WHO Environmental Noise Guidelines Research Articles

Improvement of noise calculation method considering aerodynamic noise condition during aircraft landing

Recently, while aircraft engine noise has become quieter, aerodynamic noise such as airframe noise, gear, and flaps have become relatively louder. In addition, the WHO environmental noise guidelines for the European region require consideration of small noise effects, and it has become necessary to increase the validity of calculations at distant airports, where aerodynamic noise fluctuations are large. Therefore, Nakazawa et al. reported a method to improve the validity of noise prediction for distant airports by correcting the existing noise calculation method to take aerodynamic noise into account. However, the predicted results deviated to a smaller extent than the measured results, indicating that the correction method needs to be improved. This method was improved, and using the results of highly accurate microphone array measurements with 195 microphones, NPD data for correction was prepared from aircraft noise by component using J-FRAIN, taking aerodynamic noise

Traffic-Related High Sleep Disturbance in the LIFE-Adult Cohort Study: A Comparison to the WHO Exposure-Response-Curves

Sleep is negatively affected by environmental noise. In the present study, we investigated self-reported high sleep disturbances (being "highly sleep disturbed"-HSD) from road traffic (primary and secondary road networks), rail (train and tram) and air traffic noise in the LIFE-Adult cohort study in Leipzig, Germany. For this, we used exposure data from 2012 and outcome data of Wave 2 (collected during 2018-2021). HSD was determined and defined according to internationally standardized norms. The highest risk for transportation noise-related HSD was found for aircraft noise: the odds ratio (OR) was 19.66, 95% CI 11.47-33.71 per 10 dB increase in Lnight. For road and rail traffic, similar risk estimates were observed (road: OR = 2.86, 95% CI 1.92-4.28; rail: OR = 2.67, 95% CI 2.03-3.50 per 10 dB Lnight increase). Further, we compared our exposure-risk curves with the curves of the WHO environmental noise guidelines for the European region. The proportion of individuals with HSD for a given noise level was lower for rail traffic but higher for aircraft noise in the LIFE study than in the WHO curves. For road traffic, curves are not directly comparable because we also included the secondary road network. The results of our study add to the body of evidence for increased health risks by traffic noise. Moreover, the results indicate that aircraft noise is particularly harmful to health. We recommend reconsidering threshold values for nightly aircraft exposure.

The WHO Environmental Noise Guidelines and noise policy in Denmark - the case of noise from motorways

The WHO Environmental Noise Guidelines and noise policy in Denmark Studies from Denmark - and a background article from the WHO report on Environmental Noise Guidelines from 2018- supports the Danish noise limit on Lden = 58 dB for ordinary roads for 10 % highly annoyed. Other studies however shows that motorways are more annoying - close to WHO guidelines at 53 dB. A Danish investigations point to Lden = 52 dB for 10 % highly annoyed for motorways. A Swiss study suggests Lden 51 dB for 10% highly annoyed for motorways. According to the studies the Danish EPA has made an investigation of the consequences for new motorways and urban planning - if the guidelines would be changed from 58 dB to 53 dB. It shows the difficulties for urban planners if the noise limit would be changed - but also that it is fact possible to lower the limits technically - through speed limits, noise barriers etc. The study also shows that new projects for new housing economically would be difficult outside larger cities - because of increasing cost. This paper shows what policy implications this entails in Denmark.

Cardiovascular consequences of aircraft noise exposure.

The results from epidemiological studies suggest that environmental noise including aircraft, railway, road traffic, wind turbine, and leisure-related noise is a growing public health concern. According to the WHO, at least 100 million people in the European Union are affected by traffic noise levels above the WHO-recommended thresholds. Environmental noise can adversely affect physical and mental health, as well as wellbeing. Chronic low-level noise exposure typical for most environmental sources is associated with psychophysiological stress causing non-auditory or indirect noise effects leading ultimately to cardiovascular diseases. Among all environmental noise sources, aircraft noise is considered the most annoying, and its leading mechanism of action is autonomic system activation such as increases in heart rate and blood pressure. Previously, we observed that long-term exposure to aircraft noise was associated with increased diastolic blood pressure, arterial stiffness (as assessed by pulse wave velocity), and impaired left ventricular diastolic function. All mentioned above effects are early, subclinical, and potentially reversible changes which preceded late noise effects in the cardiovascular system, that is, established cardiovascular diseases such as myocardial infarction, stroke, and heart failure. However, even a short-term reduction in aircraft noise exposure as observed during the COVID-19 lockdown may reverse these negative effects on arterial stiffness and blood pressure and may decrease the prevalence of insomnia. In this review, we aimed to critically discuss our obtained results considering recent studies on the influence of aircraft noise (and other traffic noises) on cardiovascular diseases in the context of the WHO Environmental Noise Guidelines for the European Region.

Review of environmental noise policies and economics in 2014-2016

This review has highlighted the important developments relating to noise issues performed by international organizations and the activities in some developed and developing countries to improve environmental noise management.
 The World Health Organization is in the process of finalizing the WHO Environmental Noise Guidelines for the European Region as an update of the WHO Community Noise Guidelines of 1999/2000.
 The International Civil Aviation Organization, in Chapter 14, has lowered the current chapter 4 standards for subsonic jet aircraft and propeller driven aeroplanes.
 In 2014-2016 the European Parliament and the Council and the European Commission have achieved significant progress in amending laws and regulations and creating new legislation. Efforts referred to regulating the EU type-approval of all new buses and trucks with regard to their sound level and the introduction of noise-related operating restrictions at airports, in accordance with ICAO’s Balanced Approach. The EC amended the END and arranged for the evaluation of the END based on the criteria of relevance, coherence, effectiveness and impacts, efficiency, and EU added value. Two new regulations addressed the issues of technical specification for interoperability of high-speed trains related to sound emission levels and the implementation of provisions establishing noise-differentiated track access charges.
 The European Environment Agency published the ‘Noise in Europe’ report describing the impacts of noise exposure in terms of cases of premature death, hospital admissions, cases of hypertension and annoyance. In addition, the European Environment Agency developed a good practice guide on quiet areas, refined the methodology for a quietness suitability index, and published its report on “Quiet areas in Europe”.
 In the United Kingdom, the Civil Aviation Authority reported new and updated evidence on attitudes to aviation noise around airports in England, and the Airports commission published recommendations for development in the aviation sector around London. The Department of Transport formulated a draft Airports National Policy Statement on expansion options for South East England airports.
 Switzerland published its Environment Report 2015 and estimated the annual external costs of road traffic, railway and aircraft noise which are quite substantial.
 Developing countries become increasingly aware that noise levels have gone up abnormally high and can cause acute and chronic health impacts on the human population. In consequence, Costa Rica has lowered the permissible sound pressure levels, and India, Iraq and Mexico have set new daytime and night-time noise standards. Tanzania has approved permissible sound pressure limits, which were prepared by the National Environment Management Council almost a decade ago. The Egyptian Environmental Affairs Agency developed a national plan to combat noise, which is currently implemented on a collaborative effort of 11 ministries, a rare phenomenon in developing countries. Kenya is currently committed to develop a strategy for environmental noise management.

AORN Position Statement on Managing Distractions and Noise During Perioperative Patient Care

<scp>AORN</scp> Position Statement on Managing Distractions and Noise During Perioperative Patient Care

Evidence for Environmental Noise Effects on Health for the United Kingdom Policy Context: A Systematic Review of the Effects of Environmental Noise on Mental Health, Wellbeing, Quality of Life, Cancer, Dementia, Birth, Reproductive Outcomes, and Cognition.

This systematic review commissioned by the UK Department for the Environment, Food and Rural Affairs (Defra), considers how the evidence base for noise effects on health has changed following the recent reviews undertaken for the WHO Environmental Noise Guidelines. This systematic review assesses the quality of the evidence for environmental noise effects on mental health, wellbeing, and quality of life; birth and reproductive outcomes; and cognition for papers published since the WHO reviews (mid-2015 to March 2019), as well as for cancer and dementia (January 2014 to March 2019). Using the GRADE methodology (Grading of Recommendations Assessment, Development and Evaluation) most evidence was rated as low quality as opposed to very low quality in the previous reviews. There is now low-quality evidence for a harmful effect of road traffic noise on medication use and interview measures of depression and anxiety and low quality evidence for a harmful effect of road traffic noise, aircraft noise, and railway noise on some cancer outcomes. Many other conclusions from the WHO evidence reviews remain unchanged. The conclusions remain limited by the low number of studies for many outcomes. The quantification of health effects for other noise sources including wind turbine, neighbour, industrial, and combined noise remains a research priority.

A Systematic Review of the Basis for WHO's New Recommendation for Limiting Aircraft Noise Annoyance.

The new WHO Environmental Noise Guidelines for the European Region have recommendations for limiting noise exposure associated with adverse health effects. The limits are said to be based on a systematic review of existing evidence. This paper gives a systematic assessment of the presented evidence with respect to annoyance from aircraft noise. The new guidelines have been based on the results from a selection of existing aircraft noise studies. This paper demonstrates that a similar selection of other existing post-2000 studies will yield very different results. In addition, the validity of the presented evidence has been questioned as some of the referenced studies have not been conducted according to standardized methods, and the selection of respondents is not representative of the general airport population.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Quality of Life, Wellbeing and Mental Health.

This systematic review assesses the quality of the evidence across studies on the effect of environmental noise (road traffic noise, aircraft noise, railway noise, wind-turbine noise) on quality of life, wellbeing and mental health. Quantitative studies of noise effects on children and adults published from January 2005 up to October 2015 were reviewed. A total of 29 papers were identified. 90% of the papers were of cross-sectional design, with fewer studies of longitudinal or intervention design. Outcomes included depression and anxiety, medication use and childhood emotional problems. The quality of the evidence across the studies for each individual noise source was assessed using an adaptation of the GRADE methodology. Overall, given the predominance of cross-sectional studies, most evidence was rated as very low quality, with evidence of effects only being observed for some noise sources and outcomes. These ratings reflect inconsistent findings across studies, the small number of studies and a lack of methodological robustness within some domains. Overall, there are few studies of clinically significant mental health outcomes; few studies of railway noise exposure; and studies of large samples are needed. The lack of evidence for noise effects across studies for many of the quality of life, wellbeing and mental health domains examined does not necessarily mean that there are no effects: rather, that they have not yet been studied robustly for different noise sources.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Effects on Sleep.

To evaluate the quality of available evidence on the effects of environmental noise exposure on sleep a systematic review was conducted. The databases PSYCINFO, PubMed, Science Direct, Scopus, Web of Science and the TNO Repository were searched for non-laboratory studies on the effects of environmental noise on sleep with measured or predicted noise levels and published in or after the year 2000. The quality of the evidence was assessed using GRADE criteria. Seventy four studies predominately conducted between 2000 and 2015 were included in the review. A meta-analysis of surveys linking road, rail, and aircraft noise exposure to self-reports of sleep disturbance was conducted. The odds ratio for the percent highly sleep disturbed for a 10 dB increase in Lnight was significant for aircraft (1.94; 95% CI 1.61–2.3), road (2.13; 95% CI 1.82–2.48), and rail (3.06; 95% CI 2.38–3.93) noise when the question referred to noise, but non-significant for aircraft (1.17; 95% CI 0.54–2.53), road (1.09; 95% CI 0.94–1.27), and rail (1.27; 95% CI 0.89–1.81) noise when the question did not refer to noise. A pooled analysis of polysomnographic studies on the acute effects of transportation noise on sleep was also conducted and the unadjusted odds ratio for the probability of awakening for a 10 dBA increase in the indoor Lmax was significant for aircraft (1.35; 95% CI 1.22–1.50), road (1.36; 95% CI 1.19–1.55), and rail (1.35; 95% CI 1.21–1.52) noise. Due to a limited number of studies and the use of different outcome measures, a narrative review only was conducted for motility, cardiac and blood pressure outcomes, and for children’s sleep. The effect of wind turbine and hospital noise on sleep was also assessed. Based on the available evidence, transportation noise affects objectively measured sleep physiology and subjectively assessed sleep disturbance in adults. For other outcome measures and noise sources the examined evidence was conflicting or only emerging. According to GRADE criteria, the quality of the evidence was moderate for cortical awakenings and self-reported sleep disturbance (for questions that referred to noise) induced by traffic noise, low for motility measures of traffic noise induced sleep disturbance, and very low for all other noise sources and investigated sleep outcomes.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cardiovascular and Metabolic Effects: A Summary.

To update the current state of evidence and assess its quality, we conducted a systematic review on the effects of environmental noise exposure on the cardio-metabolic systems as input for the new WHO environmental noise guidelines for the European Region. We identified 600 references relating to studies on effects of noise from road, rail and air traffic, and wind turbines on the cardio-metabolic system, published between January 2000 and August 2015. Only 61 studies, investigating different end points, included information enabling estimation of exposure response relationships. These studies were used for meta-analyses, and assessments of the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A majority of the studies concerned traffic noise and hypertension, but most were cross-sectional and suffering from a high risk of bias. The most comprehensive evidence was available for road traffic noise and Ischeamic Heart Diseases (IHD). Combining the results of 7 longitudinal studies revealed a Relative Risk (RR) of 1.08 (95% CI: 1.01–1.15) per 10 dB (LDEN) for the association between road traffic noise and the incidence of IHD. We rated the quality of this evidence as high. Only a few studies reported on the association between transportation noise and stroke, diabetes, and/or obesity. The quality of evidence for these associations was rated from moderate to very low, depending on transportation noise source and outcome. For a comprehensive assessment of the impact of noise exposure on the cardiovascular and metabolic system, we need more and better quality evidence, primarily based on longitudinal studies.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cognition.

This systematic review assesses the quality of the evidence across individual studies on the effect of environmental noise (road traffic, aircraft, and train and railway noise) on cognition. Quantitative non-experimental studies of the association between environmental noise exposure on child and adult cognitive performance published up to June 2015 were reviewed: no limit was placed on the start date for the search. A total of 34 papers were identified, all of which were of child populations. 82% of the papers were of cross-sectional design, with fewer studies of longitudinal or intervention design. A range of cognitive outcomes were examined. The quality of the evidence across the studies for each individual noise source and cognitive outcome was assessed using an adaptation of GRADE methodology. This review found, given the predominance of cross-sectional studies, that the quality of the evidence across studies ranged from being of moderate quality for an effect for some outcomes, e.g., aircraft noise effects on reading comprehension and on long-term memory, to no effect for other outcomes such as attention and executive function and for some noise sources such as road traffic noise and railway noise. The GRADE evaluation of low quality evidence across studies for some cognitive domains and for some noise sources does not necessarily mean that there are no effects: rather, that more robust and a greater number of studies are required.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Annoyance.

Background: This paper describes a systematic review and meta-analyses on effects of environmental noise on annoyance. The noise sources include aircraft, road, and rail transportation noise as well as wind turbines and noise source combinations. Objectives: Update knowledge about effects of environmental noise on people living in the vicinity of noise sources. Methods: Eligible were published studies (2000–2014) providing comparable acoustical and social survey data including exposure-response functions between standard indicators of noise exposure and standard annoyance responses. The systematic literature search in 20 data bases resulted in 62 studies, of which 57 were used for quantitative meta-analyses. By means of questionnaires sent to the study authors, additional study data were obtained. Risk of bias was assessed by means of study characteristics for individual studies and by funnel plots to assess the risk of publication bias. Main Results: Tentative exposure-response relations for percent highly annoyed residents (%HA) in relation to noise levels for aircraft, road, rail, wind turbine and noise source combinations are presented as well as meta-analyses of correlations between noise levels and annoyance raw scores, and the OR for increase of %HA with increasing noise levels. Quality of evidence was assessed using the GRADE terminology. The evidence of exposure-response relations between noise levels and %HA is moderate (aircraft and railway) or low (road traffic and wind turbines). The evidence of correlations between noise levels and annoyance raw scores is high (aircraft and railway) or moderate (road traffic and wind turbines). The evidence of ORs representing the %HA increase by a certain noise level increase is moderate (aircraft noise), moderate/high (road and railway traffic), and low (wind turbines). Strengths and Limitations: The strength of the evidence is seen in the large total sample size encompassing the included studies (e.g., 18,947 participants in aircraft noise studies). Main limitations are due to the variance in the definition of noise levels and %HA. Interpretation: The increase of %HA in newer studies of aircraft, road and railway noise at comparable Lden levels of earlier studies point to the necessity of adjusting noise limit recommendations. Funding: The review was funded by WHO Europe.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Permanent Hearing Loss and Tinnitus.

Background: Hearing loss is defined as worsening of hearing acuity and is usually expressed as an increase in the hearing threshold. Tinnitus, defined as “ringing in the ear”, is a common and often disturbing accompaniment of hearing loss. Hearing loss and environmental exposures to noise are increasingly recognized health problems. Objectives: The objective was to assess whether the exposure-response relationship can be established between exposures to non-occupational noise and permanent hearing outcomes such as permanent hearing loss and tinnitus. Methods: Information sources: Computer searches of all accessible medical and other databases (PubMed, Web of Science, Scopus) were performed and complemented with manual searches. The search was not limited to a particular time span, except for the effects of personal listening devices (PLDs). The latter was limited to the years 2008–June 2015, since previous knowledge was summarized by SCENIHR descriptive systematic review published in 2008. Study eligibility criteria: The inclusion criteria were as follows: the exposure to noise was measured in sound pressure levels (SPLs) and expressed in individual equivalent decibel values (LEX,8h), the studies included both exposed and reference groups, the outcome was a permanent health effect, i.e., permanent hearing loss assessed with pure-tone audiometry and/or permanent tinnitus assessed with a questionnaire. The eligibility criteria were evaluated by two independent reviewers. Study appraisal and synthesis methods: The risk of bias was assessed for all of the papers using a template for assessment of quality and the risk of bias. The GRADE (grading of recommendations assessment, development, and evaluation) approach was used to assess the overall quality of evidence. Meta-analysis was not possible due to methodological heterogeneity of included studies and the inadequacy of data. Results: Out of 220 references identified, five studies fulfilled the inclusion criteria. All of them were related to the use of PLDs and comprised in total of 1551 teenagers and young adults. Three studies used hearing loss as the outcome and three tinnitus. There was a positive correlation between noise level and hearing loss either at standard or extended high frequencies in all three of the studies on hearing loss. In one study, there was also a positive correlation between the duration of PLD use and hearing loss. There was no association between prolonged listening to loud music through PLDs and tinnitus or the results were contradictory. All of the evidence was of low quality. Limitations: The studies are cross-sectional. No study provides odds ratios of hearing loss by the level of exposure to noise. Conclusions: While using very strict inclusion criteria, there is low quality GRADE evidence that prolonged listening to loud music through PLDs increases the risk of hearing loss and results in worsening standard frequency audiometric thresholds. However, specific threshold analyses focused on stratifying risk according to clearly defined levels of exposure are missing. Future studies are needed to provide actionable guidance for PLDs users. No studies fulfilling the inclusion criteria related to other isolated or combined exposures to environmental noise were identified.

P3410Traffic noise and ischemic heart disease - review of the evidence for the WHO environmental noise guidelines for the European region

P3410Traffic noise and ischemic heart disease - review of the evidence for the WHO environmental noise guidelines for the European region

WHO Environmental Noise Guidelines for the European Region: A Systematic Review of Transport Noise Interventions and Their Impacts on Health.

This paper describes a systematic review (1980–2014) of evidence on effects of transport noise interventions on human health. The sources are road traffic, railways, and air traffic. Health outcomes include sleep disturbance, annoyance, cognitive impairment of children and cardiovascular diseases. A conceptual framework to classify noise interventions and health effects was developed. Evidence was thinly spread across source types, outcomes, and intervention types. Further, diverse intervention study designs, methods of analyses, exposure levels, and changes in exposure do not allow a meta-analysis of the association between changes in noise level and health outcomes, and risk of bias in most studies was high. However, 43 individual transport noise intervention studies were examined (33 road traffic; 7 air traffic; 3 rail) as to whether the intervention was associated with a change in health outcome. Results showed that many of the interventions were associated with changes in health outcomes irrespective of the source type, the outcome or intervention type (source, path or infrastructure). For road traffic sources and the annoyance outcome, the expected effect-size can be estimated from an appropriate exposure–response function, though the change in annoyance in most studies was larger than could be expected based on noise level change.

EEG Arousal Norms by Age

Brief arousals have been systematically scored during sleep for more than 20 years. Despite significant knowledge concerning the importance of arousals for the sleep process in normal subjects and patients, comprehensive age norms have not been published. Seventy-six normal subjects (40 men) without sleep apnea or periodic limb movements of sleep, aged 18 to 70 years, slept in the sleep laboratory for 1 or more nights. Sleep and arousal data were scored by the same scorer for the first night (comparable to clinical polysomnograms) and summarized by age decade. There were no statistically significant differences for sex or interaction of sex by age (p > .5 for both). The mean arousal index increased as a function of age. Newman-Keuls comparisons (.05) showed arousal index in the 18- to 20-year and 21- to 30-year age groups to be significantly less than the arousal index in the other 4 age groups. Arousal index in the 31-to 40-year and 41-to 50-year groups was significantly less than the arousal index in the older groups. The arousal index was significantly negatively correlated with total sleep time and all sleep stages (positive correlation with stage 1 and wake). Brief arousals are an integral component of the sleep process. They increase with other electroencephalographic markers as a function of age. They are highly correlated with traditional sleep-stage amounts and are related to major demographic variables. Age-related norms may make identification of pathologic arousal easier.