Home Email this page Print this page Bookmark this page Decrease font size Default font size Increase font size
Noise & Health  
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Email Alert *
Add to My List *
* Registration required (free)  

   Protocol of the ...
   Identification o...
   Studies on Adults
   Studies on Children
   Meta Analysis
   Article Figures
   Article Tables

 Article Access Statistics
    PDF Downloaded211    
    Comments [Add]    
    Cited by others 63    

Recommend this journal


ARTICLE Table of Contents   
Year : 2009  |  Volume : 11  |  Issue : 44  |  Page : 161-168
Exposure-response relationship of the association between aircraft noise and the risk of hypertension

1 Department of Environmental Hygiene, Federal Environment Agency, Germany
2 Centre for Environmental Health Research, The National Institute for Public Health and Environmental Protection, Netherlands

Click here for correspondence address and email
Date of Web Publication11-Jul-2009

Noise is a stressor that affects the autonomic nervous system and the endocrine system. Under conditions of chronic noise stress the cardiovascular system may adversely be affected. Epidemiological noise studies regarding the relationship between aircraft noise and cardiovascular effects have been carried out on adults and on children focussing on mean blood pressure, hypertension and ischemic heart diseases as cardiovascular endpoints. While there is evidence that road traffic noise increases the risk of ischemic heart disease, including myocardial infarction, there is less such evidence for such an association with aircraft noise. This is partly due to the fact that large scale clinical studies are missing. There is sufficient qualitative evidence, however, that aircraft noise increases the risk of hypertension in adults. Regarding aircraft noise and children's blood pressure the results are still inconsistent. The available literature was evaluated for the WHO working group on "Aircraft Noise and Health" based on the experts' comprehensive knowledge in this field. With respect to the needs of a quantitative risk assessment for burden of disease calculations an attempt was made to derive an exposure-response relationship based on a meta-analysis. This association must be viewed as preliminary due to limitations which are concerned with the pooling of studies due to methodological differences in the assessment of exposure and outcome between studies. More studies are needed to establish better estimates of the risk.

Keywords: Aircraft noise, hypertension, cardiovascular risk, meta-analysis, exposure-response relationship, risk assessment

How to cite this article:
Babisch W, Kamp Iv. Exposure-response relationship of the association between aircraft noise and the risk of hypertension. Noise Health 2009;11:161-8

How to cite this URL:
Babisch W, Kamp Iv. Exposure-response relationship of the association between aircraft noise and the risk of hypertension. Noise Health [serial online] 2009 [cited 2023 Dec 1];11:161-8. Available from: https://www.noiseandhealth.org/text.asp?2009/11/44/161/53363

  Introduction Top

The auditory system is continuously analyzing acoustic information, which is filtered and interpreted by different brain structures. The hypothesis that long-term exposure to environmental noise - including aircraft noise - causes adverse health effects is based on three major findings and facts:

  1. Laboratory studies show that exposure to acute noise affects the sympathetic and endocrine system, resulting in unspecific physiological responses (e.g. heart rate, blood pressure, vasoconstriction, stress hormones, EEG). [1],[2],[3],[4],[5],[6],[7],[8]
  2. Noise-induced instantaneous autonomic responses do not only occur in waking hours but also in sleeping subjects even when no EEG awakening is present. [9],[10],[11],[12] They do not fully adapt on a long-term basis although a clear subjective habituation occurs after a few nights. [13],[14] Repeated arousal from sleep is associated with a sustained increase in daytime blood pressure. [15] The cortical perception of the sound as well as sub-cortical reflections due to the direct nervous interactions of the acoustic nerve with hypothalamic structures stimulates the autonomous nervous system. From this the hypothesis emerged that long-term exposure to noise adversely affects the homeostasis of the human organism, including metabolic function and the cardiovascular system. [16],[17],[18],[19],[20] Persistent changes in endogenous risk factors due to noise-induced dysregulation promote the development of chronic disorders such as atherosclerosis, hypertension and ischemic heart diseases and others in the long run.
  3. Although effects tend to be diluted in occupational studies due to the "healthy worker effect", epidemiological studies carried out in the occupational field have shown that employees working in high noise environments are at a higher risk for high blood pressure and myocardial infarction. [21],[22],[23],[24],[25],[26] Similar effects may occur with respect to community noise.
The general stress theory referring to the sympathetic-adrenal-medullar system (SAM axis) and the pituitary-adrenal-cortical system (hypothalamic-pituitary-adrenal = HPA axis) is the rationale for the non-auditory physiological effects of noise.[27],[28] The biological plausibility derives from laboratory experiments on acute noise effects. Epidemiological studies have been carried out assessing the relationship between road and aircraft noise on cardiovascular endpoints.

  Protocol of the Review Top

The focus here is on epidemiological studies or surveys directly related to associations between aircraft noise and cardiovascular disease (CVD) outcomes. Many environmental noise studies refer to road traffic noise, serving as an approximation of effects of transportation noise, in general. In accordance with the reaction model, the endpoints considered in this review are primarily of cardiovascular nature. Noise research has been focusing on these endpoints for reasons of statistical power (high prevalence in the general population) and their impact on public health. [29] A distinction is made between the effects on adults and on children. Clinical manifestations of cardiovascular diseases are not very likely in young people. Therefore blood pressure reading is the major outcome that has been studied in children and adolescents. In adults, however, manifestations of high blood pressure (hypertension) and ischemic heart diseases (myocardial infarction, angina pectoris, ischemic signs in the ECG, heart failure) are major outcomes of interest. The diagnosis is either based on self-reported doctor-diagnosed occurrence and/or treatment of disease, hospital admission rates, drug medication intake, or on actual blood pressure measurements (taken at rest). The same applies to the assessment of exposure. It is either based on self-reported traffic volume (e.g. type of street) or subjective perception of the noise (disturbance/annoyance), or on modeled noise contours (noise maps, isophones) or noise measurements taken near the subjects' houses. Finally, the type of study (ecologic, descriptive (e.g. cross-sectional study), and analytic (e.g. case-control study, cohort study) is considered as a decision criterion.

  Identification of Relevant Studies Top

The selection of relevant studies is made on comprehensive previous reviews [21],[30],[31] and the experts' knowledge about new publications and ongoing research in this field. In a recent review update [32],[33] altogether 61 epidemiological studies were identified that addressed the association between transportation noise and cardiovascular endpoint; 20 of which referred to commercial aircraft noise, [34],[35],[36],[37],[38],[39],[40],[41],[42],[43],[44],[45],[46],[47],[48],[49],[50],[51],[52],[53],[54],[55] 8 to military aircraft noise, 32 to road traffic noise, and 13 to other environmental noise sources. The cardiovascular chapters of the WHO reports "Night Noise Guidelines" [12] and "Environmental Noise Burden of Disease" refer to this review. [56] Studies focusing on low flying jet-fighter noise showed higher blood pressure readings in children but not in adults. [57],[58],[59],[60],[61] The effects may largely be due to anxiety and fear rather than to the noise stress as such. These studies are therefore not considered in this present summary on the effects of aircraft noise. However, studies regarding noise from aircraft operations around airfields, which is comparable to commercial aircraft noise (no steep level increases) are considered. [50],[62] New aircraft noise studies are now available that were not considered in previous reviews. [63],[64],[65],[66],[67],[68],[69]

Evaluation criteria for the validity of studies with respect to possible exposure misclassification, confounding, selection bias, recall and observation bias were: Objective (noise level) vs. subjective exposure assessment, objective (clinical) vs. subjective assessment of outcome, type of study, reasonable control of confounding factors, statistical methods of analyses, peer-reviewed reference.

  Studies on Adults Top

Some studies are not feasible for a synthesis or a meta-analysis, either because only sparse information is given with respect to the study design and selection criteria or confounding factors are insufficiently accounted for. [34],[53] Some study results are only preliminary or not yet peer-reviewed. [46],[54],[55],[68] However, in those cross-sectional studies - although mostly not significant - higher mean blood pressure readings or a higher prevalence of cardiovascular disorders or medication intake were found in exposed subjects compared with non-exposed, supporting the hypothesis as such (consistency). [70]

Repeated studies carried out around Schiphol airport in the Netherlands looking at aircraft noise and drug medication either on an individual level (self-reported medication intake) or on a spatial level (prescribed medication purchased by pharmacies) revealed higher relative risks of cardiovascular medication ranging between 1.2 and 1.4 for a noise level difference of approximately 10 dB(A). [37],[47],[64] When comparing the noise exposure throughout the whole day (L den ) with the noise exposure during the night (L night ) effects were stronger with respect to L den . In the most recent phase of the Schiphol environment and health monitoring programme a higher risk of approximately 1.8 was found for the same noise level difference. [65],[66] In a longitudinal approach a decrease in the purchase of cardiovascular and antihypertensive drugs was found after a reduction of night flights. [39] A recent cross-sectional study carried out around Cologne airport in Germany demonstrated higher individual prescriptions of antihypertensive and cardiac drugs in subjects exposed to high levels of aircraft noise, particularly, during the night and the early morning hours (3-5 hrs). [63] The study was unbiased with respect to the assessment of exposure and outcome because objective data were used (noise contours, health insurance records). However, no data regarding individual confounders were available, only spatially aggregated covariates could be considered. Higher risks were found for subjects where L night exceeded 39 dB(A). Preliminary results from a Swedish follow-up study carried out around Stockholm's airport suggest a higher intake of antihypertensive medication in subjects exposed to noise levels ('FBN') of more than 55 dB(A) compared to less exposed (relative risk 1.6). The results are based on a small sub-sample of the total cohort. [55]

Regarding the prevalence of hypertension and heart problems much information is derived from Dutch studies carried out around Schiphol airport. [37],[38],[65],[66],[71],[72] The assessment of high blood pressure and ischemic heart problems was based on clinical measurements, [37],[38] medical interviews, [37],[38] hospital admission rates, [65],[66] and self-reported hypertension. [65],[66] In the older studies, a non-significant increase in risk of heart disease was found ranging between 1.1 and 1.4 in people (males and females taken together) who were exposed to 'NNI' >37 (approximately L dn > 62 dB(A)). [37] For hypertension a significantly higher risk of 1.7 (95% CI = 1.4-2.2) was found for this noise level difference of approximately 10 dB(A). [37] Regarding the prevalence of all cardiovascular diseases, including high blood pressure, a significant relative risk of 1.8 was found. [38] In the later studies, no noise effects were found with respect to hospital admissions for cardiovascular diseases. [65],[66] However, a statistical significant effect of L den was found on self-reported hypertension. When the noise level increases by 3 dB(A) the odds ratio was 1.2, which corresponds with a relative risk of approximately 1.8 for a 10 dB(A) difference in noise level, confirming the earlier studies. In a new multi-centred study carried out around six European airports a significant increase in the risk of hypertension of 1.1 (95% CI = 1.0-1.3) for a 10 dB(A) difference of aircraft noise during the night (L night ) was found. [67] Hypertension was determined by a combination of three criteria: Measured resting blood pressure (systolic/diastolic blood pressure >140/90 mmHg), self-reported doctor-diagnosed hypertension, anti-hypertensive medication (ATC coding). Across categories no clear exposure-response relationship was found. However, the large confidence intervals did not discard the assumption of a linear relationship. No such association was found with respect to the exposure during the day, possibly due to exposure misclassification (time spent away from home). Thus, a smaller relative risk was found for the 24 hr noise indicator L den of 1.1 (95% CI = 0.9-1.3) per 20 dB(A). [Note: Because the data were previously not published by the Hyena group, the exact data are given here (OR per 10 dB(A) = 1.037, 95% CI = 0.962-1.119)].

A Swedish study carried out around Stockholm's major airport assessed the prevalence of (self-reported doctor-diagnosed) high blood pressure by postal questionnaire. An exposure-response association between aircraft noise and high blood pressure was found with relative risks ranging between 1.1 and 2.1 for noise levels between approximately 'FBN' = 53 to 63 dB(A). [52] When noise categories were combined, the effect was significant for 'FBN' > 55 dB(A). The trend analysis resulted in a relative risk of 1.3 (95% CI = 0.8-2.2) per 5 dB(A). Studies carried out around the Kadena military airfield on the Japanese island of Okinawa also demonstrated an exposure-response relationship of an increasing prevalence of clinically assessed hypertension with increasing noise exposure. [50],[73],[74] The effects were found at higher noise levels than for civil airports ('WECPNL' > 75 dB, approximately L dn > 60 dB(A). This may be due to the fact that night- and weekend-flights were largely omitted. However, older noise data were used which might not have adequately reflected the exposure when the health data were assessed. Only one prospective study assessing disease incidence is known. The study was carried out around Stockholm's major airport. The association between aircraft noise and high blood pressure was investigated. Subjects exposed to weighted energy-averaged levels ('FBN') above 50 dB(A) had a significant relative risk of 1.2 for the development of hypertension over the 10-year follow-up period compared with less exposed. [69] The increase in risk per 10 dB(A) was 1.2 (95% CI = 1.0-1.2). The effect was particularly found in older people, which may reflect longer years of residence.

  Studies on Children Top

Most evidence in relation to aircraft noise on children is derived from school studies carried out in Los Angeles, [40],[41] the Munich Airport study, [42],[43],[75] the Sydney Airport study, [44],[45] and the RANCH study. [76]

In studies around the Los Angeles airport blood pressure differences of 2 to 7 mmHg were found between groups of exposure depending on the years enrolled in school. The results may be confounded by incomplete control of ethnicity. [45] Blood pressure measures were taken during quiet periods in school, in order to exclude acute noise effects. Longitudinal measurements after a year failed to show a relationship between noise exposure at school and a change in blood pressure, probably due to selective migration of the schoolchildren. The cross-sectional study around the old Munich airport revealed a borderline significant effect of 2 mmHg higher systolic blood pressure readings in schoolchildren from noise exposed areas (L eq, 24hr = 68 dB(A)) as compared to unexposed children (L eq, 24hr = 59 dB(A)). No noise effect was found with regard to diastolic blood pressure. [42] Longitudinal studies carried out around the new airport showed a 2 to 4 mmHg larger increase in BP readings in exposed children than in their counterparts from the quiet areas 18 months after the opening of the new airport. However, the well-matched children from the exposed and the control group had the same absolute blood pressure. The higher change in blood pressure was due to lower values at the beginning of the follow-up. The cross-sectional study around Sydney Airport revealed a non-significant relation between aircraft noise and diastolic and systolic blood pressure in children. [45]

In a cross-sectional study carried out around Schiphol and Heathrow airports on schoolchildren (RANCH) a non-significant relationship was found between aircraft exposure at school (LAeq, 7-23 hr) and measured systolic blood pressure, diastolic blood pressure and heart rate after adjustment for relevant confounders. [76] However, aircraft noise at home (expressed as LAeq, 7-23hr) was significantly related to higher systolic (0.10 mmHg/dB(A)) and diastolic (0.19 mmHg/dB(A)) blood pressure. Chronic aircraft noise exposure during the night (LAeq, 23-7hr) at home was also positively associated with blood pressure. This latter association was significant only for systolic blood pressure. In the pooled data-set an increase of 0.09 mmHg/dB(A) was found. Due to significant differences in noise effects between the two centres no univocal conclusions about the association between aircraft noise exposure and blood pressure in children could be drawn. [76] Explanations put forward concern differences in flight pattern variation, and aircraft fleet. Also differences in schooling systems and teachers' attitudes towards noise might have differential effects on the children's reactions to noise. None of these could be tested on the available data. Finally, even though the results were adjusted for ethnic differences and diet residual confounding due to these factors might explain the differences. [77]

  Meta Analysis Top

Different approaches have been used to assess pooled effect estimates and exposure-response relationships in order to carry out a quantitative risk assessment. Van Kempen et al . [21] calculated uniform regression coefficients across all noise categories within individual studies ('regression approach'). The regression coefficients were then pooled over all studies. Babisch [32] calculated pooled relative risks for individual noise categories from different noise studies, which were then considered for an exposure-response relationship ('category approach'). Both approaches have advantages and disadvantages. The regression approach has the advantage that regression coefficients can easily be pooled regardless of actual noise levels; only the slopes (regression coefficient) of the exposure-response relationships of individual studies are taken into account, regardless of (different) noise level ranges and possible thresholds of effect. For example, some studies showed high risks at relatively low noise levels, [52] while others showed an increase of risk only at higher noise exposures. [50] The category approach is noise level oriented. Only relative risks from different studies referring to the same noise category are pooled to derive an exposure-response curve. This has the advantage that possible thresholds of effects can be determined. The approach also accounts for non-linear associations. It is less likely to obscure possible higher risks in higher noise categories where the numbers of subjects are often small - which is the case in random population samples given the empirical noise distributions, and specifically around large airports. For example, in case of j-shaped or quadratic associations an overall regression coefficient underestimates the risks in higher noise categories, simply because the slope of the regression line is primarily determined by the larger numbers of subjects in the lower exposure categories, where effects may be smaller. The disadvantage of this approach is that it relies on relatively homogeneous and comparable noise indicators in order to pool the effect estimates from different studies within noise categories. One could think of studies where relationships within the studies reflect true associations (slope), but the noise assessment in absolute terms may not be comparable due to methodological reasons (e.g. measurement vs. modeling, different calculation methods, different time periods, weighing factors, different reference points, different sides of the house, etc.).

For both approaches it is essential that critical decisions are made as to which studies are included in the meta-analyses and which are not. Studies that are not suitable with respect to issues of exposure misclassification, selection bias, observation bias, or confounding should be excluded from the meta-analyses. Only very few epidemiological studies are available on adults, in which the association between aircraft noise and clinical states of cardiovascular diseases were assessed. Five studies appear reasonably valid for further consideration because minimum requirements regarding the validity of the assessment of exposure, outcome and the statistical control for confounding factors were fulfilled. [37],[50],[51],[52],[67],[69] However, noise level related data pooling ('categorical approach') is difficult due to the fact that different (national) exposure indices were used. A graphical presentation of results using approximations with respect to the common noise indicator L dn is shown in [Figure 1]. No conclusions regarding possible threshold values or noise level related risks (in absolute terms) can be drawn.

When linear trend coefficients of all the five studies are calculated and pooled afterwards ('regression approach') the pooled effect estimate of the relative risk is 1.13 (95% CI = 1.00-1.28) per 10 dB(A). The results are shown in [Table 1]. The pooled effect estimate is significant. No major difference between fixed and random effect models is found when the individual coefficients obtained from the six airports of the HYENA study are considered individually in the meta-analysis to better account for the heterogeneity between individual studies. (Note: If the pooled Hyena results are used instead as shown in [Figure 1], significant fixed and random effect estimates of 1.12 and 1.29, respectively, are calculated.) The result is almost the same when either the 'Okinawa study' (military aircraft noise, out-dated noise data) or the 'Stockholm1 study' (subjective assessment of exposure) or both are excluded from the meta-analysis due to their low statistical weights (OR = 1.12, 95% CI = 0.98-1.28).

The calculations were made using the procedures 'Meta' and 'Metareg' of the statistical package STATA, Version 9. Individual odds ratios and confidence intervals were taken from summary reports [32] and the original publications for this purpose [67],[69] to calculate regression coefficients of individual studies and odds ratios with respect to the weighted day/night noise indicator L dn , which is supposed to be very similar to L den . [78] Approximations for the conversion of noise indices were given elsewhere. [79]

The noise assessment in the studies was made according to national regulations and calculation methods that were used by the time the studies were carried out in those countries. In the Amsterdam study [37] the Dutch 'Kosten Units' noise index (B) was calculated which considers the average maximum noise level of overflights during a 24-hour period and the number of events which are weighted by the time of the day (day 1.33, evening 5.25, night 9.75). The averaging is done on a sound-energy basis. The assignment of noise levels was based on maps of aircraft noise (1974) as modelled by the National Aerospace Laboratory. [80] In the Swedish studies (Stockholm 1 and Stockholm 2) [52],[69] the 24h-hour time weighted yearly equal energy level (FBN) was calculated; the number of events were weighted by the time of the day (evening 3, night 10). GIS-based noise dispersion models were used to define the noise contours. The Hyena consortium used the American INM (version 6.0) as uniform standard for all airports considered in the study to calculate yearly average noise contours for the day, the evening and the night (except the UK, where the national standard (Ancon model) was applied). The calculation was based on radar tracks of fight paths and the composition of aircrafts. The weighted 24-hour noise index L den according to the European Noise Directive was calculated (weighting: Evening + 5 dB(A), night + 10 dB(A)). In the Japanese study [50],[51] the noise assessment was based on continuous long-term and point selective short-term noise measurements based on monitoring programmes. The noise index WECPNL considers the average maximum noise level and the number of events. The events were weigthed by the time of the day (early evening 3, late evening and night 10). As pointed out earlier, the year of noise assessment did not coincident with the year of the health assessment, which raises some concern regarding exposure misclassification of which the direction of the impact on the results is unclear.

One also has to bear in mind that different criteria and assessment methods for hypertension were used. For example, some studies (Amsterdam, Stockholm1, Okinawa) refer to the 'old' WHO criterion of 160/100 mmHg, [37],[51],[52] others (Hyena, Stockholm 2) refer to the 'new' WHO criterion of 140/90 mmHg. [67],[69] It was assumed that relative (noise) effects were independent of the absolute prevalence of hypertension depending on the cut-off criterion for high blood pressure.

  Discussion Top

In the present summary, only those studies were considered in which aircraft noise was the explicit noise source. However, in a situation where information is lacking, the results of studies on the association between road traffic noise and myocardial infarction may also serve as an approximation for possible effects of aircraft noise. Considering the fact that at the same average noise level aircraft noise tends to be more annoying than road traffic noise, [81],[82] this approximation may even underestimate the effects of aircraft noise. Differences in the acoustical characteristics of the type of noise (e.g. frequency spectrum, quasi continuous road noise vs. single event aircraft noise, maximum noise level, length of single events, number of events), as well as non-acoustical factors (e.g. fear of aircraft crashes, attitude towards airport, effectiveness of coping strategies) may have an impact not only on the subjective perception of the noise, but also on physical health. Since aircraft noise comes from the top shielding of buildings is less effective. Because there is no access to a quiet side, sleep may be more affected by aircraft noise on a population level.

The available results do not allow for a distinction between the sexes. Males have been studied much more often than females. There is some indication that males may be more affected by road traffic noise. [67],[83],[84],[85] However, contradictory results were also found. [86] The data-base is too weak for final conclusions regarding any gender differences. Due to the use of different noise indicators in aircraft noise studies only very crude comparisons can be made between studies on the basis of common noise indicators, e.g. L dn or L Aeq,6-22hr . Most aircraft noise studies did not distinguish between day and the night. A road traffic noise study and two aircraft noise studies suggest that noise during the night may be more harmful than during the day. [63],[67],[87] However, no firm conclusions can be drawn about the relative contribution of day and night exposure because noise indices are usually highly correlated. One study suggests not only that noise during the night may be the primary source of adverse effects; it also shows that within the night period, effects due to noise in the early morning shoulder hours may be larger. [63]

The impact of noise on children's blood pressure is still not fully understood. Pre-dispositional and lifestyle factors seem to dominate and it is hard to study the influence of environmental noise separately. This might be one of the reasons why conclusions about the effect of noise exposure on children's blood pressure are limited and inconsistent. Methodological problems which arise are study size, insufficient contrast between noise levels, selection bias and insufficient adjustment for factors such as socioeconomic status, parental history, noise insulation and ethnicity. Moreover, most studies on cardiovascular effects in children have focused on school exposure while at least the combination of day- and night time exposure and the related lack of restoration might be of importance in the development of cardiovascular disease due to early childhood blood pressure changes.

Energy-based indicators of exposure (L eq ) are adequate and sufficient for the assessment of the relationship between long-term exposure to community noise and chronic diseases, e.g. cardiovascular disorders. These include L day,16h , L day,12h + L evening,4h , and L night,8h . Different periods of the day should be considered. Only if detailed data are not available L 24h is recommended. Although Leq -based indicators tend to be highly correlated in many exposure conditions, it remains unclear whether weighted indicators, such as L dn or L den reflect the physiological response of the human organism appropriately. However, when all information is available, weighted and non-weighted indicators can easily be calculated for use in health studies and related quantitative risk assessment.

  Conclusion Top

The general conclusion is that there is sufficient evidence for a positive relationship between aircraft noise and high blood pressure and the use of cardiovascular medication. Depending on whether high blood pressure was assessed by a self-administered postal questionnaire or by clinical measurements in studies, the magnitudes and the possible thresholds of effect varied between and within studies. [66],[68] Effects were more pronounced, when subjective measurements of high blood pressure were considered. This may raise questions regarding over-reporting. [66],[68],[88] The validity of study results appears to be even more a problem when subjective noise annoyance was considered for exposure. [47],[65],[66],[68] The effect estimates tend to be larger but may be prone to over-reporting, particularly in cross-sectional studies where both, exposure and outcome, are assessed on a self-reported basis with the same questionnaire.

No single, generalized and empirically supported exposure-response relationship can be established yet for the association between aircraft noise and cardiovascular risk due to methodological differences between studies (noise assessment, noise indicators, definition of hypertension) and the lack of continuous or semi-continuous (multi-categorical) noise data provided in the publications. For the same reason no answer can be given regarding possible effect thresholds. However, in spite of these limitations an attempt has been made to derive a "best guess" estimate, which can be used for practical purposes of quantitative risk assessment for the moment until more data are available. The calculated relative risk for an increase ("regression approach") of the day/night average weighted sound pressure level of aircraft noise of 10 dB(A) based on the presented meta-analysis is OR = 1.13, 95% CI = 1.00-1.28, range = 45-70 dB(A). Since this effect estimate is based on different slopes from different studies with different noise level ranges and methods being used, a decision must be made by the user with respect to the noise level onset of the increase in risk. Road traffic noise studies suggest that the cardiovascular risk increases when the outdoor noise level during the day exceeds 60-65 dB(A) and 50-55 dB(A) during the night, respectively. [89] As to whether this information can be applied to aircraft noise remains unclear. However, this may be a conservative approach, considering the results of annoyance studies showing that aircraft noise effects may even be stronger than those of road traffic noise. Annoyance studies showed that aircraft noise was more annoying than road traffic noise of the same average noise level, [81],[82] which might partly be explained by less exposure misclassification (no shielding of aircraft noise, no unexposed rooms). New aircraft noise studies suggest that the risk may increase at even lower night noise levels. It is therefore suggested to use L den ≤ 50 or L den ≤ 55 dB(A) as a reference category of the exposure-response relationship. The respective relative risks for subjects who live in areas where L den is between 55 to 60 dB(A) and between 60 to 65 dB(A) would then approximate to 1.13 and 1.20, or 1.06 and 1.13, respectively.

  Acknowledgement Top

The authors would like to thank Elise van Kempen and Danny Houthuijs from The National Institute For Public Health and Environmental Protection of The Netherlands for their helpful comments.

  References Top

1.WHO. Guidelines for community noise. In: Berglund B, Lindvall T, Schwela DH, editors. Geneva: World Health Organization; 1999. URL: http://whqlibdoc.who.int/hq/1999/a68672.pdf [last accessed on Jun 2007].  Back to cited text no. 1    
2.WHO Regional Office for Europe. Noise and health. In: Bonnefoy X, Berglund B, Maschke C, editors. Copenhagen: World Health Organization; 2000.  Back to cited text no. 2    
3.Vera MN, Vila J, Godoy JF. Cardiovascular effects of traffic noise: The role of negative self-statements. Psychol Med 1994;24:817-27.  Back to cited text no. 3    
4.Raggam RB, Cik M, Hφldrich RR, Fallast K, Gallasch E, Fend M, et al . Personal noise ranking of road traffic: Subjective estimation versus physiological parameters under laboratory conditions. Int J Hyg Environ Health 2007;210:97-105.  Back to cited text no. 4    
5.Lusk SL, Gillespie B, Hagerty BM, Ziemba RA. Acute effects of noise on blood pressure and heart rate. Arch Environ Health 2004;59:392-9.  Back to cited text no. 5    
6.Maschke C, Harder J, Ising H, Hecht K, Thierfelder W. Stress hormone changes in persons exposed to simulated night noise. Noise Health 2002;5(17):35-45.  Back to cited text no. 6    
7.Babisch W. Stress hormones in the research on cardiovascular effects of noise. Noise Health 2003;5(18):1-11.  Back to cited text no. 7    
8.WHO Regional Office for Europe. Noise and health (WHO website). 2006. Available from: http://wwweurowhoint/Noise (last accessed on Mar 2006).  Back to cited text no. 8    
9.Muzet A. Rιactivitι de l`homme endormi. In: Benoit O, Foret J, editors. Le sommeil humain bases expιrimentales et physiopathologiques. Paris: Masson; 1995.  Back to cited text no. 9    
10.Davies RJO, Belt PJ, Roberts SJ, Ali NJ, Stradling JR. Arterial blood pressure responses to graded transient arousal from sleep in normal humans. J Appl Physiol 1993;74:1123-30.  Back to cited text no. 10    
11.Muzet A. Environmental noise, sleep and health. Sleep Med Rev 2007;11:135-42.  Back to cited text no. 11    
12.WHO European Centre for Environment and Health - Bonn Office. Night noise guidelines (NNGL) for Europe - Final implementation report. 2007. Available from: http://eceuropaeu/health/ph_projects/2003/action3/docs/2003_08_frep_enpdf (last accessed on Sep 2008).  Back to cited text no. 12    
13.Muzet A. The need for a specific noise measurement for population exposed to aircraft noise during night-time. Noise Health 2002;4:61-4.  Back to cited text no. 13  [PUBMED]  Medknow Journal
14.Haralabidis AS, Dimakopoulou K, Vigna-Taglianti F, Giampaolo M, Borgini A, Dudley M-L, et al . Acute effects of night-time noise exposure on blood pressure in populations living near airports. Eur Heart J 2008;doi:10.1093/eurheartj/ehn013:7 pages.  Back to cited text no. 14    
15.Morrell MJ, Finn L, Kim H, Peppard PE, Badr MS, Young T. Sleep fragmentation, awake blood pressure, and sleep-disordered breathing in a population-based study. Am J Respir Crit Care med 2000;162:2091-6.  Back to cited text no. 15    
16.Maschke C, Rupp T, Hecht K. The influence of stressors on biochemical reactions - a review of present scientific findings with noise. Int J Hyg Environ Health 2000;203:45-53.  Back to cited text no. 16    
17.Passchier-Vermeer W. Relationship between environmental noise and health. J Aviation Environ Res 2003;7:35-44.  Back to cited text no. 17    
18.Passchier-Vermeer W, Passchier WF. Noise exposure and public health. Environ Health Perspect 2000;108:123-31.  Back to cited text no. 18    
19.Babisch W. The noise/stress concept, risk assessment and research needs. Noise Health 2002;4(16):1-11.  Back to cited text no. 19    
20.Ising H, Kruppa B. Stress effects of noise. In: Luxon L, Prasher D, editors. Noise and its effects. Chichester: John Wiley and Sons; Ltd; 2007.  Back to cited text no. 20    
21.van Kempen EEMM, Kruize H, Boshuizen HC, Ameling CB, Staatsen BAM, de Hollander AEM. The association between noise exposure and blood pressure and ischaemic heart disease: A meta-analysis. Environ Health Perspect 2002;110:307-17.  Back to cited text no. 21    
22.Deyanov C, Mincheva L, Hadjiolova I, Ivanovich E. Study on the level of blood pressure and prevalence of arterial hypertendion depending on the duration of occupational exposure to industrial noise. Central European Journal of Occupational and Environmental Medicine 1995;1:109-16.  Back to cited text no. 22    
23.Stansfeld SA, Matheson MP. Noise pollution: Non-auditory effects on health. Br Med Bull 2003;68:243-57.  Back to cited text no. 23    
24.Concha-Barrientos M, Campbell-Lendrum D, Steenland K. Occupational noise. Assessing the burden of disease from work-related hearing impairment at national and local levels. Environmental Burden of Disease Series, No. 9. Geneva 2004: World Health Organization; 2004.  Back to cited text no. 24    
25.Babisch W. Epidemiological studies of the cardiovascular effects of occupational noise - a critical appraisal. Noise Health 1998;1(1):24-39.  Back to cited text no. 25    
26.McNamee R, Burgess G, Dippnall WM, Cherry N. Occupational noise exposure and ischaemic heart disease mortality. Occup Environ Med 2006;63:813-9.  Back to cited text no. 26    
27.Henry JP, Stephens PM. Stress, health,and the social environment, a sociobiologic approach to medicine. New York: Springer-Verlag; 1977.  Back to cited text no. 27    
28.Henry JP. Biological basis of the stress response. NIPS 1993;8:69-73.  Back to cited text no. 28    
29.WHO. The world health report 2002. Geneva: World Health Organization; 2002.  Back to cited text no. 29    
30.Babisch W. Traffic noise and cardiovascular disease: Epidemiological review and synthesis. Noise Health 2000;2(8):9-32.  Back to cited text no. 30    
31.IEH. Workshop on non-auditory health effects of noise. Report No. R10. Leicester: Institute for Environment and Health; 1997.  Back to cited text no. 31    
32.Babisch W. Transportation noise and cardiovascular risk, Review and synthesis of epidemiological studies, Dose-effect curve and risk estimation. WaBoLu-Hefte 01/06. Dessau: Umweltbundesamt; 2006. Available from: http://www.umweltbundesamt.de/uba-info-medien/mysql_medien.php?anfrage=KennummerandSuchwort=2997 (last accessed on Apr 2006).  Back to cited text no. 32    
33.Babisch W. Transportation noise and cardiovascular risk: Updated review and synthesis of epidemiological studies indicate that the evidence has increased. Noise Health 2006;8:1-29.  Back to cited text no. 33  [PUBMED]  Medknow Journal
34.Karagodina IL, Soldatkina SA, Vinokur IL, Klimukhin AA. Effect of aircraft noise on the population near airport. Hygiene and Sanitation 1969:182-7.  Back to cited text no. 34    
35.von Eiff AW, Czernik A, Horbach L, Jφrgens H, Wenig H-G. Kapitel 7. Der medizinische Untersuchungsteil. In: Forschungsgemeinschaft D, editor. Fluglδrmwirkungen I, Hauptbericht. Boppard: Harald Boldt Verlag KG; 1974. p. 349-424.  Back to cited text no. 35    
36.Rohrmann B. Das Fluglδrmprojekt der Deutschen Forschungsgemeinschaft, Kurzbericht. Boppard: Harald Boldt Verlag KG; 1974.  Back to cited text no. 36    
37.Knipschild P. V. Medical effects of aircraft noise: Community cardiovascular survey. Int Arch Occup Environ Hlth 1977;40:185-90.  Back to cited text no. 37    
38.Knipschild P. VI. Medical effects of aircraft noise: General practice survey. Int Arch Occup Environ Hlth 1977;40:191-6.  Back to cited text no. 38    
39.Knipschild P. VII. Medical effects of aircraft noise: Drug survey. Int Arch Occup Environ Hlth 1977;40:197-200.  Back to cited text no. 39    
40.Cohen S, Evans GW, Krantz DS, Stokols D, Sheryl K. Aircraft noise and children: Longitudinal and cross-sectional evidence on adaptation to noise and the effectiveness of noise abatement. Journal of Personality and Social Psychology 1981;40:331-45.  Back to cited text no. 40    
41.Cohen S, Evans GW, Krantz D, Stokols D. Physiological, motivational, and cognitive effects of aircraft noise on children. American Psychologist 1980;35:231-43.  Back to cited text no. 41    
42.Evans GW, Hygge S, Bullinger M. Chronic noise and psychological stress. Psychological Science 1995;6:333-8.  Back to cited text no. 42    
43.Evans GW, Bullinger M, Hygge S. Chronic noise exposure and physiological response: A prospective study of children living under environmental stress. Psychological Science 1998;9:75-7.  Back to cited text no. 43    
44.Morrell S, Taylor R, Carter N, Peploe P, Job S. Cross-sectional and longitudinal results of a follow-up examination of child blood pressure and aircraft noise--The inner Sydney child blood pressure study. internoise 2000 The 29th International Congress and Exhibition on Noise Control Engineering, Nice 2000.  Back to cited text no. 44    
45.Morrell S, Taylor R, Carter N, Job S, Peploe P. Cross-sectional relationship between blood pressure of school children and aircraft noise. In: Carter N, Job RFS, editors. Noise Effects ′98 Proceedings of the 7th International Congress on Noise as a Public Health Problem, Sydney 1998. Sydney: Noise Effects ′98 PTY LTD; 1998. p. 275-9.  Back to cited text no. 45    
46.Vallet M, Cohen JM, Trucy D. Airport noise and epidemiological study of health effects: A feasibility study. In: Cuschieri J, Glegg S, Yong Y, editors. Internoise 99, The 1999 International Congress on Noise Control Engineering, Fort Lauderdale Washington D.C.: Institute of Noise Control Engineering; 1999.  Back to cited text no. 46    
47.Franssen EAM, Wiechen CMAG, Nagelkerke NJD, Lebret E. Aircraft noise around a large international airport and its impact on general health and medication use. Occup Environ Med 2004;61:405-13.  Back to cited text no. 47    
48.Franssen EAM, Staatsen BAM, Lebret E. Assessing health consequences in an environmental impact assessment. The case of Amsterdam Airport Schiphol. Environmental Impact Assessment Review 2002;22:633-53.  Back to cited text no. 48    
49.Franssen E. Health impact assessment, the Schiphol airport study. Transparenties 1999.  Back to cited text no. 49    
50.Matsui T, Uehara T, Miyakita T, Hitamatsu K, Osada Y, Yamamoto T. The Okinawa study: Effects of chronic aircraft noise on blood pressure and some other physiological indices. Journal of Sound and Vibration 2004;277:469-70.  Back to cited text no. 50    
51.Matsui T, Uehara T, Miyakita T, Hiramatsu K, Osada Y, Yamamoto T. Association between blood pressure and aircraft noise exposure around Kadena airfield in Okinawa. In: Boone R, editor. Internoise 2001 Proceedings of the 2001 International Congress and Exhibition on Noise Control Engineering, The Hague, Vol 3. Maastricht: Nederlands Akoestisch Genootschap; 2001. p. 1577-82.  Back to cited text no. 51    
52.Rosenlund M, Berglind N, Pershagen G, Jδrup L, Bluhm G. Increased prevalence of hypertension in a population exposed to aircraft noise. Occup Environ Med 2001;58:769-73.  Back to cited text no. 52    
53.Goto K, Kaneko T. Distribution of blood pressure data from people living near an airport. Journal of Sound and Vibration 2002;250:145-9.  Back to cited text no. 53    
54.Maschke C, Wolf U, Leitmann T. Epidemiological examinations of the influence of noise stress on the immune system and the emergence of arteriosclerosis. Report 298 62 515 (in German, executive summary in English), WaBoLu-Hefte 01/03. Berlin: Umweltbundesamt; 2003.  Back to cited text no. 54    
55.Bluhm G, Eriksson C, Hilding A, Östenson C-G. Aircraft noise exposure and cardiovascular risk among men - First results from a study around Stockholm Arlanda airport. In: Czech Acoustical Society, editor. Proceedings of the 33rd International Congress and Exhibition on Noise Control Engineering. Prague: The Czech Acoustical Society; 2004.  Back to cited text no. 55    
56.WHO European Centre for Environment and Health - Bonn Office. Quantifying burden of disease from environmental noise: Second technical meeting report. 2005. Available from: http://www.euro.who.int/Noise/activities/20021203_3 (last accessed on 30 2008).  Back to cited text no. 56    
57.Schulte W, Otten H. Results of a low-altitude flight noise study in Germany: Long-term extraaural effects. In: Ising H, Kruppa B, editors. Lδrm und Krankheit - Noise and Disease Proceedings of the International Symposium, Berlin 1991. Stuttgart: Gustav Fischer Verlag; 1993.p. 328-38.  Back to cited text no. 57    
58.Schulte W, Otten H. Auswirkungen des militδrischen Tieffluflδrms auf das Blutdruckverhalten bei Kindern. In: Poustka K, editor. Die physiologischen und psychischen Auswirkungen des militδrischen Tiefflugbetriebs. Bern: Hans Huber; 1991. p. 110-8.  Back to cited text no. 58    
59.Ising H, Rebentisch E, Poustka F, Curio I. Annoyance and health risk caused by military low-altitude flight noise. Int Arch Occup Environ Health 1990;62:357-63.  Back to cited text no. 59    
60.Ising H, Rebentisch E, Curio I, Otten H, Schulte W. Gesundheitliche Wirkungen des Tieffluglδrms. Kurzbericht über wesentliche Ergebnisse der Hauptstudie. Bundesgesundheitsblatt 1991;34:473-9.  Back to cited text no. 60    
61.Schmeck K, Poustka F. Psychophysiological and psychiatric tests with children and adolescents in a low-altitude flight region. In: Ising H, Kruppa B, editors. Lδrm und Krankheit - Noise and Disease Proceedings of the International Symposium, Berlin 1991. Stuttgart: Gustav Fischer Verlag; 1993. p. 293-306.  Back to cited text no. 61    
62.Pulles MPJ, Biesiot W, Stewart R. Adverse effects of environmental noise on health: An interdisciplinary approach. Environmental International 1990;16:437-45.  Back to cited text no. 62    
63.Greiser E, Greiser C, Janhsen K. Night-time aircraft noise increases prevalence of prescriptions of anthypertensive and cardiovascular drugs irrespective of social class - the Cologne-Bonn Airport study. J Public Health 2007;15:1613-2238.  Back to cited text no. 63    
64.Breugelmans ORP, Wiechen MAGv, Kamp Iv, Heisterkamp SH, Houthuijs DJM, 630100001. Gezondheid en beleving van de omgevingskwaliteit in de regio Schiphol: 2002 - Health and perception of environmental quality in the Schiphol Airport Area. 2002 (in Dutch, English summary), report no. 630100001. Bilthoven: RIVM; 2004.  Back to cited text no. 64    
65.Houthuijs DJM, Wiechen CMAGv, (eds). Monitoring van gezondheid en beleving rondom de luchthaven Schiphol - Monitoring health and perceptions around Schiphol Airport (in Dutch, English Summary), report no. 630100003. Bilthoven: RIVM; 2006.  Back to cited text no. 65    
66.van Kamp I, Houthuijs D, van Wiechen C, Breugelmans O. Environmental noise and cardiovascular diseases: Evidence from 10 year Schiphol research. In: I-INCE, editor. Inter-Noise 2006 Proceedings of the 35th International Congress and Exposition of Noise Control Engineering, Honolulu, Hawaii: Institute of Noise Control Engineering of the USA, Inc.; 2006. p. 07_132, 7 pages (on CD).  Back to cited text no. 66    
67.Jarup L, Babisch W, Houthuijs D, Pershagen G, Katsouyanni K, Cadum E, et al . Hypertension and exposure to noise near airports - the HYENA study. Environmental Health Perspectives 2008;116:329-33. Available from: http://www.ehponline.org/members/2007/10775/.pdf (last accessed on Apr 2008).  Back to cited text no. 67    
68.Babisch W, Houthuijs D, Pershagen G, Katsouyanni K, Velonakis M, Cadum E, et al . Association between noise annoyance and high blood pressure. Preliminary results from the HYENA study. In: Turkish Acoustical Society, editor. Proceedings of the 36th International Congress and Exhibition on Noise Control Engineering Inter-noise 2007, Istanbul. Istanbul: Turkish Acoustical Society, Istanbul Technical University, Faculty of Mechanical Engineering; 2007. p. 07-133 (10 pages).  Back to cited text no. 68    
69.Eriksson C, Rosenlund M, Pershagen G, Hilding A, Östenson C-G, Bluhm G. Aircraft noise and incidence of hypertension. Epidemiology 2007;18:716-21.  Back to cited text no. 69    
70.Hill AB. The environment and disease: Association or causation? Proc Royal Soc Med 1965;58:295-300.  Back to cited text no. 70    
71.Health Council of the Netherlands. Public health impact of large airports. Report by a committee of the Health Council of the Netherlands. The Hague: Health Council of the Netherlands; 1999.  Back to cited text no. 71    
72.Health Council of the Netherlands. Noise and health. Report by a committee of the Health Council of the Netherlands. The Hague: Health Council of the Netherlands; 1994.  Back to cited text no. 72    
73.Hiramatsu K, Yamamoto T, Taira K, Ito A, Nakasone T. A survey on health effects due to aircraft noise on residents living around Kadena Air Base in the Ryukyus. Journal of Sound and Vibration 1997;205:451-60.  Back to cited text no. 73    
74.Miyakita T, Matsui T, Ito A, Tokuyama T, Hiramatsu K, Osada Y, et al . Population-based questionnaire survey on health effects of aircraft noise on residents living around U.S. airfields in the Ryukyus. Part 1: An analysis of 12 scale scores. Journal of Sound and Vibration 2002;250:129-37.  Back to cited text no. 74    
75.Hygge S, Evans GW, Bullinger M. The Munich airport noise study - effects of chronic aircraft noise on children′s cognition and health. In: Carter N, Job RFS, editors. Noise Effects ′98 Proceedings of the 7th International Congress on Noise as a Public Health Problem, Sydney 1998. Sydney: Noise Effects ′98 PTY LTD; 1998. p. 268-74.  Back to cited text no. 75    
76.van Kempen E, van Kamp I, Fischer P, Davies H, Houthuijs D, Stellato R, et al . Noise exposure and children′s blood pressure and heart rate: The RANCH-project. Occup Environ Med 2006;63:632-9.  Back to cited text no. 76    
77.Author. Personal communication.  Back to cited text no. 77    
78.Miedema, H M E, Oudshoorn C G M. Annoyance from transportation noise: Relationships with exposure metrics DNL and DENL and their confidence intervals. Environ Health Perspect 2001;109:409-16.  Back to cited text no. 78    
79.Passchier-Vermeer, W, Noise and health. Publication No. A93/02E. The Hague: Health Council Of The Netherlands; 1993.  Back to cited text no. 79    
80.Baarslag, J F W. De lawaaibelasting rond Schiphol in 1974 (in Dutch). Amsterdam: NLR; 1975.  Back to cited text no. 80    
81.Working Group on Health and Socio-Economic Aspects. Position paper on dose-effect relationships for night time noise. Brussels: European Commission; 2004. Available from: http://ec.europa.eu/environment/noise/pdf/positionpaper.pdf (last accessed on Jan 2007).  Back to cited text no. 81    
82.European Commission Working Group on Dose-Effect Relations. Position paper on dose response relationships between transportation noise and annoyance. Luxembourg: Office for Official Publications of the European Communities; 2002. Available from: http://ec.europa.eu/environment/noise/pdf/noise_expert_network.pdf (last accessed on Jan 2007).  Back to cited text no. 82    
83.Herbold M, Hense H-W, Keil U. Effects of road traffic noise on prevalence of hypertension in men: Results of the Lübeck blood pressure study. Soz Praeventivmed 1989;34:19-23.  Back to cited text no. 83    
84.Belojevic G, Saric-Tanaskovic M. Prevalence of arterial hypertension and myocardial infarction in relation to subjective ratings of traffic noise exposure. Noise Health 2002;4(16):33-7.  Back to cited text no. 84    
85.Babisch W, Beule B, Schust M, Kersten N, Ising H. Traffic noise and risk of myocardial infarction. Epidemiology 2005;16:33-40.  Back to cited text no. 85    
86.Bluhm GL, Berglind N, Nordling E, Rosenlund M. Road traffic noise and hypertension. Occup Environ Med 2007;64:122-6.  Back to cited text no. 86    
87.Maschke C. Epidemiological research on stress caused by traffic noise and its effects on high blood pressure and psychic disturbances. In: Jong Rd, Houtgast T, Franssen EAM, Hofman W, editors. ICBEN 2003 Proceedings of the 8th International Congress on Noise as a Public Health Problem, Rotterdam, ISBN 90-807990-1-7. Schiedam: Foundation ICBEN 2003; 2003. p. 93-5.  Back to cited text no. 87    
88.Babisch W, Ising H, Gallacher JEJ. Health status as a potential effect modifier of the relation between noise annoyance and incidence of ischaemic heart disease. Occup Environ Med 2003;60:739-45.  Back to cited text no. 88    
89.Babisch W. Road traffic noise and cardiovascular risk. Noise Health 2008;10:27-33.  Back to cited text no. 89  [PUBMED]  Medknow Journal

Correspondence Address:
Wolfgang Babisch
Federal Environment Agency, Corrensplatz 1, 14195 Berlin
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1463-1741.53363

Rights and Permissions


  [Figure 1]

  [Table 1]

This article has been cited by
1 Bi-objective airport slot scheduling considering scheduling efficiency and noise abatement
Huilin Feng, Rong Hu, Deyun Wang, Junfeng Zhang, Chuntao Wu
Transportation Research Part D: Transport and Environment. 2023; 115: 103591
[Pubmed] | [DOI]
2 Occupational and Environmental Noise Exposure and Extra-Auditory Effects on Humans: A Systematic Literature Review
Yongho Lee, Seunghyun Lee, Wanhyung Lee
GeoHealth. 2023; 7(6)
[Pubmed] | [DOI]
3 Soundscape and subjective factors affecting residents’ evaluation of aircraft noise in the communities under flight routes
Fei Qu, Zhuoming Li, Tongtong Zhang, Wenjun Huang
Frontiers in Psychology. 2023; 14
[Pubmed] | [DOI]
4 Acoustic study and architectural proposals to improve acoustic comfort in a university campus of Mexico City
Antonio B. Kuri, Santiago J. Pérez R.
Applied Acoustics. 2022; 185: 108416
[Pubmed] | [DOI]
5 Incident hypertension in relation to aircraft noise exposure: results of the DEBATS longitudinal study in France
Aboud Kourieh, Lise Giorgis-Allemand, Liacine Bouaoun, Marie Lefèvre, Patricia Champelovier, Jacques Lambert, Bernard Laumon, Anne-Sophie Evrard
Occupational and Environmental Medicine. 2022; : oemed-2021
[Pubmed] | [DOI]
6 Bibliometric analysis and review of auditory and non-auditory health impact due to road traffic noise exposure
Manish Manohare, E. Rajasekar, Manoranjan Parida, Sunali Vij
Noise Mapping. 2022; 9(1): 67
[Pubmed] | [DOI]
7 Association between traffic noise-induced psychophysiological, and socio-demographic factors of motorcycle riders
Chidananda Prasad Das, Shreerup Goswami, Bijay Kumar Swain, Mira Das
Applied Acoustics. 2022; 196: 108898
[Pubmed] | [DOI]
8 Effect of wearing helmet on traffic noise-induced health issues of motorcycle riders
Chidananda Prasad Das, Shreerup Goswami, Bijay Kumar Swain, Mira Das
Journal of Transport & Health. 2022; 27: 101507
[Pubmed] | [DOI]
9 Epidemiologische Studien zu chronischen Straßenlärm-Expositionen und dem Blutdruck: Ein systematischer Review mit Metaanalysen
René A. Renner, Valérie J. Groß, Angela Ernst, Martin Hellmich, Thomas C. Erren
Das Gesundheitswesen. 2021; 83(05): 384
[Pubmed] | [DOI]
10 Lifestyle, psychological, socioeconomic and environmental factors and their impact on hypertension during the coronavirus disease 2019 pandemic
Reinhold Kreutz, Piotr Dobrowolski, Aleksander Prejbisz, Engi A.E-H Algharably, Grzegorz Bilo, Felix Creutzig, Guido Grassi, Vasilios Kotsis, Dragan Lovic, Empar Lurbe, Pietro A. Modesti, Marco Pappaccogli, Gianfranco Parati, Alexandre Persu, Jorge Polonia, Marek Rajzer, Philippe de Timary, Thomas Weber, Burkhard Weisser, Konstantinos Tsioufis, Giuseppe Mancia, Andrzej Januszewicz
Journal of Hypertension. 2021; 39(6): 1077
[Pubmed] | [DOI]
11 Blood Pressure and Arterial Stiffness in Association With Aircraft Noise Exposure: Long-Term Observation and Potential Effect of COVID-19 Lockdown
Wiktoria Wojciechowska, Andrzej Januszewicz, Tomasz Drozdz, Marta Rojek, Justyna Baczalska, Michal Terlecki, Karol Kurasz, Agnieszka Olszanecka, Mikolaj Smólski, Aleksander Prejbisz, Piotr Dobrowolski, Tomasz Grodzicki, Tomasz Hryniewiecki, Reinhold Kreutz, Marek Rajzer
Hypertension. 2021;
[Pubmed] | [DOI]
12 Traffic Noise and Inhabitant Health—A Comparison of Road and Rail Noise
Marcin Wrótny, Janusz Bohatkiewicz
Sustainability. 2021; 13(13): 7340
[Pubmed] | [DOI]
13 Prediction of traffic noise induced annoyance: A two-staged SEM-Artificial Neural Network approach
Chidananda Prasad Das, Bijay Kumar Swain, Shreerup Goswami, Mira Das
Transportation Research Part D: Transport and Environment. 2021; 100: 103055
[Pubmed] | [DOI]
14 Association of road traffic noise exposure and prevalence of coronary artery disease: A cross-sectional study in North India
Towseef Ahmed Gilani, Mohammad Shafi Mir
Environmental Science and Pollution Research. 2021; 28(38): 53458
[Pubmed] | [DOI]
15 Environmental exposures and sleep outcomes: A review of evidence, potential mechanisms, and implications
Jianghong Liu, Lea Ghastine, Phoebe Um, Elizabeth Rovit, Tina Wu
Environmental Research. 2021; 196: 110406
[Pubmed] | [DOI]
16 Impact of exposure to noise on the risk of hypertension: A systematic review and meta-analysis of cohort studies
Fan Chen, Wenning Fu, Oumin Shi, Dandan Li, Qingqing Jiang, Tiantian Wang, Xue Zhou, Zuxun Lu, Shiyi Cao
Environmental Research. 2021; 195: 110813
[Pubmed] | [DOI]
17 Long-term aircraft noise exposure and risk of hypertension in the Nurses' Health Studies
Chloe S. Kim, Stephanie T. Grady, Jaime E. Hart, Francine Laden, Trang VoPham, Daniel D. Nguyen, JoAnn E. Manson, Peter James, John P. Forman, Kathryn M. Rexrode, Jonathan I. Levy, Junenette L. Peters
Environmental Research. 2021; : 112195
[Pubmed] | [DOI]
18 Measurement of Sound Level in Sport Natural Areas Using the Maintaining Athletes’ Health Approach
Mohammad Taheri Hossseinabadi, Seyed Mostafa Tayebi Sani, Hooman Bahmanpour, Ali Fahiminejad
Annals of Applied Sport Science. 2020; 8(3): 0
[Pubmed] | [DOI]
19 Impacts of Aviation Emissions on Near-Airport Residential Air Quality
Neelakshi Hudda, Liam W. Durant, Scott A. Fruin, John L. Durant
Environmental Science & Technology. 2020; 54(14): 8580
[Pubmed] | [DOI]
20 Residential noise exposure and health: Evidence from aviation noise and birth outcomes
Laura M. Argys, Susan L. Averett, Muzhe Yang
Journal of Environmental Economics and Management. 2020; 103: 102343
[Pubmed] | [DOI]
21 The social acceptance of airport expansion scenarios: A factorial survey experiment
Ulf Liebe, Peter Preisendörfer, Heidi Bruderer Enzler
Transportation Research Part D: Transport and Environment. 2020; 84: 102363
[Pubmed] | [DOI]
22 Predicting the aircraft take-off noise level
Ayodele Adekunle Faiyetole, Ibrahim Taofiq Toyin
Vibroengineering PROCEDIA. 2019; 22: 129
[Pubmed] | [DOI]
23 Occupational noise exposure and risk of hypertension in an industrial workforce
Baylah Tessier-Sherman, Deron Galusha, Linda F. Cantley, Mark R. Cullen, Peter M. Rabinowitz, Richard L. Neitzel
American Journal of Industrial Medicine. 2017; 60(12): 1031
[Pubmed] | [DOI]
24 Noise Pollution: Knowledge, Attitudes and practice of sawmill workers in Osun State, Nigeria
J. A. E. Eziyi, IO Akinwumi, IO Olabanji, OO Ashaolu, YB Amusa
Nigerian Journal of Health Sciences. 2015; 15(1): 36
[Pubmed] | [DOI]
25 Environmental Burden of Disease in Europe: Assessing Nine Risk Factors in Six Countries
Otto Hänninen, Anne B. Knol, Matti Jantunen, Tek-Ang Lim, André Conrad, Marianne Rappolder, Paolo Carrer, Anna-Clara Fanetti, Rokho Kim, Jurgen Buekers, Rudi Torfs, Ivano Iavarone, Thomas Classen, Claudia Hornberg, Odile C.L. Mekel
Environmental Health Perspectives. 2014; 122(5): 439
[Pubmed] | [DOI]
26 Associations between Traffic Noise, Particulate Air Pollution, Hypertension, and Isolated Systolic Hypertension in Adults: The KORA Study
Wolfgang Babisch, Kathrin Wolf, Markus Petz, Joachim Heinrich, Josef Cyrys, Annette Peters
Environmental Health Perspectives. 2014; 122(5): 492
[Pubmed] | [DOI]
27 Environmental noise and sleep disturbances: A threat to health?
Halperin Demian
Sleep Science. 2014;
[Pubmed] | [DOI]
28 Road traffic noise and hypertension – Accounting for the location of rooms
Wolfgang Babisch,Gabriele Wölke,Joachim Heinrich,Wolfgang Straff
Environmental Research. 2014;
[Pubmed] | [DOI]
29 Cardiovascular effects of environmental noise exposure
T. Munzel,T. Gori,W. Babisch,M. Basner
European Heart Journal. 2014; 35(13): 829
[Pubmed] | [DOI]
30 Occupational Noise Exposure and the Risk of Hypertension
Zara A. Stokholm,Jens Peter Bonde,Kent L. Christensen,Åse M. Hansen,Henrik A. Kolstad
Epidemiology. 2013; 24(1): 135
[Pubmed] | [DOI]
31 Exposure to aircraft and road traffic noise and associations with heart disease and stroke in six European countries: a cross-sectional study
Sarah Floud,Marta Blangiardo,Charlotte Clark,Kees de Hoogh,Wolfgang Babisch,Danny Houthuijs,Wim Swart,Göran Pershagen,Klea Katsouyanni,Manolis Velonakis,Federica Vigna-Taglianti,Ennio Cadum,Anna L Hansell
Environmental Health. 2013; 12(1): 89
[Pubmed] | [DOI]
32 Auditory and non-auditory effects of noise on health
Mathias Basner,Wolfgang Babisch,Adrian Davis,Mark Brink,Charlotte Clark,Sabine Janssen,Stephen Stansfeld
The Lancet. 2013;
[Pubmed] | [DOI]
33 Cardiovascular health, traffic-related air pollution and noise: are associations mutually confounded? A systematic review
Louis-François Tétreault,Stéphane Perron,Audrey Smargiassi
International Journal of Public Health. 2013; 58(5): 649
[Pubmed] | [DOI]
34 Noise annoyance — A modifier of the association between noise level and cardiovascular health?
Wolfgang Babisch,Göran Pershagen,Jenny Selander,Danny Houthuijs,Oscar Breugelmans,Ennio Cadum,Federica Vigna-Taglianti,Klea Katsouyanni,Alexandros S. Haralabidis,Konstantina Dimakopoulou,Panayota Sourtzi,Sarah Floud,Anna L. Hansell
Science of The Total Environment. 2013; 452-453: 50
[Pubmed] | [DOI]
35 Noise annoyance - A modifier of the association between noise level and cardiovascular health?
Babisch, W. and Pershagen, G. and Selander, J. and Houthuijs, D. and Breugelmans, O. and Cadum, E. and Vigna-Taglianti, F. and Katsouyanni, K. and Haralabidis, A.S. and Dimakopoulou, K. and Sourtzi, P. and Floud, S. and Hansell, A.L.
Science of the Total Environment. 2013; 452-453: 50-57
36 Noise and health in vulnerable groups: A review
Van Kamp, I. and Davies, H.
Noise and Health. 2013; 15(64): 153-159
37 Sample size estimation for field studies on the effects of aircraft noise on sleep
Basner, M. and Brink, M.
Applied Acoustics. 2013; 74(6): 812-817
38 Health effects of aircraft noise: Current status of evidence [Gesundheitliche Folgen von Fluglarm: Aktueller Stand der Evidenz]
Weinmann, T.
Gesundheitswesen. 2013; 75(1): 63-64
39 Occupational noise exposure and the risk of hypertension
Stokholm, Z.A. and Bonde, J.P. and Christensen, K.L. and Hansen, A.M. and Kolstad, H.A.
Epidemiology. 2013; 24(1): 135-142
40 Effects of environmental noise on sleep
Hume, K.I. and Brink, M. and Basner, M.
Noise and Health. 2012; 14(61): 297-302
41 Noise and cardiovascular disease: A review of the literature 2008-2011
Davies, H. and Van Kamp, I.
Noise and Health. 2012; 14(61): 287-291
42 NORAH (Noise-Related Annoyance, Cognition, and Health) - Concept of a study on effects of transportation noise on residents living in the vicinity of an airport [NORAH (Noise-Related Annoyance, Cognition, and Health) - Konzept einer studie zur wirkung von verkehrslärm bei anwohnern von flughäfen]
Schreckenberg, D. and Eikmann, T. and Guski, R. and Klatte, M. and Müller, U. and Peschel, C. and Schmidt, J. and Seidler, A. and Möhler, U.
Larmbekampfung. 2012; 7(3): 107-114
43 Objective assessment of total noise exposure over 24 hours: A cross-sectional study in Bavaria [Objektive Bestimmung der 24-Stunden-Gesamtlärmbelastung: eine Querschnittsstudie in Bayern]
Weinmann, T. and Sárközi, E. and Praml, G. and Von Kries, R. and Ehrenstein, V. and Nowak, D. and Radon, K.
Gesundheitswesen. 2012; 74(11): 710-715
44 Annoyance and other reaction measures to changes in noise exposure - A review
Laszlo, H.E. and McRobie, E.S. and Stansfeld, S.A. and Hansell, A.L.
Science of the Total Environment. 2012; 435-436: 551-562
45 Feasibility study of HIA (Health Impact Assessment) on road traffic noise induced health effects on children
Mekelo, O.C.L. and Sierigc, S. and Claßenc, T.
Pollution Atmospherique. 2012; (216): 343-352
46 The quantitative relationship between road traffic noise and hypertension: A meta-analysis
Van Kempen, E. and Babisch, W.
Journal of Hypertension. 2012; 30(6): 1075-1086
47 Towards a general framework for including noise impacts in LCA
Stefano Cucurachi, Reinout Heijungs, Katrin Ohlau
The International Journal of Life Cycle Assessment. 2012;
[VIEW] | [DOI]
48 Annoyance and other reaction measures to changes in noise exposure — A review
H.E. Laszlo,E.S. McRobie,S.A. Stansfeld,A.L. Hansell
Science of The Total Environment. 2012; 435-436: 551
[Pubmed] | [DOI]
49 The quantitative relationship between road traffic noise and hypertension
Elise van Kempen,Wolfgang Babisch
Journal of Hypertension. 2012; 30(6): 1075
[Pubmed] | [DOI]
50 Aircraft Noise and Myocardial Infarction Mortality :
Anke Huss, Adrian Spoerri, Matthias Egger, Martin Röösli
Epidemiology. 2011; 22(2): 284
[VIEW] | [DOI]
51 A Study of Ridersæ Noise Exposure on Bay Area Rapid Transit Trains
Alexis Dinno, Cynthia Powell, Margaret Mary King
Journal of Urban Health. 2011; 88(1): 1
[VIEW] | [DOI]
52 Trends in aircraft noise annoyance: The role of study and sample characteristics
Sabine A. Janssen, Henk Vos, Elise E. M. M. van Kempen, Oscar R. P. Breugelmans, Henk M. E. Miedema
The Journal of the Acoustical Society of America. 2011; 129(4): 1953
[VIEW] | [DOI]
53 Indoor environment and childrenæs health: Recent developments in chemical, biological, physical and social aspects
Pierre Le Cann, Nathalie Bonvallot, Philippe Glorennec, Séverine Deguen, Christophe Goeury, Barbara Le Bot
International Journal of Hygiene and Environmental Health. 2011;
[VIEW] | [DOI]
54 Transportation Noise and Blood Pressure in a Population-Based Sample of Adults
Environmental Health Perspectives. 2011; 120(1): 50
[VIEW] | [DOI]
55 Risk of hypertension related to road traffic noise among reproductive-age women
Bendokiene, I. and Grazuleviciene, R. and Dedele, A.
Noise and Health. 2011; 13(55): 371-377
56 The Urban enviroment as a cardiovascular disease risk factor [Kardiyovasküler risk faktörü olarak kent çevresi]
Okeahialam, B.N.
TAF Preventive Medicine Bulletin. 2011; 10(3): 369-372
57 Infrasound and low frequency noise from wind turbines: Exposure and health effects
Bolin, K. and Bluhm, G. and Eriksson, G. and Nilsson, M.E.
Environmental Research Letters. 2011; 6(3)
58 The authors respond:
Huss, A. and Spoerri, A. and Egger, M. and Röösli, M.
Epidemiology. 2011; 22(2): 284
59 A study of riders noise exposure on bay area rapid transit trains
Dinno, A. and Powell, C. and King, M.M.
Journal of Urban Health. 2011; 88(1): 1-13
60 Overview of the Environmental Damage, Property Loss, and Health Impairment of Residents around a US Air Force Firing Range
Hyun-Sul Lim
Korean Journal of Environmental Health Sciences. 2011; 37(3): 173
[VIEW] | [DOI]
61 Concerning the report on traffic noise and cardiovascular system [Ke zprávě dopravní hluk a kardiovaskulá rní systém]
Havel, B.
Hygiena. 2010; 55(2): 67-68
62 MDMA (ecstasy) enhances loud noise-induced morphofunctional alterations in heart and adrenal gland
Federica Fulceri, Michela Ferrucci, Paola Lenzi, Paola Soldani, Alessia Bartalucci, Antonio Paparelli, Marco Gesi
Microscopy Research and Technique. 2010; : n/a
[VIEW] | [DOI]
63 Noisy Days, Noisy Nights
David Sharp
Journal of Urban Health. 2010; 87(3): 349
[VIEW] | [DOI]