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

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14 METHODS AND CRITERIA Fig. 1.8 shows the relative contributions to overall sleep disturbance caused by noise from different sources in the Netherlands. These data were derived from surveys in 1998 and 2003 (van Dongen et al., 2004) in which 4000 and 2000 people, randomly selected, were asked: “To what extent is your sleep disturbed by noise from [source mentioned]…” on a scale from 1 to 10. People recording the three highest points in the scale were considered “highly disturbed”, according to an international convention. The totals are calculated from the number of people reporting serious sleep disturbance from one or more sources. Unfortunately, comparable research data from other countries or regions is not available, and there is reason to believe that there may be considerable differences in the figures. Since this study is based on a survey conducted in the Netherlands, it is not representative for other Member States in the EU. General (not specific for nighttime) annoyance data from Germany and the United Kingdom give an indication that similar numbers of people are affected. Fig. 1.8 Percentage of population highly disturbed by noise during sleep in the Netherlands However, the fact that other noise nuisances may contribute significantly to overall sleep disturbance should not be overlooked. Further research on this topic is needed in order to gain an insight into the contribution of various noise sources to sleep disturbance. 1.5 CONCLUSIONS The methods and criteria for deriving guidelines rest on well-established procedures from epidemiology. To relate the effects to the dose, standard metrics will be used wherever available. If possible, the values found in literature will be converted to avoid confusion. Most of the conversions are relatively straightforward and depend on physical laws; others, in particular the conversion between outside and inside levels, depend on local factors and should be used only if no other information is available. Information about night-time noise exposure is relatively scarce, despite 10 EU Member States having limit values for night-time noise. The END could substantially increase this information (large-scale noise mapping is foreseen in 2007), increasing the demand for guidance. NIGHT NOISE GUIDELINES FOR EUROPE
15 CHAPTER 2 THE RELATION BETWEEN SLEEP AND HEALTH A night of quiet and repose in the profound silence of Dingley Dell, and an hour’s breathing of its fresh and fragrant air on the ensuing morning, completely recovered Mr Pickwick from the effects of his late fatigue of body and anxiety of mind. (Charles Dickens, The Pickwick Papers, 1836) 2.1 SLEEP, NORMAL SLEEP, DEFINITIONS OF SLEEP DISTURBANCE, CHARACTERISTICS MECHANISMS, THE INSOMNIA MODEL 2.1.1 NORMAL SLEEP (OBJECTIVE MEASUREMENTS) Sleep is part of living and, along with being awake, forms an inherent biological rhythm (Cooper, 1994). Normal sleep can be defined in an objective or subjective manner. The objective criteria are defined using a polysomnographic recording (PSG) of sleep, the method that measures different physiological functions during sleep. Minimal polygraphic requirements to measure sleep adequately include two channels of electroencephalography (EEG), one channel for the electrooculogram (EOG), and one channel for the submental electromyography (EMG). In routine PSG, additional channels are used to assess respiration, leg movements, oxygenation and cardiac rhythm (Ebersole and Pedley, 2003). Scoring of sleep stages is usually done on an epoch-by-epoch basis, with a 30-second length used as a standard. Epochs are scored according to the guidelines of Rechtschaffen and Kales (1968). Each epoch is scored as the stage that occupies more than 50% of that epoch. Sleep can be divided into the following stages. • Arousal is not a uniform concept and has been defined differently by different researchers. Commonly, the occurrence of alpha rhythms is required for EEG arousal. Depending on the additional requirements and on the length of time that the slower cortical rhythms are interrupted, arousals have been called, for instance, micro-arousal, minor arousal, EEG awakening or transient activation phases. The American Sleep Disorders Association (1992, 1997) devised a scoring system, taking sequences of 3–15 seconds into account for transient arousals which are not transferred to macroscopic behavioural awakening. Eleven further criteria must be met (see also Chapter 3, section 3.1.2). • Vegetative arousals are activations of the sympathic nervous system. • Stage W corresponds to the waking stage and is characterized by alpha activity or low-voltage, mixed-frequency EEG activity. Rapid eye movements (REMs), eye blinks, and tonic EMG activity are usually present. • Stage 1 is scored when more than 50% of an epoch is low-voltage, 2–7 Hertz (Hz) activity. Vertex waves may occur in late stage 1. Slow rolling eye movements lasting several seconds are routinely seen early in stage 1, but K complexes and sleep spindles are absent by definition. Tonic EMG activity is usually less than that of relaxed wakefulness. NIGHT NOISE GUIDELINES FOR EUROPE
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Page 4 and 5: Keywords NOISE - ADVERSE EFFECTS -
Page 6 and 7: IV CONTENTS CHAPTER 3 EFFECTS OF NI
Page 8 and 9: VI ABSTRACT The WHO Regional Office
Page 10 and 11: VIII LIST OF CONTRIBUTORS Torbjörn
Page 12 and 13: X EXECUTIVE SUMMARY PROCESS OF DEVE
Page 14 and 15: XII EXECUTIVE SUMMARY An example of
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Page 66 and 67: 46 EFFECTS ON SLEEP ing sleep stage
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64 EFFECTS ON HEALTH commonly accep
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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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70 EFFECTS ON HEALTH Regarding airc
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72 EFFECTS ON HEALTH 4.5.10 DOSE-RE
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74 EFFECTS ON HEALTH larger increas
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76 EFFECTS ON HEALTH 4.5.14 RISK EV
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78 EFFECTS ON HEALTH No particular
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80 EFFECTS ON HEALTH Research into
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82 EFFECTS ON HEALTH tle direct res
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84 EFFECTS ON HEALTH level of expos
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86 EFFECTS ON HEALTH lage newly exp
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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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