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Year : 2004  |  Volume : 6  |  Issue : 22  |  Page : 5-13
Health effects caused by noise : Evidence in the literature from the past 25 years

Federal Environmental Agency (retired), Berlin, Germany

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  Abstract 

Traffic noise is the most important source of environmental annoyance. According to the Environmental Expert Council of Germany, severe annoyance persistent over prolonged periods of time is to be regarded as causing distress. Previously, extraaural noise effects were mostly assessed using a paradigm in which the sound level played the major role. On the basis of this paradigm the relatively low sound level of environmental noise was not considered to be a potential danger to health. In contrast to this numerous empirical results have shown long≠term noise-induced health risks. Therefore a radical change of attitude - a change of paradigm - is necessary. For an immediate triggering of protective reactions (fight/flight or defeat reactions) the information conveyed by noise is very often more relevant than the sound level. It was shown recently that the first and fastest signal detection is mediated by a subcortical area - the amygdala. For this reason even during sleep the noise from aeroplanes or heavy goods vehicles may be categorised as danger signals and induce the release of stress hormones. In accordance with the noise stress hypothesis chronic stress hormone dysregulations as well as increases of established endogenous risk factors of ischaemic heart diseases have been observed under long-term environmental noise exposure. Therefore, an increased risk of myocardial infarction is to be expected. The results of individual studies on this subject in most cases do not reach statistical significance. However, according to the Environmental Expert Council, these studies show a consistent trend towards an increased cardiovascular risk if the daytime immission level exceeds 65 dB(A). Most of the previous studies on the extraaural effects of occupational noise have been invalidated by exposure misclassifications. In future studies on health effects of noise a correct exposure assessment is one of the most important preconditions.

Keywords: Noise, environmental, occupational, annoyance, stress hormones, cardiovascular risk

How to cite this article:
Ising H, Kruppa B. Health effects caused by noise : Evidence in the literature from the past 25 years. Noise Health 2004;6:5-13

How to cite this URL:
Ising H, Kruppa B. Health effects caused by noise : Evidence in the literature from the past 25 years. Noise Health [serial online] 2004 [cited 2014 Sep 2];6:5-13. Available from: http://www.noiseandhealth.org/text.asp?2004/6/22/5/31678

  Introduction Top


The Federal Immission Protection Act (Bundes≠Immissionsschutzgesetz) specifies adverse environmental noise effects on the general public or in specific neighbourhoods as

  • hazards, such as health risks,
  • substantial losses, e.g. in property values,
  • substantial disturbances.


Acute noise events which do not cause permanent health impairments are considered as non-substantial. However, effects of long term noise exposure, which do not habituate but increase the long-term risk of physical damage, are assessed as health hazards.

The issue of personal losses in terms of material assets will not be considered in this paper.

Most questionnaires used to evaluate the degree of individual noise disturbances, offer a scale of answers ranging from "not disturbed at all" to "very much disturbed". To meet the criterion of substantial disturbance only such persons are included who classify themselves in the intermediate range or higher. [Table - 1] depicts mean noise levels L den (reference time period: 24 h, with supplementary malusses of 5 dB and 10 dB added to evening and night time level respectively) at which 20% of the interviewed persons felt significantly or very much disturbed.

The data are taken from a recent meta-analysis (Miedema and Vos, 1998) of studies on the dose≠response relationship between various types of traffic noise and their disturbing effects. It is clearly shown that at identical noise levels the disturbance by aircraft noise is greater than that by rail or road traffic noise.


  Paradigms of occupational and environmental noise effects Top


The legal basis on noise protection at the workplace (cf. Regulations on the Prevention of Accidents, 1990) contain regulations both about preventive medical measures and the right to claim damage compensation. Because these two cases require different levels of evidence for noise-induced health impairments, they may briefly be discussed at this point. With regard to damage compensation, clear evidence is required of a causative connection between defined noise exposure and the postulated health impairment. In the case of preventive health protection, however, any reasonable assumption of a possible health hazard justifies protective measures. From the point of view of preventive medicine the quality of the evidence connecting noise exposure and health hazards is usually classified in one of three categories:

  • sufficient
  • limited
  • inadequate


Up to now, the only noise induced occupational disease acknowledged with sufficient evidence is noise induced hearing loss.

According to ISO 1999, occupational noise induced hearing damage does not occur below immission levels of L eq = 80 dB(A) with reference to 40 working hours per week. Higher exposure will increase the risk of permanent hearing threshold shifts - also for listeners to loud music. An analogy is observed between noise-induced hearing impairment and the damaging effects of exogenous toxic substances. The effects of toxins and of loud noise on the hearing capacity is proportional to the total amount absorbed and to the total sound energy immitted respectively. For all extraaural noise effects no analogy is found to toxic substances.

The majority of studies on extraaural work noise effects were based upon the paradigms of aural noise effects and have erroneously used persons with noise exposure below 85 dB(A) as "non≠exposed" control groups. Additionally, ear protection - which is normally only partly used - was rarely taken into account. This has lead to severely underestimated noise effects resulting from exposure misclassifications of up to 30 dB and bereaving such studies of any relevant contribution to the question of work noise≠induced extraaural health impairments. Therefore the conclusions being drawn from these studies are false (Babisch, 1998). There are only a few studies, in which such incorrect methods were avoided. These studies, however, have revealed a significant increase in cardiovascular diseases as well as increased mortality rates following long-term work noise exposure (Zhao et al.1991; Ising et al. 1999; Melamed et al. 1999).

There is a major need, therefore, to abolish such paradigmatic errors of the past, and not to draw misleading conclusions from earlier methodically incorrect occupational noise studies.

On the other hand, Jansen and Notbohm (1994) have come to the conclusion that the risk of cardiovascular disease can scarcely be increased by traffic noise, since the noise effect research has failed to provide unambiguous findings in spite of essentially higher noise exposure. Even more extraordinary is the assessment quoted by the above authors, based solely on the noise level, as "healthy / indifferent / unhealthy or disturbing / substantially disturbing / hazardous". Moderator variables such as situative factors are not taken into account.

Their model, which led to this overestimation of the noise level, is valid only for direct noise effects such as hearing damage.

extraaural noise effects i.e. physiological, psychological and mental, are believed to be in analogy with aural noise effects. The authors argue as follows: The lower the sound intensity measured the greater is the variation in the reactions observed in terms of individual and situational influences, with the result that any scientific statements on extraaural noise effects are subject to considerable limitations.

The first part of this statement is correct, but the conclusive part seems rather preposterous. It is true that in laboratory tests with very high sound levels these are closely correlated with the noise effects, but they yield no information on the effects of environmental noise. In the sound level range of environmental noises, the moderators play a decisive part (Deutsche Forschungsgemeinschaft, 1974). Therefore, environmental noise effects must be analyzed using adequate methods.

Environmental noise effects cannot be extrapolated from short-term laboratory findings, as has been shown in a study: "Stress reactions and health hazards induced by traffic noise exposure, comparison of methods between field and laboratory trials" (Ising, 1983). Several hours of exposure to road noise under field conditions at level L m = 60 dB(A) caused greater blood pressure reactions in self-estimated noise sensitive persons than in those who were noise insensitive. Short-term sound exposure in the laboratory with intermittent noise at L =100 dB(A) showed opposite results. No correlation between blood pressure reactions under field conditions with hours of exposure and laboratory studies with a duration of several minutes could be established.

This shows that results of short-term laboratory tests cannot be used as a model of long-term effects caused by environmental noise exposure. Therefore, the dose-response diagram in [Table - 1] is not apt to be used as a basis for assessing environmental noise effects. As a consequence, such paradigmatic errors of the past ought to be recognized as such and be eliminated.

Serious mistakes were also made when establishing limiting levels for environmental noise immission (Maschke et al. 2001a,b). This was a result of inadequate interdisciplinary cooperation. A prerogative of any competent future studies in the area of noise effect research should therefore consist of requesting and planning a close cooperation between the physico-technical, the socio-psychological and medical as well as the epidemiological disciplines. Positive examples today are the interdisciplinary working group " Problems of Noise Effects" of the Federal Environmental Agency (UBA) and among the larger research projects the flight noise study of the German Research Association (Deutsche Forschungsgemeinschaft, 1974) as well as the studies on the health effects of military low≠flight noise conducted on behalf of the UBA (Curio and Ising 1986, Ising et al. 1991) and the Caerphilly-Speedwell cardiovascular studies (Babisch et al. 1999).


  Psycho-social noise effects Top


A major result of the DFG-Study was the finding that noise disturbances can only be predicted to a maximum of one third by acoustic measures such as noise level, exposure time, frequency range etc. Non-acoustical variables, such as situative and individual moderators, exert a considerable influence on noise processing while remaining unchanged under noise exposures (Guski 2001).

Evidence of disturbances resulting from environmental noise has been designated as definitely sufficient and assigned an initial threshold L dn = 42dB(A) (outside) in the "Noise and Health" report of the Health Council of the Netherlands (1994). Jansen and Notbohm quote L m = 45-55 dB(A) as the range of the threshold for reactions by the population (based on a disturbed contingent between 0 and 20%) (Jansen and Notbohm, 1994). Ortscheid and Wende (2000), in their assessment of flight noise based on currently available literature, come to the conclusion that the boundary to substantial disturbance is reached with a flight noise of 55 dB(A) in the daytime and 45 dB(A) at night (outside).

In their report the two types of noise effects "disturbance" and "health impairment" play a central part in their objective to develop protective measures. In its special assessment "Environment and Health", the panel of experts for environmental questions (1999) adopted the following viewpoint on questions of disturbance by environmental noise: In Western Europe the trend has become apparent that the number of citizens suffering from serious disturbance is decreasing, but those subject to less serious disturbance is increasing. The main source of disturbance is road traffic noise. In the "old" Lands of the Federal Republic 68% of the population are disturbed, in the "new" Lands the rate is 83%. Approximately 50% of the population are disturbed by flight noise and 20% each by rail and industrial noise. Under constant noise exposure the degree of disturbance remains unchanged. There are no indications as to people habituating to noise. If the disturbance persists over longer periods of time this strain is to be classified as negative stress (distress).


  Noise-induced sleep disturbances and endocrine reactions Top


In the past an arousal reaction was considered as being the only relevant health effect of nocturnal noise. In the above mentioned expertise "Environment and Health" it is quoted, however: According to (Maschke, 1998), merely considering the arousal reaction does not take into account either the derangement of the physiological sleep structure, nor the interference with the normal sequence of the sleep stages and the detrimental effects of compensation.

Although there is no proof yet as to whether and to what extent prolonged noise exposure with ensuing sleep disorders will cause health detriments as described by Maschke, the Environmental Council give their opinion as follows: From our point of view it cannot be excluded that the observed sleep disturbances may adversely influence health and performance capacity in the long term.

Therefore for reasons of medical prevention it is necessary principally to avoid noise-induced impairments even when below the arousal threshold.

Acute and chronic stress hormone increases during sleep have been measured even at relatively low sound levels. In a prospective interventional study on children, Evans et al. (1998) found significant increases in adrenaline and noradrenaline excretion after a new airport had been opened. Total cortisol showed a tendential increase, but free cortisol was not measured.

In a field survey on persons living in the neighbourhood of the Berlin Tegel Airport, using recorded simulated night flight noise, an increased adrenaline excretion was measured after the first two test nights. In comparison, an increase in cortisol excretion was found after the third and fourth test nights. As few as 16 overflights at maximum levels of 55 dB(A) - the mean level during test nights being 30 dB(A) - induced significant stress hormone increases and a distinctly deteriorated subjective sleep quality (Maschke et al., 1995). In this study, however, the question on the influence of habituation to night-flight noise remained unanswered.

Harder et al. (1999), therefore, measured free cortisol excretions during three test nights without noise exposure and 37 test nights with simulated flight noise played-back into the bedrooms via loudspeakers. The mean values in the test group showed an acute increase in cortisol excretion only after flight noise test nights two and three. In the following, the mean cortisol excretion values went back to normal, merely superimposed by slight alterations in a seven day rhythm. The most impressive result was a significant increase in cortisol excretion with values above the normal range during the last two weeks under night flight conditions (Maschke et al., 2002). This study has shown that long-term nocturnal noise exposures may lead, in persons liable to be stressed by noise, to permanently increased cortisol concentrations above the normal range.

As part of a survey on "Traffic and health in densely populated Berlin areas" the catecholamine excretion of 200 women was measured (Babisch et al. 1996). Women whose bedrooms were orientated towards streets with rather high noise levels (mean levels at night L m > 57 dB(A) (outside)) showed significantly increased excretion values of catecholamines compared to those of women living in relatively quiet homes (L m < 52 dB(A). The results remained stable after controlling covariables (smoking, alcohol, social status etc.).

Additionally, stress hormone excretions were measured in test persons who lived in noisy streets and were asked to leave their bedroom windows open in order to further increase the noise level. These test persons had for several years been exposed to nocturnal mean traffic noise levels between 53 and 69 dB(A) (outside). Acute noise level increases of 9 to 18 dB(A) through leaving the windows open, resulted in a mean increase of free cortisol excretion by one third. A comparison with a control group living in quieter surroundings (L m < 45 dB(A) showed that the noradrenaline and cortisol excretions in the heavy traffic noise group was higher in concentration even when their windows were kept closed. This finding gives evidence of persistent stress hormone increases as a result of long years of nocturnal noise exposure (Braun, 1999).

Evans et al. (2001) examined children exposed to moderate road traffic noises (outside daytime level L m > 60 dB(A)). Their night-time urine contained increased concentrations of free cortisol and cortisol metabolites compared to those of children living in quieter areas (outside daytime level < 50 dB(A)), whereas no differences in catecholamines were observed.

Also, in a study on children with high traffic noise exposures day and night, mainly caused by heavy goods vehicles (Ising H. and Ising M., 2002), a significant increase in excretion of free cortisol and cortisol metabolites was found in the first half of the night, but not in the second half. A comparison of these findings to those of children living in quieter surroundings clearly illustrates an interference of nocturnal noise exposure with the spontaneous circadian rhythm of normal cortisol release.

A review of recent studies on the relationship between traffic noise levels and stress hormone increases is given in [Table - 2]. In only two out of ten studies no stress hormone increases under traffic noise conditions were found. Among five flight noise studies only one (Ising et al. 1999) failed to find stress hormone increases, the reason being that in this case noise exposures were too short in duration and incidences only rare. These were caused by occasional overflights of military aircraft in the late evening hours. The negative results of a road traffic noise study (Carter et al. 1994) has been caused by a methodological error, as stress hormone concentrations were presented rather than hormone excretions or concentrations related to creatinine.

It should be added, however, that - although mostly stress hormone increases were observed - in some rare cases decreased excretions of stress hormones were found under nocturnal noise conditions, (Ising und Braun 2000, Harder et al. 1999).

The Health Council of the Netherlands (1994) classified the evidence of biochemical noise effects as limited. Yet, the results of the presented studies demonstrate that noise exposures over time periods of years may induce, in a certain percentage of exposed persons, permanent changes of the stress hormone regulation, along with possible consequences in terms of functional and organic damages. A decisive factor in the assessment of noise-induced health effects are persistent stress reactions. Up till now, the majority of studies investigating noise stress effects were based on measurements of the catecholamines adrenaline and noradrenaline and of cortisol.

In terms of the psycho-physiological stress model of Henry (1992), displayed in [Figure - 1], these stress hormones may be viewed as "guiding substances" for the identification of stress reaction types described there. An increase in cortisol for example shows activation of the hypothalamus, pituitary and adrenal cortex system (HPA system). The consequences of long term activation of the HPA system, may among other things, be insulin resistance, stress-ulcers and cardiovascular diseases.


  Environmental noise and cardiovascular risk Top


The hypothesis of an increased risk of cardiovascular diseases is derived from the stress concepts (Selye 1956, Henry 1992, Bjorntorp 1997). As shown above, noise exposure may lead to acute and chronic changes of the physiological stress hormone regulation. The different types of stress reactions may lead to derangement of normal neuro-vegetative and hormonal processes and exert an adverse influence on the equilibrium of vital body functions. These include cardiovascular parameters such as blood pressure, cardiac function, serum cholesterol, triglycerides, and free fatty acids, hemostatic factors (fibrinogen) impeding the blood flow in terms of increased plasma viscosity (Friedman and Rosenman 1975), and presumably blood sugar concentration as well. Pathological changes of these parameters may be caused by a variety of endogenous and exogenous factors representing the classical risk factors of cardiovascular diseases. In this context, disturbing noise as well as stress inducing noise at night time is to be classified as an exogenous risk factor in the development of atheriosclerosis, hypertension, ischemic heart disease and myocardial infarction (VDI≠Richtlinie 3722, 1988; Babisch 2001; 2002).

Maschke et al (2003) assessed the traffic noise exposure at day and night time separately and found a dose dependent and significant increas of lifetime prevalence of hypertension in persons with L eq night > 50 dB(A) but not with daytime noise exposure.

In [Figure - 2], these effects are depicted in a diagram. Sound or noise immissions are processed via central pathways and activate the neuro-endocrinological systems either by inducing direct effects as in the case of work noise, or in the case of relatively low environmental noise levels or during sleep, through instant signal processing in the amygdala which is itself linked with cortical, limbic and hypothalamic centres (Spreng 2000) - or inducing indirect stress effects like disturbances of communication and concentration.

Concerning noise and cardiovascular risk the expertise "Health and Environment" states as follows: Noise, when acting as a stress factor, may enhance the pathogenesis of several health disorders. This is the case with cardiovascular diseases.

The long-term consequences of noise induced increase of stress hormones have to be investigated in epidemiological studies. Studies on the relationship between road traffic noise and coronary heart diseases are briefly described with the following conclusion:. ... "The studies presented are lacking in test power on account of too few cases in groups with higher noise exposure; the results are statistically insignificant ...

Nevertheless, the Environmental Council is of the opinion that the results show a consistent trend. The threshold level for possible noise≠induced risk of myocardial infarction has been established at a daytime immission level of 65 dB(A)."

With mean road traffic noise exposure levels of more than 55 / 65 dB(A) (daytime / night time) (outside), however, an increase in the risk of myocardial infarction by 20% is to be expected. According to the evaluation of the Health Council of the Netherlands (1994), evidence of an increased risk of cardiovascular disease induced by traffic noise exposures above L m = 70 dB(A) is considered as being sufficient.

The concurring tendencies and the basic consistency of the traffic noise studies known so far yield sufficient scientific reasons for preventive protection measures to be taken against noise-induced risk increases of cardiovascular disease.[41]

 
  References Top

1.Babisch, W., Fromme, H., Beyer, A., Ising, H. (1996) Katecholaminausscheidung im Nachturin bei Frauen aus unterschiedlich verkehrsbelasteten Wohngebieten. WaBoLu Hefte. Vol. 9/96. Institut fiir Wasser-, Boden- und Lufthygiene des Umweltbundesamtes Berlin  Back to cited text no. 1    
2.Babisch, W. (1998) Epidemiological studies of the cardiovascular effects of occupational noise - a critical appraisal. Noise & Health 1:24-39  Back to cited text no. 2    
3.Babisch, W., Ising, H., Gallacher, J.E.J., Sweetnam, P.M., Elwood, P.C. (1999) Traffic noise and cardiovascular risk: The Caerphilly and Speedwell studies, third phase - 10 years follow-up. Archives of Environmental Health 54(3):210-216  Back to cited text no. 3    
4.Babisch, W. (2001) Larmbedingtes Risiko fur Herz≠Kreislauf-Krankheiten. In: Wichmann, Schlipkoter, Fiilgraff (eds.) Handbuch der Umweltmedizin. Kapitel VII-1 Larm, Erg. Lfg.7/01 Ecomed, Landsberg  Back to cited text no. 4    
5.Babisch, W. (2002) Noise/Stress Concept, Risk Assessment and Research Needs. Noise & Health 4(16): 1-11  Back to cited text no. 5    
6.Bjorntorp, P. (1997) Stress and cardiovascular disease. Acta Physiol. Scand.;161 (suppl. 640):144-148  Back to cited text no. 6    
7.Braun, C. (1999) Nachtlicher StraBenverkehrslarm und Stresshormonausscheidung beim Menschen. Dissertation, Berlin  Back to cited text no. 7    
8.Carter, N.L., Hunyor, S.N., Crawford, G., Kelly, D., Smith, A.J.M. (1994) Environmental noise and sleep - a study of arousals, cardiac arrhythmia and urinary catecholamines. Sleep 17: 298-307  Back to cited text no. 8    
9.Curio, I., Ising, H. et al. (1986) Gesundheitliche Auswirkungen des militarischen Tieffluglarms - Vorstudie. Umweltbundesamt, Berlin.  Back to cited text no. 9    
10.DER RAT VON SACHVERSTANDIGEN FOR UMWELTFRAGEN 1999 Umwelt und Gesundheit - Risiken richtig einschatzen. Sondergutachten. Metzler≠Poeschel. Stuttgart  Back to cited text no. 10    
11.DEUTSCHE FORSCHUNGSGEMEINSCHAFT 1974, Fluglarmwirkungen, Boppard  Back to cited text no. 11    
12.Evans, G. W., Bullinger, M., Hygge, S. (1998) Chronic noise exposure and physiological response: A prospective study of children living under environmental stress. American Psychological Soc., Vol.9: 75-77  Back to cited text no. 12    
13.Evans, G., Lercher, P., Meis, M., Ising, H., Kofler, W. (2001) Typical Community Noise Exposure and Stress in Children. J. Acoust. Soc. Am. 109 (3) 1023-1027  Back to cited text no. 13    
14.Friedman, M., Rosenman, R.H. (1975) Der A-Typ und der B-Typ. Rowohlt Verlag GmbH. Reinbek bei Hamburg  Back to cited text no. 14    
15.Guski, R. (2001) Moderatoren der Larmwirkung. In: WICHMANN, SCHLIPKOTER, FLTLGRAFF (eds.) Handbuch der Umweltmedizin. Kapitel VII-1 Larm, Erg. Lfg.7/01 Ecomed, Landsberg  Back to cited text no. 15    
16.Harder, J., Maschke, C., Ising, H. (1999) Langsschnittstudie zum Verlauf von StreBreaktionen unter Einflu3 von nachtlichem Feuglarm. WaBoLu-Hefte. Umweltbundesamt, Berlin  Back to cited text no. 16    
17.HEALTH COUNCIL 1994 Noise and health. Report by a committee of the Health Council of the Netherlands. Health Council of the Netherlands, The Hague.  Back to cited text no. 17    
18.Henry, J.P. (1992) Biological basis of the stress response. Integrative Physiological and Behavioral Science 27: 66-83  Back to cited text no. 18    
19.Ising, H. (1983) StreBreaktionen und Gesundheitsrisiko bei Verkehrslarmbelastung. WaBoLu-Berichte 2/1983, Dietrich Reimer. Berlin  Back to cited text no. 19    
20.Ising, H., Curio, I., Otten, H., Rebentisch, E., Schulte, W., Babisch, W. et al. (1991) Gesundheitliche Wirkungen des Tieffluglarms - Hauptstudie. Umweltbundesamt Berlin  Back to cited text no. 20    
21.Ising, H., Babisch, W., Giinther, T. (1999) Work noise as a risk factor in myocardial infarction. J. Clin Basic Cardiol 2: 64-68  Back to cited text no. 21    
22.Ising, H., Braun, C. (2000) Acute and chronic endocrine effects of noise: review of the research conducted at the Institute for Water, Soil and Air Hygiene. Noise & Health 7: 7-24  Back to cited text no. 22    
23.Ising, H., Pleines, F., Meis, M. (1999) Beeinflussung der Lebensqualitat von Kindern durch militarischen Fluglarm. Umweltbundesamt Berlin  Back to cited text no. 23    
24.Ising, H., Ising, M. (2002) Chronic cortisol increases in the first half of the night caused by road traffic noise. Noise & Health 4(16): 13-21  Back to cited text no. 24    
25.ISO 1999 "Bestimmung der berufsbedingten Larmexposition und Einschatzung der larmbedingten Horschadigung" January 1990  Back to cited text no. 25    
26.Jansen, G., Notbohm, G. (1994) Andere Umweltfaktoren, Kapitel VII-1, Larm. In: Wichmann, Schlipkoter, Fiilgraff (eds.) Handbuch der Umweltmedizin. Ecomed, Landsberg  Back to cited text no. 26    
27.Maschke, C., Arndt, D., Ising, H. (1995) Nachtlicher Fluglarm und Gesundheit: Ergebnisse von Labor- und Feldstudien. Bundesgesundhbl. 38, 4 (1995) 130-137  Back to cited text no. 27    
28.Maschke, C., Harder, J., Hecht, K., Balzer, H.U. (1998) Nocturnal aircraft noise and adaptation. Noise Effects '98, 7th International Congress on Noise as a Public Health Problem 2: 433-438  Back to cited text no. 28    
29.Maschke, C., Hecht, K., Wolf, U., Feldmann, J. (2001) 19 x 99 Dezibel (A) - ein gesicherter Befund der Larmwirkungsforschung? Bundesgesundheitsblatt 44 (2); 137-148  Back to cited text no. 29    
30.Maschke, C., Hecht, K., Wolf, U. (2001) Nachtliches Erwachen durch Fluglarm - Beginnen Aufwachreaktionen bei Maximalpegeln von 60 Dezibel (A) Bundesgesundheitsblatt 44: 1001-1010  Back to cited text no. 30    
31.Maschke, C., Harder, J., Ising, H., Hecht, K., Thierfelder W. (2002) Stress hormone changes in persons under simulated night noise exposure. Noise & Health 5(17): 35-45  Back to cited text no. 31    
32.Maschke, C, Wolf, U and Leitmann, T (2003). Epidemiologische Untersuchungen zum Einfluss von Larmstress auf das Immunsystem und die Entstehung von Arteriosklerose Forschungbericht 29862515, Umweltbundesamt, Berlin  Back to cited text no. 32    
33.Melamed, S., Kristal-Boneh, E., Froom, P. (1999) Industrial noise exposure and risk factors for cardiovascular disease: Findings from the CORDIS study. Noise & Health 4:49-56  Back to cited text no. 33    
34.Miedema, H.M.E., Vos, H. (1998) Exposure-response relationships for transportation noise. J. Acoust. Soc. Am. 104: 3432-3445  Back to cited text no. 34    
35.Ortscheid, J., Wende, H. (2000) Fluglarmwirkungen, Umweltbundesamt, Berlin.  Back to cited text no. 35    
36.Selye, H. (1953) The stress of life. McGraw-Hill. New York  Back to cited text no. 36    
37.Spreng, M. (2000) Possible health effects of noise induced cortisol increase. Noise & Health 7: 59-63  Back to cited text no. 37    
38.Spreng, M. (2001) Periphere und zentrale Aktivierungsprozesse. In: Wichmann, Schlipkoter, Fiilgraff (eds.) Handbuch der Umweltmedizin. Kapitel VII-1 Larm, Erg. Lfg.7/01 Ecomed, Landsberg  Back to cited text no. 38    
39.UNFALLVERHUTUNGSVORSCHRIFT (UVV) Larm 1990 Carl Heymanns, Koln  Back to cited text no. 39    
40.VDI-Richtlinie 3722 B. 1988 Wirkungen von Verkehrsgerauschen. Beuth Verlag. Berlin  Back to cited text no. 40    
41.Zhao, Y., Zhang, S., Selvin, S., Spear, R.C. (1991) A dose response relation for noise induced hypertension. British Journal of Industrial Medicine 48:179-184  Back to cited text no. 41    

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[Pubmed]
7 Do quiet areas afford greater health-related quality of life than noisy areas?
Shepherd, D. and Welch, D. and Dirks, K.N. and McBride, D.
International Journal of Environmental Research and Public Health. 2013; 10(4): 1284-1303
[Pubmed]
8 On the Influence of Freight Trains on Humans: A Laboratory Investigation of the Impact of Nocturnal Low Frequency Vibration and Noise on Sleep and Heart Rate
Smith, M.G. and Croy, I. and √Ėgren, M. and Persson Waye, K.
PLoS ONE. 2013; 8(2)
[Pubmed]
9 Road traffic noise and self-reported sleep disturbance: Results from a cross-sectional study in western India
Banerjee, D.
Noise and Vibration Worldwide. 2013; 44(2): 10-17
[Pubmed]
10 Long-term exposure to road traffic noise and incident diabetes: A cohort study
S√ėrensen, M. and Andersen, Z.J. and Nordsborg, R.B. and Becker, T. and Tj√ėnneland, A. and Overvad, K. and Raaschou-Nielsen, O.
Environmental Health Perspectives. 2013; 121(2): 217-222
[Pubmed]
11 Interior noise control with an active window system
Kwon, B. and Park, Y.
Applied Acoustics. 2013; 74(5): 647-652
[Pubmed]
12 Noise and childrens health: Research in central, eastern and south-eastern europe and newly independent states
Paunovic, K.
Noise and Health. 2013; 15(62): 32-41
[Pubmed]
13 Chronic noise exposure causes persistence of tau hyperphosphorylation and formation of NFT tau in the rat hippocampus and prefrontal cortex
Cui, B. and Zhu, L. and She, X. and Wu, M. and Ma, Q. and Wang, T. and Zhang, N. and Xu, C. and Chen, X. and An, G. and Liu, H.
Experimental Neurology. 2012; 238(2): 122-129
[Pubmed]
14 Characterization of traffic noise for a typical Indian road crossing
Shukla, S.P. and Yadav, S.K. and Lohani, B. and Biswas, S. and Behra, S.N. and Singh, N.B. and Singh, N.K.
Current Science. 2012; 103(10): 1193-1201
[Pubmed]
15 Participation in Mass Gatherings Can Benefit Well-Being: Longitudinal and Control Data from a North Indian Hindu Pilgrimage Event
Tewari, S. and Khan, S. and Hopkins, N. and Srinivasan, N. and Reicher, S.
PLoS ONE. 2012; 7(10)
[Pubmed]
16 Human factors in the operating room - The surgeonśs view
Kurmann, A. and Tschan, F. and Semmer, N.K. and Seelandt, J. and Candinas, D. and Beldi, G.
Trends in Anaesthesia and Critical Care. 2012; 2(5): 224-227
[Pubmed]
17 Assessment of traffic noise pollution in the surrounding area of an upcoming airport
Mishra, A.K. and Srivastava, P.
Indian Journal of Environmental Protection. 2012; 32(10): 857-863
[Pubmed]
18 Noise and stress effects on preschool personnel
Sjödin, F. and Kjellberg, A. and Knutsson, A. and Landström, U. and Lindberg, L.
Noise and Health. 2012; 14(59): 166-178
[Pubmed]
19 Neuronal connectivity and interactions between the auditory and limbic systems. Effects of noise and tinnitus
Kraus, K.S. and Canlon, B.
Hearing Research. 2012; 288(1-2): 34-46
[Pubmed]
20 The annoyance of snoring and psychoacoustic parameters: A step towards an objective measurement
Rohrmeier, C. and Herzog, M. and Haubner, F. and Kuehnel, T.S.
European Archives of Oto-Rhino-Laryngology. 2012; 269(5): 1537-1543
[Pubmed]
21 An analysis of landscape penetration by road infrastructure and traffic noise
Nega, T. and Smith, C. and Bethune, J. and Fu, W.-H.
Computers, Environment and Urban Systems. 2012; 36(3): 245-256
[Pubmed]
22 Towards a general framework for including noise impacts in LCA
Cucurachi, S. and Heijungs, R. and Ohlau, K.
International Journal of Life Cycle Assessment. 2012; 17(4): 471-487
[Pubmed]
23 Influence of environmental noise on sleep quality and sleeping disorders - Implications for health [Einfluss von umweltlärm auf schlafqualität und schlafstörungen und auswirkungen auf die gesundheit]
Kohlhuber, M. and Bolte, G.
Somnologie. 2012; 16(1): 10-16
[Pubmed]
24 Noise frequency components and the prevalence of hypertension in workers
Chang, T.-Y. and Liu, C.-S. and Young, L.-H. and Wang, V.-S. and Jian, S.-E. and Bao, B.-Y.
Science of the Total Environment. 2012; 416: 89-96
[Pubmed]
25 Distance-based assessment of open country Quiet Areas in Greece
Votsi, N.E.P. and Drakou, E.G. and Mazaris, A.D. and Kallimanis, A.S. and Pantis, J.D.
Landscape and Urban Planning. 2012; 104(2): 279-288
[Pubmed]
26 Annoyance of traffic noise on roads and rail
Cik, M. and Fallast, K. and Fellendorf, M.
Transportation Research Record. 2012; (2270): 16-22
[Pubmed]
27 Involuntary and persistent environmental noise influences health and hearing in Beirut, Lebanon
Fooladi, M.M.
Journal of Environmental and Public Health. 2012; 2012(235618)
[Pubmed]
28 Transportation noise and blood pressure in a population-based sample of adults
Dratva, J. and Phuleria, H.C. and Foraster, M. and Gaspoz, J.-M. and Keidel, D. and K√ľnzli, N. and Sally Liu, L.-J. and Pons, M. and Zemp, E. and Gerbase, M.W. and Schindler, C.
Environmental Health Perspectives. 2012; 120(1): 50-55
[Pubmed]
29 Recovery of chronic noise exposure induced spatial learning and memory deficits in young male Sprague-Dawley rats
Chengzhi, C. and Yan, T. and Xuejun, J. and Xiang, L. and Youbin, Q. and Baijie, T.
Journal of Occupational Health. 2011; 53(3): 157-163
[Pubmed]
30 Influence of environmental noise on sleep quality and sleeping disorders-implications for health [Einfluss von umweltlärm auf schlafqualität und schlafstörungen und auswirkungen auf die gesundheit]
Kohlhuber, M. and Bolte, G.
Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2011; 54(12): 1319-1324
[Pubmed]
31 The study of the effect of constant frequency sound with varying intensity levels on Blood pressure and Heart rate of healthy individuals
Laad, M.
International Journal of Applied Engineering Research. 2011; 6(11): 1355-1361
[Pubmed]
32 Effect of low light and high noise on behavioural activity, physiological indicators of stress and production in laying hens
OśConnor, E.A. and Parker, M.O. and Davey, E.L. and Grist, H. and Owen, R.C. and Szladovits, B. and Demmers, T.G.M. and Wathes, C.M. and Abeyesinghe, S.M.
British Poultry Science. 2011; 52(6): 666-674
[Pubmed]
33 Verification of endocrinological functions at a short distance between parametric speakers and the human body
Lee, S. and Katsuura, T. and Shimomura, Y.
Neuroendocrinology Letters. 2011; 32(5): 676-682
[Pubmed]
34 Moderate noise induced cognition impairment of mice and its underlying mechanisms
Cheng, L. and Wang, S.-H. and Chen, Q.-C. and Liao, X.-M.
Physiology and Behavior. 2011; 104(5): 981-988
[Pubmed]
35 How and why environmental noise impacts animals: An integrative, mechanistic review
Kight, C.R. and Swaddle, J.P.
Ecology Letters. 2011; 14(10): 1052-1061
[Pubmed]
36 Physiciansś perceptions of background noise in a pediatric emergency department
Ratnapalan, S. and Cieslak, P. and Mizzi, T. and McEvoy, J. and Mounstephen, W.
Pediatric Emergency Care. 2011; 27(9): 826-833
[Pubmed]
37 Exposure to road traffic and railway noise and associations with blood pressure and self-reported hypertension: A cohort study
S√łrensen, M. and Hvidberg, M. and Hoffmann, B. and Andersen, Z.J. and Nordsborg, R.B. and Lillelund, K.G. and Jakobsen, J. and Tj√łnneland, A. and Overvad, K. and Raaschou-Nielsen, O.
Environmental Health: A Global Access Science Source. 2011; 10(1)
[Pubmed]
38 Assessment of noise levels generated by music shops in an urban city in Nigeria
Ebare, M.N. and Omuemu, V.O. and Isah, E.C.
Public Health. 2011; 125(9): 660-664
[Pubmed]
39 Local determinants of road traffic noise levels versus determinants of air pollution levels in a Mediterranean city
Foraster, M., Deltell, A., BasagaŮa, X., Medina-Ramůn, M., Aguilera, I., Bouso, L., Grau, M., (...), KŁnzli, N.
Environmental Research. 2011; 111(1): 177-183
[Pubmed]
40 High-frequency hearing loss, occupational noise exposure and hypertension: A cross-sectional study in male workers
Chang, T.-Y., Liu, C.-S., Huang, K.-H., Chen, R.-Y., Lai, J.-S., Bao, B.-Y.
Environmental Health: A Global Access Science Source. 2011; 10(1): art 35
[Pubmed]
41 Road traffic noise and stroke: A prospective cohort study
SÝrensen, M., Hvidberg, M., Andersen, Z.J., Nordsborg, R.B., Lillelund, K.G., Jakobsen, J., TjÝnneland, A., (...), Raaschou-Nielsen, O.
European Heart Journal. 2011; 32(6): 737-744
[Pubmed]
42 Characterization of road traffic noise exposure and prevalence of hypertension in central Taiwan
Chang, T.-Y., Liu, C.-S., Bao, B.-Y., Li, S.-F., Chen, T.-I., Lin, Y.-J.
Science of the Total Environment. 2011; 409(6): 1053-1057
[Pubmed]
43 Parameters of well-being and subjective health and their relationship with residential traffic noise exposure - A representative evaluation in Switzerland
Brink, M.
Environment International. 2011; 37(4): 723-733
[Pubmed]
44 Spatio-temporal patterns of road traffic noise pollution in Karachi, Pakistan
Mehdi, M.R., Kim, M., Seong, J.C., Arsalan, M.H.
Environment International. 2011; 37(1): 97-104
[Pubmed]
45 A study of riders noise exposure on bay area rapid transit trains
Dinno, A., Powell, C., King, M.M.
Journal of Urban Health. 2011; 88(1): 1-13
[Pubmed]
46 Physiological and psychological evaluation of strength of auditory stimulus
Umehara, S., Asano, H., Ide, H.
IEEJ Transactions on Industry Applications. 2010; 130(11): 1199-1204
[Pubmed]
47 Noise pollution and its effects on medical care workers and patients in hospitals
Juang, D.F., Lee, C.H., Yang, T., Chang, M.C.
International Journal of Environmental Science and Technology. 2010; 7(4): 705-716
[Pubmed]
48 Authorśs reply
Fidell, S.
Noise and Health. 2010; 12(49): 285-286
[Pubmed]
49 Associations of exposure to noise with physiological and psychological outcomes among post-cardiac surgery patients in ICUs
Hsu, S.-M., Ko, W.-J., Liao, W.-C., Huang, S.-J., Chen, R.J., Li, C.-Y., Hwang, S.-L.
Clinics. 2010; 65(10): 985-989
[Pubmed]
50 Noise pollution and human health: A case study of municipal corporation of Delhi
Firdaus, G., Ahmad, A.
Indoor and Built Environment. 2010; 19(6): 648-656
[Pubmed]
51 Analysis of factors that influence noise levels inside urban buses
Portela, B.S., Zannin, P.H.T.
Journal of Scientific and Industrial Research. 2010; 69(9): 684-687
[Pubmed]
52 The state of the art of predicting noise-induced sleep disturbance in field settings
Fidell, S., Tabachnick, B., Pearsons, K.
Noise and Health. 2010; 12(47): 77-87
[Pubmed]
53 Evoked response of heart rate variability using short-duration white noise
Lee, G.-S., Chen, M.-L., Wang, G.-Y.
Autonomic Neuroscience: Basic and Clinical. 2010; 155((1-2)): 94-97
[Pubmed]
54 Stress recovery during exposure to nature sound and environmental noise
Alvarsson, J.J., Wiens, S., Nilsson, M.E.
International Journal of Environmental Research and Public Health. 2010; 7(3): 1036-1046
[Pubmed]
55 Abating New York city transit noise: A matter of will, not way
Bronzaft, A.L.
Noise and Health. 2010; 12(46): 1-6
[Pubmed]
56 Impact of road traffic noise annoyance on health-related quality of life: Results from a population-based study
Dratva, J., Zemp, E., Dietrich, D.F., Bridevaux, P.-O., Rochat, T., Schindler, C., Gerbase, M.W.
Quality of Life Research. 2010; 19(1): 37-46
[Pubmed]
57 An expert system for predicting the effects of noise pollution on grass trimming task using fuzzy modeling
Mallick, Z., Kaleel, A.H., Siddiqui, A.N.
International Journal of Applied Environmental Sciences. 2009; 4(4): 389-403
[Pubmed]
58 Spatio-temporal covariation of urban particle number concentration and ambient noise
Weber, S.
Atmospheric Environment. 2009; 43(34): 5518-5525
[Pubmed]
59 Expert system to predict effects of noise pollution on operators of power plant using neuro-fuzzy approach
Ahmed, H.K., Zulquernain, M.
Noise and Health. 2009; 11(45): 206-216
[Pubmed]
60 Effects of environmental noise exposure on ambulatory blood pressure in young adults
Chang, T.-Y., Lai, Y.-A., Hsieh, H.-H., Lai, J.-S., Liu, C.-S.
Environmental Research. 2009; 109(7): 900-905
[Pubmed]
61 Work zone noise levels at Aarti steel plant, Orissa and its attenuation in far field
Kerketta, S., Dash, P.K., Narayan, L.T.P.
Journal of Environmental Biology. 2009; 30((5 SUPPL)): 903-908
[Pubmed]
62 A review of the urban development and transport impacts on public health with particular reference to Australia: Trans-disciplinary research teams and some research gaps
Black, D., Black, J.
International Journal of Environmental Research and Public Health. 2009; 6(5): 1557-1596
[Pubmed]
63 Development and evaluation of a category ratio scale with semantic descriptors: The Environmental Annoyance Scale: Cognition and Neurosciences
Nordin, S., Lidťn, E., GidlŲf-Gunnarsson, A.
Scandinavian Journal of Psychology. 2009; 50(2): 93-100
[Pubmed]
64 Noise characteristics of grass-trimming machine engines and their effect on operators
Mallick, Z., Badruddin, I.A., Khaleed Hussain, M.T., Salman Ahmed, N.J., Kanesan, J.
Noise and Health. 2009; 11(43): 98-102
[Pubmed]
65 Can Rh antigens be a risk factor in noise-induced hearing loss?
AyÁiÁek, A., SargIn, R., Kenar, F., DerekŲy, F.S.
European Archives of Oto-Rhino-Laryngology. 2009; 266(3): 363-366
[Pubmed]
66 Saliva cortisol and exposure to aircraft noise in six European countries
Selander, J., Bluhm, G., Theorell, T., Pershagen, G., Babisch, W., Seiffert, I., Houthuijs, D., (...), Jšrup, L.
Environmental Health Perspectives. 2009; 117(11): 1713-1717
[Pubmed]
67 Appraisal and mapping the spatial-temporal distribution of urban road traffic noise
Banerjee, D., Chakraborty, S.K., Bhattacharyya, S., Gangopadhyay, A.
International Journal of Environmental Science and Technology. 2009; 6(2): 325-335
[Pubmed]
68 Attitudinal response towards road traffic noise in the industrial town of Asansol, India
Banerjee, D., Chakraborty, S.K., Bhattacharyya, S., Gangopadhyay, A.
Environmental Monitoring and Assessment. 2009; 151((1-4)): 37-44
[Pubmed]
69 Investigating and influencing how buildings affect health: Interdisciplinary endeavours
Veitch, J.A.
Canadian Psychology. 2008; 49(4): 281-288
[Pubmed]
70 Acute effects of night-time noise exposure on blood pressure in populations living near airports
Haralabidis, A.S., Dimakopoulou, K., Vigna-Taglianti, F., Giampaolo, M., Borgini, A., Dudley, M.-L., Pershagen, G., Jarup, L.
European Heart Journal. 2008; 29(5): 658-664
[Pubmed]
71 Effects of nocturnal railway noise on sleep fragmentation in young and middle-aged subjects as a function of type of train and sound level
Saremi, M., GrenŤche, J., Bonnefond, A., Rohmer, O., Eschenlauer, A., Tassi, P.
International Journal of Psychophysiology. 2008; 70(3): 184-191
[Pubmed]
72 Prospective analysis of traffic exposure as a risk factor for incident coronary heart disease: The atherosclerosis risk in communities (ARIC) study
Kan, H., Heiss, G., Rose, K.M., Whitsel, E.A., Lurmann, F., London, S.J.
Environmental Health Perspectives. 2008; 116(11): 1463-1468
[Pubmed]
73 The PRONET project: Pollution reduction options network to enhance implementation of successful transport and indoor environment practices in Europe
van den Hazel, P.J., van Loenhout, J., Slottje, P., Jongeneel, R.
International Journal of Environment and Health. 2008; 2((3-4)): 293-303
[Pubmed]
74 Extended high-frequency audiometry in subjects exposed to occupational noise
Korres, G.S., Balatsouras, D.G., Tzagaroulakis, A., Kandiloros, D., Ferekidis, E.
B-ENT. 2008; 4(3): 147-155
[Pubmed]
75 The relationship between noise frequency components and physical, physiological and psychological effects of industrial workers
Mahendra Prashanth, K., Sridhar, V.
Noise and Health. 2008; 10(40): 90-98
[Pubmed]
76 Artisanal fishing in Andalusia (II): Safety and working conditions policy
Piniella, F., Novalbos, J.P., Nogueroles, P.J.
Marine Policy. 2008; 32(4): 551-558
[Pubmed]
77 Investigation of road-traffic noise and annoyance in beijing: A cross-sectional study of 4th ring road
Li, H.-J., Yu, W.-B., Lu, J.-Q., Zeng, L., Li, N., Zhao, Y.-M.
Archives of Environmental and Occupational Health. 2008; 63(1): 27-33
[Pubmed]
78 Noise levels in a tertiary care hospital
Vinodhkumaradithyaa, A., Srinivasan, M., Ananthalakshmi, I., Kumar, D., Jeba Rajasekhar, R., Daniel, T., Thirumalaikolundusubramanian, P.
Noise and Health. 2008; 10(38): 11-13
[Pubmed]
79 Acute effects on heart rate variability when exposed to hand transmitted vibration and noise
BjŲr, B., BurstrŲm, L., Karlsson, M., Nilsson, T., Nšslund, U., Wiklund, U.
International Archives of Occupational and Environmental Health. 2007; 81(2): 193-199
[Pubmed]
80 Occupational exposure and chronic heart failure severity | [Esposizione professionale e gravita dello scompenso cardiaco cronico]
Beltrame, D., Lo Cascio, N., Miotto, D., Mapp, C.E., De Rosa, E., Boschetto, P.
Giornale Italiano di Medicina del Lavoro ed Ergonomia. 2007; 29(3): 438-439
[Pubmed]
81 Noise in critical care
Pugh, R.J., Griffiths, R.
Care of the Critically Ill. 2007; 23(4): 105-109
[Pubmed]
82 Extra-auditory effects of noise in laboratory animals: The relationship between noise and sleep
Rabat, A.
Journal of the American Association for Laboratory Animal Science. 2007; 46(1): 35-41
[Pubmed]
83 Noise pollution: A modern plague
Goines, L., Hagler, L.
Southern Medical Journal. 2007; 100(3): 287-294
[Pubmed]
84 Occupational exposure and chronic heart failure severity [Esposizione professionale e gravita dello scompenso cardiaco cronico]
Beltrame, D. and Lo Cascio, N. and Miotto, D. and Mapp, C.E. and De Rosa, E. and Boschetto, P.
Giornale Italiano di Medicina del Lavoro ed Ergonomia. 2007; 29(3): 438-439
[Pubmed]
85 Chronic exposure of rats to noise: Relationship between long-term memory deficits and slow wave sleep disturbances
Rabat, A., Bouyer, J.J., George, O., Le Moal, M., Mayo, W.
Behavioural Brain Rese. 2006; 171(2): 303-312
[Pubmed]
86 Traffic density as a surrogate measure of environmental exposures in studies of air pollution health effects: Long-term mortality in a cohort of US veterans
Lipfert, F.W., Wyzga, R.E., Baty, J.D., Miller, J.P.
Atmospheric Environment. 2006; 40(1): 154-169
[Pubmed]
87 Chronic exposure to an environmental noise permanently disturbs sleep in rats: Inter-individual vulnerability
Rabat, A., Bouyer, J.J., Aran, J.M., Le Moal, M., Mayo, W.
Brain Research. 2005; 1059(1): 72-82
[Pubmed]
88 Hearing in laboratory animals: Strain differences and nonauditory effects of noise
Turner, J.G., Parrish, J.L., Hughes, L.F., Toth, L.A., Caspary, D.M.
Comparative Medicine. 2005; 55(1): 12-23
[Pubmed]
89 Acute noise stress analgesia in relation to 5-HT2 and μ-opioid receptor changes in the frontal cortex of young mice
Vitale, G., Arletti, R., Sandrini, M.
Life Sciences. 2005; 77(20): 1-2
[Pubmed]
90 Acute noise stress analgesia in relation to 5-HT2 and μ-opioid receptor changes in the frontal cortex of young mice
Vitale, G., Arletti, R., Sandrini, M.
Life Sciences. 2005; 77(20): 2500-2513
[Pubmed]



 

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