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

EFFECTS ON HEALTH
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and cohort studies on the association between noise level and incidence of IHD. In
cross-sectional studies, IHD prevalence was assessed by clinical symptoms of angina
pectoris, myocardial infarction, ECG abnormalities as defined by WHO criteria
(Rose and Blackburn, 1968), or from self-reported questionnaires regarding
doctor-diagnosed heart attack. In longitudinal studies, IHD incidence was assessed
by clinical myocardial infarction as obtained from hospital records, ECG measurements
or clinical interviews. The majority of studies refer to road traffic noise.
With regard to IHD, the evidence of an association between community noise and
IHD risk has increased since a previous review (Babisch, 2000). There is not much
indication of a higher IHD risk for subjects who live in areas with a daytime average
sound pressure level of less than 60 dB(A) across the studies. For higher noise
categories, a higher IHD risk was relatively consistently found amongst the studies.
Statistical significance was rarely achieved. Some studies permit reflections on
dose–response relationships. These mostly prospective studies suggest an increase
in IHD risk at noise levels above 65–70 dB(A), the relative risks ranging from 1.1
to 1.5 when the higher exposure categories were grouped together. Noise effects
were larger when mediating factors like residence time, room orientation and window-opening
habits were considered in the analyses. This accounts for an induction
period (Rose, 2005) and improves exposure assessment. The results appear as
consistent when subjective responses of disturbance and annoyance are considered,
showing relative risks ranging from 0.8 to 2.7 in highly
annoyed/disturbed/affected subjects. However, these findings may be of lower
validity due to methodological issues.
4.5.8 MEDICATION AND DRUG CONSUMPTION
Table A8 of the major report (Babisch, 2006) gives the results of studies on the
relationship between drug consumption and community noise. Medication was
primarily investigated with respect to aircraft noise. A significant prevalence ratio
for medication with cardiovascular drugs of 1.4 was found in the sample of
Amsterdam Schiphol Airport (Knipschild, 1977a). The results of the “drug survey”,
where the annual data of the pharmacies regarding the purchase of cardiovascular
drugs were analysed (repeated cross-sectional survey), supported this
finding. An increase in drug purchase over time in the exposed areas and not in
the less exposed was found. This refers to the purchase of cardiovascular and
antihypertensive drugs, as well as the purchase of hypnotics, sedatives and
antacids (Knipschild and Oudshoorn, 1977). Furthermore a dependency with
changes in night flight regulations was found (decrease after reduction of night
flights). A large recent study around Amsterdam Schiphol Airport found only a
slightly higher risk of self-reported medication with cardiovascular drugs, including
antihypertensive drugs (relative risk 1.2), in subjects exposed to aircraft noise
where the noise level L den exceeded 50 dB(A) (Franssen et al., 2004).
Dose–response relationships across noise levels (L den =