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64 EFFECTS ON HEALTH commonly accepted arguments for a causal relationship (Bradford Hill, 1965; Evans, 1976; Morabia, 1991; Weed and Hursting, 1998). Classical, systematic and quantitative reviews have been published in the past, summarizing the results of studies that have been carried out up to the end of the last century, and assessing the evidence of the relationship between community noise and cardiovascular disease outcomes (Health Council of the Netherlands, 1994, 1999, 2004; Berglund and Lindvall, 1995; IEH, 1997; Morrell, Taylor and Lyle, 1997; Porter, Flindell and Berry, 1998; Babisch, 2000; Passchier-Vermeer and Passchier, 2000), including a classical review and synthesis report by Babisch (2000) and a systematic review (meta-analysis) by van Kempen et al. (2002). In a meta-analysis it was concluded that the risk of hypertension due to aircraft noise was 1.26 per increase of 5 dB(A) (95% CI: 1.14–1.39, L day = 55–72 dB(A)) (van Kempen et al., 2002). But, only one study (Knipschild, 1977a) was considered in the meta-analysis. With respect to road traffic noise and hypertension a pooled estimate of 0.95 per 5 dB(A) (95% CI: 0.84–1.08, L day =
EFFECTS ON HEALTH 65 knowledge of the topic and respective literature. Details are given in the major report (Babisch, 2006). Information particularly on night-time exposure (L night : 22.00–06.00 or 23.00–07.00) was seldom available. Newer studies used nonweighted or weighted averages of the 24-hour exposure (L eq , L dn , L den ). Some aircraft noise studies used national calculation methods (for example, Dutch Kosten Units). For comparisons of study results and the pooling of data (meta-analysis), sound levels were converted on the basis of best guess approximations to L day (Matschat and Müller, 1984; Passchier-Vermeer, 1993; Bite and Bite, 2004; Franssen et al., 2004). It should be noted in this context that doubling/halving of road traffic volume results in a 3 dB(A) higher/lower average sound pressure level. Not all studies allowed dose–response reflections because some of them considered very broad exposure categories. Besides objective noise measurements, subjective measurements of exposure have been used in some epidemiological noise studies, which is in accordance with the noise–stress model. Type of road (for example, busy street, side street, etc.), disturbances and annoyance were rated by the study subjects from given scales. 4.5.5 MEAN BP Table A2 of the major report (Babisch, 2006) lists the major findings of epidemiological traffic noise studies in which mean BP was considered as the outcome. It indicates mean systolic and diastolic BP differences as obtained from extreme group comparisons of noise exposure. The effects in children and in adults are discussed separately. The findings in children are difficult to interpret with regard to possible health risks in their later life. The effect may be of a temporary nature and may not be relevant to permanent health damage. There is evidence during childhood (Gillman et al., 1992), adolescence (Yong et al., 1993) and adulthood (Tate et al., 1995) that the BP level at an early age is an important predictor of the BP level at a later age. Studies over the full age range are missing (tracking). Growth and body weight are important factors in BP development. The impact of body size was not adequately considered in some of the studies. A crude hint regarding reversible effects on BP came from one study (Morrell et al., 2000). Results of the Munich intervention study on the effects of a reduction of aircraft noise have only been reported regarding cognitive performance but not with respect to change of BP (Hygge, Evans and Bullinger, 2002). It was concluded from the available data on the length of exposure that children do not seem to adapt to high levels of road traffic noise but to some extent to aircraft noise (Passchier-Vermeer, 2000; Bistrup et al., 2001). However, the database appears to be too poor to draw final conclusions. Aircraft noise studies focused on exposure at school, while road traffic noise studies mostly considered noise exposure at home. The conclusions given by Evans and Lepore (1993) seem still to hold true: “We know essentially nothing about the long-term consequences of early noise exposure on developing cardiovascular systems. The degree of blood pressure elevations is small. The clinical significance of such changes in childhood blood pressure is difficult to determine. The ranges of blood pressure among noiseexposed children are within the normal levels and do not suggest hypertension. The extent of BP elevations found from chronic exposure are probably not significant for children during their youth, but could portend elevations later in life that might be health damaging.” NIGHT NOISE GUIDELINES FOR EUROPE
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NIGHT NOISE GUIDELINES FOR EUROPE
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Keywords NOISE - ADVERSE EFFECTS -
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IV CONTENTS CHAPTER 3 EFFECTS OF NI
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VI ABSTRACT The WHO Regional Office
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VIII LIST OF CONTRIBUTORS Torbjörn
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X EXECUTIVE SUMMARY PROCESS OF DEVE
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XII EXECUTIVE SUMMARY An example of
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XIV EXECUTIVE SUMMARY Effect Indica
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XVI EXECUTIVE SUMMARY 50 100 Fig. 4
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XVIII EXECUTIVE SUMMARY For the pri
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2 METHODS AND CRITERIA impact on th
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4 METHODS AND CRITERIA ITALY: NETHE
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6 METHODS AND CRITERIA There are im
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8 METHODS AND CRITERIA use and heal
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10 METHODS AND CRITERIA L night = L
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12 METHODS AND CRITERIA 1.3.6 BACKG
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Page 36 and 37: 16 SLEEP AND HEALTH • Stage 2 req
Page 38 and 39: 18 SLEEP AND HEALTH Table 2.3 Mean
Page 40 and 41: 20 SLEEP AND HEALTH vegetative, mot
Page 42 and 43: 22 SLEEP AND HEALTH mal range. The
Page 44 and 45: 24 SLEEP AND HEALTH Type Behavioura
Page 46 and 47: 26 SLEEP AND HEALTH sible beyond th
Page 48 and 49: 28 SLEEP AND HEALTH Early reports d
Page 50 and 51: 30 SLEEP AND HEALTH ents’ reports
Page 52 and 53: 32 SLEEP AND HEALTH Although cortic
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Page 56 and 57: 36 SLEEP AND HEALTH cardiovascular
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Page 62 and 63: 42 SLEEP AND HEALTH 2.5 ANIMAL STUD
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Page 66 and 67: 46 EFFECTS ON SLEEP ing sleep stage
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Page 98 and 99: 78 EFFECTS ON HEALTH No particular
Page 100 and 101: 80 EFFECTS ON HEALTH Research into
Page 102 and 103: 82 EFFECTS ON HEALTH tle direct res
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Page 106 and 107: 86 EFFECTS ON HEALTH lage newly exp
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Page 118 and 119: 98 EFFECTS ON HEALTH • number of
Page 120 and 121: 100 EFFECTS ON HEALTH Furthermore,
Page 122 and 123: 102 GUIDELINES AND RECOMMENDATIONS
Page 132 and 133: 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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