PROCEEDINGS of the
23rd International Congress on Acoustics
9 to 13 September 2019 in Aachen, Germany

Reviewing the current guidance in England for the valuation ofnoise impacts
Hilary NOTLEY 1; Alisha IYER1; Emma POWELL1
1

Defra, UK

ABSTRACTIn England, the current guidance for valuing impacts associated with environmental noise is published by the
Department for Environment Food and Rural Affairs (Defra) and the Interdepartmental Group on Costs andBenefits Noise Subject Group, (IGCB(N)).
The development of the World Health Organization (WHO) Environmental Noise Guidelines followed arigorous methodology and their recommendations are based on systematic reviews published separately.
The systematic reviews considered evidence published between 2000 and 2014 – 2016 (health outcome
dependent). There have been several high quality studies published since those considered by the WHO that
may further develop the understanding of the link between noise exposure and health.
This paper describes the steps that the IGCB(N) are taking to determine whether they should update theircurrent recommendations. The paper describes the commissioned reviews of evidence relating to healtheffects and efforts to assess a number of potential effects that are outside of the scope of the WHO, such as
the benefits of quiet areas/tranquility and the impact on productivity. The paper further describes how thevaluation of any effects will be considered.
Keywords: Noise, Health, Valuation

1. INTRODUCTION
In England, the current guidance for valuing impacts associated with environmental noise ispublished by the Department for Environment Food and Rural Affairs (Defra) 1 on behalf of theInterdepartmental Group on Costs and Benefits Noise Subject Group, (IGCB(N)) (1).
The IGCB is a Defra-led group of government analysts and policy officials that provides analysis
and advice relating to the quantification and valuation of local environmental impacts. It aims to do
this through the development of methodology, evidence reviews and subsequent recommendations.
The Noise subject group, IGCB(N), described its current methodology for valuing health impacts
associated with environmental noise in two documents in 2010 and 2014 (2,3). The relevant healthoutcomes are annoyance, sleep disturbance, hypertension (via stroke and dementia) and acute
myocardial infarction. Other factors considered are the benefits of quiet areas and impacts of noiseon productivity. Together, these recommendations outline the current guidance to the UK
Government for incorporating noise impacts in cost benefit analysis. These recommendations havesubsequently been incorporated into the DfT transport analysis guidance (WebTAG) and the HMT
Green Book (4,5) on appraisal and evaluation.
On 10th October 2018, the World Health Organization (WHO) Regional Office for Europe
published its Environmental Noise Guidelines for the European Region (6), ‘the WHO Guidelines’.
The guidelines provide recommendations for protecting human health from exposure to environmental
noise originating from various sources: transportation (road traffic, railway and aircraft) noise, windturbine noise and leisure noise. The development of the guidelines followed a rigorous methodology;
their recommendations are based on systematic reviews of evidence published separately (7).
The publication of the WHO Guidelines has generated interest from stakeholders. Ministers havewelcomed the WHO’s focus on this important issue and in line with the government’s commitment to1

noise@defra.gov.uk

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ensure noise is managed effectively, the IGCB(N) was convened to consider any necessary updates torelevant government guidance.
This paper describes the process that the IGCB(N) is following to determine whether it might
update the current recommendations. The paper describes the commissioned reviews of evidence
relating to health effects and efforts to assess a number of potential effects that are outside of thescope of the WHO, such as the benefits of quiet areas/tranquility and the impact on productivity. The
paper further describes how the valuation of any effects could be considered.
Noise policy is a devolved matter in the UK. The IGCB(N) membership consists ofrepresentatives from the Devolved Administrations (Wales, Scotland and Northern Ireland), as well
as representatives from departments across central Government.

2. IDENTIFICATION OF SCOPE
The broad methodology currently applied by the IGCB(N) is the impact pathway approach which
involves following the pollutant (the noise emissions) from its source (such as a vehicle) to a receptor.
The impact on the receptor from this exposure is then classified into one of four broad groups of
endpoints and evaluated. The broad groups of endpoints in the current guidance are health, amenity,
productivity and environmental outcomes:x Health – Noise is associated with a range of effects on health, including both morbidity andmortality. The health effects currently valued are heart attacks (AMI), strokes and dementia (fromhypertension).
x Amenity - In the current guidance amenity reflects public well-being, including directannoyance. It also includes positive benefits such as from quiet areas. However, in one of thecurrent IGCB(N) reports, it is defined as including “the conscious negative reaction of those
exposed to the noise” in relation primarily to annoyance, but also to sleep disturbance. The
IGCB(N) felt that this definition may no longer be appropriate. There is evidence that suggeststhat some of the health impacts, in particular those associated with sleep disturbance, may beconsidered to be ‘unconscious’. Therefore, the IGCB(N) agreed to redefine these endpoints. For
the purposes of this review, annoyance and sleep disturbance will come under the ‘health’ endpoint.
This is in line with the WHO’s broad definition of health as a “state of complete physical, mental
and social well-being and not merely the absence of disease or infirmity”. Quiet areas will be
subsumed into the environmental endpoint and the ‘amenity’ term is no longer required.
x Productivity - Through distraction, fatigue and interrupting communication, noise can have anegative impact on productivity. At the time of the previous publication, it was not possible toassess and value these impacts.
x Environmental - Noise can have a notable impact on the natural environment, for example noise
may alter bird breeding patterns, disturb wildlife and damage sensitive ecosystems.
The current approach was decided by the IGCB(N) in 2010 and a similar impact pathway approachis used in other areas, e.g. air quality (IGCB(A)). The IGCB(N) agreed to continue with this broad
approach, albeit with some re-categorisation as detailed above. It should be noted that the endpoints
were redefined purely for ease of carrying out this review and solely within the context of this review.
Accordingly, the revised endpoints are:x Health;x Productivity; andx Environmental.
2.1 Noise Sources
Once it had been agreed to continue within the existing framework, the first task undertaken by
the IGCB(N) was to identify noise sources within the scope of the work. Defra has overall lead
responsibility for policy on (non-occupational) noise management in England. At a national level,
noise is managed through the implementation of the Noise Policy Statement for England (NPSE) (8).
Its vision is to “promote good health and a good quality of life through the effective management ofnoise within the context of Government policy on sustainable development”. The NPSE recognisesthat it is not possible to have a single objective noise-based measure that is applicable to all sourcesof noise in all situations. This is because effect levels are likely to be different for different noise
sources and at different times.

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The aims of the NPSE are:“Through the effective management and control of environmental, neighbour and neighbourhood
noise within the context of Government policy on sustainable development:
x avoid significant adverse impacts on health and quality of life;
x mitigate and minimise adverse impacts on health and quality of life; andx where possible, contribute to the improvement of health and quality of life.”
The intention is that the NPSE should apply to all types of noise apart from noise in the workplace(occupational noise). For the purposes of the NPSE:
x Environmental noise - includes noise from transportation sources, such as road, rail andaviation;x Neighbour noise - includes noise from inside and outside people’s homes. It includes noisefrom and between neighbours’ premises (including gardens) that tends to affect people in theimmediate vicinity – for example, noise from high volumes on televisions, music equipment, pets,
household products and noise from people activity such as doors slamming or shouting; andx Neighbourhood noise - includes noise from within the community that can affect a larger
number of people – for example, from entertainment premises (e.g. pubs, clubs, music venues),
outdoor concerts, industrial, business or trade premises, construction sites, equipment or machinery
being used in the street and wind farms.
The definition of ‘noise’ is commonly expanded to include (environmental) vibration. The
IGCB(N) used the NPSE as the starting point for defining which noise sources were within the scopeof the review. Discussions were held to identify those sources for which there were likely to be someliterature on studies relevant to the IGCB(N). Thus, the following noise sources were determined to
be in scope:x Roadx Railx Aircraftx Windfarms
x Industry
x Noise from building services equipment including ground and air source heat pumps
x Neighbour noisex Neighbourhood noise (including leisure noise, not from personal listening devices)
2.2 Health Endpoint
The second task undertaken by the IGCB(N) was to identify the health outcomes within the scopeof work. The starting point was the WHO Guidelines. The WHO systematic reviews consideredevidence published between 2000 and 2014-2016 (dependent on health outcome). Table 1 details theexact dates considered by the WHO systematic reviews by health outcome.
Table 1 – Period considered by WHO Systematic Reviews
Health Outcome
End Date of Review
Annoyance
Dec 2014
Effects on Sleep
1 Dec 2015
Cardiovascular and Metabolic Effects
Aug 2015
Cognition
Jun 2015
Adverse Birth Outcomes
Dec 2016
Quality of Life, Well-Being and Mental HealthOct 2015
There have been several high quality studies published since those considered by the WHO that
may further develop the understanding of the link between noise exposure and health. Some studies
consider not only the health outcomes above considered by the WHO, but also additional healthoutcomes. The IGCB(N) discussed including these additional health outcomes and concluded that toensure all the relevant evidence were considered, the scope of the review should be wider than thatcovered by the WHO. It is acknowledged that the evidence for some of these health outcomes may
be insufficient to progress to a valuation methodology, but it was felt important that they at least be
considered. The IGCB(N) agreed to consider not only the supporting evidence base of the WHO, butalso other subsequent high-quality evidence carried out in the UK and abroad.

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Thus, the following health endpoints were determined to be in scope:x Annoyancex Sleep Disturbancex Cardiovascular (Ischaemic Heart Disease, Hypertension)x Metabolic Disease (Stroke, Diabetes, Obesity)x Cognitive Effects in Children
x Mental Health (excluding annoyance, but including well-being and quality of life)
x Reproductive Outcomes (Birth weight, etc)
x Cancers (non-Hodgkin’s Lymphoma)x Cognitive degeneration (dementia, Parkinson’s)
Consideration of hypertension requires an additional explanation. The current IGCB(N)recommends using a two-step approach to value hypertension-related impacts. Step 1 is to quantify
the likely number of additional cases of hypertension due to noise. Step 2 is to monetise these
additional cases of hypertension by quantifying and valuing the consequential impact on dementia andstroke. This approach was taken because there was no agreed disability weight for hypertension at
the time. However, the recent guidance document developed for the European Commission statedthat not all exposure-response functions derived as part of the WHO review are valid for use in ahealth impact assessment. Hypertension is not considered as a health outcome, but rather as a risk
factor and as such is sufficiently covered by coronary heart disease (9). It was agreed by the IGCB(N)to consider whether the current approach should be amended to align with this newer approach, toensure that double-counting does not occur.
2.3 Productivity and Environmental Endpoints
Future tasks for the IGCB(N) include defining the scope for these two endpoints.
anticipated to commence in July 2019.

This is3. REVIEW OF EVIDENCE
3.1

Health Endpoint

3.1.1 Process
It was decided to seek evidence for every combination of noise source and health outcome (asdetailed for road traffic noise in Figure 1).

Figure 1 – Road Traffic Noise and Health Outcomes to be considered

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There are three scenarios for each source-outcome combination.
x Source-outcome combinations IN BOTH current IGCB(N) and WHO (e.g. road traffic noise
and annoyance) - The WHO systematic review was considered to be sufficient as a starting point.
However, as mentioned earlier, it is acknowledged that high quality studies may have been
published since the cut-off point of the systematic reviews. Therefore, it was decided tocommission evidence reviews to identify relevant studies published after each specific systematic
review cut-off date. The evidence review was to follow the methodology of the WHO reviews as
closely as possible. The outcome of the review is to form a view on whether any identified new
evidence suggests that a material change to the exposure-response relationships proposed in the
WHO systematic review might be considered by the IGCB(N).
x Source-outcome combination NOT in current IGCB(N), but IS in WHO (e.g. windfarm noise
and annoyance) - The WHO systematic review was considered to be sufficient as a starting point
and the same process as in the previous bullet point followed. The outcome of the review is toform a view firstly on whether the scope of the current IGCB(N) recommendations might beextended to include this new source-outcome combination and secondly, on whether any identified
new evidence suggests that a material change to the exposure-response relationships proposed in
the WHO systematic review might be considered.
x Source-outcome combination NOT in current IGCB(N) or in WHO (e.g. neighbour noise andannoyance) - Relevant evidence from 2000 onwards is to be identified, again following the processof the WHO reviews as closely as possible. The outcome of the review is to form a view onwhether the scope of the current IGCB(N) recommendations might be extended to include this new
source-outcome combination.
Some noise sources have long-established links to health outcomes, e.g. transport noise withannoyance. Other sources are less-well researched. The level of robustness of evidence for each ofthese potential relationships varies greatly both in terms of the body of research (repeatability of
results) and the quality of the research (e.g. carried out on sufficient sample sizes and with recognised
approaches). The aim of the evidence reviews are to confirm for each source-outcome combination
whether sufficient robust evidence exists to suggest a relationship may be defined and whether that
evidence is relevant to the UK. A view then needs to be taken on whether that relationship should
be included in any future IGCB(N) recommendations.
It is accepted that a viable and realistic outcome from the evidence reviews may be that for manyof the source-outcome combinations, the evidence reviews may suggest that:x There is SUFFICIENT robust evidence to suggest that a relationship does NOT exist;
x There is INSUFFICIENT robust evidence to suggest that a relationship DOES exists; orx The evidence may suggest that a link might exist, but that there is currently insufficient robust
evidence to define a relationship.
These are considered acceptable outcomes and may provide the IGCB(N) with a clear andevidenced reason to NOT consider the source-outcome combination any further in the process.
3.1.2 Progress
To date evidence reviews have been commissioned considering the eight scoped noise sources(road, rail, air, wind turbines, building services, industry, neighbour and neighbourhood) and the nine
scoped health outcomes (annoyance, sleep disturbance, cardiovascular (ischaemic heart disease andhypertension), metabolic (stroke, obesity, diabetes, blood pressure), mental health (incl quality of life
and well-being), cognitive effects, cancers, neurodegenerative diseases (Parkinson’s, dementia) andreproductive outcomes (pre-term, birth weight, infertility)). Results are not yet available at the timeof submission of this paper, but discussions with the researchers suggests that many more papers than
expected were identified in the initial searches, thus showing that the exercise is well-worth
undertaking.
Initial indications of the results suggest that there will be insufficient evidence to determine
exposure-response functions for some of the newly included noise sources (e.g. building services,neighbour, neighbourhood noise). This is not entirely unexpected. The heterogeneity of neighbour
and neighbourhood noise sources makes it extremely complex to define the noise sources in a
repeatable manner. It may be that these generic sources need breaking down further into more
specific sources, e.g. instead of neighbour noise, it may be possible to consider voices, impact noise,barking dogs and so on separately. However, finding sufficient sample sizes of these individual
sources might then prove difficult and there would be challenges around the control of any such study
as the sources are not as constant or predictable as say those from a major road.

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Initial indications of the results also suggest that there will be insufficient evidence to determine
exposure-response functions for some of the health outcomes (e.g. reproductive outcomes). Again,
this is not entirely unexpected as the WHO also concluded that additional high quality studies wererequired to explore potential links between many of the noise sources and reproductive outcomes (9)and it would be unrealistic to expect that enough of these have been published between 2017 and 2019.
However, this does not mean that the effects do not exist, just that there is insufficient quality evidence
at present to conclude one way or the other.
Interestingly, for some of the noise source-health outcome combinations, the initial indications of
the results suggest that enough quality evidence is now available to consider carrying out new metaanalyses and to potentially define more robust or different exposure-response functions. The
IGCB(N) will need to consider whether this is a route they wish to take after considering the final
conclusions of the reviews carefully.
However, and as a caveat, it should be borne in mind that the results are not yet finalised, and so
the above discussion is subject to change.
3.2 Productivity EndpointAt the time of drafting this paper, the scoping for this endpoint had not been completed. However,as a minimum, an update to the previous review of noise related sleep disturbance impacts on
productivity is expected to be undertaken. It is accepted that the methodology for reviewing theevidence relating to productivity is perhaps less developed and/or standardised than that for theevidence reviews of noise-health effects.
3.3 Environmental Endpoint
One factor considered in the previous IGCB(N) review was the beneficial effects of access to quiet
areas. To be beneficial it is generally agreed that an area needs to be not only relatively quiet
compared to the surrounding area, but also tranquil. However, a tranquil space need not necessarily
be quiet, e.g. in the vicinity of a waterfall or waves on a beach. More recently, these concepts havebeen included in the topic known as ‘soundscape’. One area for consideration by the IGCB(N) is
therefore that of a positive soundscape, including quiet, tranquility, the absence (or masking) of noise,and restorative benefits.
Another area which the IGCB(N) may choose to consider is that of environmental noise exposureand ecosystem impacts.
Again, it is accepted that the methodology for reviewing the evidence relating to both these points
is perhaps less developed and/or standardised than that for the evidence reviews of noise-health effects.
3.4 Other Work Packages
There are some additional areas that the IGCB(N) may wish to explore.
x Change Effect - The WHO systematic review for annoyance suggests some changes to the
exposure response relationships from those previously used (11). Particularly for air transport,
this has generated some debate. One argument centres on “change effect”. The question iswhether there is an increased sensitivity to noise and if so, is this irrespective of a change to the
local environment. The quantification of effects often occurs during consideration of a change
and it may be possible that this has influenced the results in some way. It seems quite feasiblethat the initial reported annoyance from those experiencing a change in noise exposure from say
55dBLAeq,16hr to 58dBLAeq,16hr is elevated compared to those experiencing a constant exposure of
58dBLAeq,16hr . The question is whether there is sufficient evidence for determining whether this“change effect” reduces over time, by how much and whether it ever aligns with the steady-state
relationship.
x Non-Acoustic Interventions - One common used method to mitigate noise impact is that ofrespite – ensuring the noise is not present e.g. at certain times of the day or during the week.
However, current LAeq,t based noise metrics are insensitive to respite, whereas community response
is very sensitive.

4. Valuation of Effects
The effects of noise on health are currently valued using a quality-adjusted life year (QALY)
framework. This is based on a value assigned to a life year lived in perfect health and a set ofadjustment factors, known as utility weights, that adjust the perfect health value for different

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conditions in relation to their severity or impact on an individual’s quality of life. This approach isused in other Defra areas, e.g. air quality, and is recommended in HMT’s Green Book. It is a twodimensional measure of both the impact on length of life (longevity) and health-related quality of life.
The current monetary willingness-to-pay (WTP) value for a QALY is £60,000 (sterling – 2014 prices).
Disability-adjusted-life-years (DALYs) are a measure of life-years adjusted for loss of quality oflife and loss of life expectancy for people living with a health condition or its consequences.
Appraisal of an intervention is concerned with estimating the difference that it makes – hence theintervention’s impacts could be described in terms of QALYs gained or DALYs prevented. However,in practice, DALYs differ in some subtler ways and are used less often in the UK. However, theWHO’s Burden of Disease from Environmental Noise uses the DALY. The currently IGCB(N)methodology uses a disability weight to estimate the health impact of an outcome in DALYs. Thisis then valued in line with the prevailing guidance on valuing life and health. The recommended
monetary value of a QALY is the recommended Department of Health DALY, and therefore consistentacross the two approaches.
The IGCB(N) may also consider two additional work packages on valuation:
x Estimation of costs to the NHS and social care due to the health impacts of noise pollution –this is an area considered by the Public Health England (12) for Air Quality and it may prove
possible to investigate whether it can be adapted for noise; andx Costs to local government (and other relevant bodies), for example in investigating complaints– in 2012, Defra commissioned a report to estimate the cost of complaints about noisenuisance (13). These were the estimated costs to both the individual making the complaint about
an alleged statutory noise nuisance in England (in hours) as well as the cost to a Local Authority
in investigating and enforcing the complaint (in hours and monetised). The IGCB(N) has
commissioned an update to this report.

5. Summary and Conclusions
The IGCB(N) has already agreed to undertake an ambitious programme of work. This programmeof work covers 4 main work areas – health effects from noise, productivity impacts attributable tonoise exposure, environmental impacts (and benefits) of noise (and positive soundscapes) and thevaluation of those effects and impacts. Whilst the scoping remains incomplete for some areas, inothers great progress has already been made in rapidly convening the IGCB(N) and commissioning
three work packages – two covering reviews of eight noise sources and nine potential health effects
and one updating an existing report on the cost of complaints about noise to both the complainant andthe investigating authority.
Work will continue over the coming months to complete the scoping and commission the remaining
work packages. The IGCB(N) will then consider all the evidence and determine what updates, if any,
are advisable to the current guidance. Any revised guidance will be published by the IGCB(N) in
due course.

ACKNOWLEDGEMENTS
The author would like to thank the members of the Defra Noise and Statutory Nuisance Team andeconomists without whom this assessment would not be possible. The author would also like toacknowledge the input of the IGCB(N).

References
1. Interdepartmental Group on Costs and Benefits Noise Subject Group, (IGCB(N)):
http://webarchive.nationalarchives.gov.uk/20130402224016/http://archive.defra.gov.uk/evidence/economics/igcb/index.htm
2. Defra. Environmental Noise: Valuing Impacts on: Sleep Disturbance, Annoyance, Hypertension,
Productivity and Quiet. 2014.
3. The Interdepartmental Group on Costs and Benefits Noise Subject Group (IGCB(N)). Noise &Health – Valuing the Human Health Impacts of Environmental Noise Exposure. 2010.
4. Department
forTransport,
Transport
Analysis
Guidance(webTAG):
http://www.gov.uk/guidance/transport-analysis-guidance-webtag
5. HM Treasury, The Green Book – Appraisal and Evaluation in Central Government:
https://www.gov.uk/government/publications/the-green-book-appraisal-and-evaluation-in-

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central-governent
6. WHO Regional Office for Europe. Environmental Nosie Guidelines for the European Region.
2018.
7. Int. J. Environ. Res. and Public Health. Special Issue “WHO Noise and Health Evidence Reviews”.
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8. Defra. Noise Policy Statement for England. 2010.
9. RIVM. Study on Methodology to perform Environmental Noise and Health Assessment. 2018.
10. Int. J. Environ. Res. and Public Health. WHO Environmental Noise Guidelines for the European
Region: A Systematic Review on Environmental Noise and Adverse Birth Outcomes. 2017.
11. Int. J. Environ. Res. and Public Health. WHO Environmental Noise Guidelines for the European
Region: A Systematic Review on Environmental Noise and Annoyance. 2017.
12. PHE. Estimation of costs to the NHS and social care due to the health impacts of air pollution.
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13. Defra. Estimating the Cost of Complaints about Noise Nuisance. 2012.

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