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

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