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EFFECTS ON HEALTH 61
4.5 CARDIOVASCULAR EFFECTS OF NOISE –
FINDINGS FROM EPIDEMIOLOGICAL STUDIES
4.5.1 INTRODUCTION
It is a common experience that noise is unpleasant and affects the quality of life. It
disturbs and interferes with activities of the individual including concentration, communication,
relaxation and sleep (WHO Regional Office for Europe, 2000; Schwela,
2000). Besides the psychosocial effects of community noise, there is concern about
the impact of noise on public health, particularly regarding cardiovascular outcomes
(Suter, 1992; Passchier-Vermeer and Passchier, 2000; Stansfeld, Haines and Brown,
2000). Non-auditory health effects of noise have been studied in humans for a couple
of decades using laboratory and empirical methods. Biological reaction models
have been derived, which are based on the general stress concept (Selye, 1956; Henry
and Stephens, 1977; Ising et al., 1980; Lercher, 1996). Amongst other non-auditory
health end points, short-term changes in circulation including BP, heart rate, cardiac
output and vasoconstriction, as well as stress hormones (epinephrine, norepinephrine
and corticosteroids) have been studied in experimental settings for many years
(Berglund and Lindvall, 1995; Babisch, 2003). Various studies have shown that classical
biological risk factors are higher in subjects who were exposed to high levels of
traffic noise (Arguelles et al., 1970; Eiff et al., 1974; Verdun di Cantogno et al.,
1976; Algers, Ekesbo and Strömberg, 1978; Knipschild and Sallé, 1979; Manninen
and Aro, 1979; Eiff et al., 1981a; Rai et al., 1981; Marth et al., 1988; Babisch and
Gallacher, 1990; Babisch et al., 1990; Lercher and Kofler, 1993; Schulte and Otten,
1993; Dugué Leppänen and Gräsbeck, 1994; Yoshida et al., 1997; Goto and
Kaneko, 2002). Although controls for other risk factors were not consistent in all
these studies, the hypothesis emerged that persistent noise stress increases the risk of
cardiovascular disorders including high BP (hypertension) and IHD.
• Sound/noise is a psychosocial stressor that activates the sympathetic and endocrine
system.
• Acute noise effects do not only occur at high sound levels in occupational settings,
but also at relatively low environmental sound levels when, more importantly,
intended activities such as concentration, relaxation or sleep are disturbed.
The following questions need to be answered.
• Do these changes observed in the laboratory habituate or persist under chronic
noise exposure?
• If they habituate, what are the physiological costs? If they persist, what are the
long-term health effects?
The answers to these questions come from epidemiological noise research. Largescale
epidemiological studies have been carried out for a long time (Babisch,
2000). The studies suggest that transportation noise is associated with adverse
cardiovascular effects, in particular IHD. The epidemiological evidence is constantly
increasing (Babisch, 2002, 2004a). The biological plausibility of the association
derives from the numerous noise experiments that have been carried out
in the laboratory. There is no longer any need to prove the noise hypothesis as
such. Decision-making and risk management, however, rely on a quantitative risk
assessment which requires an established dose–response relationship. Since many
of the stress indicators and risk factors that have been investigated in relation to
NIGHT NOISE GUIDELINES FOR EUROPE