Mark Brink

Auditory and non-auditory effects of noise on health

Noise is pervasive in everyday life and can cause both auditory and non-auditory health effects. Noise-induced hearing loss remains highly prevalent in occupational settings, and is increasingly caused by social noise exposure (eg, through personal music players). Our understanding of molecular mechanisms involved in noise-induced hair-cell and nerve damage has substantially increased, and preventive and therapeutic drugs will probably become available within 10 years. Evidence of the non-auditory effects of environmental noise exposure on public health is growing. Observational and experimental studies have shown that noise exposure leads to annoyance, disturbs sleep and causes daytime sleepiness, affects patient outcomes and staff performance in hospitals, increases the occurrence of hypertension and cardiovascular disease, and impairs cognitive performance in schoolchildren. In this Review, we stress the importance of adequate noise prevention and mitigation strategies for public health.

Contact-free measurement of heart rate, respiration rate, and body movements during sleep

We describe a noncontact method for the ambulant measurement of basic sleep physiology parameters in humans, particularly for field studies involving sleep research and sleep disturbances. This method traces the body movements, respiration, and heart action of a person at rest or asleep on a bed, using four high-resolution force sensors installed under the bedposts. The recoil movement of the body at each heartbeat, known as the cardioballistic effect, as well as the lifting and lowering of the thorax, while breathing, causes very small shifts of the center of gravity of the bed and the subject. These shifts are reflected in the altering force distributions across the four sensors. Cardiac and respiratory parameters and the subject’s movement activity can be calculated from the sensor signals. Neither electrodes nor other kinds of transducers are in direct contact with the subject, which is the main advantage of this technique over conventional methods. Laboratory experiments were carried out to estimate validity and practicability. The method has been found to be adequate, especially for automated and unattended sleep-data collection over long periods of time.

Office workers' daily exposure to light and its influence on sleep quality and mood

To study the amount of light entering the eye and its effects on office workers, measurements were taken from 23 office workers over a period of seven consecutive days. Two parameters of visible light were recorded: (i) illuminance and (ii) irradiance of the blue spectral component. Every evening before going to bed, a questionnaire had to be filled out, containing scales relating to the mood dimensions of pleasure and arousal, questions about the previous night’s sleep and a rough time table with information about the person’s whereabouts during the day. The exposure to light on workdays is regular but it varies strongly on days off. No evidence could be provided for the influence of age, sex or seasonal affective disorder (SAD) scores on the daily exposure to light of office workers. The amount of light entering the eye during the day appears to have a positive impact on sleep quality the following night. Pleasure and arousal were not significantly associated with daily light exposure.

ICBEN Review of Research on the Biological Effects of Noise 2011-2014

The mandate of the International Commission on Biological Effects of Noise (ICBEN) is to promote a high level of scientific research concerning all aspects of noise-induced effects on human beings and animals. In this review, ICBEN team chairs and co-chairs summarize relevant findings, publications, developments, and policies related to the biological effects of noise, with a focus on the period 2011-2014 and for the following topics: Noise-induced hearing loss; nonauditory effects of noise; effects of noise on performance and behavior; effects of noise on sleep; community response to noise; and interactions with other agents and contextual factors. Occupational settings and transport have been identified as the most prominent sources of noise that affect health. These reviews demonstrate that noise is a prevalent and often underestimated threat for both auditory and nonauditory health and that strategies for the prevention of noise and its associated negative health consequences are needed to promote public health.

The association between road traffic noise exposure, annoyance and health-related quality of life (HRQOL).

The aim of this study is to investigate the relationships between road traffic noise exposure, annoyance caused by different noise sources and validated health indicators in a cohort of 1375 adults from the region of Basel, Switzerland. Road traffic noise exposure for each study participant was determined using modelling, and annoyance from various noise sources was inquired by means of a four-point Likert scale. Regression parameters from multivariable regression models for the von Zerssen score of somatic symptoms (point symptom score increase per annoyance category) showed strongest associations with annoyance from industry noise (2.36, 95% CI: 1.54, 3.17), neighbour noise (1.62, 95% CI: 1.17, 2.06) and road traffic noise (1.53, 95% CI: 1.09, 1.96). Increase in modelled noise exposure by 10 dB(A) resulted in a von Zerssen symptom score increase of 0.47 (95% CI: −0.01, 0.95) units. Subsequent structural equation modelling revealed that the association between physical noise exposure and health-related quality of life (HRQOL) is strongly mediated by annoyance and sleep disturbance. This study elucidates the complex interplay of different factors for the association between physical noise exposure and HRQOL.

Long-term exposure to transportation noise and air pollution in relation to incident diabetes in the SAPALDIA study

Abstract Background Epidemiological studies have inconsistently linked transportation noise and air pollution (AP) with diabetes risk. Most studies have considered single noise sources and/or AP, but none has investigated their mutually independent contributions to diabetes risk. Methods We investigated 2631 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), without diabetes in 2002 and without change of residence between 2002 and 2011. Using questionnaire and biomarker data, incident diabetes cases were identified in 2011. Noise and AP exposures in 2001 were assigned to participants’ residences (annual average road, railway or aircraft noise level during day-evening-night (Lden), total night number of noise events, intermittency ratio (temporal variation as proportion of event-based noise level over total noise level) and nitrogen dioxide (NO2) levels. We applied mixed Poisson regression to estimate the relative risk (RR) of diabetes and their 95% confidence intervals (CI) in mutually-adjusted models. Results Diabetes incidence was 4.2%. Median [interquartile range (IQR)] road, railway, aircraft noise and NO2 were 54 (10) dB, 32 (11) dB, 30 (12) dB and 21 (15) μg/m3, respectively. Lden road and aircraft were associated with incident diabetes (respective RR: 1.35; 95% CI: 1.02–1.78 and 1.86; 95% CI: 0.96–3.59 per IQR) independently of Lden railway and NO2 (which were not associated with diabetes risk) in mutually adjusted models. We observed stronger effects of Lden road among participants reporting poor sleep quality or sleeping with open windows. Conclusions Transportation noise may be more relevant than AP in the development of diabetes, potentially acting through noise-induced sleep disturbances.

Effects of Noise from Non-traffic-Related Ambient Sources on Sleep: Review of the Literature of 1990-2010

This article reviews the literature about the effects of specific non-traffic-related ambient noise sources on sleep that appeared in the last two decades. Although everybody is faced with noise of non-traffic and non-industry origin (e.g. sounds made by neighbors, talk, laughter, music, slamming doors, structural equipment, ventilation, heat pumps, noise from animals, barking dogs, outdoor events etc.), little scientific knowledge exists about its effects on sleep. The findings of the present extensive literature search and review are as follows: Only a small number of surveys, laboratory and field studies about mainly neighborhood, leisure and animal noise have been carried out. Most of them indicate that ambient noise has some effect on human sleep. However, a quantitative meta-analysis and comparison is not possible due to the small number of studies available and at times large differences in quality.

Long-term transportation noise annoyance is associated with subsequent lower levels of physical activity.

Noise annoyance (NA) might lead to behavioral patterns not captured by noise levels, which could reduce physical activity (PA) either directly or through impaired sleep and constitute a noise pathway towards cardiometabolic diseases. We investigated the association of long-term transportation NA and its main sources (aircraft, road, and railway) at home with PA levels. We assessed 3842 participants (aged 37-81) that attended the three examinations (SAP 1, 2, and 3 in years 1991, 2001 and 2011, respectively) of the population-based Swiss cohort on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA). Participants reported general 24-h transportation NA (in all examinations) and source-specific NA at night (only SAP 3) on an ICBEN-type 11-point scale. We assessed moderate, vigorous, and total PA from a short-questionnaire (SAP 3). The main outcome was moderate PA (active/inactive: cut-off≥150min/week). We used logistic regression including random effects by area and adjusting for age, sex, socioeconomic status, and lifestyles (main model) and evaluated potential effect modifiers. We analyzed associations with PA at SAP 3 a) cross-sectionally: for source-specific and transportation NA in the last year (SAP 3), and b) longitudinally: for 10-y transportation NA (mean of SAP 1+2), adjusting for prior PA (SAP 2) and changes in NA (SAP 3-2). Reported NA (score≥5) was 16.4%, 7.5%, 3%, and 1.1% for 1-year transportation, road, aircraft, and railway at SAP 3, respectively. NA was greater in the past, reaching 28.5% for 10-y transportation NA (SAP 1+2). The 10-y transportation NA was associated with a 3.2% (95% CI: 6%-0.2%) decrease in moderate PA per 1-NA rating point and was related to road and aircraft NA at night in cross-sectional analyses. The longitudinal association was stronger for women, reported daytime sleepiness or chronic diseases and it was not explained by objectively modeled levels of road traffic noise at SAP 3. In conclusion, long-term NA (related to psychological noise appraisal) reduced PA and could represent another noise pathway towards cardiometabolic diseases.

An event-related analysis of awakening reactions due to nocturnal church bell noise

The sleep disturbing effects of nocturnal ambient non-traffic related noises such as bell strokes emitted from church bell towers on nearby residents are presently unknown. Nonetheless, this specific noise source is suspected to cause sleep disturbances in a small but qualified minority of people living in the vicinity of the bell towers that throughout the night indicate the time with bell ringings. A field study was carried out to elucidate whether acoustic properties of such bell strokes relate to awakening and to provide event-related exposure-effect functions between acoustical predictors and awakening probability. Awakening reactions were determined in 27 voluntary subjects, measured in their home setting for four consecutive nights with ambulatory polysomnography (PSG) and concurrent acoustic recordings in- and outside the dwelling. Results indicate that the bell ringing events increase awakenings in a similar fashion as has previously been reported with transportation noise events and that awakening probability first and foremost depends on maximum sound pressure level of an event. The number of bell strokes and the personal variables gender, age, and noise sensitivity did not influence awakening probability significantly. Awakening probability by tendency increased with elapsed time after sleep onset, and was decreased during slow wave sleep and REM sleep compared to S2 sleep. The results suggest that a reduction of the maximum sound pressure level or an interruption of ringings during nighttime might reduce awakenings. The determined exposure-effect relationships are compared with similar functions for impulsive noise and transportation noise, more specifically, aircraft noise. The paper concludes with a few considerations regarding nighttime noise regulation.

Critical Appraisal of Methods for the Assessment of Noise Effects on Sleep

Various sleep measurement techniques have been applied in past studies on the effects of environmental noise on sleep, complicating comparisons between studies and the derivation of pooled exposure-response relationships that could inform policy and legislation. To date, a consensus on a standard measurement technique for the assessment of environmental noise effects on sleep is missing. This would be desirable to increase comparability of future studies. This manuscript provides a detailed description of the sleep process, typical indicators of disturbed sleep, and how noise interferes with sleep. It also describes and discusses merits and drawbacks of five established methods commonly used for the assessment of noise effects on sleep (i.e., polysomnography, actigraphy, electrocardiography, behaviorally confirmed awakenings, and questionnaires). Arguments supporting the joint use of actigraphy and a single channel electrocardiogram as meaningful, robust, and inexpensive methods that would allow for the investigation of large representative subject samples are presented. These could be used as a starting point for the generation of an expert consensus.