Health effects from noise



Noise health effects are the health consequences of elevated sound levels. Elevated workplace or other noise can cause hearing impairment, hypertension, ischemic heart disease, annoyance, and sleep disturbance. Changes in the immune system and birth defects have been attributed to noise exposure.

Although some presbycusis may occur naturally with age, in many developed nations the cumulative impact of noise is sufficient to impair the hearing of a large fraction of the population over the course of a lifetime. Noise exposure also has been known to induce tinnitus, hypertension, vasoconstriction, and other cardiovascular adverse effects.

Beyond these effects, elevated noise levels can create stress, increase workplace accident rates, and stimulate aggression and other anti-social behaviors. The most significant causes are vehicle and aircraft noise, prolonged exposure to loud music, and industrial noise. In Norway, road traffic has been demonstrated to cause almost 80% of the noise annoyances reported.

There may be psychological definitions of noise as well. Firecrackers may upset domestic and wild animals or noise-traumatized individuals. The most common noise-traumatized persons are those exposed to military conflicts, but often loud groups of people can trigger complaints and other behaviors about noise. Infants are easily startled by noise.

The social costs of traffic noise in EU22 are more than €40 billion per year, and passenger cars and lorries (trucks) are responsible for bulk of costs. Traffic noise alone is harming the health of almost every third person in the WHO European Region. One in five Europeans is regularly exposed to sound levels at night that could significantly damage health.

Noise also is a threat to marine and terrestrial ecosystems.

Hearing loss
The mechanism of hearing loss arises from trauma to stereocilia of the cochlea, the principal fluid filled structure of the inner ear. The pinna combined with the middle ear amplifies sound pressure levels by a factor of twenty, so that extremely high sound pressure levels arrive in the cochlea, even from moderate atmospheric sound stimuli. Underlying pathology to the cochlea are reactive oxygen species, which play a significant role in noise-induced necrosis and apoptosis of the stereocilia. Exposure to high levels of noise have differing effects within a given population, and the involvement of reactive oxygen species suggests possible avenues to treat or prevent damage to hearing and related cellular structures.

The elevated sound levels cause trauma to cochlear structure in the inner ear, which gives rise to irreversible hearing loss. A very loud sound in a particular frequency range can damage the cochlea's hair cells that respond to that range, thereby reducing the ear's ability to hear those frequencies in the future, however, loud noise in any frequency range has deleterious effects across the entire range of human hearing. The outer ear (visible portion of the human ear) combined with the middle ear amplifies sound levels by a factor of 20 when sound reaches the inner ear.

Age-related (presbycusis)
Hearing loss is somewhat inevitable with age. Though older males exposed to significant occupational noise demonstrate significantly reduced hearing sensitivity compared to non-exposed peers, differences in hearing sensitivity decrease with time and the two groups are indistinguishable by age 79.

Women exposed to occupational noise do not differ from their peers in hearing sensitivity, although they do hear better than their non-exposed male counterparts. Due to loud music and a generally noisy environment, young people in the United States have a rate of impaired hearing 2.5 times greater than their parents and grandparents, with an estimated 50 million individuals with impaired hearing estimated in 2050.

In Rosen's work on health effects and hearing loss, one of his findings derived from tracking Maaban tribesmen, who were insignificantly exposed to transportation or industrial noise. This population was systematically compared by cohort group to a typical U.S. population. The findings proved that aging is an almost insignificant cause of hearing loss, which instead is associated with chronic exposure to moderately high levels of environmental noise.

Cardiovascular effects
Noise has been associated with important cardiovascular health problems. In 1999, the World Health Organization concluded that the available evidence suggested a weak correlation between long-term noise exposure above 67-70 dB(A) and hypertension. More recent studies have suggested that noise levels of 50 dB(A) at night may also increase the risk of myocardial infarction by chronically elevating cortisol production.

Fairly typical roadway noise levels are sufficient to constrict arterial blood flow and lead to elevated blood pressure; in this case, it appears that a certain fraction of the population is more susceptible to vasoconstriction. This may result because annoyance from the sound causes elevated adrenaline levels trigger a narrowing of the blood vessels (vasoconstriction), or independently through medical stress reactions. Other effects of high noise levels are increased frequency of headaches, fatigue, stomach ulcers, and vertigo.

Stress
Research commissioned by Rockwool, a UK insulation manufacturer, reveals in the UK one third (33%) of victims of domestic disturbances claim loud parties have left them unable to sleep or made them stressed in the last two years. Around one in eleven (9%) of those affected by domestic disturbances claims it has left them continually disturbed and stressed. More than 1.8 million people claim noisy neighbours have made their life a misery and they cannot enjoy their own homes. The impact of noise on health is potentially a significant problem across the UK given that more than 17.5 million Britons (38%) have been disturbed by the inhabitants of neighbouring properties in the last two years. For almost one in ten (7%) Britons this is a regular occurrence.

The extent of the problem of noise pollution for public health is reinforced by figures collated by Rockwool from local authority responses to a Freedom of Information Act (FOI) request. This research reveals in the period April 2008 - 2009 UK councils received 315,838 complaints about noise pollution from private residences. This resulted in environmental health officers across the UK serving 8,069 noise abatement notices, or citations under the terms of the Anti-Social Behaviour (Scotland) Act.

Westminster City Council has received more complaints per head of population than any other district in the UK with 9,814 grievances about noise, which equates to 42.32 complaints per thousand residents. Eight of the top 10 councils ranked by complaints per 1,000 residents are located in London.

Annoyance
Because some stressful effects depend on qualities of the sound other than its absolute decibel value, the annoyance associated with sound may need to be considered in regard to health effects. For example, noise from airports is typically perceived as more bothersome than noise from traffic of equal volume. Annoyance effects of noise are minimally affected by demographics, but fear of the noise source and sensitivity to noise both strongly affect the 'annoyance' of a noise. Even sound levels as low as 40 dB(A) (about as loud as a refrigerator or library ) can generate noise complaints and the lower threshold for noise producing sleep disturbance is 45 dB(A) or lower.

Other factors that affect the 'annoyance level' of sound include beliefs about noise prevention and the importance of the noise source, and annoyance at the cause (i.e. non-noise related factors) of the noise. For instance, in an office setting, audible telephone conversations and discussions between co-workers were considered to be irritating, depending upon the contents of the conversations. Many of the interpretations of the level of annoyance and the relationship between noise levels and resulting health symptoms could be influenced by the quality of interpersonal relationships at the workplace, as well as the stress level generated by the work itself. Evidence for impact on annoyance of long-term noise versus recent changes is equivocal.

Estimates of sound annoyance typically rely on weighting filters, which consider some sound frequencies to be more important than others based on their presumed audibility to humans. The older dB(A) weighting filter described above is used widely in the U.S., but underestimates the impact of frequencies around 6000 Hz and at very low frequencies. The newer ITU-R 468 noise weighting filter is used more widely in Europe. The propagation of sound varies between environments; for example, low frequencies typically carry over longer distances. Therefore different filters, such as dB(B) and dB(C), may be recommended for specific situations.

Furthermore, studies have shown that neighborhood noise (consisting of noise from neighboring apartments, as well as noise within one's own apartment or home) can cause significant irritation and noise stress within people, due to the great deal of time people spend in their residences. This can result in an increased risk of depression and psychological disorders, migraines, and even emotional stress.

In the workplace, noise pollution is generally a problem once the noise level is greater than 55 dB(A). Selected studies show that approximately 35% to 40% of office workers find noise levels from 55 to 60 dB(A) extremely irritating. The noise standard in Germany for mentally stressful tasks is set at 55 dB(A), however, if the noise source is continuous, the threshold level for tolerability among office workers is lower than 55 dB(A).

One important effect of noise is to make a person's speech less easy to hear. The human brain compensates for background noise during speech production in a process called the Lombard effect in which speech becomes louder with more distinct syllables. However, this cannot fully remove the problems of communication intelligibility made in noise.

Child physical development
The U.S. Environmental Protection Agency authored a pamphlet in 1978 that suggested a correlation between low-birthweight (using the World Health Organization definition of less than 2,500 g (~5.5 lb) and high sound levels, and also high rates of birth defects in places where expectant mothers are exposed to elevated sound levels, such as typical airport environs. Specific birth abnormalities included harelip, cleft palate, and defects in the spine.

According to Lester W. Sontag of The Fels Research Institute (as presented in the same EPA study): “There is ample evidence that environment has a role in shaping the physique, behavior, and function of animals, including man, from conception and not merely from birth. The fetus is capable of perceiving sounds and responding to them by motor activity and cardiac rate change." The effects of noise exposure are highest when it occurs between 15 and 60 days after conception, a period in which major internal organs and the central nervous system are formed.

Later developmental effects occur as vasoconstriction in the mother reduces blood flow and therefore oxygen and nutrition to the fetus. Low birth weights and noise were also associated with lower levels of certain hormones in the mother. These hormones are thought to affect fetal growth and to be good indicators of protein production. The difference between the hormone levels of pregnant mothers in noisy versus quiet areas increased as birth approached.

In a 2000 publication, a review of studies on birthweight and noise exposure note that while some older studies suggest that when women are exposed to >65 dB aircraft noise a small decrease in birthweight occurs, in a more recent study of 200 Taiwanese women including noise dosimetry measurements of individual noise exposure, the authors found no significant association between noise exposure and birth weight after adjusting for relevant confounders, e.g. social class, maternal weight gain during pregnancy, etc.

Cognitive development
When young children are regularly exposed to levels of noise that interfere with speech, they may develop speech or reading difficulties, because auditory processing functions are compromised. Children continue to develop their speech perception abilities until they reach their teens. Evidence has shown that when children learn in noisier classrooms, they have a more difficult time understanding speech than those who learn in quieter settings.

In a study conducted by Cornell University in 1993, children exposed to noise in learning environments experienced trouble with word discrimination, as well as various cognitive developmental delays. In particular, the writing learning impairment known as dysgraphia is commonly associated with environmental stressors in the classroom.

The effect of high noise levels on small children has been known to cause physical health damages as well. Children from noisy residences often possess a heart rate that is significantly higher (by 2 beats/min on average) than those of children from quieter homes.

Regulations
Environmental noise regulations usually specify a maximum outdoor noise level of 60 to 65 dB(A), while occupational safety organizations recommend that the maximum exposure to noise is 40 hours per week at 85 to 90 dB(A). For every additional 3 dB(A), the maximum exposure time is reduced by a factor 2, e.g. 20 hours per week at 88 dB(A). Sometimes, a factor of two per additional 5 dB(A) is used, however, these occupational regulations are acknowledged by the health literature as inadequate to protect against hearing loss and other health effects. In recent years, Buy Quiet programs and initiatives have arisen in an effort to combat occupational noise exposures. These programs promote the purchase of quieter tools and equipment and encourage manufacturers to design quieter equipment.

With regard to indoor noise pollution in residences, the U.S. EPA has not set any restrictions on limits to the level of noise. Rather, it has provided a list of recommended levels in its Model Community Noise Control Ordinance, which was published in 1975. For instance, the recommended noise level for indoor residences is less than or equal to 45 dB.

Noise pollution control in residences is not funded by the federal government in part because of the disagreements in establishing causal links between sounds and health risks, since the effect of noise is often psychological and also, because it leaves no singular tangible trace of damage on the human body. For instance, hearing loss could be attributed to a variety of factors including age, rather than solely due to excessive exposure to noise. A state or local government is able to regulate indoor residential noise, however, such as when excessive noise from within a home causes disturbances to nearby residences.