WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cardiovascular and Metabolic Effects: A Summary

• Published in: International journal of environmental research and public health 2018-02, Vol.15 (2), p.379
• Main Authors: Kempen, Elise van, Casas, Maribel, Pershagen, Göran, Foraster, Maria
• Format: Article
• Language: English
• Subjects: Air pollution; Air traffic; Air traffic control; Aircraft; Background noise; Blood pressure; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Cardiovascular system; Coronary artery disease; Correlation analysis; Cross-Sectional Studies; Diabetes mellitus; Environmental effects; Environmental Exposure - adverse effects; Europe - epidemiology; Evaluation; Exposure; Female; Guidelines; Guidelines as Topic; Heart; Heart diseases; Hipertensió; Humans; Hypertension; Incidence; International organizations; Longitudinal studies; Male; Meta-analysis; Metabolic Diseases - epidemiology; Metabolic Diseases - etiology; Metabolic Diseases - prevention & control; Metabolism; Mortality; Noise; Noise levels; Noise, Transportation - adverse effects; Noise, Transportation - prevention & control; Obesity; Outdoor air quality; Public health; Quality assessment; Reference Standards; Review; Roads & highways; Soroll; Studies; Systematic review; Traffic; Transportation noise; Turbines; Wind power; World Health Organization
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph15020379

To update the current state of evidence and assess its quality, we conducted a systematic review on the effects of environmental noise exposure on the cardio-metabolic systems as input for the new WHO environmental noise guidelines for the European Region. We identified 600 references relating to studies on effects of noise from road, rail and air traffic, and wind turbines on the cardio-metabolic system, published between January 2000 and August 2015. Only 61 studies, investigating different end points, included information enabling estimation of exposure response relationships. These studies were used for meta-analyses, and assessments of the quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A majority of the studies concerned traffic noise and hypertension, but most were cross-sectional and suffering from a high risk of bias. The most comprehensive evidence was available for road traffic noise and Ischeamic Heart Diseases (IHD). Combining the results of 7 longitudinal studies revealed a Relative Risk (RR) of 1.08 (95% CI: 1.01-1.15) per 10 dB (L ) for the association between road traffic noise and the incidence of IHD. We rated the quality of this evidence as high. Only a few studies reported on the association between transportation noise and stroke, diabetes, and/or obesity. The quality of evidence for these associations was rated from moderate to very low, depending on transportation noise source and outcome. For a comprehensive assessment of the impact of noise exposure on the cardiovascular and metabolic system, we need more and better quality evidence, primarily based on longitudinal studies.