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

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EFFECTS ON HEALTH
Regarding aircraft noise, the cross-sectional Okinawa study (Matsui et al., 2001;
Matsui et al., 2004) on the association between aircraft noise and hypertension
fulfils the inclusion criteria. When studies are included that did not assess
dose–response relationships but only compared dichotomous categories of exposure
in the analyses, two more studies appear on the list. The studies were carried
out in the vicinity of Amsterdam Schiphol Airport. They suggest a higher risk of
cardiovascular diseases in general (Knipschild, 1977b), and – specifically – for
hypertension and IHD (angina pectoris, ECG abnormalities, heart trouble)
(Knipschild, 1977a) in subjects from areas exposed to high aircraft noise. These
studies were considered in the meta-analysis by van Kempen et al. (2002).
However, they do not fulfil the strict criteria set here. Finally, if the inclusion criteria
are widened to include peer-reviewed studies that assessed dose–response
relationships between objective indicators of exposure and the subjective (selfreported)
prevalence of diseases, a further two studies can be considered. These
are the cross-sectional study carried out in Stockholm regarding the association
between aircraft noise and hypertension (Rosenlund et al., 2001), and the crosssectional
part of the study in Berlin regarding the association between road traffic
noise and myocardial infarction (Babisch et al., 1994). Fig. 4.4 shows the
results of the three aircraft noise studies carried out in Amsterdam, Okinawa and
Stockholm (Knipschild, 1977a; Rosenlund et al., 2001; Matsui et al., 2004). The
graph clearly indicates that the results are too heterogeneous to derive a pooled
dose–response curve. However, all three studies show an increase in risk with
increasing noise level.
Studies that are not given a high ranking according to the above mentioned criteria,
however, may serve as additional sources of information to support the evidence
of the conclusions being made on the basis of this review. This is illustrated
in Fig. 4.5. The entries are relative risks (centre of the bars) with 95% confidence
intervals (the bars) for dichotomous comparisons of noise exposure
(extreme groups or high vs. low). A relative consistent shift of the bars to relative
risks greater than 1 can be seen. The dark-shaded bars in the diagram refer to
studies where the noise exposure was determined objectively (noise levels), the
Amsterdam
Stockholm
Okinawa
Fig. 4.4
Association between
aircraft noise level and the
prevalence of hypertension
Relative risk
2.2
2
1.8
1.6
1.4
1.2
1
0.8
46–50
51–55
56–60
61–65
66–70
71–75
76–80
Approx.Lday dB(A)
NIGHT NOISE GUIDELINES FOR EUROPE