Noise impacts on health.
Date: 2015-02-19
Institutions: Directorate-General for Environment
Subjects: health risk, noise, noise level, noise pollution, noise protection, public health

Science for Environment Policy

THEMATIC ISSUE:
Noise impacts on health

January 2015
Issue 47

Environment

2

Science for Environment Policy

This Thematic Issue is written and edited by the Science Communication Unit, 

University of the West of England (UWE), Bristol 
Email: sfep.editorial@uwe.ac.uk

Contents

Environmental Noise 
Guest editorial from Professor Dick Botteldooren

Summary of articles in this Thematic Issue 

Transport noise mitigation must consider 
the medical impacts  
A review of research into the effects of noise on cardiovascular diseases.

3

5

6

Children are more hyperactive 
if they live near busy roads 
10
Children  living  close  to  busy  roads  may  have  an  increased  risk  of 
hyperactivity, reveals recent research.

Reviewing the multiple impacts of noise pollution 
11
A new review examines studies that have investigated noise sources, including 
environmental (such as traffic) and social (such as via headphones).

Loss of healthy life due to UK noise exposure 
valued at €1.34 billion 
7
A recent study reveals how exposure to day-time noise above recommended 
levels  affected  the  blood  pressure  and  associated  health  complications  of 
the UK population.

Aircraft noise at night can damage blood vessels 
8
and cause long-term cardiovascular disease  
Disturbed  sleep  caused  by  night-time  aircraft  noise  can  damage  blood 
vessels and increase the levels of stress hormones in the body, new research 
shows.

Health of vulnerable people exposed to noise 
is under-researched 
9
Vulnerable  groups  of  people  may  be  more  at  risk  from  exposure  to 
environmental noise than healthy adults, say researchers. 

Preserving quiet areas improves health 
12
The quality of life for people living in quiet and noisy locations is assessed 
in a recent study.

How sounds affect our state of mind 
13
Researchers  have  developed  a  model  for  exploring  human  responses  to 
sound, which may help us understand better the health impacts of long-
term exposure to noise, as well as the potential benefits of spending time 
in quiet spaces.

Are motorways the best spot for wind turbines? 
14
Wind  turbine  noise  can  be  detected  at  low  levels,  even  when  it  is  heard 
alongside motorway traffic noise, a study finds.

Further reading 

15

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© European Union 2015

NOISE IMPACTS ON HEALTH 
3

EDITORIAL

Environmental Noise  

Our ears are constantly exploring our living environment for potential threats and opportunities. They are a vital 
part of the body’s defense mechanism: preparing our brains for fight-or-flight if needed and, as such, affecting 
many bodily functions. The plasticity of the human hearing system and the ability of the brain to block out 
irrelevant information from this permanently alert sensory system are remarkable.

However, this perfectly evolved hearing system is under threat. Many 
people’s modern living environments are filled with low-quality sound 
that  has  little  or  no  importance.  The  sounds  of  cars,  planes,  trains, 
cooling systems, ventilation, machines, electronically amplified music 
and  announcements  –  or  simply  the  sound  of  living  closer  together 
in a 24/7 city – are constantly present. Gating out these sounds can 
consume a significant fraction of cognitive resources and the body is 
frequently  triggered  in  vain  to  prepare  for  fight-or-flight.  Moreover, 
the information carried by this sound – mainly related to its source – 
influences our appraisal of our person-environment relationship. The 
feeling  of  not  being  in  control  of  one’s  living  environment  can  lead 
to additional stress particularly in the absence of coping resources or 
mechanisms.  Both  the  autonomous  response  and  stress  path  could 
eventually lead to negative effects on health and wellbeing, such as an 
increased risk of high blood pressure or circulatory disease, as explained 
in this thematic issue.

Health effects related to environmental noise result in a cost for society. 
The  loss  of  healthy  life  years  is  often  valued  in  euros,  but  there  are 
also indirect and hidden costs, such as the cost of medical treatment 
(e.g. medication for hypertension or mental illness); loss of efficiency 
at  work  due  to  illness  or  fatigue  resulting  from  sleep  deprivation  or 
ineffective resting periods; reduced creativity and learning – and even 
less  prosocial  behaviour  –  caused  by  noise  stress,  resulting  in  safety 
and  security  costs.  It  is  therefore  essential  that  environmental  sound 
is  included  in  different  policy  areas  effectively  and  efficiently:  in 
particular, at a preventive stage.

The papers presented in this Science for Environment Policy Thematic 
Issue explore research into the threat to health posed by environmental 
noise. They cover topics such as the link between environmental noise 
and  serious  health  issues  like  cardiovascular  disease  and  stroke;  the 
effect of noise on vulnerable people and how sound affects our state 
of mind. 

In the EU, exposure to excessive noise is becoming recognised as a large 
environmental  health  concern.  Estimates  from  available  data  suggest 
that 65% of Europeans living in major urban areas are exposed to high 
noise levels exceeding Lden 60 dBA (which could be due to attendance 

at social activities, such as bars and concerts), and that more than 20% 
are  exposed  to  night-time  noise  levels  exceeding  55  dBA,  (the  level 
at which there is an increased risk of adverse health effects occurring, 
according  to  the WHO).  Although  exact  numbers  are  not  available, 
recent estimates suggest that one to two million disability adjusted life 
years (DALYS) are lost to environmental noise every year in the EU. 
Nevertheless, health extends beyond the lack of disability: quality of 
life  is  also  relevant  here,  so  methodologies  for  determining  optimal 
conditions may need to be adjusted accordingly. 

Currently,  the  European  Commission  is  committed  to  meeting 
challenging  targets  on  noise  reduction  through  the  7th Environment 
Action  Programme1.  In  addition,  the  World  Health  Organization 
(WHO)  is  revising  the  Community  Noise  Guidelines2  for  the 
European  region.  The  Guidelines  will  include  a  review  of  evidence 
on the health effects of environmental noise to incorporate significant 
recent research.  

The  EU’s  Environmental  Noise  Directive  (2002)3  aims  at  protecting 
people from the adverse impacts of noise and has triggered many new 
initiatives and raised awareness of noise at the urban and citizen level. 
Understanding how different soundscapes and, in particular, tranquil 
areas in the urban environment affect overall health and wellbeing is 
allowing for new types of urban design. These improvements may limit 
health  effects  from  noise  annoyance  and  improve  wellbeing,  while 
allowing noise activities in appropriate contexts – but will inevitably 
require an understanding of the spatial and temporal details at a finer 
granulation. 

Prevention-oriented  health  systems  are  crucial  to  meeting  Europe’s 
challenges of the 21st century. And noise policy should also be strongly 
directed  at  avoiding  any  additional  and  preventable  health  effects. 
Accurate  knowledge  of  noise’s  effects  on  human  health  will  help 
policymakers  to  decide  whether  limited  resources  should  be  focused 
on black spots – the highest exposure – or on reducing overall levels of 
unwanted sound.

But opportunities for innovative, micro-policies should also be created. 
Exposure-aware citizens can play a crucial role in noise policymaking, 

1  http://ec.europa.eu/environment/noise/directive.htm
2  http://www.euro.who.int/en/health-topics/environment-and-health/noise/
activities/development-of-who-guidelines-for-community-noise-for-the-
european-region

3  http://ec.europa.eu/environment/newprg/index.htm

NOISE IMPACTS ON HEALTH4

both as observers using monitoring equipment or their own ears, and as 
solution providers – and scientific research will help policymakers and 
citizens to understand these dynamics and optimal conditions. Direct 
involvement  of  individuals  through  social  media  and  monitoring 
could lead to new fine-grained solutions. This level of detail and citizen 
participation  might  also  extend  the  concept  of  ‘vulnerable  groups’ 
to the individual, as there is a growing body of evidence that health 
sensitivity to noise has a strong genetic component.

The studies presented in this Thematic Issue, alongside future scientific 
research, will help decision makers to develop more effective policies 
based  on  recent  scientific  results.  It  is  essential  that  environmental 
sound is considered by a range of different policy areas such as mobility 
planning, urban development, housing and preventive health, and that 
noise policy is based on the assessment of all possible impacts.

Professor Dick Botteldooren, Department of 
Information Technology, University of Ghent, Belgium

NOISE IMPACTS ON HEALTH5

Summary of the articles in 
this Thematic Issue 

Research into noise pollution and health is outlined in 
‘Reviewing the multiple impacts of noise pollution’. 
This focuses on studies on the health impacts of noise 
– including environmental and social (via headphones) 
noise. Hearing impairment as a result of noise exposure 
presents  a  serious  public  health  problem  -  The  World 
Health Organization (WHO) estimates that 10% of the 
global population are currently exposed  to  noise levels 
that could lead to hearing impairment. 

The  article  ‘Preserving  quiet  areas  improves  health’ 
provides  evidence  of  the  beneficial  effects  of  access  to 
tranquil  places.  The  researchers  took  data  from  those 
living in rural and urban locations and found that those 
living  in  so-called  ‘noisy’  urban  areas  were  more  likely 
than those in ‘quiet’ urban areas to be very annoyed by 
noise. 

  ‘How  sounds  affect  our  state  of  mind’  examines 
research  which  finds  that  a  diversity  of  acoustic 
environments is preferable over more uniform acoustic 
environments  that  comply  with  certain  legal  noise 
limits.  Therefore  tranquil  places  as  well  as  more  lively 
places should be found in our cities.

Knowledge  about  the  source  of  a  noise  (e.g.  wind 
turbines)  has  been  shown  to 
influence  people’s 
judgement  of  noise  annoyance.  Motorways  have  been 
proposed as good locations for turbines, partly because 
the  traffic  could  help  conceal  turbine  noise.  Based  on 
a  Belgian  study,  the  final  article  ‘Are  motorways  the 
best  spot  for  wind  turbines?’  describes  a  listening 
experiment in which participants detected turbine noise 
even  when  it  was  23  dBA  quieter  than  accompanying 
motorway noise, and they could hear turbines above any 
volume of noise from local roads. 

Two articles in this Thematic Issue describe how stress 
and  sleep  disturbance  resulting  from  environmental 
noise  are  pathways  to  cardiovascular  disease.  Research 
summarised  in  ‘Transport  noise  mitigation  must 
consider the medical impacts’ reveals that night-time 
noise  may  have  more  of  an  impact  on  cardiovascular 
health  than  day-time  noise.  Noise  exposure  at  night 
is  a  particular  problem  because  it  disturbs  sleep.  The 
researchers  recommend  that  noise  reduction  policies 
consider  the  medical  effects  of  noise  and  suggest 
targeting noise problems at their source. 

The  second  article,  ‘Loss  of  healthy  life  due  to  UK 
noise exposure valued at €1.34 billion’ is based on a 
study  in  which  researchers  evaluated  how  exposure  to 
day-time  noise  above  recommended  levels  affected  the 
blood  pressure  and  associated  health  complications  of 
the  UK  population.  They  found  a  marked  increase  in 
three  health  problems  most  strongly  associated  with 
high blood pressure: heart disease, stroke and dementia; 
this increase has a significant cost to society. 

The  effects  of  night-time  noise  on  health  are  also 
examined in ‘Aircraft noise at night can damage blood 
vessels  and  cause  long-term  cardiovascular  disease’, 
which reports on a study of 75 healthy volunteers aged 
between  20  and  60  years.  Researchers  monitored  the 
blood pressure and heart rate of the volunteers during 
the  night  and  found  that  those  exposed  to  greater 
amounts of night-time aircraft noise suffered disturbed 
sleep,  damaged  blood  vessels  and  increased  levels  of 
stress hormones in the body. These physical changes can 
lead to high blood pressure, heart and circulatory disease 
over the long term.

Vulnerable groups of people (such as those with mental 
illness,  shift  workers  and  those  with  tinnitus)  may 
be  at  increased  risk  from  exposure  to  environmental 
noise.  The  article  ‘Health  of  vulnerable  people 
exposed  to  noise  is  under-researched’,  reports  that 
although  children’s  health  is  less  likely  to  be  affected 
by  environmental  noise  than  adults’,  it  has  been 
observed  to  lead  to  hyperactivity  and  inattention. 
Based  on  a  German  study,  the  article  ‘Children  are 
more hyperactive if they live near busy roads’ reveals 
that  in  addition  to  an  increased  risk  of  hyperactivity, 
children living close to busy roads may also have more 
emotional  problems,  especially  if  they  are  exposed  to 
higher levels of noise during the night.

NOISE IMPACTS ON HEALTH6

Transport noise mitigation 
must consider the medical 
impacts

People living close to road, rail and aircraft noise are likely to experience negative health effects. Long-term noise exposure 
may lead to problems with their heart and circulatory (cardiovascular) system and night-time noise is particularly disruptive 
of sleep patterns, which in turn may lead to cardiovascular health problems, a review of research into the effects of noise on 
cardiovascular diseases has found. 

“Night-time noise may 
have more of an impact on 

cardiovascular health than 

day-time noise, and noise 

exposure at night is a 

particular problem because 

sleep is disturbed.”

In  addition  to  annoyance  and  a  perception  of  a  lower 
quality  of  life,  long-term  exposure  to  environmental 
noise  can  affect  people’s  health  in  other  ways.  This 
study, based on current literature, reviewed research into 
the impact that exposure to transport noise has on the 
cardiovascular system, to help improve noise mitigation 
policies. 

exposure  and  raised  blood  pressure,  heart  attacks  and 
strokes. 

The  World  Health  Organisation  (WHO)  considers 
night-time  noise  levels  of  less  than  55  dBA  to  be 
necessary to prevent adverse health effects from noise in 
the short term, although the long-term goal is 40 dBA. 
Around 40% of the European population is exposed to 
road-traffic noise of more than 55 dBA LDN, according 
to the WHO. Results from a number of studies suggest 
that the risk of heart disease increases for people exposed 
to road traffic noise of between 55 and 60 dBA. The risk 
of having a stroke was also found to increase, particularly 
in the elderly.

Several studies on people living near airports have found 
a link between increased exposure to aircraft noise and 
the  risk  of  having  high  blood  pressure.  Recent  studies 
have  also  associated  exposure  to  day  and  night-time 
aircraft noise with an increased risk of heart disease and 
strokes in people living close to airports.

The researchers suggest that the association between road, 
rail  and  aircraft  traffic  noise  with  adverse  health  effects 
requires policies to reduce the burden of noise that take 
into account the associated medical effects. They suggest 
that  noise  should  be  targeted  at  source,  for  example 
take-off  and  landing  procedures  of  aircraft  should  be 
controlled to reduce noise levels, traffic curfews could be 
imposed, and better sound insulation could be installed 
where source control measures are not feasible.4

4  The energy-equivalent average A-weighted SPL (LAeq) as 
expressed in decibels is the most commonly used indicator 
of the noise exposure that people perceive outside and inside 
their homes. The A-weighting accounts for the different 
sensitivity of the human ear at different sound frequencies.

Night-time  noise  may  have  more  of  an  impact  on 
cardiovascular  health  than  day-time  noise,  and  noise 
exposure at night is a particular problem because sleep 
is  disturbed.  Exposure  to  noise  may  lead  to  changes 
in  the  way  the  body  functions:  laboratory  studies 
have  demonstrated  that  the  body  reacts  to  acute 
noise  exposure  by  releasing  stress  hormones,  such  as 
adrenaline. As shown by field studies, these acute effects 
occur not only at high sound levels in workplace settings, 
but  also  at  relatively  low  environmental  noise  levels 
when  concentration,  relaxation,  or  sleep  is  disturbed. 
This  flight-or-fight  reaction  is  automatic  and  does  not 
even require a conscious awareness to occur. As a result, 
people do not get enough sleep and their sleep pattern 
is  broken  -  disrupted  sleep  can  lead  to  cardiovascular 
health problems. 

For  example,  exposure  to  aircraft  noise  at  night  was 
linked  with  increased  blood  pressure.  If  night-time 
noise levels stimulate high blood pressure – preventing 
blood vessels from relaxing in order to restore themselves 
overnight  –  this  can  lead  to  continued  high  blood 
pressure,  hardening  of  the  arteries  and  cardiovascular 
diseases such as heart attacks and strokes in people who 
have long-term exposure to high enough noise levels. 

Population studies on long-term exposure to road, rail 
traffic  and  aircraft  noise  have  used  different  research 
methods,  but  in  general  reveal  a  link  between  noise 

SPL:  The  sound  pressure  level  (SPL)  is  a  logarithmic  measure  of  the  effective  pressure  of  a  sound  relative  to  a 
reference  value.  It  is  measured  in  decibels  higher  than  a  reference  level.  The  reference  sound  pressure  in  air  is  
20 µPa (2×10-5 Pa), which is equivalent to the human hearing threshold at a sound frequency of 1000 Hz.

Source: Münzel, T., 
Gori, T., Babisch, W. 
and Basner, M. (2014) 
Cardiovascular effects 
of environmental noise 
exposure. European 
Heart Journal. 
DOI:10.1093/
eurheartj/ehu030

Contact: 
tmuenzel@uni-mainz.
de

Themes: Environment 
and health, Noise

NOISE IMPACTS ON HEALTH7

Loss of healthy life due to 
UK noise exposure valued 
at €1.34 billion

Exposure to environmental noise levels above recommended levels results in 1169 cases of dementia, 788 strokes and 542 
heart attacks every year in the UK alone, new research suggests. Valuing a year of healthy life at £60 000 (€74 002) means 
that these health impacts together have a ‘cost’ of £1.09 billion (€1.34 billion), the study’s authors conclude.

To  calculate  the  cost  of  these  health  impacts  the 
researchers  used  ‘quality  adjusted  life  years’  (QALYs). 
The QALY takes into account quality of life by assessing 
not only the total number of years of life but also how 
many  years  might  be  spent  coping  with  a  non-life 
threatening illness. For example, an individual who lives 
for 70 years but only has 60% of full health would have 
42 QALYs. 

Using  a  standard  government  figure  of  £60  000  (€74 
002) for the ‘value’ of a single year of healthy life, the 
researchers calculated that the health impacts of exposure 
to noise above LAeq 16hr 55 A-weighted decibels cost £1.09 
billion  (€1.34  billion),  with  dementia  accounting  for 
44% of this figure. 

The  researchers  note  that  these  are  intangible,  or 
invisible,  ‘costs’  arising  from  loss  of  a  healthy  life  (see 
standard  figure  above),  rather  than  the  wider  costs  to 
society, such as healthcare. If these latter costs were to 
be  included,  the  figures  would  likely  be  substantially 
higher;  for  instance,  previous  research  has  estimated 
that  99%  of  the  costs  of  dementia  are  associated  with 
healthcare and informal care and only 1% with loss of 
healthy life.

“…the researchers set out 

to evaluate how exposure 
to day-time noise above 

recommended levels 

affected the prevalence 

of abnormally high blood 

pressure and associated 

health complications of the 

UK population”

Exposure  to  noise  pollution  is  a  widespread  problem 
-  in  1996  the  European  Commission  estimated  that 
20%  of  the  EU  population  were  likely  to  suffer 
negative  impacts  to  their  health  or  well-being  due  to 
noise. In the UK, a government study estimated that 
54% of the population was exposed to day-time noise 
pollution  above  recommended  levels  of  LAeq  16hr  55 
A-weighted decibels – a unit which measures sound in 
a way similar to the human hearing system, averaged 
over a 16-hour period.

Environmental  noise  has  been  linked  to  a  number 
of  different  health  problems  including  high  blood 
pressure.  This  can,  in  turn,  increase  the  risk  of  other 
health  problems  such  as  heart  disease  or  stroke.  For 
this  study,  the  researchers  set  out  to  evaluate  how 
exposure to day-time noise above recommended levels 
affected  the  prevalence  of  abnormally  high  blood 
pressure and associated health complications of the UK 
population.  They  focused  on  three  health  problems 
most  strongly  associated  with  high  blood  pressure: 
heart disease, stroke and dementia (vascular dementia 
and Alzheimer’s disease).

To  estimate  levels  of  noise  pollution,  1160  sites  were 
monitored across the country between 2000 and 20015. 
These  data  were  then  combined  with  information  on 
the  age  and  sex  of  UK  residents,  as  these  factors  can 
influence health risk. The researchers then calculated the 
added health problems that were predicted as a result of 
the noise pollution exposure for groups of different ages 
or sexes and multiplied this by the number of people in 
each group. 

The results suggested that exposure to noise levels above 
recommended levels resulted in an additional 1169 cases 
of dementia, 788 cases of stroke and 542 cases of heart 
attack in the UK over the course of a single year.

5  These sites were monitored by the Building Research 

Establishment (BRE).

Source: Harding, 
A-H, Frost, G. A., 
Tan, E. & Tsuchiya, 
A. (2013). The cost of 
hypertension-related 
ill-health attributable 
to environmental 
noise. Noise & Health. 
67 (15): 437-445. 
DOI: 10.4103/1463-
1741.121253.

Contact: anne-helen.
harding@hsl.gsi.gov.uk 

Theme(s): Noise, 
Environment and 
health

NOISE IMPACTS ON HEALTH8

Aircraft noise at night can 
result in dysfunction of blood 
vessels and cause long-term 
cardiovascular disease

Recent research into the impact of different levels of noise on 75 volunteers, reveals that disturbed sleep caused by night-time 
aircraft noise can damage blood vessels and increase the levels of stress hormones in the body. As these physical changes are 
potential pathways to high blood pressure, heart and circulatory disease over the long term, reducing night-time aircraft noise 
is important for preventing cardiovascular disease in people living near airports.

“Reducing noise from 

aircraft at night would 

help prevent heart and 

circulatory problems in 

people living near airports.”

Aircraft noise tends to be more annoying and disruptive 
to sleep than road and rail traffic noise, and long-term 
night-time  exposure  to  aircraft  noise  is  implicated  in 
cardiovascular disease (such as heart attacks and strokes) 
more than day-time exposure to aircraft noise. 

People need sleep to maintain normal good health and 
this  depends  not  only  on  the  length  of  a  night’s  sleep 
but also its quality. Repeated noise disturbances, with or 
without waking up, interrupt the restorative powers of 
sleep, and cause a person’s blood pressure to fluctuate in 
response to the noise.

In this study, the researchers tested the impact of night-
time aircraft noise on 75 healthy volunteers aged between 
20  and  60  years.  All  the  participants  were  exposed  to 
recordings of different patterns of aircraft noise in their 
own homes. On one night the volunteers were exposed 
to background noise, as a control, and on the other two 
nights they were exposed to repeated aircraft noise either 
30 or 60 times during the night. Volunteers kept to their 
normal sleep patterns and on the nights of exposure to 
aircraft  noise,  the  noise  event  sequence  lasted  for  415 
minutes. The researchers monitored the blood pressure 
and heart rate of the volunteers during the night. 

The  following  morning,  the  volunteers  visited  a 
laboratory  where  the  researchers  used  ultrasound  to 
measure changes to the diameter of the main artery in 
the arm, which affects blood flow. The results revealed 
that  the  arteries  were  stiffer  (also  called  endothelial 
dysfunction) after an aircraft noise night, and the more 
severe the noise, the less flexible the blood vessels became. 
This suggests that the blood vessels were affected by poor 
sleep as a result of the aircraft noise.

Source: Schmidt, F.P., 
Basner, M., Kröger, 
G. et al. (2013) Effect 
of nighttime aircraft 
noise exposure on 
endothelial function 
and stress hormone 
release in healthy 
adults. European Heart 
Journal. DOI:10.1093/
eurheartj/eht269 

Contact: tmuenzel@
uni-mainz.de

Themes: Environment 
and health, Noise

In those volunteers who were first exposed to 30 episodes 
of aircraft noise, the effect on their arteries became worse 
(the arteries became less flexible) when they were then 
exposed  to  60  noise  episodes  during  the  night.  Thus, 
the  vessel  does  not  adapt  to  noise,  and  becomes  more 
sensitive. Moreover, blood pressure increased in response 
to the aircraft noise.

The  researchers  also  tested  the  volunteers’  blood  for 
stress (fight-or-flight) hormones, and found there was a 
significant increase in adrenaline levels after exposure to 
nights where the volunteers were exposed to the aircraft 
noise. Volunteers also reported poor sleep quality on the 
noise nights. Over a long period of time, this repeated 
exposure to aircraft noise can result in permanently high 
blood pressure due to more rigid blood vessels leading to 
cardiovascular disease. 

In further tests, five volunteers, who had been exposed 
to  a  60-event  aircraft  noise  night,  were  given Vitamin 
C  in  the  laboratory.  The  researchers  detected  an 
improvement  in  arterial  flexibility.  Vitamin  C  is  a 
powerful  anti-oxidant,  and  the  researchers  suggest  the 
mechanism by which the arteries become less flexible is 
related to oxidative stress of the blood vessels as a result 
of exposure to the aircraft noise. 

Taken  together,  the  observed  stiffening  of  the  arteries 
(even  in  young  healthy  adults),  and  the  increase  in 
adrenaline  levels,  combined  with  volunteers’  reported 
poor  sleep  quality,  indicate  that  their  raised  blood 
pressure  was  most  likely  related  to  the  aircraft  noise 
at  night,  suggest  the  researchers.  As  this  can  lead  to 
cardiovascular disease, night-time aircraft noise may be 
considered  as  a  new  risk  factor.  Reducing  noise  from 
aircraft at night would help prevent heart and circulatory 
problems in people living near airports.

NOISE IMPACTS ON HEALTH9

Health of vulnerable 
people exposed to noise is 
under-researched

Vulnerable groups of people, including those with long-term illnesses, those sensitive to noise or tinnitus (ringing of the ears), 
people with mental health problems and unborn and newly born babies, are often more susceptible to physical and emotional 
stresses. So, vulnerable groups of people may be more at risk from exposure to environmental noise than healthy adults, say 
researchers after reviewing the health impacts. 

“Several studies suggest 
that schoolchildren 

exposed to noise from 

aircraft and road traffic 

experience learning and 

comprehension difficulties.”

However, there is comparatively little research focusing 
on  the  adverse  health  effects  of  noise  on  vulnerable 
people. This study reviewed 62 papers, published from 
April 2006 to April 2011, which included the impact of 
environmental noise on the health of vulnerable people, 
including  primary  school  children,  young  adolescents, 
preschool children, the elderly, and children with autism, 
asthma and attention deficit hyperactivity disorder. 

3.  Heart  and  circulation  problems.  Research  on 
the impact of aircraft and road traffic noise on the 
cardiovascular  health  of  schoolchildren  shows  that 
the main effect appears to be short-term raised blood 
pressure,  although  the  strength  of  the  association 
between noise exposure and cardiovascular effects is 
inconsistent between studies because of differences 
in the methods used. 

One  study  linked  hospital  admissions  for  respiratory 
diseases and pneumonia for young children (less than 10 
years old) with exposure to road traffic noise, and another 
found that girls with asthma were prone to asthma attacks 
if they had been annoyed by night-time noise.

The  most  common  effects  of  noise  on  the  vulnerable 
identified by the studies included:

1.  Annoyance. 

found 

studies 

Several 

that 
schoolchildren  (aged  between  eight  and  14)  are 
less annoyed by aircraft and road traffic noise then 
adults.  One  paper,  reviewing  multiple  studies, 
found  that  both  the  youngest  and  people  over  60 
are the least likely to be highly annoyed by air and 
road traffic noise, irrespective of the level of noise or 
how sensitive to noise they were.

2.  Sleep  disturbance.  Results  from  several  studies 
indicate that children are less likely than adults to be 
woken by noise, but they tend to experience more 
physical reactions, including raised blood pressure. 
Studies  have  not  found  evidence  of  the  long-term 
health  effects  of  sleep  disturbance  for  vulnerable 
groups, including people sensitive to noise. 

4.  Quality  of  life.  Several  studies  have  linked  noise 
exposure  at  school  to  children  having  more 
headaches, being more tired and having raised stress 
hormone levels in the blood. One study associated 
deterioration in physical and mental quality of life 
in people over 60 with exposure to road traffic noise.

5.  Cognitive  processes.  Several  studies  suggest  that 
schoolchildren  exposed  to  noise  from  aircraft  and 
road traffic experience learning and comprehension 
difficulties.  One  study  found  that  noise  at  work 
affected the job performance of teenage boys.

6.  Hearing. Little is known about the impact of noise 
on  the  hearing  of  children,  although  it  is  likely 
any  effects  will  be  cumulative  over  the  long  term. 
Research  has  been  done  on  the  impact  of  loud 
noise  from  concerts,  discotheques  and  listening 
to  music  from  headphones  on  teenagers,  with  the 
most common effects being short-term tinnitus and 
hearing loss. 

The  researchers  advise  that  more  research  is  needed, 
especially on little studied groups of vulnerable people, 
including  those  with  mental  illness,  shift  workers  and 
those with tinnitus.

Source: van Kamp, 
I. and Davies, H. 
(2013). Noise and 
health in vulnerable 
groups: A review. 
Noise and Health. 
15(64): 153-159. 
DOI: 10.4103/1463-
1741.112361

Available from:  
http://www.noi-
seandhealth.org/text.
asp?2013/15/64/ 
153/112361 

Contact: irene.van.
kamp@rivm.nl

Themes: Environment 
and health, Noise

NOISE IMPACTS ON HEALTH10

Children are more 
hyperactive if they live 
near busy roads

Children living close to busy roads may have an increased risk of hyperactivity. They may also have more emotional problems, 
especially if they are exposed to higher levels of noise during the night, according to research carried out on children’s health 
in Germany. 

The  study  concluded  that  being  exposed  to  higher 
noise  levels  was  associated  with  significantly  greater 
problems  of  hyperactivity  and 
inattention.  The 
researchers  also  found  that  children  were  more  likely 
to display emotional problems if they were exposed to 
higher noise levels. 

In particular, night-time exposure to noise may have more 
adverse effects than exposure to day-time noise, because 
the  body  needs  adequate  sleep  to  remain  healthy.  The 
researchers also assessed the impact of night-time noise 
exposure on sleeping problems in 287 of the children, 
as  this  data  was  available  for  this  subgroup.  Children 
appeared  to  have  more  sleeping  problems,  especially 
falling  asleep,  with  increasing  exposure  to  night-time 
noise  levels.  It  is  possible  that  road  traffic  noise  levels 
that  the  researchers  used  do  not  necessarily  reflect  the 
actual  noise  levels  the  children  were  exposed  to  –  for 
example the researchers had no information about any 
noise insulation that had been installed in the houses. 

This  study  focused  on  the  environment  where  the 
children spent most of their time – at home, which the 
researchers highlight as a major strength of the study.

“…night-time exposure 

to noise may have more 

adverse effects than 
exposure to day-time 

noise, because the body 

needs adequate sleep to 

remain healthy.”

Source: Tiesler, 
C.M.T., Birk, M., 
Thiering, E. et al. 
(2013). Exposure to 
road traffic noise and 
children’s behavioural 
problems and sleep 
disturbance: Results 
from the GINIplus 
and LISAplus studies. 
Environmental 
Research. 123: 1–8. 
DOI:10.1016/j.
envres.2013.01.009 

Contact: heinrich@
helmholtz-muenchen.
de

Research  on  the  negative  health  effects  of  noise  on 
children has mainly focused on aircraft noise at school, 
but less is known about the impact of road traffic noise 
on children at home.

In  this  study,  the  researchers  investigated  the  impact 
of  road  traffic  noise  at  home  on  10-year-old  children’s 
mental  health  and  behaviour,  including  problems  of 
hyperactivity  or  inattention  and  emotional  problems 
such  as  being  anxious,  easily  scared  or  unhappy. 
Information  on  the  872  children  in  this  study  came 
from  two  ongoing  German  population-based  studies, 
LISAplus6  and  GINIplus7,  which  are  following  the 
physical wellbeing of healthy children, from birth to the 
age  of  10  years,  and  assessed  behavioural  problems  at 
the age of 10. 

Using  data  from  existing  noise  maps,  the  researchers 
assigned  maximum  and  minimum  levels  of  noise  at 
the  exterior  wall  exposed  to  the  most  noise  (facing 
the  street)  and  the  exterior  wall  exposed  to  the  least 
noise,  at  each  child’s  home. The  researchers  chose  two 
noise indicators, the night noise indicator to assess the 
disturbance of children’s sleep by night-time noise and 
the day-evening-night noise indicator to measure overall 
noise annoyance.

The  researchers  assessed  the  children  for  behavioural 
problems using a standardised questionnaire and various 
aspects  of  their  behaviour  were  categorised  as  normal, 
borderline or abnormal.

6  LISAplus: The Influence of Life-style factors on the 

development of the Immune System and Allergies in East 
and West Germany Plus the influence of traffic emissions 
and genetics.

http://www.helmholtz-muenchen.de/en/epi1/research/
research-units/research-unit-1-environmental-epidemiology/
projects/lisa-plus/index.html

7  GINIplus: German Infant Study on the influence of 

Nutrition Intervention Plus environmental and genetic 
influences on allergy development. 

Themes: Environment 
and health, Noise

http://www.helmholtz-muenchen.de/en/epi1/research/
research-units/research-unit-1-environmental-epidemiology/
projects/giniplus/index.html

NOISE IMPACTS ON HEALTH 
 
11

Reviewing the multiple 
impacts of noise pollution

 While occupational exposure to noise has declined, ‘social’ exposure in the form of personal music players or rock concerts 
is estimated to have tripled for young people since the 1980s. A new review examines studies that have investigated noise 
sources including environmental (e.g. traffic) and social (e.g. via headphones). The review also explores research into the range 
of health effects beyond hearing impairments, such as annoyance and cardiovascular problems.

Noise  is  ubiquitous  to  everyday  life.  Exposure  in 
the  workplace  is  a  common  problem  and  as  a  result 
many  countries  have  developed  legislation  to  protect 
employees.  The  increase  in  social  exposure  to  noise 
is  worrying,  say  the  review’s  authors,  as  there  is  now 
evidence that noise exposure when young can contribute 
to hearing loss in later life.

Hearing impairment as a result of noise exposure presents 
a  serious  public  health  problem;  it  is  estimated  that 
worldwide 1.3 billion people suffer from this condition 
and the World Health Organisation (WHO) estimates 
that 10% of the global population are currently exposed 
to  noise  levels  that  could  lead  to  hearing  impairment. 
However,  new  treatments  are  under  development.  An 
oral  drug,  D-methionine,  has  shown  good  protection 
against hearing loss in animals and the review’s authors 
predict that these kinds of treatments will be available 
for human use in the next 10 years.

In addition to hearing problems the non-auditory health 
impacts of noise exposure, including annoyance, sleep 
disturbance,  heart  disease  and  cognitive  impairment, 
are all causing increasing concern. Annoyance, which 
could  be  thought  of  as  trivial,  can  in  fact  lead  to 
anger, stress and exhaustion and, because of the large 
number of individuals affected, is estimated to be the 
second most important cause of health impacts due to 
environmental noise.

Sleep disturbance is thought to have the greatest effect 
on  health  because  it  can  have  impacts  on  alertness, 
performance at work and general quality of life. In fact, 
studies  have  suggested  that  noise  levels  at  night  may 
have  a  greater  impact  on  long-term  health  than  noise 
exposure during the day.

“In addition to hearing 

problems, the non-

auditory health impacts 

of noise exposure, 

including annoyance, sleep 

disturbance, heart disease 
and cognitive impairment, 

are all causing increasing 

concern.”

Source: Basner, M., 
Babisch, W., Davis, A. 
et al. (2014). Auditory 
and non-auditory 
effects of noise on 
health. The Lancet. 
383: 1325-1332. 
DOI: 10.1016/S0140-
6736(13)61613-X. 

Contact: basner@
upenn.edu

Theme(s): Noise, 
Environment and 
health

Cardiovascular  disease,  which  includes  high  blood 
pressure,  heart  disease  and  stroke,  has  been  clearly 
linked with long-term exposure to environmental noise. 
For  instance,  an  analysis  combining  the  results  from 
many different studies found that an increase of 10 dB 
of  transport  noise  (traffic  and  aircraft)  can  lead  to  an 
increase in risk of high blood pressure or heart disease of 
between 7 and 17%.

Finally,  the  results  of  over  20  studies  have  shown  that 
environmental  noise  can  affect  children’s  learning  and 
cognitive development. Exposure to road, rail and aircraft 
noise  over  long  periods  can  reduce  memory,  reading 
ability and test performance. For example, as part of the 
EU-funded RANCH project8, a study was carried out on 
2844 9-to-10 year-olds attending 89 schools near major 
airports  in  London,  Amsterdam  and  Madrid.  After 
accounting  for  variables  such  as  socioeconomic  status, 
the results showed a clear link between noise exposure 
and reduced reading comprehension and memory.

8  The RANCH (Road traffic and Aircraft Noise exposure and 
children’s Cognition and Health) project was supported 
by the European Commission. See: http://ec.europa.eu/
research/quality-of-life/ka4/pdf/report_ranch_en.pdf

NOISE IMPACTS ON HEALTH12

Preserving quiet areas 
improves health

Living  in  a  quiet  area  has  a  positive  impact  on  health.  A  study  assessed  quality  of  life  for  people  living  in  quiet  and  noisy 
locations and found that those who lived in quiet locations – particularly in rural areas – had a better quality of life.

About 15% of those living in the noisy city location said 
they were very annoyed by transport-related noise. This 
is  similar  to  European  cities,  where  10-35%  of  people 
are  severely  or  very  annoyed  by  traffic  noise.  People 
living in the quiet city location and the two rural areas 
were  less  annoyed  by  noise.  However,  of  the  two  so-
called noisy areas, the rural location was home to more 
people who were ‘very annoyed’ by noise compared to 
the  city  location.  This  suggests  that  unnatural  sounds, 
such as those of wind turbines, are more annoying in the 
context of green areas and perhaps mask other natural 
sounds. 

Overall,  the  researchers  say  their  research  justifies  the 
aims  of  the  European  Noise  Directive  in  preserving 
quiet spaces for health. Some of the more specific health 
impacts of living in noisy or quiet areas require further 
study. For instance, how much does traffic noise disturb 
sleep and how much do quiet areas reduce stress levels? 
There were also no data on the differences in actual sound 
levels between the four sites. However, the authors note 
that decibel measurements can be misleading as they are 
heavily influenced by the setting.

The EU’s Noise Directive exists to protect people from 
the  adverse  impacts  of  noise  and  preserve  the  health 
benefits of quiet spaces. However, while there have been 
many studies on the negative impacts of noise, such as 
annoyance and lost sleep, there have been relatively few 
studies on the positive impacts of quiet spaces.

Noise impacts – positive or negative – can be measured 
and  compared  by  using  health-related  quality  of  life 
(HRQOL),  which  asks  people  to  rate  how  satisfied 
they  are  with  numerous  aspects  of  their  health.  Other 
measures  can  be  used  to  express  health  impacts  in 
terms  of  the  healthy  days  or  years  of  life  that  are  lost. 
For  example,  in  Europe  each  year,  the  equivalent  of  a 
million healthy years of life are thought to be lost due to 
traffic noise. The authors decided to adopt a HRQOL 
approach  to  compare  the  health  impacts  of  noise  in 
‘noisy’ versus ‘quiet’ areas in New Zealand.

They  used  data  from  studies  on  noise-related  health 
carried  out  in  four  different  areas,  described  as:  ‘quiet 
rural’, ‘noisy rural’, ‘quiet city’ and ‘noisy city’. The noisy 
rural location was near to a wind farm, while the noisy 
city locations were near an airport or major motorways. 
Both quiet locations were situated away from busy roads 
and  industry.  A  total  of  823  people  were  surveyed  in 
these four locations.

The authors found that quality of life increased as noise 
levels  decreased  –  health-related  quality  of  life  was 
highest in the quiet rural location. But while there was a 
clear association between transport noise and HRQOL, 
the  relationship  between  neighbourhood  noises  such 
as  dogs  barking  and  lawn  mowers  was  less  clear.  The 
researchers suggest this may be because such noises are 
less  constant  and  so  have  a  smaller  impact  on  health, 
even if they are sometimes very annoying. 

“About 15% of those 

living in the noisy city 

location said they were 

very annoyed by transport-

related noise. This is 

similar to European cities, 

where 10-35% of people 
are severely or very 

annoyed by traffic noise.”

Source: Shepherd, 
D., Welch, D., Dirks, 
K.N. et al. (2013). Do 
Quiet Areas Afford 
Greater Health-
Related Quality of 
Life than Noisy Areas? 
International Journal 
of Environmental 
Research and Public 
Health, 10, 1284-
1303. DOI: 10.3390/
ijerph10041284 

Contact: daniel.
shepherd@aut.ac.nz

Themes: Environment 
and health, Noise

NOISE IMPACTS ON HEALTH 
13

How sounds affect our 
state of mind

Sounds  affect  our  state  of  mind  differently  depending  on  whether  they  are  pleasant  or  annoying.  In  a  theoretical  study, 
researchers developed a model for exploring human responses to sound. Their work may help us to understand better the health 
impacts of long-term exposure to noise, as well as the potential benefits of spending time in quiet spaces.

When  we  are  in  environments  that  make  us  feel  safe, 
according to the model, our state of mind is restorative. 
Therefore,  in  the  second,  ‘restoring’  waking  state,  we 
have freedom in our thinking and behaviour. However, 
if we feel threatened by our environment, we have to pay 
more attention to it and – in the authors’ fourth state 
-  switch  constantly  between  thoughts  about  the  tasks 
we’re trying to get on with and potential external threats. 
Continually being in this state of high alert and carrying 
out such mental switching means not only that we can’t 
focus on specific thoughts, but that we miss out on the 
restorative benefits of free thinking. These various states 
of mind may be strongly influenced by the ‘soundscapes’ 
(acoustic environments) we are exposed to.

However,  the  researchers  also  think  that  people  may 
benefit from changes in soundscapes – from spending 
time  in  lively  places  as  well  as  quiet  places.  They  say 
a diversity of acoustic environments is preferable over 
more uniform acoustic environments that comply with 
certain  legal  noise  limits.  Such  an  approach  might 
also  be  less  costly  than  trying  to  keep  sound  levels 
uniformly low.

It seems clear that there are health benefits to living in a 
quiet, pleasant environment. But the researchers wanted 
to consider what ‘quiet’ actually means. Within policy 
contexts, ‘quiet’ may be interpreted as meaning little or 
no noise. However, other interpretations may have less 
to do with sound levels than with a lack of disturbances 
in a given location or a level of control that people feel 
they have over the sounds.

While  pleasant,  natural  sounds  make  us  feel  calm  and 
safe and allow us to remain in a tranquil state of mind, 
sudden ‘loud’ and ‘annoying’ sounds made by machines 
or other people may force us out of this tranquil state 
and  become  the  focus  of  our  attention.  We  may  even 
have  evolved  –  like  other  animals  –  to  pay  attention 
to  the  annoying  sounds,  because  they  indicate  danger. 
People  can  become  finely  attuned  to  the  sounds  that 
most disturb them, heightening their annoyance. In the 
same way, an absence of pleasant sounds may also put us 
on high alert, because it offers no guarantees of safety.

After reviewing existing studies on the way that people 
react  to  pleasant  and  annoying  sounds,  the  authors 
developed  their  own  model,  focusing  on  the  influence 
of sound on ‘mind states’. Their model draws on theories 
from  different  disciplines,  including  psychology  and 
neurobiology.  They  describe  four  possible  states  of 
mind:  1.  maximally  restoring  (sleep);  2.  restoring;  3. 
effortful (requiring focused attention); and 4. inefficient 
and more effortful.

“People can become 

finely attuned to the 

sounds that most disturb 

them, heightening their 

annoyance.”

Source: Andringa, T. 
C., & Lanser, J. J. L. 
(2013). How pleasant 
sounds promote and 
annoying sounds 
impede health: a 
cognitive approach. 
International Journal of 
Environmental Research 
and Public Health, 
10(4), 1439–61. 
doi:10.3390/
ijerph10041439 

Contact: jjllanser@
gmail.com

Themes: Environment 
and health, Noise

NOISE IMPACTS ON HEALTH14

Are motorways the best 
spot for wind turbines? 

 Wind turbine noise can be detected at low levels, even when it is heard alongside motorway traffic noise, a study finds. It is 
possible for louder motorways to drown out turbine noise, however. The participants in this listening experiment could easily 
detect wind turbine noise, but only once they knew it was present in recordings of environmental noise. 

When  asked  to  name  what  they  had  heard,  nearly  all 
participants  correctly  identified  road  traffic  noise.  Just 
under half said they had heard wind turbines. A number 
of  incorrect  answers  were  given,  including  air  traffic 
(48% of respondents) and sea waves (28%).

In  a  second  stage  of  the  experiment,  the  researchers 
explored  how  loud  traffic  noise  would  have  to  be  in 
relation to turbines, to mask their noise effectively. The 
participants were asked to deliberately listen for turbines 
in recordings, which had an overall volume of around 40 
dBA, but with varying ratios of turbine and traffic noise.

At this stage, the listeners easily detected turbine noise 
in combined recordings, now they knew it was present. 
Those who detected it most easily tended to be the same 
people who had rated it as annoying in the first part of 
the experiment.

Listeners  started  to  detect  turbine  noise  when  it  was 
23  dBA  quieter  than  accompanying  motorway  noise. 
The  turbine  noise’s  acoustical  energy  was  thus  200 
times lower than the motorway’s. In contrast, turbines 
could be detected at all volumes when combined with 
local road traffic, which suggests that road traffic is not 
suitable for masking turbines. 

The  researchers  caution  that  the  study  was  small-scale 
and short-term; some patterns they observed here might 
be different if they had conducted a long-term study. 

“…turbines could be 

detected at all volumes 

when combined with 

local road traffic, which 

suggests that road traffic 

is not suitable for masking 
turbines.”

Public annoyance with wind turbine noise is rising with 
the  increasing  number  of  turbines  installed.  Previous 
studies  have  suggested  that  people  are  more  annoyed 
by  wind  turbines  than  other  sources  of  environmental 
noise,  such  as  road  traffic,  even  if  they  are  equally  as 
loud. Research has also indicated that masking turbine 
noise with other sounds could reduce annoyance. 

This  Belgian  study  adds  to  the  body  of  research  into 
turbine noise. Motorways have been proposed as good 
locations  for  turbines,  partly  because  the  traffic  could 
help conceal turbine noise. Fifty people participated in 
a listening test in which they were asked to identify and 
detect wind turbine noise when heard alongside traffic 
noise. None of the participants held negative attitudes 
towards  wind  energy,  and  only  one  was  particularly 
familiar with turbine noise.

The researchers first played recordings of noise at realistic 
indoor sound levels (40 A-weighted decibels (dBA)) to 
participants  while  they  read  at  leisure  in  an  otherwise 
quiet room. At this stage, the participants did not know 
the true purpose of the study or that they were going to 
be played recorded noises. 

There were four types of recording: pure wind-turbine 
noise,  pure  motorway  noise,  combined  motorway 
traffic and wind turbine noise, and combined local road 
traffic  and  wind  turbine  noise.  Motorway  noise  was 
continuous,  whereas  local  road  noise  was  intermittent 
and individual vehicles could be heard driving past. 

The researchers asked participants to rate how annoying 
they  found  the  noise  recordings,  without  telling 
them  what  the  recordings  actually  were.  Participants 
considered  local  road  traffic  recordings  much  more 
annoying than motorway and turbine recordings. There 
was  little  difference  in  annoyance  levels  for  motorway 
and  turbine  recordings,  whether 
isolation  or 
combined. 

in 

Source: Van 
Renterghem, T., 
Bockstael, A., 
De Weirt, V., 
Botteldooren, D. 
(2013) Annoyance, 
detection and 
recognition of 
wind turbine noise. 
Science of the Total 
Environment. 456-
457: 333-345. 
DOI: 10.1016/j.
scitotenv.2013.03.095. 

Contact: Timothy.
Van.Renterghem@
intec.Ugent.be 

Themes: Environment 
and health, Noise

NOISE IMPACTS ON HEALTH 
15

Further Reading

You may also be interested in reading the following publications from 
Science for Environment Policy.

News Alert articles

Thematic issues

Environmental Noise
(Nov 2011)

Noise  pollution  is  among  the  most  common  complaints  regarding 
environmental  issues  in  Europe,  especially  in  densely  populated 
and  residential  areas  near  major  roads,  railways  and  airports.  But 
noise  -  unwanted  sound  -  is  more  than  a  mere  annoyance,  even  at 
levels  below  ear  damaging  volumes.  The  EU’s  Environmental  Noise 
Directive (END) has initiated action plans in Member States to reduce 
environmental  noise  exposure  and  its  effects.  This  Thematic  Issue 
reports  on  recent  research  to  help  guide  effective  noise  action  plans 
throughout Europe.
http://ec.europa.eu/environment/integration/research/newsalert/
pdf/29si.pdf

To  view  any  of  our  publications  in  full  you  can  also  visit:  
http://ec.europa.eu/science-environment-policy, and search according to 
publication date or theme.

Traffic noise pollution 
mapped with new mobile 
phone app (Nov 2014)

A  new  mobile  phone  application  which  can  help  monitor  traffic-
noise  exposure  is  presented  in  a  recent  study.  The  app,  ‘2Loud?’, 
can measure indoor night-time noise exposure and, given large-scale 
community  participation,  could  provide  valuable  data  to  aid  urban 
planning, the researchers say. In an Australian pilot study, nearly half 
of  participants  who  used  the  app  found  that  they  were  exposed  to 
potentially unhealthy levels of night-time noise.
http://ec.europa.eu/environment/integration/research/newsalert/
archive/noise.htm 

Both traffic noise and air 
pollution linked to stroke 
(Oct 2014)

Road traffic noise and air pollution both increase the risk of having a 
stroke, recent research from Denmark suggests. The results suggest that 
traffic noise is more strongly associated with ischaemic stroke, whereas 
only air pollution appears to be linked with more serious, fatal strokes.
http://ec.europa.eu/environment/integration/research/newsalert/pdf/
traffic_noise_air_pollution_links_strokes_390na7_en.pdf 

Aircraft noise at night may 
lead to long-term health 
impacts (Feb 2014)

Exposure  to  aircraft  noise  at  night  for  more  than  20  years  could 
increase  the  risk  of  heart  disease  and  stroke,  according  to  research 
conducted around six European airports. Risk also increased for those 
constantly exposed to road traffic, but this may have been caused by air 
pollution rather than noise.
http://ec.europa.eu/environment/integration/research/newsalert/
pdf/363na1_en.pdf 

NOISE IMPACTS ON HEALTHK
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