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Keywords NOISE – ADVERSE EFFECTS – PREVENTION AND CONTROL SLEEP DEPRIVATION – ETIOLOGY SLEEP DISORDERS – PREVENTION AND CONTROL ENVIRONMENTAL HEALTH HEALTH POLICY – LEGISLATION GUIDELINES ISBN 978 92 890 4173 7 Address requests about publications of the WHO Regional Office for Europe to: Publications WHO Regional Office for Europe Scherfigsvej 8 · DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). © World Health Organization 2009 All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to reproduce or translate its publications, in part or in full. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The views expressed by authors, editors, or expert groups do not necessarily represent the decisions or the stated policy of the World Health Organization. Edited by Charlotte Hurtley, Layout by Dagmar Bengs
CONTENTS III ABSTRACT FOREWORD LIST OF CONTRIBUTORS EXECUTIVE SUMMARY CHAPTER 1 INTRODUCTION: METHODS AND CRITERIA VI VII VIII IX 1.1 Introduction: methods and criteria 1 1.1.1 Existing policy documents for night-time noise 1 1.1.2 General model 2 1.1.3 Process of developing guidelines 3 1.2 Strength of evidence 4 1.2.1 Basic concepts 4 1.2.2 Risk assessment and risk control 5 1.2.3 Cause–effect chain 5 1.2.4 Procedure for deriving guidelines 6 1.3 Considerations with regard to night-time noise indicators 7 1.3.1 Length of night 7 1.3.2 Event or long-term descriptor 7 1.3.3 Number of events 8 1.3.4 Conversion between indicators 8 1.3.5 Inside/outside differences 10 1.3.6 Background level 12 1.3.7 Choice of indicators for regulatory purposes 12 1.4 Exposure in the population 13 1.4.1 Noise levels 13 1.4.2 Reported night-time noise disturbance 13 1.5 Conclusions 14 CHAPTER 2 THE RELATION BETWEEN SLEEP AND HEALTH 2.1 Sleep, normal sleep, definitions of sleep disturbance, characteristics, mechanisms, the insomnia model 15 2.1.1 Normal sleep (objective measurements) 15 2.1.2 Definitions of disturbed sleep 18 2.1.3 Conclusions 20 2.2 Long-term health risk mediated by sleep disturbances 20 2.2.1 Stressors, neurobehavioural data and functional neuroimaging 20 2.2.2 Signals mediated by subcortical area (the amygdala), the role of stress hormones in sleep disturbance and their health consequences 21 2.2.3 Sleep restriction, environmental stressors (noise) and behavioural, medical and social health consequences of insufficient sleep: risk of morbidity and mortality 22 2.3 Risk groups 25 2.3.1 Health effects of disturbed sleep in children 25 2.3.2 Basic individual factors: gender and age 33 2.3.3 Persons exposed to stressors as a risk group 34 2.3.4 Shift work as a risk factor for sleep disturbance and health effects 36 2.3.5 Conclusion 41 2.4 Accidents related to sleep quality 41 2.5 Animal studies 42 2.6 Conclusions 42
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36 SLEEP AND HEALTH cardiovascular
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38 SLEEP AND HEALTH So do fatigue-r
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40 SLEEP AND HEALTH ers that the ag
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42 SLEEP AND HEALTH 2.5 ANIMAL STUD
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NIGHT NOISE GUIDELINES FOR EUROPE
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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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54 EFFECTS ON SLEEP motility have b
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58 EFFECTS ON HEALTH for aircraft:
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60 EFFECTS ON HEALTH acoustic and n
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62 EFFECTS ON HEALTH Noise Exposure
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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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