fred first's List: NOISE

• Noise, even at levels that are not harmful to hearing, is perceived subconsciously as a danger signal, even during sleep.²  The body reacts to noise with a “fight or flight” response, with resultant nervous, hormonal, and vascular changes that have far reaching consequences.^1-11   Despite the fact that much has been written about the health effects of noise, it seems that much of the following information is not appreciated by the medical community and even less so by the general public
• The interested reader should consult Noise Off (www.NoiseOFF.org), The Noise Pollution Clearinghouse (www.nonoise.org), Noise Free America (www.noisefree.org), or the League for the Hard of Hearing (www.lhh.org/noise) for additional information about this subject. 
• (EPA) estimated that nearly 100 million Americans lived in areas where the daily average noise levels exceeded those identified as being safe. ¹⁷   However, in 1982, the government abruptly terminated federal funding for the Office of Noise Abatement and Control, the vehicle by which the public was to be protected from the adverse effects of noise
• The number of people exposed to unhealthy levels of noise in the United  States is unquestionably greater than it was in 1974; the degree of oversight and control is unquestionably less
• There is general agreement that exposure to sound levels less than 70 dB does not produce hearing damage, regardless of the duration of exposure. ^{1, 17}  There is also general agreement that exposure for more than 8 hours to sound levels in excess of 85 dB is potentially hazardous; to place this in context, 85 dB is roughly equivalent to the noise of heavy truck traffic on a busy road. ¹   With sound levels above 85 dB, damage is related to sound pressure (measured in dB) and to time of exposure.  The major cause of hearing loss is occupational exposure, although other sources of noise, particularly recreational noise, may produce significant deficits.  Studies suggest that children seem to be more vulnerable than adults to noise induced hearing impairment. ¹   
• In 2001, it was estimated that 12.5% of American children between the ages of 6 to 19 years had impaired hearing in one or both ears.
• The WHO recommends that unprotected exposure to sound levels greater than 100 dB (for example, the sound of a jackhammer or a snowmobile) should be limited in duration (4 hours) and frequency (four times/year).¹  The threshold for pain is usually given as 140 dB; a level readily achieved in today’s boom-cars.  Impulse noise exposure (gunfire and similar sources of intense noise of brief duration) should never exceed 140 dB in adults and 120 dB in children.  Firecrackers, cap pistols, and other toys can generate sufficient sound levels to cause sudden and permanent hearing   loss. ¹⁹   Levels greater than 165 dB, even for a few milliseconds, are likely to cause acute cochlear damage.
• It has been postulated that noise acts as a nonspecific biologic stressor eliciting reactions that prepare the body for a “fight or flight” response. ^{1, 2, 6}  For this reason, noise can trigger both endocrine and autonomic nervous system responses that affect the cardiovascular system and thus may be a risk factor for cardiovascular disease. ^{1, 2, 6, 11, 33- 36}   These effects begin to be seen with long-term daily exposure to noise levels above 65 dB or with acute exposure to noise levels above 80 to 85 dB. ^{1, 3}   Acute exposure to noise activates nervous and hormonal responses, leading to temporary increases in blood pressure, heart rate, and vasoconstriction.

• Even though the increased risk for noise-induced cardiovascular disease may be small, it assumes public health importance because both the number of people at risk and the noise to which they are exposed continue to increase. ^{1, 2}

    

              Children are at risk as well.  Children who live in noisy environments have been shown to have elevated blood pressures and elevated levels of stress-induced hormones.
• Noise levels above 80 dB are associated with both an increase in aggressive behavior and a decrease in behavior helpful to others. ^38-40   The news media regularly report violent behavior arising out of disputes over noise; in many cases these disputes ended in injury or death.  The aforementioned effects of noise may help explain some of the dehumanization seen in the modern, congested, and noisy urban environment. 
• The degree of annoyance produced by noise may vary with the time of day, the unpleasant characteristics of the noise, the duration and intensity of the noise, the meaning associated with it, and the nature of the activity that the noise interrupted. ^{1  Annoyance} may be influenced by a variety of non-acoustical factors including individual sensitivity to noise^{. 43}   These include fear of the noise source, conviction that noise could be reduced by third parties, individual sensitivity, the degree to which an individual feels able to control the noise, and whether or not the noise originated from an important economic activity. ^{1, 10}   Other less direct effects of annoyance are disruption of one’s peace of mind, the enjoyment of one’s property, and the enjoyment of solitude. 
• Noise adversely affects general health and well-being in the same way as does chronic stress.

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• “Worldwide, noise-induced hearing impairment is the most prevalent irreversible occupational hazard, and it is estimated that 120 million people worldwide have disabling hearing difficulties.”
• A soft whisper at 3 feet equals 30 dBA, a busy freeway at 50 feet is around 80 dBA, and a chain saw can reach 110 dBA or more at operating distance. Brief exposure to sound levels exceeding 120 dBA without hearing protection may even cause physical pain.
• Indeed, the term secondhand noise is increasingly used to describe noise that is experienced by people who did not produce it. Anti-noise activists say its effect on people is similar to that of secondhand smoke. “Secondhand noise is really a civil rights issue,” says Les Blomberg, executive director of the Noise Pollution Clearinghouse, an anti-noise advocacy group based in Montpelier, Vermont. “Like secondhand smoke, it’s put into the environment without people’s consent and then has effects on them that they don’t have any control over.”
• dishwashers, vacuum cleaners, and hair dryers can all reach or exceed 90 dBA.
• Listening to music at a level of 150 dBA would be like standing next to a Boeing 747 airplane with its engines at full throttle, according to statistics provided by Noise Free America, an anti-noise advocacy group.
• The American Tinnitus Association estimates that 12 million Americans suffer from this condition, with at least 1 million experiencing it to the extent that it interferes with their daily activities.
• Stephenson notes that from adolescence onward, females tend to have better hearing than males
• July 2001 issue of Pediatrics, researchers from the Centers for Disease Control and Prevention reported that, based on audiometric testing of 5,249 children as part of the Third National Health and Nutrition Examination Survey, an estimated 12.5% of American children have noise-induced hearing threshold shifts—or dulled hearing—in one or both ears. Most children with noise-induced hearing threshold shifts have only limited hearing damage, but continued exposure to excessive noise can lead to difficulties with high-frequency sound discrimination. The report listed stereos, music concerts, toys (such as toy telephones and certain rattles), lawn mowers, and fireworks as producing potentially harmful sounds.
• Nonauditory effects of noise exposure are those effects that don’t cause hearing loss but still can be measured, such as elevated blood pressure, loss of sleep, increased heart rate, cardiovascular constriction, labored breathing, and changes in brain chemistry. According to the WHO Guidelines for Community Noise, “these health effects, in turn, can lead to social handicap, reduced productivity, decreased performance in learning, absenteeism in the workplace and school, increased drug use, and accidents.”
• unwanted sound is most annoying at the times when people expect to rest or sleep, that it can interrupt or delay sleep, and that it can have subtle effects on sleep, such as causing shifts from deeper to lighter sleep stages. “The research is pretty solid that noise can prevent people from getting a good night’s sleep,” Hume says. “I believe that sleep deprivation can have negative health effects when it becomes a chronic problem.”
• “Population pressure has prompted Europe to move more quickly on the noise issue than the United States has,” Hume says. In the European Union, countries with cities of at least 250,000 people are creating noise maps of those cities to help leaders determine noise pollution policies. Paris has already prepared its first noise maps.
• Congress did establish the Office of Noise Abatement and Control (ONAC), as well as federal standards for business, industries, and communities, and it did begin researching the effects of sound exposures. In 1982, however, the Reagan administration defunded the office.

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• essayist Ambrose Bierce did around the turn of the last century: as "a stench in the ear."
• Providing scientific proof of this has not been easy -- in part because noise, defined as "unwanted sound," is to a large degree a matter of personal taste and sensitivity. The romantic hears a train whistle differently from the insomniac. And no small number of Americans pay good money to hear the same rock-and-roll music that was used to torture the holed-up Panamanian dictator, Manuel Noriega, and Waco's David Koresh and induce cooperation from prisoners in Iraq and Guantanamo Bay, Cuba
• "We don't say to people, 'You just have to learn to live with sewage in your water,' " Hagler said in an interview. "Why should we tolerate sewage coming into our ears?"
• All told, more than 100 million Americans are regularly exposed to noise levels in excess of the 55 decibels that federal agencies have recommended as a reasonable background intensity.
• children living on the lower, noisier floors of an apartment building overlooking a busy Manhattan bridge had lower reading scores than those living on higher floors.
• by the time the students reached sixth grade, those whose classrooms faced the train were a year behind those whose classrooms were on the quiet side of the building. After noise reduction materials were installed in the classrooms and around the tracks, reading scores in the two groups equalized, strengthening the case that noise was the culprit.

• Children near the working airports had significantly higher levels of adrenaline and cortisol -- the body's so-called stress hormones. 

   

   Those hormones are part of the body's "fight or flight" response, which helps a person deal with sudden emergencies
• "The idea that people get used to noise is a myth," the Environmental Protection Agency has reported. "Even when we think we have become accustomed to noise, biological changes still take place inside us."
• Children given puzzles in moderately noisy classrooms are not only more likely to fail to solve them but are also more likely to surrender early.
• Perhaps most disturbing in these times of political and economic polarization is that noise undermines generosity

• People report being far less annoyed by noises they willingly accept or actively select (riding a motorcycle, for example) than by those they have no control over (the car alarm outside your window). 

   

   On the other hand, the hormonal systems of even the mellowest of people in noisy places may still be quietly seething. 

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• Noise can affect the neurological system directly or indirectly through subjective experience (disturbance, annoyance). The consequences are vegetative reactions such as the reduction of the skin's resistance or changes in heartbeat frequency, as well as changed concentrations of the activation hormones adrenalin, noradrenalin and cortisol in body fluids. In this way, metabolic procedures, the regulation of vital body functions and the immune system can be influenced….
  

    

    

    

  In adults, chronic annoyance by neighbourhood noise was related to increased risks for the cardiovascular system….Significantly increased risks appeared for cardiovascular symptoms and hypertension in conjunction with severe and chronic annoyance by neighbourhood noise. The trend within the annoyance categories was likewise significant….
   
   …The risk of bronchitis appeared significantly increased….
  
   Pronounced effects of severe and chronic annoyance by neighbourhood noise were obvious in the stress-sensitive musculoskeletal system [Figure - 15]. Highly increased significant risks were calculated for arthritic symptoms as well as for arthritis. The trend within the annoyance categories was highly significant….
   
   Distinctive effects on the neuro-psychic system were also registered with chronic annoyance by neighbourhood noise [Figure - 16]. The trend for depression (SALSA) as well as medically diagnosed depressions significantly increases with severe and chronic annoyance by neighbourhood noise. The trend within the annoyance categories was highly significant. Beyond that, a highly increased risk of migraine was confirmed with severe and chronic annoyance by neighbourhood noise. The trend within the annoyance categories was here also highly significant.

• 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, premature ejaculation, bowel movements, sleep disturbance, death, and decreased sexual performance. Changes in the immune system and birth defects have been attributed to noise exposure, but evidence is limited.^[1] Although some presbycusis may occur naturally with age,^[2] 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.^[3][4] Noise exposure has also been known to induce tinnitus, hypertension, vasoconstriction and other cardiovascular impacts.^[5] Beyond these effects, elevated noise levels can create stress, increase workplace accident rates, and stimulate aggression and other anti-social behaviors.^[6] The most significant causes are vehicle and aircraft noise, prolonged exposure to loud music, and industrial noise.

• human organisms are not prepared to shut off the noise. Hearing is a permanent process using cortical and subcortical structures to filter and interpret acoustical information; the analysis of acoustical signals is essential for human survival and communication. Noise is detrimental to health in several respects, for example, hearing impairment, sleep disturbance, cardiovascular effects, psychophysiologic effects, psychiatric symptoms, and fetal development (Stansfeld et al. 2000). Furthermore, noise has widespread psychosocial effects including noise annoyance, reduced performance, and increased aggressive behavior
• Even ear-safe sound levels can cause nonauditory health effects if they chronically interfere with recreational activities such as sleep and relaxation, if they disturb communication and speech intelligibility, or if they interfere with mental tasks that require a high degree of attention and concentration
• the hypothesis emerged that persistent noise stress increases the risk of cardiovascular disorders including high blood pressure and ischemic heart disease. Classical biologic risk factors have been shown to be elevated in subjects who were exposed to high levels of traffic noise. Nowadays the biological plausibility of the association is established

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• “A person who says ‘My noise is my right’ basically means ‘Your ear is my hole.
• He questions why American culture in general seems to be on the loud side, examines “the historic relationship between noise and violence, between the arrogance of power and contempt for the weak.
• “noise is yet another ‘baked-in’ environmental effect of ‘the technology used and the physical infrastructure in which it is based.’ In other words, we can take noise out of our civilization with about the same ease as we can extract an egg from a cake.”
• For example, when they say, “You’re just complaining because you don’t like (my kind of) music,” you respond: “This is like saying that a person who opposes rape doesn’t like sex. In fact, there is convincing anecdotal evidence to suggest that people who truly love music are the most likely to resent having it forced on them.

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