disturbances due to road traffic noise and the incidence of ischaemic heart disease (IHD) was studied in 3950 middle aged men.

RESULTS

Depending on the questionnaire item, non-significant odds ratios for IHD incidence ranging from 0.9 to 1.4 were found for the highly noise annoyed/disturbed subjects when compared with the less annoyed/disturbed subjects, over the six year follow up period. However, this relation was strongly modified by the prevalence of pre-existing chronic diseases. In subjects free of any chronic disease at the beginning of the follow up, significant odds ratios between 1.7 and 3.0 were seen. In the subgroup with chronic diseases no such noise effects were seen. This surprising result of no effect in the group of people with a potential risk, due to pre-existing health problems, may be because of the dilution of the true effect due to recall bias.

CONCLUSIONS

Annoyance and disturbance due to road traffic noise is associated with a higher incidence of IHD. Prevalence of disease can be an important effect modifier of the relation between noise annoyance and health outcomes.

A meta-analysis of the efficacy of music therapy for premature infants

This meta-analysis on music research with premature infants in neonatal intensive care units (NICU) showed an overall large, significant, consistent effect size of almost a standard deviation (d =.83) (Cohen, 1998). Effects were not mediated by infants' gestational age at the time of study, birthweight, or type of music delivery nor by physiologic, behavioral, or developmental measures of benefit. The homogeneity of findings suggests that music has statistically significant and clinically important benefits for premature infants in the NICU. The unique acoustic properties that differentiate music from all other sounds are discussed and clinical implications for research-based music therapy procedures cited.