Richard L. Neitzel

Environmental noise pollution in the United States: developing an effective public health response.

Background: Tens of millions of Americans suffer from a range of adverse health outcomes due to noise exposure, including heart disease and hearing loss. Reducing environmental noise pollution is achievable and consistent with national prevention goals, yet there is no national plan to reduce environmental noise pollution. Objectives: We aimed to describe some of the most serious health effects associated with noise, summarize exposures from several highly prevalent noise sources based on published estimates as well as extrapolations made using these estimates, and lay out proven mechanisms and strategies to reduce noise by incorporating scientific insight and technological innovations into existing public health infrastructure. Discussion: We estimated that 104 million individuals had annual LEQ(24) levels > 70 dBA (equivalent to a continuous average exposure level of >70 dBA over 24 hr) in 2013 and were at risk of noise-induced hearing loss. Tens of millions more may be at risk of heart disease, and other noise-related health effects. Direct regulation, altering the informational environment, and altering the built environment are the least costly, most logistically feasible, and most effective noise reduction interventions. Conclusion: Significant public health benefit can be achieved by integrating interventions that reduce environmental noise levels and exposures into the federal public health agenda. Citation: Hammer MS, Swinburn TK, Neitzel RL. 2014. Environmental noise pollution in the United States: developing an effective public health response. Environ Health Perspect 122:115–119; http://dx.doi.org/10.1289/ehp.1307272

Integrated assessment of artisanal and small-scale gold mining in Ghana--part 1: human health review.

This report is one of three synthesis documents produced via an integrated assessment (IA) that aims to increase understanding of artisanal and small-scale gold mining (ASGM) in Ghana. Given the complexities surrounding ASGM, an IA framework was utilized to analyze economic, social, health, and environmental data, and co-develop evidence-based responses with pertinent stakeholders. The current analysis focuses on the health of ASGM miners and community members, and synthesizes extant data from the literature as well as co-authors’ recent findings regarding the causes, status, trends, and consequences of ASGM in Ghana. The results provide evidence from across multiple Ghanaian ASGM sites that document relatively high exposures to mercury and other heavy metals, occupational injuries and noise exposure. The work also reviews limited data on psychosocial health, nutrition, cardiovascular and respiratory health, sexual health, and water and sanitation. Taken together, the findings provide a thorough overview of human health issues in Ghanaian ASGM communities. Though more research is needed to further elucidate the relationships between ASGM and health outcomes, the existing research on plausible health consequences of ASGM should guide policies and actions to better address the unique challenges of ASGM in Ghana and potentially elsewhere.

Association between ambient noise exposure, hearing acuity, and risk of acute occupational injury

OBJECTIVE This study aimed to examine the associations between acute workplace injury risk, ambient noise exposure, and hearing acuity, adjusting for reported hearing protection use. METHODS In a cohort of 9220 aluminum manufacturing workers studied over six years (33 300 person-years, 13 323 person-jobs), multivariate mixed effects models were used to estimate relative risk (RR) of all injuries as well as serious injuries by noise exposure category and hearing threshold level (HTL) adjusting for recognized and potential confounders. RESULTS Compared to noise <82 dBA, higher exposure was associated with elevated risk in a monotonic and statistically significant exposure-response pattern for all injuries and serious injuries with higher risk estimates observed for serious injuries [82-84.99 dBA: RR 1.26, 95% confidence interval (95% CI) 0.96-1.64; 85-87.99 dBA: RR 1.39, 95% CI 1.05-1.85; ≥88 dBA: RR 2.29, 95% CI 1.52-3.47]. Hearing loss was associated with increased risk for all injuries, but was not a significant predictor of risk for the subset of more serious injuries. Compared to those without hearing loss, workers with HTL ≥25 dB had 21% increased all injury risk (RR 1.21, 95% CI 1.09-1.33) while those with HTL 10-24.99 dB had 6% increased risk (RR 1.06, 95% CI 1.00-1.13). Reported hearing protection type did not predict injury risk. CONCLUSION Noise exposure levels as low as 85 dBA may increase workplace injury risk. HTL was associated with increased risk for all, but not the subset of serious, injuries. Additional study is needed both to confirm the observed associations and explore causal pathways.

Exposures to transit and other sources of noise among New York City residents.

To evaluate the contributions of common noise sources to total annual noise exposures among urban residents and workers, we estimated exposures associated with five common sources (use of mass transit, occupational and nonoccupational activities, MP3 player and stereo use, and time at home and doing other miscellaneous activities) among a sample of over 4500 individuals in New York City (NYC). We then evaluated the contributions of each source to total noise exposure and also compared our estimated exposures to the recommended 70 dBA annual exposure limit. We found that one in ten transit users had noise exposures in excess of the recommended exposure limit from their transit use alone. When we estimated total annual exposures, 90% of NYC transit users and 87% of nonusers exceeded the recommended limit. MP3 player and stereo use, which represented a small fraction of the total annual hours for each subject on average, was the primary source of exposure among the majority of urban dwellers we evaluated. Our results suggest that the vast majority of urban mass transit riders may be at risk of permanent, irreversible noise-induced hearing loss and that, for many individuals, this risk is driven primarily by exposures other than occupational noise.

Valuing Quiet: An Economic Assessment of U.S. Environmental Noise as a Cardiovascular Health Hazard

INTRODUCTION Environmental noise pollution increases the risk for hearing loss, stress, sleep disruption, annoyance, and cardiovascular disease and has other adverse health impacts. Recent (2013) estimates suggest that more than 100 million Americans are exposed to unhealthy levels of noise. Given the pervasive nature and significant health effects of environmental noise pollution, the corresponding economic impacts may be substantial. METHODS This 2014 economic assessment developed a new approach to estimate the impact of environmental noise on the prevalence and cost of key components of hypertension and cardiovascular disease in the U.S. By placing environmental noise in context with comparable environmental pollutants, this approach can inform public health law, planning, and policy. The effects of hypothetical national-scale changes in environmental noise levels on the prevalence and corresponding costs of hypertension and coronary heart disease were estimated, with the caveat that the national-level U.S. noise data our exposure estimates were derived from are >30 years old. RESULTS The analyses suggested that a 5-dB noise reduction scenario would reduce the prevalence of hypertension by 1.4% and coronary heart disease by 1.8%. The annual economic benefit was estimated at

Street-level noise in an urban setting: Assessment and contribution to personal exposure

3.9 billion. CONCLUSIONS These findings suggest significant economic impacts from environmental noise-related cardiovascular disease. Given these initial findings, noise may deserve increased priority and research as an environmental health hazard.

Improving the accuracy of smart devices to measure noise exposure

BackgroundThe urban soundscape, which represents the totality of noise in the urban setting, is formed from a wide range of sources. One of the most ubiquitous and least studied of these is street-level (i.e., sidewalk) noise. Mainly associated with vehicular traffic, street level noise is hard to ignore and hard to escape. It is also potentially dangerous, as excessive noise from any source is an important risk factor for adverse health effects. This study was conducted to better characterize the urban soundscape and the role of street level noise on overall personal noise exposure in an urban setting.MethodsStreet-level noise measures were obtained at 99 street sites located throughout New York City (NYC), along with data on time, location, and sources of environmental noise. The relationship between street-level noise measures and potential predictors of noise was analyzed using linear and logistic regression models, and geospatial modeling was used to evaluate spatial trends in noise. Daily durations of street-level activities (time spent standing, sitting, walking and running on streets) were estimated via survey from a sample of NYC community members recruited at NYC street fairs. Street-level noise measurements were then combined with daily exposure durations for each member of the sample to estimate exposure to street noise, as well as exposure to other sources of noise.ResultsThe mean street noise level was 73.4 dBA, with substantial spatial variation (range 55.8-95.0 dBA). Density of vehicular (road) traffic was significantly associated with excessive street level noise levels. Exposure duration data for street-level noise and other common sources of noise were collected from 1894 NYC community members. Based on individual street-level exposure estimates, and in consideration of all other sources of noise exposure in an urban population, we estimated that street noise exposure contributes approximately 4% to an average individual’s annual noise dose.ConclusionsStreet-level noise exposure is a potentially important source of overall noise exposure, and the reduction of environmental sources of excessive street- level noise should be a priority for public health and urban planning.

Health seeking behaviours among electronic waste workers in Ghana

ABSTRACT Occupational noise exposure is one of the most frequent hazards present in the workplace; up to 22 million workers have potentially hazardous noise exposures in the U.S. As a result, noise-induced hearing loss is one of the most common occupational injuries in the U.S. Workers in manufacturing, construction, and the military are at the highest risk for hearing loss. Despite the large number of people exposed to high levels of noise at work, many occupations have not been adequately evaluated for noise exposure. The objective of this experiment was to investigate whether or not iOS smartphones and other smart devices (Apple iPhones and iPods) could be used as reliable instruments to measure noise exposures. For this experiment three different types of microphones were tested with a single model of iPod and three generations of iPhones: the internal microphones on the device, a low-end lapel microphone, and a high-end lapel microphone marketed as being compliant with the International Electrotechnical Commissions (IEC) standard for a Class 2-microphone. All possible combinations of microphones and noise measurement applications were tested in a controlled environment using several different levels of pink noise ranging from 60–100 dBA. Results were compared to simultaneous measurements made using a Type 1 sound level measurement system. Analysis of variance and Tukeys honest significant difference (HSD) test were used to determine if the results differed by microphone or noise measurement application. Levels measured with external microphones combined with certain noise measurement applications did not differ significantly from levels measured with the Type 1 sound measurement system. Results showed that it may be possible to use iOS smartphones and smart devices, with specific combinations of measurement applications and calibrated external microphones, to collect reliable, occupational noise exposure data under certain conditions and within the limitations of the device. Further research is needed to determine how these devices compare to traditional noise dosimeter under real-world conditions.

The Association between Noise, Cortisol and Heart Rate in a Small-Scale Gold Mining Community—A Pilot Study

BackgroundElectronic waste workers are prone to various illnesses and injuries from numerous hazards thus the need for them to seek health care. The aim of this study was to describe health-seeking behavior, and social and other factors affecting this behavior, among electronic waste workers at Agbogbloshie, Accra, Ghana.MethodsIn-depth interviews were conducted and analyzed qualitatively from a grounded theory perspective.ResultsWorkers experienced various kinds of ailments. These included physical injuries, chest and respiratory tract associated symptoms, malaria, headaches, body pains and stomach discomfort. They reported seeking health care from multiple sources, and the main determinants of health seeking behaviour were severity of illness, perceived benefit of treatment, accessibility of service, quality of service, ease of communication with service provider and cost of health care.ConclusionMultiple sources of health care were used by the e-waste workers. As cost was a major barrier to accessing formal health care, most of the workers did not subscribe to health insurance. Since enrollment in health insurance is low amongst the workers, education campaigns on the need to register with the National Health Insurance Scheme would facilitate access to formal health care and could result in improved health outcomes among e-waste workers.

Heart Rate, Stress, and Occupational Noise Exposure among Electronic Waste Recycling Workers

We performed a cross-sectional pilot study on salivary cortisol, heart rate, and personal noise exposures in a small-scale gold mining village in northeastern Ghana in 2013. Cortisol level changes between morning and evening among participants showed a relatively low decline in cortisol through the day (−1.44 ± 4.27 nmol/L, n = 18), a pattern consistent with chronic stress. A multiple linear regression, adjusting for age, sex, smoking status, and time between samples indicated a significant increase of 0.25 nmol/L cortisol from afternoon to evening per 1 dBA increase in equivalent continuous noise exposure (Leq) over that period (95% CI: 0.08–0.42, Adj R2 = 0.502, n = 17). A mixed effect linear regression model adjusting for age and sex indicated a significant increase of 0.29 heart beats per minute (BPM) for every 1 dB increase in Leq. Using standard deviations (SDs) as measures of variation, and adjusting for age and sex over the sampling period, we found that a 1 dBA increase in noise variation over time (Leq SD) was associated with a 0.5 BPM increase in heart rate SD (95% CI: 0.04–−0.9, Adj. R2 = 0.229, n = 16). Noise levels were consistently high, with 24-hour average Leq exposures ranging from 56.9 to 92.0 dBA, with a mean daily Leq of 82.2 ± 7.3 dBA (mean monitoring duration 22.1 ± 1.9 hours, n = 22). Ninety-five percent of participants had 24-hour average Leq noise levels over the 70 dBA World health Organization (WHO) guideline level for prevention of hearing loss. These findings suggest that small-scale mining communities may face multiple, potentially additive health risks that are not yet well documented, including hearing loss and cardiovascular effects of stress and noise.