Night noise guidelines for Europe - WHO/Europe - World Health ...

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X EXECUTIVE SUMMARY PROCESS OF DEVELOPING GUIDELINES In 2003, the WHO Regional Office for Europe set up a working group of experts to provide scientific advice to the European Commission and to its Member States for the development of future legislation and policy action in the area of control and surveillance of night noise exposure. The review of available scientific evidence on the health effects of night noise was carried out by an interdisciplinary team who set out to derive health-based guideline values. The contributions from the experts were reviewed by the team and integrated into draft reports following discussion at four technical meetings of the working group. In 2006, all the draft reports were compiled into a draft document on guidelines for exposure to noise at night, which was reviewed and commented on by a number of stakeholders and experts. At the final conference in Bonn, Germany, on 14 December 2006, representatives from the working group and stakeholders from industry, government and nongovernmental organizations reviewed the contents of the draft document chapter by chapter, discussed several fundamental issues and reached general agreement on the guideline values and related texts to be presented as conclusions of the final WHO Night noise guidelines for Europe. NOISE INDICATORS From the scientific point of view the best criterion for choosing a noise indicator is its ability to predict an effect. Therefore, for different health end points, different indicators could be chosen. Long-term effects such as cardiovascular disorders are more correlated with indicators summarizing the acoustic situation over a long time period, such as yearly average of night noise level outside at the facade (L night,outside ) 1 , while instantaneous effects such as sleep disturbance are better with the maximum level per event (L Amax ), such as passage of a lorry, aeroplane or train. From a practical point of view, indicators should be easy to explain to the public so that they can be understood intuitively. Indicators should be consistent with existing practices in the legislation to enable quick and easy application and enforcement. L night,outside , adopted by the END, is an indicator of choice for both scientific and practical use. Among currently used indicators for regulatory purposes, L Aeq (Aweighted equivalent sound pressure level) and L Amax are useful to predict short-term or instantaneous health effects. SLEEP TIME Time use studies, such as that undertaken by the Centre for Time Use Research, 2006 (www.timeuse.org/access/), show that the average time adult people are in bed is around 7.5 hours, so the real average sleeping time is somewhat shorter. Due to personal factors like age and genetic make-up there is considerable variation in sleeping time and in beginning and end times. For these reasons, a fixed interval of 8 hours is a minimal choice for night protection. Though results vary from one country to another, data show (see Fig. 2 as an example) that an 8-hour interval protects around 50% of the population and that it would take a period of 10 hours to protect 80%. On Sundays, sleeping time is consistently 1 hour longer, probably due to people recovering from sleep debt incurred during the week. It should also be borne in mind that (young) children have longer sleeping times. 1 L night is defined in the END as the outside level. In order to avoid any doubt, the suffix “outside” is added in this document.
EXECUTIVE SUMMARY XI 100% 80% 60% 40% 20% 0% Fig. 2 Percentage of time that the Portuguese population spend asleep or in different activities 0.00 2.00 4.00 6.00 8.00 10.00 12.00 14.00 16.00 18.00 20.00 22.00 24.00 Watch television Read Household occupation Work and study Personal care Eating Sleep Source: http://www.ine.pt/prodserv/destaque/arquivo.asp, based on a study by the Instituto Nacional de Estatistica Portugal, 1999. NOISE, SLEEP AND HEALTH There is plenty of evidence that sleep is a biological necessity, and disturbed sleep is associated with a number of health problems. Studies of sleep disturbance in children and in shift workers clearly show the adverse effects. Noise disturbs sleep by a number of direct and indirect pathways. Even at very low levels physiological reactions (increase in heart rate, body movements and arousals) can be reliably measured. Also, it was shown that awakening reactions are relatively rare, occurring at a much higher level than the physiological reactions. DEFINITION OF “SUFFICIENT” AND “LIMITED” EVIDENCE Sufficient evidence: A causal relation has been established between exposure to night noise and a health effect. In studies where coincidence, bias and distortion could reasonably be excluded, the relation could be observed. The biological plausibility of the noise leading to the health effect is also well established. Limited evidence: A relation between the noise and the health effect has not been observed directly, but there is available evidence of good quality supporting the causal association. Indirect evidence is often abundant, linking noise exposure to an intermediate effect of physiological changes which lead to the adverse health effects. The working group agreed that there is sufficient evidence that night noise is related to self-reported sleep disturbance, use of pharmaceuticals, self-reported health problems and insomnia-like symptoms. These effects can lead to a considerable burden of disease in the population. For other effects (hypertension, myocardial infarctions, depression and others), limited evidence was found: although the studies were few or not conclusive, a biologically plausible pathway could be constructed from the evidence.
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Page 6 and 7: IV CONTENTS CHAPTER 3 EFFECTS OF NI
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Page 10 and 11: VIII LIST OF CONTRIBUTORS Torbjörn
Page 14 and 15: XII EXECUTIVE SUMMARY An example of
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42 SLEEP AND HEALTH 2.5 ANIMAL STUD
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46 EFFECTS ON SLEEP ing sleep stage
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48 EFFECTS ON SLEEP sleep time can
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50 EFFECTS ON SLEEP the instantaneo
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52 EFFECTS ON SLEEP Table 3.1. Coef
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62 EFFECTS ON HEALTH Noise Exposure
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66 EFFECTS ON HEALTH Regarding mean
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68 EFFECTS ON HEALTH 1992). The rel
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78 EFFECTS ON HEALTH No particular
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88 EFFECTS ON HEALTH ting the stres
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90 EFFECTS ON HEALTH In a United Ki
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92 EFFECTS ON HEALTH 4.8.14 ASSOCIA
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94 EFFECTS ON HEALTH noise-related
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96 EFFECTS ON HEALTH have had exper
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98 EFFECTS ON HEALTH • number of
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100 EFFECTS ON HEALTH Furthermore,
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102 GUIDELINES AND RECOMMENDATIONS
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112 Ancoli-Israel S, Roth T (1999).
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114 Bistrup ML (2003). Prevention o
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116 Cartwright J, Flindell I (2000)
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118 der Streßforschung (Bonner Ver
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120 Goto K, Kaneko T (2002). Distri
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122 Ishihara K (1999). The effect o
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124 Kogi K, Ohta T (1975). Incidenc
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126 Marth E et al. (1988). Fluglär
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128 Nieminen P et al. (2002). Growt
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130 Reyner et al. (1995). Patterns
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132 Suter AH (1992). Noise sources
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134 Weed DL (2000). Interpreting ep
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136 APPENDICES Term/acronym Definit
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138 APPENDICES APPENDIX 3. ANIMAL S
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140 APPENDICES cause a certain habi
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142 APPENDICES • Acute exposure t
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144 APPENDICES dence indicate that
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146 APPENDICES Fig.1 Effects of 12
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) 148 APPENDICES 50 40 Young rats O
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150 APPENDICES neuronal degeneratio
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152 Gesi M et al. (2002a). Morpholo
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154 APPENDIX 4. NOISE AND SLEEP IN
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156 APPENDICES during quiet sleep (
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158 APPENDICES (American Academy of
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160 APPENDICES cents, 12.2% of adol
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162 REFERENCES Abel SM (1990). The
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The WHO Regional Office for Europe
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