Nighttime Aircraft Noise Research Articles

Long-term nighttime aircraft noise exposure and risk of hypertension in a prospective cohort of female nurses

There is growing interest in cardiometabolic outcomes associated with nighttime noise, given that noise can disturb sleep and sleep disturbance can increase cardiometabolic risk such as hypertension. However, there is little empirical research evaluating the association between nighttime aircraft noise and hypertension risk. In this study, we expand on previous work to evaluate associations between nighttime aircraft noise exposure and self-reported hypertension incidence in the Nurses' Health Studies (NHS/NHSII), two US-wide cohorts of female nurses. Annual nighttime average aircraft sound levels (Lnight) surrounding 90 airports for 1995–2015 (in 5-year intervals) were modeled using the Aviation Environmental Design Tool and assigned to participants’ geocoded addresses over time. Hypertension risk was estimated for each cohort using time-varying Cox proportional-hazards models for Lnight dichotomized at 45 dB (dB), adjusting for individual-level hypertension risk factors, area-level socioeconomic status, region, and air pollution. Random effects meta-analysis was used to combine cohort results. Among 63,229 NHS and 98,880 NHSII participants free of hypertension at study baseline (1994/1995), we observed 33,190 and 28,255 new hypertension cases by 2014/2013, respectively. Although ∼1% of participants were exposed to Lnight ≥45 dB, we observed an adjusted hazard ratio (HR) of 1.10 (95% CI: 0.96, 1.27) in NHS and adjusted HR of 1.12 (95% CI: 0.98, 1.28) in NHSII, comparing exposure to Lnight ≥45 versus <45 dB(A). In meta-analysis, we observed an adjusted HR of 1.11 (95% CI: 1.01, 1.23). These results were attenuated with adjustment for additional variables such as body mass index. Our findings support a modest positive association between nighttime aircraft noise and hypertension risk across NHS/NHSII, which may reinforce the concept that sleep disturbance contributes to noise-related disease burden.

Associations between Aircraft Noise, Sleep, and Sleep-Wake Cycle: Actimetric Data from the UK Biobank Cohort near Four Major Airports.

Nighttime aircraft noise may affect people's sleep, yet large-scale evidence using objective and subjective measures remains limited. Our aim was to investigate associations between nighttime aircraft noise exposure and objectively measured sleep disturbance using a large UK cohort. We used data from 105,770 UK Biobank cohort participants exposed and unexposed to aircraft noise who lived in 44 local authority districts near 4 international airports in England. We used a generalized linear regression model to examine cross-sectional associations between aircraft noise (23:00 hours-07:00 hours) and 7-d actimetric measures collected 2013-2015 (). We also used Logit and generalized estimating equations models to examine associations between and self-reported sleep measures at enrollment (2006-2010) and follow-up (2012-2013). This approach allowed us to compare and contrast the results and support potential future meta-analyses on noise-related sleep disturbance. Cross-sectional analyses of actimetric data suggested sleep disturbance associated with , showing higher level of movements during the least active continuous 8-h time period [: 0.12 milligravitational units; 95% confidence interval (CI): 0.013, 0.23]. We also saw disrupted sleep-wake cycles as indicated by index scores of lower relative amplitude (: ; 95% CI: , ), poorer interdaily stability (: ; 95% CI: , ), and greater intradaily variability (: 0.021; 95% CI: 0.019, 0.023), comparing dB with dB. Repeated cross-sectional analyses found a 52% higher odds of more frequent daytime dozing [odds ratio (OR) ; 95% CI: 1.32, 1.75] for dB in comparison with dB, whereas the likelihood for more frequent sleeplessness was more uncertain (; 95% CI: 0.92, 1.39). Higher effect sizes were seen in preidentified vulnerable groups, including individuals of age and those with diabetes or dementia. Individuals exposed to higher levels of aircraft noise experienced objectively higher levels of sleep disturbance and changes in sleep-wake cycle. https://doi.org/10.1289/EHP14156.

JS-ISH-ESH-2: NOISE POLLUTION AND ARTERIAL HYPERTENSION

Environmental noise significantly impacts human health and well-being. It is a widespread problem in Europe, where at least one in five people are exposed to harmful levels of noise. Hearing loss is the most known health effect related to noise exposure. There is, however, growing data that links noise exposure to hypertension, coronary artery disease, and stroke. According to some theories, this relationship may be explained by the indirect pathway of noise exposure, which can cause sympathetic and endocrine activation, as well as several cognitive and emotional responses, including annoyance. Noise exposure leads to stress reactions independent of cognitive involvement. There is a possibility that noise exerts its effects directly through synaptic interactions, as well as through cognitive and emotional effects. Epidemiological studies indicate that nocturnal noise exposure has more profound health consequences. Nighttime noise exposure is associated with an increase in heart rate due to sympathetic activation or parasympathetic withdrawal, and with an increase in blood pressure as well as endothelial dysfunction. Hypertension is a common condition and is an important risk indicator for other cardiovascular diseases. Previous studies showed an association between noise exposure, blood pressure and arterial hypertension. Meta-analysis of cross-sectional studies found an increase of hypertension prevalence per 10 dB increase in daytime average road traffic noise level. There is, however, some heterogeneity among these studies. Prospective studies have also found an association between aircraft noise exposure and hypertension, supporting the cross-sectional findings. The analyses, of data from the large Hypertension and Exposure to Noise near Airports (HYENA) study, showed that an increase in nocturnal aircraft noise exposure per 10 dB was associated with an increased incidence of hypertension. The meaningful effect of night-time aircraft noise on arterial hypertension was also observed in the prospective observation of the subset of individuals from that study. In a longitudinal observation of 420 participants, higher aircraft noise exposure during the night significantly associated with the incidence of hypertension. Previous cross-sectional case-control study conducted in 2015, in 2 suburban areas of Krakow, Poland, revealed an increase in blood pressure and arterial stiffness as determined by carotid - femoral pulse wave velocity in individuals exposed to increased aircraft noise levels. However, even short-term noise reduction, as experienced during the COVID-19 lockdown, may reverse those unfavorable effects. As a result of these observations, noise mitigation strategies are important for cardiovascular health.

Mutual effects of fine particulate matter, nitrogen dioxide, and fireworks on cause-specific acute cardiovascular mortality: A case-crossover study in communities affected by aircraft noise

Ambient air pollution is the leading cause of environmental mortality and morbidity worldwide. However, the individual contributions to acute mortality of traffic-related air pollutants such as nitrogen dioxide (NO2) and fine particulate matter (PM2.5) are still debated. We conducted a time-stratified case-crossover study for a population located around Zurich airport in Switzerland, including 24,886 adult cardiovascular deaths from the Swiss National Cohort. We estimated the risk of cause-specific cardiovascular mortality associated with daily NO2 and PM2.5 concentrations at home using distributed lag models up to 7 days preceding death, adjusted for daily temperature, precipitation, acute night-time aircraft noise, firework celebrations, and holidays. Cardiovascular mortality was associated with NO2, whereas the association with PM2.5 disappeared upon adjustment for NO2. The strongest association was observed between NO2 and ischemic stroke mortality (odds ratio = 1.55 per 10 μg/m3, 95% confidence intervals = 1.20–2.00). Cause-specific mortality analyses showed differences in terms of delayed effect: odds ratios were highest at 1–3 days after exposure for most outcomes but at lags of 3–5 days for heart failure. Individual vulnerabilities to NO2 associated cardiovascular mortality also varied by cause of death, possibly highlighting the role of different behaviours and risk factors in the most susceptible groups. The risk of cardiovascular mortality was also increased on firework days and after public holidays, independent from NO2 and PM2.5 concentrations. This study confirms the association between ambient NO2, as a marker for primary emissions, and acute cardiovascular mortality in a specific setting around a major airport. Future research should clarify the role of additional air pollutants including ultra-fine particles on cardiovascular diseases to inform most efficient control measures.

Associations between nighttime aircraft noise exposure and insufficient sleep in the US-based prospective Nurses’ Health Study cohort

BACKGROUND AND AIM: Chronic sleep disturbances leading to short sleep duration have been linked to chronic diseases (e.g., cardiovascular disease, hypertension). Aircraft noise may contribute to sleep disruption, indicating a potential pathway to chronic disease. However, multivariable-adjusted and longitudinal relationships have infrequently been studied in a large sample of adults. This study investigates associations between nighttime aircraft noise and insufficient sleep in the US-based Nurses’ Health Study (NHS). METHODS: Nighttime aircraft noise levels (LAeqN) were modeled for 90 U.S. airports from 1995-2015 in 5-year intervals using U.S. Federal Aviation Administration’s (FAA) Aviation Environmental Design Tool (AEDT) and linked to geocoded participants’ residential addresses for 2000, 2002, 2008, 2012, and 2014 (years when self-reported habitual sleep duration was available). Participants were classified as exposed if they lived at addresses with modeled LAeqN ≥45 decibels (dB). Sleep duration was classified as insufficient if ≤6 hours per night. A repeated measures analysis was conducted using generalized estimating equations. Multivariable models adjusted for participant-level demographics, behaviors, comorbidities, and ambient fine particulate matter. RESULTS:In 2000, the 35,226 female participants were on average 66.1 years old. The proportion of participants with insufficient sleep varied from 29.6% in 2000 to 37.0% in 2014. The percent exposed to nighttime aircraft noise varied from 1.5% to 0.6%. In age-adjusted longitudinal models the odds of insufficient sleep were 33.1% higher (95% CI: 17.0%, 51.6%) for those exposed to nighttime aircraft noise compared with those not exposed, and the association remained after multivariable adjustment (25.3% higher odds; 95% CI: 10.1%, 42.7%). CONCLUSIONS:Elevated nighttime aircraft noise was associated with shorter sleep duration in the NHS cohort. The relationship was robust after controlling for multiple confounders and with increased insufficient sleep and decreased aircraft noise exposure over time. Future research will investigate sleep quality as an additional sleep outcome. KEYWORDS: noise, epidemiology, environmental epidemiology

Acute cardiovascular mortality in communities living near a major airport: mutual effects of fine particulate matter and nitrogen dioxide

BACKGROUND AND AIM: Ambient air pollution is the leading cause of environmental mortality and morbidity worldwide. However, the individual contributions to acute mortality of traffic-related air pollutants such as nitrogen dioxide (NO2) and fine particulate matter (PM2.5) are still debated. METHODS: We conducted a time-stratified case-crossover study for a study population located around Zurich airport in Switzerland, including 24,886 adult cardiovascular deaths from the Swiss National Cohort. We estimated the risk of cause-specific cardiovascular mortality associated with daily NO2 and PM2.5 exposure at home using distributed lag models up to 7 days preceding death, adjusted for daily temperature, acute night-time aircraft noise, firework celebrations, and holidays. RESULTS:Cardiovascular mortality was associated with NO2; whereas the association with PM2.5 disappeared upon adjustment for NO2. The strongest association was observed between NO2 and ischemic stroke (OR = 1.55 per 10µg/m3, 95% CI = 1.20-2.00). Cause-specific analyses showed differences in terms of delayed effect: OR were highest at 1-3 days after exposure for most health outcomes but at lags of 3-5 days for heart failure. Individual and social vulnerabilities to NO2 associated cardiovascular mortality also varied by health outcome, possibly highlighting the role of different behaviours and risk factors in these groups. CONCLUSIONS:This study confirms the association between ambient, as a marker for primary emissions, and acute cardiovascular mortality in a specific setting around a major airport. Future research should further investigate the role of additional air pollutants including ultra-fine particles on cardiovascular disease to inform most efficient control measures. KEYWORDS: Air pollution (traffic-related), cardiovascular diseases

The role of extreme temperature in cause-specific acute cardiovascular mortality in Switzerland: A case-crossover study

Since the 2003 heatwave in Europe, evidence has been rapidly increasing on the association between extreme temperature and all-cause mortality. Little is known, however, about cause-specific cardiovascular mortality, effect modification by air pollution and aircraft noise, and which population groups are the most vulnerable to extreme temperature. We conducted a time-stratified case-crossover study in Zurich, Switzerland, including all adult cardiovascular deaths between 2000 and 2015 with precise individual exposure estimates at home location. We estimated the risk of 24,884 cardiovascular deaths associated with heat and cold using distributed non-linear lag models. We investigated potential effect modification of temperature-related mortality by fine particles, nitrogen dioxide, and night-time aircraft noise and performed stratified analyses across individual and social characteristics. We found increased risk of mortality for heat (odds ratio OR = 1.28 [95% confidence interval: 1.11–1.49] for 99th percentile of daily Tmean (24 °C) versus optimum temperature at 20 °C) and cold (OR = 1.15 [0.95–1.39], 5th percentile of daily Tmean (−3 °C) versus optimum temperature at 20 °C). Heat-related mortality was particularly strong for myocardial infarctions and hypertension related deaths, and among older women (>75 years). Analysis of effect modification also indicated that older women with lower socio-economic position and education are at higher risk for heat-related mortality. PM2.5 increased the risk of heat-related mortality for heart failure, but not all-cause cardiovascular mortality. This study provides useful information for preventing cause-specific cardiovascular temperature-related mortality in moderate climate zones comparable to Switzerland.

COVID-19 related sound reduction. Soundscape changes during Peruvian de-escalation and “abnormal” opening

The COVID-19 outbreak has changed the worldwide way of life. In March 2020, Peru declared a State of Emergency and defined different phases to control the virus spreading, and as a result of the lockdown, Peruvian cities sound levels were reduced as never before imagined. The author installed a noise sensor before the pandemic on a rooftop to record the overflights sound levels, since the office building is in a residential area, which is near to the aircraft climbing curve towards the ocean on departure from Lima. The author published in JASA an article with the soundscape analysis of Lima, Peru, registered by the device between March through June 2020, so all soundscape changes have been measured as a consequence of flight suppression (due to the airport lockdown) and also because of a ban on traffic circulation in streets and curfew to reduce social distancing. In this paper, the author will analyze the sound levels registered from July through December 2020, which includes all de-escalation stages, the restart of non-essential activities and the partial opening of Lima international airport. The most important result of this survey is to have been able to measure the nighttime aircraft noise impact, in order to assess their noise annoyance, mainly from those which overflight at dawn that they are capable of producing sleep interruption.

Does night-time aircraft noise trigger mortality? A case-crossover study on 24886 cardiovascular deaths.

AimsIt is unclear whether night-time noise events, including from aeroplanes, could trigger a cardiovascular death. In this study, we investigate the potential acute effects of aircraft noise on mortality and the specific role of different night-time exposure windows by means of a case-crossover study design.Methods and resultsWe selected 24 886 cases of death from cardiovascular disease (CVD) from the Swiss National Cohort around Zürich Airport between 2000 and 2015. For night-time deaths, exposure levels 2 h preceding death were significantly associated with mortality for all causes of CVD [OR = 1.44 (1.03–2.04) for the highest exposure group (LAeq > 50 dB vs. <20 dB)]. Most consistent associations were observed for ischaemic heart diseases, myocardial infarction, heart failure, and arrhythmia. Association were more pronounced for females (P = 0.02) and for people living in areas with low road and railway background noise (P = 0.01) and in buildings constructed before 1970 (P = 0.36). We calculated a population attributable fraction of 3% in our study population.ConclusionOur findings suggest that night-time aircraft noise can trigger acute cardiovascular mortality. The association was similar to that previously observed for long-term aircraft noise exposure.

Individual Aircraft Noise Exposure Assessment for a Case-Crossover Study in Switzerland.

Accurate exposure assessment is essential in environmental epidemiological studies. This is especially true for aircraft noise, which is characterized by a high spatial and temporal variation. We propose a method to assess individual aircraft noise exposure for a case-crossover study investigating the acute effects of aircraft noise on cardiovascular deaths. We identified all cases of cardiovascular death (24,886) occurring near Zürich airport, Switzerland, over fifteen years from the Swiss National Cohort. Outdoor noise exposure at the home address was calculated for the night preceding death and control nights using flight operations information from Zürich airport and noise footprints calculated for major aircraft types and air routes. We estimated three different noise metrics: mean sound pressure level (LAeq), maximum sound pressure level (LAmax), and number above threshold 55 dB (NAT55) for different nighttime windows. Average nighttime aircraft noise levels were 45.2 dB, 64.6 dB, and 18.5 for LAeq, LAmax, and NAT55 respectively. In this paper, we present a method to estimate individual aircraft noise exposure with high spatio-temporal resolution and a flexible choice of exposure events and metrics. This exposure assessment will be used in a case-crossover study investigating the acute effects of noise on health.

Survey Results of a Pilot Sleep Study Near Atlanta International Airport.

Aircraft noise can disturb the sleep of residents living near airports. To investigate potential effects of aircraft noise on sleep, recruitment surveys for a pilot field study were mailed to households around Atlanta International Airport. Survey items included questions about sleep quality, sleep disturbance by noise, noise annoyance, coping behaviors, and health. Of 3159 deliverable surveys, 319 were returned (10.1%). Calculated outdoor nighttime aircraft noise (Lnight) was significantly associated with lower sleep quality (poor or fair; odds ratio (OR) = 1.04/decibel (dB); p < 0.05), trouble falling asleep within 30 min ≥1/week (OR = 1.06/dB; p < 0.01), and trouble sleeping due to awakenings ≥1/week (OR = 1.04/dB; p < 0.05). Lnight was also associated with increased prevalence of being highly sleep disturbed (OR = 1.15/dB; p < 0.0001) and highly annoyed (OR = 1.17/dB; p < 0.0001) by aircraft noise. Furthermore Lnight was associated with several coping behaviors. Residents were more likely to report often or always closing their windows (OR = 1.05/dB; p < 0.01), consuming alcohol (OR = 1.10/dB; p < 0.05), using television (OR = 1.05/dB; p < 0.05) and using music (OR = 1.07/dB; p < 0.05) as sleep aids. There was no significant relationship between Lnight and self-reported general health or likelihood of self-reported diagnosis of sleep disorders, heart disease, hypertension or diabetes. Evidence of self-reported adverse effects of aircraft noise on sleep found in this pilot study warrant further investigation in larger, more representative subject cohorts.

Time-Varying Aircraft Noise Exposure and Incident Hypertension in the Nurses' Health Study

Background: Aircraft noise is of primary concern for communities living near airports. There is accumulating evidence of a relationship between aircraft noise and hypertension. However, most studies are cross-sectional or case-control, with limited numbers of prospective cohort studies and none in the U.S. This study aims to evaluate the association between long-term aircraft noise exposure and hypertension among participants in a large U.S. prospective cohort, the Nurses&amp;#8217; Health Study (NHS).Methods: Day-night average sound levels (DNL) 45-75 dB were modeled for 90 airports in the U.S. for 1995-2015 in 5-year intervals using the Aviation Environmental Design Tool and were linked to geocoded addresses of participants in NHS. We performed time-varying Cox proportional hazards models for hypertension incidence to estimate hazard ratios (HRs) for each 1 dB increase in current DNL, cumulative average DNL, and indicators for current DNL &amp;gt;45 dB (lowest dB considered &amp;#8220;exposed&amp;#8221;) and &amp;gt;55 dB, while adjusting for individual risk factors for hypertension, area-level socioeconomic status, and air pollution.Results: Among the 63,600 NHS participants free of hypertension in 1994, 28,286 new hypertension cases were observed by 2008. In each year, ~10% of the cohort were exposed to DNL levels &amp;gt;45 dB. In multivariable models, current and cumulative average DNL were not associated with hypertension incidence, but current exposure to &amp;gt;45 dB (HR&amp;#61;1.04; 95% CI: 0.99, 1.09) or &amp;gt;55 dB (HR&amp;#61;1.03; 95% CI: 0.89, 1.18) were associated with a suggestive increased risk.Conclusions: To our knowledge, this is the first study to evaluate the association between aircraft noise exposure and the risk of hypertension in a nationwide large prospective cohort study in the U.S. We will be investigating the noise-hypertension relationship in two additional cohorts, NHS II and the Health Professionals Follow-up Study, specifically examining the effect of nighttime aircraft noise exposure.

Crucial role for Nox2 and sleep deprivation in aircraft noise-induced vascular and cerebral oxidative stress, inflammation, and gene regulation.

AimsAircraft noise causes endothelial dysfunction, oxidative stress, and inflammation. Transportation noise increases the incidence of coronary artery disease, hypertension, and stroke. The underlying mechanisms are not well understood. Herein, we investigated effects of phagocyte-type NADPH oxidase (Nox2) knockout and different noise protocols (around-the-clock, sleep/awake phase noise) on vascular and cerebral complications in mice.Methods and resultsC57BL/6j and Nox2−/− (gp91phox−/−) mice were exposed to aircraft noise (maximum sound level of 85 dB(A), average sound pressure level of 72 dB(A)) around-the-clock or during sleep/awake phases for 1, 2, and 4 days. Adverse effects of around-the-clock noise on the vasculature and brain were mostly prevented by Nox2 deficiency. Around-the-clock aircraft noise of the mice caused the most pronounced vascular effects and dysregulation of Foxo3/circadian clock as revealed by next generation sequencing (NGS), suggesting impaired sleep quality in exposed mice. Accordingly, sleep but not awake phase noise caused increased blood pressure, endothelial dysfunction, increased markers of vascular/systemic oxidative stress, and inflammation. Noise also caused cerebral oxidative stress and inflammation, endothelial and neuronal nitric oxide synthase (e/nNOS) uncoupling, nNOS mRNA and protein down-regulation, and Nox2 activation. NGS revealed similarities in adverse gene regulation between around-the-clock and sleep phase noise. In patients with established coronary artery disease, night-time aircraft noise increased oxidative stress, and inflammation biomarkers in serum.ConclusionAircraft noise increases vascular and cerebral oxidative stress via Nox2. Sleep deprivation and/or fragmentation caused by noise triggers vascular dysfunction. Thus, preventive measures that reduce night-time aircraft noise are warranted.

Aircraft Noise Exposure and Subjective Sleep Quality: The Results of the DEBATS Study in France

ABSTRACT Background: Exposure to aircraft noise has been shown to have adverse effects on health, particularly on sleep. Exposure to nighttime aircraft noise clearly affects sleep architecture, as well as subjective sleep quality. Objectives: This study aimed to investigate the relationship between aircraft noise exposure and subjective sleep quality in the population living near airports in France. Methods: A total of 1,244 individuals older than 18 and living near three French airports (Paris-Charles de Gaulle, Lyon-Saint-Exupéry, and Toulouse-Blagnac) were randomly selected to participate in the study. Information on sleep as well as health, socioeconomic, and lifestyle factors was collected by means of a face-to-face questionnaire performed at their place of residence by an interviewer. For each participant, aircraft noise exposure was estimated at home using noise maps. Logistic regression models were used with adjustment for potential confounders. Results: Aircraft noise exposure was significantly associated with a short total sleep time (TST; ≤ 6 h) and with the feeling of tiredness while awakening in the morning. An increase of 10 dB(A) in aircraft noise level at night was associated with an OR of 1.63 (95% CI: 1.15–2.32) for a short TST and an OR of 1.23 (95% CI: 1.00–1.54) for the feeling of tiredness while awakening in the morning. Conclusions: These findings contribute to the overall evidence suggesting that aircraft noise exposure at nighttime may decrease the subjective amount and quality of sleep.

Association of long-term average levels of night-time road, railway, and aircraft noise and noise intermittency with arterial stiffness in the Swiss SAPALDIA cohort.

Introduction: Little is known about the biological pathways and relative contribution of source-specific transportation noise levels on cardiovascular disease (CVD), including the role of noise eve...

Is a smoking ban in UK parks and outdoor spaces a good idea?

<h3>Objectives</h3> Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of hypertension, cardiovascular disease and the use of sedatives and hypnotics. Our aim was...

Gaps in the literature on the effects of aircraft noise on children’s cognitive performance

In the past two decades, several major studies have indicated that chronic aircraft noise exposure negatively impacts children’s cognitive performance. For example, the longitudinal Munich airport study (Hygge, Am. Psychol. Soc., 2002) demonstrated that noise adversely affects reading ability, memory, attention, and speech perception. Moreover, the cross-sectional RANCH study (Stansfeld, Lancet, 2005) found a linear correlation between extended noise exposure and reduced reading comprehension and recognition memory. This presentation summarizes these and other recent studies and discusses four key areas in need of further research (ENNAH Final Report Project No. 226442, 2013). First, future studies should account for all of the following confounding factors: socioeconomic variables, daytime and nighttime aircraft, road, and train noise, and air pollution. Second, multiple noise metrics should be evaluated to determine if the character of the noise alters the relationship between noise and cognition. Third, future research should explore the mitigating effects of improved classroom acoustics and exterior sound insulation. Finally, additional longitudinal studies are necessary: (1) to establish a causal relationship between aircraft noise and cognition; and (2) to understand how changes in the duration of the exposure and in the age of the students influence the relationship. [Work supported by FAA PARTNER Center of Excellence.]

Nighttime aircraft noise impairs endothelial function and increases blood pressure in patients with or at high risk for coronary artery disease.

AimsEpidemiological studies suggest the existence of a relationship between aircraft noise exposure and increased risk for myocardial infarction and stroke. Patients with established coronary artery disease and endothelial dysfunction are known to have more future cardiovascular events. We therefore tested the effects of nocturnal aircraft noise on endothelial function in patients with or at high risk for coronary artery disease.Methods60 Patients (50p 1–3 vessels disease; 10p with a high Framingham Score of 23 %) were exposed in random and blinded order to aircraft noise and no noise conditions. Noise was simulated in the patients’ bedroom and consisted of 60 events during one night. Polygraphy was recorded during study nights, endothelial function (flow-mediated dilation of the brachial artery), questionnaires and blood sampling were performed on the morning after each study night.ResultsThe mean sound pressure levels L eq(3) measured were 46.9 ± 2.0 dB(A) in the Noise 60 nights and 39.2 ± 3.1 dB(A) in the control nights. Subjective sleep quality was markedly reduced by noise from 5.8 ± 2.0 to 3.7 ± 2.2 (p < 0.001). FMD was significantly reduced (from 9.6 ± 4.3 to 7.9 ± 3.7 %; p < 0.001) and systolic blood pressure was increased (from 129.5 ± 16.5 to 133.6 ± 17.9 mmHg; p = 0.030) by noise. The adverse vascular effects of noise were independent from sleep quality and self-reported noise sensitivity.ConclusionsNighttime aircraft noise markedly impairs endothelial function in patients with or at risk for cardiovascular disease. These vascular effects appear to be independent from annoyance and attitude towards noise and may explain in part the cardiovascular side effects of nighttime aircraft noise.

Public health perspectives on noise and cardiovascular disease

Introduction: Emerging research suggests that noise impacts human health beyond simply the auditory system. There have been recent amendments to acceptable noise level thresholds within the occupational setting and new European Union directives for noise in the community from air and road sources. The purpose of this review will be to assess the relationship between noise and cardiovascular disease in different settings. Methods: A literature review was conducted using PubMed on noise and more cardiovascular disease endpoints. All studies published in the English language between 2000-present were included. Studies on noise annoyance were excluded. Results: There is a strong positive association between occupational noise exposure and cardiovascular outcomes. There is a moderate association with noise in the community setting from road sources and a weak association with aircraft noise. The strength of the association across settings is dependent on the outcome type, interaction with age and sex of subjects, and time of measurement. Road source noise had the strongest association with myocardial infarction, notably in women during night exposures. The association with hypertension and road noise, when stratified by sex, was significant in men during night-time exposures and in pregnant older women. Only nighttime aircraft noise was associated with statistically significant findings in adults. All sources of noise demonstrate a dose response relationship, which peaks at different noise thresholds. Occupational noise exposure had the strongest association with noise > 85 dB (A) and duration of exposure. Conclusion: There is sufficient evidence to warrant the precautionary public health principle to reduce noise at the population levels for industry workers through stronger legislation, regular compliance inspections, and health promotion. Where population wide noise legislation has not yet been enacted, noise exposure reduction at the individual level may be beneficial.

Nighttime aircraft noise exposure: flying towards arterial disease

This editorial refers to ‘Effect of nighttime aircraft noise exposure on endothelial function and stress hormone release in healthy adults’, by F.P. Schmidt et al. doi:10.1093/eurheartj/eht269 Over the last four decades there has been a steady increase in air travel worldwide. The global air transport network has contributed to the growth of economies by providing better access to national and international resources, increasing tourism, encouraging investment and innovation, and improving business operations and efficiency. Air transport also offers a vital lifeline to remote communities and rapid worldwide support during emergency situations. However, along with these benefits, detrimental effects linked to the expanding air network have been recognized. There are increasing data to suggest that air pollution and noise from airplanes have significant environmental and cardiovascular implications. Air pollutants have been associated with climate changes and increased hospitalization and mortality due to cardiovascular disease in high risk populations.1 In parallel, auditory impairment as a result of the direct effects of sound energy has been well recognized. As a result, protective legislation requiring hearing protectors to be worn by those working in close proximity is currently in place.2 However, the indirect effect of noise on human health remains an area of active research. Evidence for an adverse effect on public health for aircraft noise exposure, in particular during night-time, has strengthened recently as results from epidemiological community studies have become available.3 At night, cerebral function recovers from the rigours of daytime activities and key brain processes are restored. Aircraft noise has been associated with sleep fragmentation and an increase in stress hormone levels, and concerns have been …