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| Year : 2000
| Volume
: 2 | Issue : 8 | Page
: 79-84 |
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| Noise Pollution Health Effects Reduction (NOPHER) : An European Commission Concerted Action Workplan |
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Deepak Prasher
Scientist-in-Charge, NOPHER, Institute of Laryngology and Otology, London, United Kingdom
Click here for correspondence address
and email
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How to cite this article:
Prasher D. Noise Pollution Health Effects Reduction (NOPHER) : An European Commission Concerted Action Workplan. Noise Health 2000;2:79-84 |
| Introduction | |  |
One of the aims of the concerted action is to improve the quality and effectiveness of the noise pollution research in improving our understanding of the health risks and thereby reducing the harmful effects on Man. This will be achieved through European co-operation amongst the noise specialists engaged in research in their own countries coming together and jointly gaining from each other's experiences to improve the state of the art in noise related effects research. The workplan is summarised in [Table - 1] which sets out the three main areas of the environment that the plan will cover namely work, community and leisure activities which create noise pollution affecting both the auditory and other psycho-physiological systems leading to disability. The work has been sub-divided in to tasks or work-packages, which will be lead by two task co-ordinators who will be responsible for specific issues the development of the work within that task. The concerted action co-ordinator will act as a conduit for information between task groups and major meetings and together with the steering committee the arrangements for the major meetings and report publications. The aim is for the group as a whole to achieve more than the sum of its parts. To have a better understanding of the issues and deficiencies of the current knowledge and to improve on this by a concerted joint effort on many fronts bringing people from many diverse disciplines together to discuss a common problem of noise. The engineers, otorhinolarynogologists, social scientists, audiologists, psychologists, environmental health specialists, occupational health physicians, epidemiologists, psychiatrists, lawyers, politicians, user group representatives, consumer groups, ergonomists all have an interest in improving our knowledge base on noise effects and creating an awareness of the hazards to protect future generations.
The overall methodology used to achieve the objectives is to allow individual partners in the concerted action to conduct their own research using their own methodology but have a task group in which all work associated with the particular issues is discussed and collaborative work is planned together with harmonised protocols for a gain in the research outcome and efficient use of the diverse expertise and resources available to the group. Furthermore, all groups will meet at least annually to discuss issues of common and general interest as well those of specific groups to report their recent research results. The emphasis will be on achieving consensus on issues and planning strategies for joint action on improving the health outcome.
| Details of Workpackages | | |
Work package WP1: Determine health effects of chronic exposure to transport noise Objectives
- To assess the degree of any causal association between the various adverse health effects and levels of exposure to environmental noise and to reach a Europe-wide consensus on clear observable noise pollution health effects and indicate where deficiencies exist in research evidence.
- To develop improved methods of quantification and characterisation of noise To determine the effect of chronic (traffic) noise exposure on allostatic load parameters and endocrine and immunological stress-sensitive systems
- To assess the aircraft noise affected community group's health ((with particular emphasis on sleep disturbance) in comparison with a control community
- To conduct a longitudinal and cross-sectional study of the effect of road traffic and occupational noise exposure on arteriosclerosis and cardiovascular risk factors
- To determine the influence of acoustic and non-acoustic factors affecting annoyance from environmental noise
Description of Work
The relationship between air, rail and road transportation noise and annoyance, stress reactions, sleep disturbance, neuro-endocrine, immunological and cardiovascular function will be examined. Studies will focus on subjective sleep quality and objective sleep pattern with sound recordings to determine the relationship between road and aircraft noise and sleep. Influence of sleep disturbance on health, work performance and accident risk. A longitudinal telephone survey will determine changes in annoyance as the main airport in Norway is shifted, a field study with sound recordings will establish dose-response relationships. Experiments will determine how sleep-associated release of stress hormones is influenced by noise load during the sleep period and prior to wakefulness and to clarify the functional role of sleep for the formation of psychological and immunological memory and its sensitivity to adverse effects of stress. 4000 cases of unhealthy and control individuals exposed to noise will be examined for their endocrine stress reactions (cortisol), neuro-endocrine modulation of immunological functions as well as hypertension and coronary heart disease whilst 4500 subjects will have assessments of microcirculation for any association with traffic noise. A retrospective cohort design study will examine changes in cardiovascular risk factor values in relation to noise exposure over a ten year period in 1000 subjects with different exposure values but matched for demographic factors and controlled for potentially confounding factors. It is difficult to estimate individual environmental noise exposure, for many types of noise the long term average noise level contribution can be quite low in absolute terms which makes dose-response relations difficult to interpret. Attempts will be made to improve the quality of the quantification and characterisation of the actual noise exposure experienced by the exposed subjects or populations in research studies. Methods of determining population exposure from noise source emission levels.
Work package, WP2: Development of strategies for pharmacological protection against noise trauma
Objectives
Identification of new prevention strategies.
- Improved understanding of the mechanisms involved in
- the natural recovery processes in the auditory system after a noise insult.
- pharmacological reduction or prevention of noise damage.
- processes leading to protection with sound conditioning.
- processes leading to protection with magnesium supplementation.
- Transfer of knowledge from animal research to human feasibility studies. Transfer of skills from proficient laboratories to others in the workgroup seeking to undertake such research.
Description of Work
New concepts for noise induced hearing loss suggest that the overall susceptibility of the organ of Corti and the spiral ganglion neurones may be modified and the resultant effect of damage reduced significantly. Previous studies have shown that recovery from acute hearing loss is possible in the mammalian cochlea. It is now evident that certain neuro-peptides, nitric oxide inhibitors, antagonists of glutamate or dopamine receptors, neuronal growth factors, hormones and free-radical scavengers may protect against hearing loss. This work group will be examining various means of protecting from noise and other ototoxic agents.
Improve understanding of the biological mechanisms of repair after noise trauma.
Examine the role of chemicals in the protection mechanisms.
Examine how biologically active toxic substances may be inhibited to protect the cochlea.
Examine low cost solutions for protection: sound conditioning and oral magnesium.
Work package, WP3: Effects of combined chemicals and noise exposures on hearing and balance
Objectives
- Effects of organic solvents and heavy metals on the inner ear have not been adequately documented. The studies conducted by this work group will aim to
- determine the extent and site of auditory and vestibular system damage due to occupational exposure to organic solvents, metals and asphyxiants alone and in combination with noise.
- determine the extent of potentiation of noise induced hearing loss by simultaneous exposure to chemical agents and the dose-response relationship.
- establish protocols for field studies of combined chemical and noise exposure effects on the auditory and vestibular systems.
- determine the effects of environmental exposure to lead on children's auditory central nervous system
- determine ototoxic mechanisms of organic solvents via an in-vitro approach
- development of an in-vivo test of solvent ototoxicity
- determine the effect on the auditory system of exposure to chemicals with and without physical or psycho-social stress
- Evaluate individual risk factors for hearing and balance disturbance in the work environment
Description of Work
Chemicals such as toluene, styrene, xylene, trichloroethylene, lead, mercury and carbon monoxide commonly used in the manufacturing, services, transportation, and construction industries present a major risk to hearing and balance. The risk is further increased in the presence of noise in the workplace.
This synergistic effect of chemicals and noise is extremely hazardous as either of the toxic agents can co-exist within the current permissible levels but in combination pose a greater threat. Human field studies show that the relative risk for hearing loss is increased from four times with noise alone to eleven times with noise and chemicals
This workgroup will meet to plan research protocols for harmonised epidemiological studies to be conducted in Sweden, Finland, Israel, Czech Republic, Poland, UK, and USA in workers exposed to chemicals such as styrene, toluene, trichloroethylene, lead, carbon monoxide, jet fuel with and without noise to determine the effects on the audio-vestibular system. Amongst the many industries affected by the chemicals are plastics, paint and printing works as well as those working in polluted environments such as fire fighters, tunnel and toll workers, truck drivers who will provide the populations for study from across East / West Europe. The group will determine the relationship between exposure duration, chemical concentration, and noise levels, which are responsible for the synergistic effects. The noise frequency spectrum and interactions with chemicals will be examined so that accurate predictions can be made with regard to specific work environments. Animal studies will examine the mechanisms of action of organic solvents using an in vitro approach.
The potency of only a few solvents has been determined and the ototoxic potency of many organic solvents used in large amounts are unknown. It is planned to examine the ototoxic potency of aliphatic hydrocarbons and estimate the effect of interaction with exposure to low-level noise and to study the effects of interaction on hearing of psycho-social stress.
Work package, WP4: Determine specific health effects of social and community noise on Children Objectives
- Listening to loud music poses a real hazard to hearing and may produce the very troublesome symptom of tinnitus.
- Examine whether children's stress reactions, annoyance and performance differ if home(rail and road) noise levels high compared to those with low noise levels.
- Examine the effects of low flying aircraft and living near an airport on children's learning and performance.
- Develop a Europe-wide consensus on measurement of noise from toys and health effects on children.
- Set up an international register of case studies of children affected by noisy toys.
- Examine the effect of discotheques, concerts, arcade games, personal cassette players, theme parks, sports events on young people.
- Examine the effect of environmental noise and classroom acoustics on children's performance and behaviour.
- Examine the effect of ambient noise on children using hearing aids and cochlear implants.
Description of Work
This group will gather the information on the health effects of noise on children and assess the evidence for the relationships as there are conflicting reports in the literature on the subject.
A meeting will be called to reach a consensus on the best approach to the measurement of noise from toys and determine whether there is a need for improved control of noise from toys. The group will compare the harmfulness of impulse sound levels from toy cap guns with close or open barrels and how the harmfulness of these levels are reflected measured in LpC peak or A-weighted LpA1s.
An epidemiological questionnaire study of the current listening habits and noisy leisure time pursuits such as discotheques and concerts, motor sports etc will be ascertained. Subsets will be followed up with audiometric tests to determine any dose-response relationships. A number of centres (UK, Norway, Germany, Austria) will examine the effect on learning, performance (reading skill, visual and verbal memory, concentration ability) and stress reactions (adrenaline, noradrenaline, cortisol from urine samples) of children affected by rail/road traffic, low flying aircraft and/or living near an airport.
Specific groups will be examined to determine whether they constitute a high risk group. Individual sensitivity will be examined by testing otoacoustic emissions after a single exposure to loud music at a discotheque.
Work package, WP5: Determine means of identifying individuals sensitive to noise damage
Objectives
- Examine the value of otoacoustic emissions as predictor of noise damage and identifier of individuals likely to be affected.
- Determine parameters of OAE best suited for epidemiological studies of noise damage
- Determine whether hearing continues to deteriorate after noise exposure stops
- Examine the interaction of ageing and noise on hearing
Description of Work
Hearing threshold at a particular frequency in the population approximates to the mean effect of age and noise immission but recent statistical modelling indicates that such a simple model is not justified. This is especially the case for the percentiles that lie above the upper quartile, which contains most of the cases that are subject to litigation and compensation. It is important to understand this more fully, particularly in the context of the operational requirements of the armed services in Europe. Furthermore limited longitudinal studies are now showing that the very limited evidence that noise does not have an effect after it has ceased to be a hazard may be questionable. This Group intends to acquire data on all three of these issues, but particularly with respect to the prevalence of hearing and related problems in the European armed forces.
A longitudinal study of individual susceptibility to noise damage will examine 200 military recruits with a number of audiometric tests and will be followed over a period to determine which tests offered any indication of particular individuals to be at risk of hearing loss. In another study of 2000 workers in car manufacturing plant will have otoacoustic emission measurements to determine whether they provide a subclinical indication of auditory damage prior to subjective hearing loss. Retrospective data analysis will be conducted on a large database of occupational audiometry and other risk factors as well as noise levels to determine relationships and identify specific correlations. Other areas which will be followed include an evaluation of the role of the auditory efferent system in individual protection from noise, role of sound conditioning and level of melanin and ageing on acquiring hearing loss from noise exposure.
A group of elderly subjects with hearing better than 20dB at all frequencies will be examined with emissions and questioned about their occupational, community and leisure noise exposure and compared with subjects with age appropriate hearing.
A study will be conducted in several big industries in Sweden generating a large database of auditory measurements and risk factors for hearing loss such as leisure noise, military exposure, medical history etc. on a population of noise exposed workers.
Work package, WP6: Development of an environmental noise health information system
Objectives
- Develop an expert system with machine learning for Individual Hearing Conservation Program
- Develop methods of analysis for annual industrial audiometric databases and determine their effectiveness in prevention of hearing loss
- Develop an educational material information base
- Develop a website of noise effects specialists for wider consultation
- Develop further the Journal of Noise and Health
Description of Work
The Individual Hearing Conservation Program (IHCP) will contain at least four databases including exposure evaluation, audiometric evaluation, hearing protection, and individual susceptibility information. Each module will have noise exposure, medical history, risk factors, audiometry, ear history and models of noise induced hearing loss. The expert program will generate new rules and learn from the material in order to provide IHCP on an individual basis. A knowledge based system will provide the general rules and machine learning program with fuzzy neural network will generate new knowledge. The artificial intelligence is based on a structural database. It is hoped that the system will be able to remove the effect of missing data and provide a powerful means of generating projected hearing loss information taking into account inherited vulnerability.
Methods will be developed to analyse annual serial audiometric databases from major industrial concerns with thousands of patient records obtained over a number of years. This is necessary to determine the effectiveness of the hearing conservation programmes. It is also valuable data to determine the relationship between ageing and noise exposure on hearing levels. The major questions are What are the optimal frequencies of audiograms for detecting unusual rates of hearing loss reliably? What statistical methods are appropriate for detecting differences in levels and rates of loss, comparison of levels and rates of loss between noise exposed and non-noise exposed groups? Below what noise level are the effects of noise undetectable.
Information which may be used for education, and raising public awareness of the hazards of noise will be gathered from a number of sources and made available via the website set up for this purpose. A database of noise specialists will also be posted on the internet site.
Correspondence Address:
Deepak Prasher
Scientist-in-Charge, NOPHER, Institute of laryngology and Otology, University College London, 330 Gray’s Inn Road, London WC1X 8EE
United Kingdom
 Source of Support: None, Conflict of Interest: None  | Check |
PMID: 12689465 
[Table - 1] |
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