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ARTICLES
Transportation noise and cardiovascular risk: Updated Review and synthesis of epidemiological studies indicate that the evidence has increased
Wolfgang Babisch
January-March 2006, 8(30):1-29
DOI:10.4103/1463-1741.32464  PMID:17513892
The review provides an overview of epidemiological studies that were carried out in the field of community noise and cardiovascular risk. The studies and their characteristics are listed in the tables. Risk estimates derived from the individual studies are given for 5 dB(A) categories of the average A-weighted sound pressure level during the day. The noise sources considered in the studies are road and aircraft noise. The health endpoints are mean blood pressure, hypertension and ischaemic heart disease, including myocardial infarction. Study subjects are children and adults. The evidence of an association between transportation noise and cardiovascular risk has increased since the previous review published in Noise and Health in the year 2000.
  145 23,908 1,084
Health effects caused by noise : Evidence in the literature from the past 25 years
H Ising, B Kruppa
January-March 2004, 6(22):5-13
PMID:15070524
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 long­term 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.
  90 59,972 1,003
Road traffic noise and cardiovascular risk
Wolfgang Babisch
January-March 2008, 10(38):27-33
DOI:10.4103/1463-1741.39005  PMID:18270405
Studies on the association between community noise and cardiovascular risk were subjected to a meta-analysis for deriving a common dose-effect curve. Peer-reviewed articles, objective assessment of exposure and outcome as well as control for confounding and multiple exposure categories were all necessary inclusion criteria. A distinction was made between descriptive (cross-sectional) and analytical (case-control, cohort) studies. Meta-analyses were carried out for two descriptive and five analytical studies for calculating a pooled dose-effect curve for the association between road traffic noise levels and the risk of myocardial infarction. No increase in risk was found below 60 dB(A) for the average A-weighted sound pressure levels during the day. An increase in risk was found with increasing noise levels above 60 dB(A) thus showing a dose-response relationship. A risk curve was estimated for the association using a polynomial fit of the data that can be used for risk assessment and the environmental burden of disease calculations.
  84 16,497 521
Stress hormones in the research on cardiovascular effects of noise
W Babisch
January-March 2003, 5(18):1-11
PMID:12631430
In recent years, the measurement of stress hormones including adrenaline, noradrenaline and cortisol has been widely used to study the possible increase in cardiovascular risk of noise exposed subjects. Since endocrine changes manifesting in physiological disorders come first in the chain of cause-effect for perceived noise stress, noise effects in stress hormones may therefore be detected in populations after relatively short periods of noise exposure. This makes stress hormones a useful stress indicator, but regarding a risk assessment, the interpretation of endocrine noise effects is often a qualitative one rather than a quantitative one. Stress hormones can be used in noise studies to study mechanisms of physiological reactions to noise and to identify vulnerable groups. A review is given about findings in stress hormones from laboratory, occupational and environmental studies.
  61 21,743 603
Road traffic noise and annoyance-an increasing environmental health problem
G Bluhm, E Nordling, N Berglind
July-September 2004, 6(24):43-49
PMID:15703140
Traffic noise, which is steadily increasing, is considered to be an important environmental health problem. The aim of this study was to estimate the degree of annoyance and sleep disturbance related to road traffic noise in residential settings in an urban community. The study is based on a questionnaire on environmentally related health effects distributed to a stratified random sample of 1000 individuals, 19-80 years old, in a municipality with heavy traffic in the county of Stockholm. The response rate was 76%. The individual noise exposure was estimated using evaluated noise dispersion models and local noise assessments. Frequent annoyance was reported by 13% of subjects exposed to Leq 24 hr >50 dBA compared to 2% among those exposed to <50 dBA, resulting in a difference of 11% (95% Confidence Interval (CI) 7%, 15%). Sometimes or frequently occurring sleep disturbance was reported by 23% at Leq 24 hr >50 dBA and by 13% at levels <50 dBA, a difference of 11% (95% CI 4%, 18%). A positive exposure- response relation was indicated for annoyance as well as for sleep disturbances when classifying the individuals into four different exposure categories (< 45, 46­ 50, 51-55 and >55 dBA Leq 24 hr). There was some habituation to noise for problems related to sleep but not for annoyance. The prevalence of both annoyance and sleep problems was higher when bedroom windows were facing streets. People living in apartments had more sleep problems compared to people living in detached or semi-detached houses. In conclusion traffic noise exposure, even at low levels, was associated with annoyance and sleep disturbance. Access to a quiet side seemed to be a major protective factor for noise related problems.
  44 17,665 449
Exposure-response relationship of the association between aircraft noise and the risk of hypertension
Wolfgang Babisch, Irene van Kamp
July-September 2009, 11(44):161-168
DOI:10.4103/1463-1741.53363  PMID:19602770
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.
  37 13,933 209
Genetic influences in individual susceptibility to noise : A review
RR Davis, P Kozel, LC Erway
July-September 2003, 5(20):19-28
PMID:14558889
Individual animals and humans show differing susceptibility to noise damage even under very carefully controlled exposure conditions. This difference in susceptibility may be related to unknown genetic components. Common experimental animals (rats, guinea pigs, chinchillas, cats) are outbred-their genomes contain an admixture of many genes. Many mouse strains have been inbred over many generations raeducing individual variability, making them ideal candidates for studying the genetic modulation of individual susceptibility. Erway et al. (1993) demonstrated a recessive gene associated with early presbycusis in the C57BL/6J inbred mouse. A series of studies have shown that mice homozygous for Ahlallele are more sensitive to the damaging effects of noise. Recent work has shown that mice homozygous for Ahl are not only more sensitive to noise, but also are probably damaged in a different manner by noise than mice containing the wild-type gene (Davis et al., 2001). Recent work in Noben-Trauth's lab (Di Palma et al., 2001) has shown that the wild-type Ahl gene codes for a hair cell specific cadherin. Cadherins are calcium dependent proteins that hold cells together at adherins junctions to form tissues and organs. The cadherin of interest named otocadherin or CDH23, is localized to the stereocillia of the outer hair cells. Our working hypothesis, suggests that otocadherin may form the lateral links between stereocilia described by Pickles et al (1989). Reduction of, or missing otocadherin weakens the cell and may allow stereocilia to be more easily physically damaged by loud sounds and by aging.
  34 6,663 261
EDITORIAL COMMENTARY
Cardiovascular effects of noise
Wolfgang Babisch
May-June 2011, 13(52):201-204
DOI:10.4103/1463-1741.80148  PMID:21537102
  34 20,133 132
SPEECH PERCEPTION AND UNDERSTANDING
When cognition kicks in: Working memory and speech understanding in noise
Jerker Rönnberg, Mary Rudner, Thomas Lunner, Adriana A Zekveld
October-December 2010, 12(49):263-269
DOI:10.4103/1463-1741.70505  PMID:20871181
Perceptual load and cognitive load can be separately manipulated and dissociated in their effects on speech understanding in noise. The Ease of Language Understanding model assumes a theoretical position where perceptual task characteristics interact with the individual's implicit capacities to extract the phonological elements of speech. Phonological precision and speed of lexical access are important determinants for listening in adverse conditions. If there are mismatches between the phonological elements perceived and phonological representations in long-term memory, explicit working memory (WM)-related capacities will be continually invoked to reconstruct and infer the contents of the ongoing discourse. Whether this induces a high cognitive load or not will in turn depend on the individual's storage and processing capacities in WM. Data suggest that modulated noise maskers may serve as triggers for speech maskers and therefore induce a WM, explicit mode of processing. Individuals with high WM capacity benefit more than low WM-capacity individuals from fast amplitude compression at low or negative input speech-to-noise ratios. The general conclusion is that there is an overarching interaction between the focal purpose of processing in the primary listening task and the extent to which a secondary, distracting task taps into these processes.
  33 7,049 52
ARTICLES
Annoyance caused by exposure to road traffic noise: An update
Djamel Ouis
April-June 2002, 4(15):69-79
PMID:12678952
This paper addresses the negative effects resulting from the exposure to road traffic noise on people's well being with a focus on annoyance. Following the observations that noise exposures engender physiological reactions typical of stress, the non-auditory effects of noise on humans are generally viewed as being stress-related, and annoyance is one of the first and most direct reactions to environmental noise. In general terms, it is found that the continuous exposure of people to road traffic noise leads to suffering from various kinds of discomfort thus reducing appreciably the number of their well being elements. However drawing such a conclusion is hindered by difficulties when non-acoustical factors like sensitivity, socio-economic situation and age are also taken into account along with the usual acoustical factors of road traffic noise. The results of several decades of research on this topic have permitted lately to establish a quantitative relationship between the objective quantities characterizing road traffic noise, namely the day to night noise level, and the human subjective reaction to it as expressed by the percentage of highly annoyed people. These findings are important at both the society and the individual level in as much as they may help in regulating in a more efficient way the planning of road traffic activity in order to secure minimum comfort to the affected population.
  32 7,461 319
Self-reported tinnitus and noise sensitivity among adolescents in Sweden
SE Olsen Widen, SI Erlandsson
October-December 2004, 7(25):29-40
PMID:15703147
It seems to be a common opinion among researchers within the field of audiology that the prevalence of tinnitus will increase as a consequence of environmental factors, for example exposure to loud noise. Young people are exposed to loud sounds, more than any other age group, especially during leisure time activities, i.e. at pop concerts, discotheques and gyms. A crucial factor for the prevention of hearing impairments and hearing-related symptoms in the young population is the use of hearing protection. The focus of the present study is use of hearing protection and self-reported hearing-related symptoms, such as tinnitus and noise sensitivity in a young population of high-school students (N=1285), aged 13 to 19 years. The results show that the prevalence of permanent tinnitus and noise sensitivity, reported in the total group, was 8.7% and 17.1% respectively. Permanent tinnitus was not significantly related to level of socio-economic status, but age-related differences in the prevalence rates of experienced tinnitus and noise sensitivity were found to be significant. Older students reported such symptoms to a greater extent than younger students did. Those who reported tinnitus and other hearing-related symptoms protected their hearing to the highest extent and were the ones most worried.
  32 10,279 234
The noise/stress concept, risk assessment and research needs
Wolfgang Babisch
July-September 2002, 4(16):1-11
PMID:12537836
In principle, the noise/stress hypothesis is well understood: Noise activates the pituitary­adrenal-cortical axis and the sympathetic-adrenal-medullary axis. Changes in stress hormones including epinephrine, norepinephrine and cortisol are frequently found in acute and chronic noise experiments. The catecholamines and steroid hormones affect the organism's metabolism. Cardiovascular disorders are especially in focus for epidemiological studies on adverse noise effects. However, not all biologically notifiable effects are of clinical relevance. The relative importance and significance of health outcomes to be assessed in epidemiological noise studies follow a hierarchical order, i.e. changes in physiological stress indicators, increase in biological risk factors, increase of the prevalence or incidence of diseases, premature death. Decision-making and risk management rely on quantitative risk assessment. Epidemiological methods are the primary tool for providing the necessary information. However, the statistical evidence of findings from individual studies is often weak. Magnitude of effect, dose-response relationship, biological plausibility and consistency of findings among studies are issues of epidemiological reasoning. Noise policy largely depends on considerations about cost­effectiveness, which may vary between populations. Limit or guideline values have to be set within the range between social and physical well-being - between nuisance and health. The cardiovascular risk is a key-outcome in non-auditory noise effects' research because of the high prevalence of related diseases in our communities. Specific studies regarding critical groups, different noise-sources, day/evening/night comparisons, coping styles and other effect­modifying factors, and the role of annoyance as a mediator of effect are issues for future research in this field.
  31 16,650 446
Noise-induced annoyance and morbidity results from the pan-European LARES study
H Niemann, X Bonnefoy, M Braubach, K Hecht, C Maschke, C Rodrigues, N Robbel
April-June 2006, 8(31):63-79
DOI:10.4103/1463-1741.33537  PMID:17687182
Traffic noise (road noise, railway noise, aircraft noise, noise of parking cars), is the most dominant source of annoyance in the living environment of many European countries. This is followed by neighbourhood noise (neighbouring apartments, staircase and noise within the apartment). The subjective experience of noise stress can, through central nervous processes, lead to an inadequate neuro-endocrine reaction and finally lead to regulatory diseases. Within the context of the LARES-survey (Large Analysis and Review of European housing and health Status), noise annoyance in the housing environment was collected and evaluated in connection with medically diagnosed illnesses. Adults who indicated chronically severe annoyance by neighbourhood noise were found to have an increased health risk for the cardiovascular system and the movement apparatus, as well as an increased risk of depression and migraine. Furthermore adults with chronically strong annoyance by traffic noise additionally showed an increased risk for respiratory health problems. With regards to older people both neighbourhood and traffic noise indicated in general a lower risk of noise annoyance induced illness than in adults. It can be assumed that the effect of noise-induced annoyance in older people is concealed by physical consequences of age (with a strong increase of illnesses). With children the effects of noise-induced annoyance from traffic, as well as neighbourhood noise, are evident in the respiratory system. The increased risk of illness in the respiratory system in children does not seem to be caused primarily by air pollutants, but rather, as the results for neighbourhood noise demonstrate, by emotional stress.
  31 12,081 598
Noise and mental performance : Personality attributes and noise sensitivity
G Belojevic, B Jakovljevic, V Slepcevic
October-December 2003, 6(21):77-89
PMID:14965455
The contradictory and confusing results in noise research on humans may partly be due to individual differences between the subjects participating in different studies. This review is based on a twelve year research on the role of neuroticism, extroversion and subjective noise sensitivity during mental work in noisy environment. Neurotic persons might show enhanced "arousability" i.e. their arousal level increases more in stress. Additional unfavorable factors for neurotics are worrying and anxiety, which might prevent them coping successfully with noise, or some other stressors during mental performance. In numerous experiments introverts have showed higher sensitivity to noise during mental performance compared to extroverts, while extroverts often cope with a boring task even by requesting short periods of noise during performance. Correlation analyses have regularly revealed a highly significant negative relation between extroversion and noise annoyance during mental processing. Numerous studies have shown that people with high noise sensitivity may be prevented from achieving the same work results as other people in noisy environment, thus leading to psycho­somatic, neurotic or other difficulties. Positive relation between noise annoyance and subjective noise sensitivity might be very strong. Our results have shown, after matching with the results of other relevant studies, that more stable personality, with extroversive tendencies and with a relatively lower subjective noise sensitivity measured with standard questionnaires, may be expected to better adapt to noise during mental performance, compared to people with opposite personality traits.
  30 31,747 716
Low frequency noise and annoyance
HG Leventhall
April-June 2004, 6(23):59-72
PMID:15273024
Low frequency noise, the frequency range from about 10Hz to 200Hz, has been recognised as a special environmental noise problem, particularly to sensitive people in their homes. Conventional methods of assessing annoyance, typically based on A-weighted equivalent level, are inadequate for low frequency noise and lead to incorrect decisions by regulatory authorities. There have been a large number of laboratory measurements of annoyance by low frequency noise, each with different spectra and levels, making comparisons difficult, but the main conclusions are that annoyance of low frequencies increases rapidly with level. Additionally the A-weighted level underestimates the effects of low frequency noises. There is a possibility of learned aversion to low frequency noise, leading to annoyance and stress which may receive unsympathetic treatment from regulatory authorities. In particular, problems of the Hum often remain unresolved. An approximate estimate is that about 2.5% of the population may have a low frequency threshold which is at least 12dB more sensitive than the average threshold, corresponding to nearly 1,000,000 persons in the 50-59 year old age group in the EU-15 countries. This is the group which generates many complaints. Low frequency noise specific criteria have been introduced in some countries, but do not deal adequately with fluctuations. Validation of the criteria has been for a limited range of noises and subjects.
  30 126,527 968
The influence of socio-economic status on adolescent attitude to social noise and hearing protection
SE Olsen Widen, SI Erlandsson
October-December 2004, 7(25):59-70
PMID:15703150
The focus of the present study, of 1285 adolescents, was young people's attitudes towards noise and their use of hearing protection at discos and pop concerts. Comparisons were made between adolescents from different age groups, and with different socio-economic status. Logistic regressions indicated that "worry before attending noisy activities" and "hearing symptoms" such as tinnitus and noise sensitivity could, to some degree, explain the use of hearing protection in noisy environments. Another conclusion to be drawn from this study was that adolescents' attitudes and behaviors regarding hearing protection use differed between levels of socio-economic status. Individuals with high SES expressed more negative attitudes and used ear protection to a greater extent than those with lower SES. This result might indicate differences in the development of future auditory problems among individuals with different levels of socio-economic status. The cause of hearing impairment and tinnitus may not be restricted merely to noise exposure. Psychological aspects, such as attitudes towards noisy environments and the individual's behavior regarding the use of hearing protection may be considered as important factors in the understanding of why the prevalence of hearing­ related problems has increased among adolescents.
  30 9,804 314
Associations between noise sensitivity and sleep, subjectively evaluated sleep quality, annoyance, and performance after exposure to nocturnal traffic noise
A Marks, B Griefahn
January-March 2007, 9(34):1-7
DOI:10.4103/1463-1741.34698  PMID:17851221
In order to determine the influence of noise sensitivity on sleep, subjective sleep quality, annoyance, and performance after nocturnal exposure to traffic noise, 12 women and 12 men (age range, 19-28 years) were observed during four consecutive nights over a three weeks period. After a habituation night, the participants were exposed with weekly permuted changes to air, rail and road traffic noise. Of the four nights, one was a quiet night (32 dBA), while three were noisy nights with exposure to equivalent noise levels of 39, 44, and 50 dBA in a permuted order. The traffic noise caused alterations of most of the physiological parameters, subjective evaluation of sleep, annoyance, and performance. Correlations were found between noise sensitivity and subjective sleep quality in terms of worsened restoration, decreased calmness, difficulty to fall asleep, and body movements. The results suggest that alterations of subjective evaluation of sleep were determined by physical parameters of the noise but modified by individual factors like noise sensitivity.
  30 10,494 419
Does health promotion work in relation to noise?
HM Borchgrevink
January-March 2003, 5(18):25-30
PMID:12631433
Noise is a health risk. The only scientifically established adverse health effect of noise is noise­induced hearing loss (NIHL). Besides noise may affect quality of life and cause annoyance and sleep disturbance. The present scientific evidence of potential non-auditory effects of noise on health is quite weak. Whether health promotion works in relation to noise may be reflected by permanent hearing threshold shift development in population studies. Hearing impairment continues to be the most prevalent disability in Western societies. The National Institute of Occupational Safety and Health (NIOSH) still rates noise induced hearing loss among the top ten work-related problems. Recent studies report that employees continue to develop noise induced hearing loss although to a lesser extent than before, in spite of occupational hearing conservation programmes. Besides socio-acusis and leisure noise seem to be an increasing hazard to hearing, also in young children and adolescents. This seems partly related to acute leisure noise exposure (e.g. toy pistols, amplified music). However, population studies increasingly find non­normal high-frequency hearing including the characteristic NIHL-"notch" around 6kHz also in subjects who do not report noise exposure incidents or activities. Today 12.5% of US children 6-19 years show a noise-"notch" in one or both ears (n= 5249, Niskar et al 2001). A Norwegian county audiometry survey on adults > 20 years (n=51.975) showed mean unscreened thresholds +10dB at 6kHz for both genders even for the youngest age group 20-24 years (Borchgrevink et al 2001). Accordingly, the present health promotion initiatives seem insufficient in relation to noise and noise-induced hearing loss.
  28 13,241 437
Noise annoyance in Canada
DS Michaud, SE Keith, D McMurchy
April-June 2005, 7(27):39-47
DOI:10.4103/1463-1741.31634  PMID:16105248
The present paper provides the results from two nation-wide telephone surveys conducted in Canada on a representative sample of 5,232 individuals, 15 years of age and older. The goals of this study were to gauge Canadians' annoyance towards environmental noise, identify the source of noise that is viewed as most annoying and quantify annoyance toward this principal noise source according to internationally accepted specifications. The first survey revealed that nearly 8% of Canadians in this age group were either very or extremely bothered, disturbed or annoyed by noise in general and traffic noise was identified as being the most annoying source. A follow-up survey was conducted to further assess Canadians' annoyance towards traffic noise using both a five-item verbal scale and a ten-point numerical scale. It was shown that 6.7% of respondents indicated they were either very or extremely annoyed by traffic noise on the verbal scale. On the numerical scale, where 10 was equivalent to "extremely annoyed" and 0 was equivalent to "not at all annoyed", 5.0% and 9.1% of respondents rated traffic noise as 8 and above and 7 and above, respectively. The national margin of error for these findings is plus or minus 1.9 percentage points, 19 times out of 20. The results are consistent with an approximate value of 7% for the percentage of Canadians, in the age group studied, highly annoyed by road traffic noise (i.e. about 1.8 million people). We found that age, education level and community size had a statistically significant association with noise annoyance ratings in general and annoyance specifically attributed to traffic noise. The use of the International Organization for Standardization/Technical Specification (ISO/TS)-15666 questions for assessing noise annoyance makes it possible to compare our results to other national surveys that have used the same questions.
  28 9,185 333
The influence of ageing on noise-induced hearing loss
U Rosenhall
July-September 2003, 5(20):47-53
PMID:14558892
A lifetime of exposure to noise is likely to have negative effects on the hearing, but the interaction between noise-induced hearing loss (NIHL) and age-related hearing loss is difficult to determine. The most commonly accepted assumption is a simple accumulating effects of noise and ageing on the hearing. However, both a less than additive effect as well as a supra­additive effect has been proposed. Recently an interesting interaction between NIHL and age­related hearing loss has been reported (Gates et al., 2000). NIHL before old age reduces the effects of ageing at noise-associated frequencies, but accelerates the deterioration of hearing in adjacent frequencies. Findings from the longitudinal and cross-sectional gerontological and geriatric population study of 70-year-olds in Gothenburg, Sweden supports these observations. The incidence of tinnitus increases in old age, but not at the same high rate as presbyacusis. According to the gerontological and geriatric population study in Gothenburg tinnitus in old age is related more to hearing loss than to ageing. There are no simple correlations between exposure to noise during the active years and tinnitus in old age.
  27 12,079 438
Vibroacoustic disease
NAA Castelo Branco, M Alves-Pereira
April-June 2004, 6(23):3-20
PMID:15273020
Vibroacoustic disease (VAD) is a whole-body, systemic pathology, characterized by the abnormal proliferation of extra-cellular matrices, and caused by excessive exposure to low frequency noise (LFN). VAD has been observed in LFN-exposed professionals, such as, aircraft technicians, commercial and military pilots and cabin crewmembers, ship machinists, restaurant workers, and disk-jockeys. VAD has also been observed in several populations exposed to environmental LFN. This report summarizes what is known to date on VAD, LFN­induced pathology, and related issues. In 1987, the first autopsy of a deceased VAD patient was performed. The extent of LFN­induced damage was overwhelming, and the information obtained is, still today, guiding many of the associated and ongoing research projects. In 1992, LFN-exposed animal models began to be studied in order to gain a deeper knowledge of how tissues respond to this acoustic stressor. In both human and animal models, LFN exposure causes thickening of cardiovascular structures. Indeed, pericardial thickening with no inflammatory process, and in the absence of diastolic dysfunction, is the hallmark of VAD. Depressions, increased irritability and aggressiveness, a tendency for isolation, and decreased cognitive skills are all part of the clinical picture of VAD. LFN is a demonstrated genotoxic agent, inducing an increased frequency of sister chromatid exchanges in both human and animal models. The occurrence of malignancies among LFN-exposed humans, and of metaplastic and displastic appearances in LFN-exposed animals, clearly corroborates the mutagenic outcome of LFN exposure. The inadequacy of currently established legislation regarding noise assessments is a powerful hindrance to scientific advancement. VAD can never be fully recognized as an occupational and environmental pathology unless the agent of disease - LFN - is acknowledged and properly evaluated. The worldwide suffering of LFN-exposed individuals is staggering and it is unethical to maintain this status quo.
  27 32,520 562
The development of the noise sensitivity questionnaire
Martin Schutte, Anke Marks, Edna Wenning, Barbara Griefahn
January-March 2007, 9(34):15-24
DOI:10.4103/1463-1741.34700  PMID:17851223
The existing questionnaires for determining the noise sensitivity of individuals provide information only about global noise sensitivity, although empirical data suggest that measuring noise sensitivity for different situations in daily life might be more logical. Therefore, the "Noise-Sensitivity-Questionnaire" (NoiSeQ) was developed to measure global noise sensitivity as well as the sensitivity of five domains of daily life, namely, leisure, work, habitation, communication, and sleep. The assessment of the measurement characteristics was based on the Generalizability (G) theory. The results of the G-study (N = 66) proved that a single application of the questionnaire is sufficient for determining an individual's noise sensitivity. Furthermore, the ratings are age and gender independent. The subsequently conducted Decision (D)-study (N = 288) provides information on the reliability of NoiSeQ. If the questionnaire is used for measuring global noise sensitivity, the reliability (relative and absolute G-coefficient) reaches a value above 0.90. According to ISO 10075-3, the questionnaire satisfies the precision level 1 "accurate measurement" in this case. The G-coefficients for all the subscales exceed the lower limit 0.70, with the exception of subscale leisure, which did not prove satisfactory. However, this subscale can reach a reliability of more than 0.70 if additional items are included. The validity of the instrument was proven for the subscales habitation (N = 72) and work (N = 72). In both the studies, the participants were asked to rate the annoyance in the presence of several rail and traffic noise scenarios. The subjects were characterized as low and high noise sensitive according to their sensitivity values obtained from NoiSeQ. In conclusion, a significant difference in annoyance rates was observed between the low and high noise sensitive groups for both the subscales habitation and work. This data support the validity of NoiSeQ.
  27 11,150 437
Synergistic ototoxicity due to noise exposure and aminoglycoside antibiotics
Hongzhe Li, Peter S Steyger
January-March 2009, 11(42):26-32
DOI:10.4103/1463-1741.45310  PMID:19265251
Acoustic exposure to high intensity and/or prolonged noise causes temporary or permanent threshold shifts in auditory perception, reflected by reversible or irreversible damage in the cochlea. Aminoglycoside antibiotics, used for treating or preventing life-threatening bacterial infections, also induce cytotoxicity in the cochlea. Combined noise and aminoglycoside exposure, particularly in neonatal intensive care units, can lead to auditory threshold shifts greater than simple summation of the two insults. The synergistic toxicity of acoustic exposure and aminoglycoside antibiotics is not limited to simultaneous exposures. Prior acoustic insult which does not result in permanent threshold shifts potentiates aminoglycoside ototoxicity. In addition, exposure to subdamaging doses of aminoglycosides aggravates noise-induced cochlear damage. The mechanisms by which aminoglycosides cause auditory dysfunction are still being unraveled, but likely include the following: 1) penetration into the endolymphatic fluid of the scala media, 2) permeation of nonselective cation channels on the apical surface of hair cells, and 3) generation of toxic reactive oxygen species and interference with other cellular pathways. Here we discuss the effect of combined noise and aminoglycoside exposure to identify pivotal synergistic events that can potentiate ototoxicity, in addition to a current understanding of aminoglycoside trafficking within the cochlea. Preventing the ototoxic synergy of noise and aminoglycosides is best achieved by using non-ototoxic bactericidal drugs, and by attenuating perceived noise intensity when life-saving aminoglycoside therapy is required.
  27 5,821 129
Output sound pressure levels of personal music systems and their effect on hearing
Ajith Kumar, Kuruvilla Mathew, Swathy Ann Alexander, Chitra Kiran
July-September 2009, 11(44):132-140
DOI:10.4103/1463-1741.53357  PMID:19602765
This study looked at output levels produced by new generation personal music systems (PMS), at the level of eardrum by placing the probe microphone in the ear canal. Further, the effect of these PMS on hearing was evaluated by comparing the distortion product otoacoustic emissions and high frequency pure tone thresholds (from 3 kHz to 12 kHz) of individuals who use PMS to that of age matched controls who did not use PMS. The relationship between output sound pressure levels and hearing measures was also evaluated. In Phase I output SPLs produced by the PMS were measured in three different conditions - a) at volume control setting that was preferred by the subjects in quiet b) at volume control setting that was preferred by the subject in presence of 65 dB SPL bus noise c) at maximum volume control settings of the instrument. In Phase II pure tone hearing thresholds and DPOAEs were measured. About 30% of individuals in a group of 70 young adults listened to music above the safety limits (80 dBA for 8 hours) prescribed by Ministry of Environment and Forests, India. Addition of bus noise did not increase the preferred volume control settings of the subjects significantly. There were no significant differences between the experimental and control groups for mean pure tone threshold and for mean DPOAE amplitude comparisons. However, a positive correlation between hearing thresholds and music levels and a negative correlation between DPOAE measures and music levels were found.
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Chronic cortisol increases in the first half of the night caused by road traffic noise
Hartmut Ising, Martin Ising
July-September 2002, 4(16):13-21
PMID:12537837
56 children age 7 - 10 had a medical check-up and they and their mothers completed questionnaires. Additionally the children's excretion of free cortisol was measured by HPLC in two urine samples collected at 1 p.m. and in the morning. The children lived either at a busy road with 24 h lorry traffic or in quiet areas. At the side of the road the noise level was registered during five nights. In the bedrooms representative measurements of the short-term maximal sound level (L Amax and L Cmax ) and of the frequency spectrum were taken. During the night on average every 2 minutes a lorry with L max > 80 dB(A) passed by the houses. The indoor levels of the higher exposed half of the children were L max = 33-52 dB(A) resp. 55­-78dB(C)). The frequency spectrum had its maximum below 100 Hz. 74% of the higher exposed never opened their windows as compared to 25% in the lower exposed half group. The excretion of free cortisol and its metabolites in the first half of the night was significantly correlated to L Cmax (co-variables: age, sex, and the day of the week) as well as to impaired sleep, memory and ability to concentrate. The cortisol excretion in the second half of the night was not correlated to the noise level. Disturbances of the normal circadian rhythm of cortisol can be quantified by the quotient of the cortisol excretion in the first half of the night in relation to that in the second half. Children under long-term road traffic noise exposure during the night had an increased risk of chronic stress hormone regulation disturbances. These disturbances were significantly correlated to L Cmax and findings of allergy and/or asthma bronchial. Long-term low frequency noise exposure with Lmax < 55 dB(A) during the night resulted in chronic increases of children's excretion of free cortisol in the first half of the night and in serious disturbances of the circadian rhythm of cortisol. Indications of increased risks of asthma bronchial and allergies in noise exposed children with stress hormone regulation disturbances need further clarification
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* Source: CrossRef