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Int J Environ Res Public Health. 2018 Feb 22;15(2). pii: E379. doi: 10.3390/ijerph15020379.

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

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Dutch National Institute for Public Health and the Environment (RIVM), Centre for Sustainability, Environment and Health, P.O.-Box 1, 3729BA Bilthoven, The Netherlands.
Barcelona Institute for Global Health (ISGlobal), 08036 Barcelona, Spain.
Institute of Environmental Medicine, Karolinska Institute, SE-171 77 Stockholm, Sweden.
Barcelona Institute for Global Health (ISGlobal), 08036 Barcelona, Spain.
Swiss Tropical and Public Health Institute, University of Basel, 4002 Basel, Switzerland.


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 (LDEN) 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.


blood pressure; diabetes; hypertension; ischaemic heart disease; meta-analysis; noise exposure; obesity; stroke

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