5es Assises Nationales de la Qualité de l'environment Sonore Reims, 11 au 13 décembre 2007 Les Effects du Bruit des Transports sur la Santé de l'homme Health Effects of Traffic Noise Wolfgang Babisch Agence Fédérale de l'environment Allemagne www.umweltbundesamt.de 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 1
and Hearingloss Noise Exposure (Sound Level) Direct pathway Indirect pathway Disturbance of activities, sleep, communication Annoy- ance Cognitive and emotional response Stress Indicators Reactionscheme Testhypotheses Physiological stress reactions (unspecific) - Autonomic nervous system (sympathetic nerve) - Endocrine system (pituitary gland, adrenal gland) Risk Factors Blood pressure Blood lipids Blood viscosity Cardiac output Blood glucose Blood clotting factors Manifest Disorders Cardiovascular Diseases Hypertension Arteriosclerosis Ischaemic heart disease 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 2
Exposure Response Curve Road traffic noise Myocardial infarction Exposure-response function: OR = 1.629657 0.000613*(Lday,16h)2 + 0.000007357*(Lday16h)3, R2 = 0.96 Analytic studies Odds ratio OR Source: Umweltbundesamt (2006) 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 3
Misclassification of Exposure Incidence of Major Ischaemic Heart Diseases Caerphilly & Speedwell Studies Group comparison: L day,6-22 h = 66-70 db(a) vs. 51-55 db(a) Incidence odds ratio (OR +/- 95% CI) 2.5 2.25 2 1.75 1.5 1.25 1 0.75 0.5 0.25 0 address only + window orientation + open window + 15 yr residence 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 4
Day/Night Difference Prevalence of Hypertension Spandau Health Survey Day (Living room) Night (Bedroom) 4 4 Odds Ratio 3 2 Odds Ratio 3 2 1 1 0 < 60 60-65 > 65 0 < 50 50-55 > 55 Lday,16h [db(a)] Lnight,8h [db(a)] OR = 1.9 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 5
Risk Evaluation Hazard identification Exposure assessment Dose-response assessment Risk characterization Attributable risk concept Risk management Regulatory options 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 6
Conclusion Road Traffic Noise Ischaemic Heart Diseases Descriptive studies (cross-sectional) Threshold: L day,16h 60 db(a) Analytic studies (case-control, cohort) Dose-effect relationship: L day,16h > 60 db(a) Nameable increase in risk L day,16h > 65 db(a) L night > 55 db(a) Population attributable fraction Germany: (PAR% = 2.9) approx. 4,000 MI cases/year approx. 25,000 IHD cases/year 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 7
Environmental Quality Targets Outdoors Cardiovascular: L day 65 db(a) Serious annoyance: L day 55 db(a) Sleep disturbance: L night 45 db(a) Cognitive impairment: L day 55 db(a) 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 8
Thank You Calling noise a nuisance is like calling smog an inconvenience (W. H. Steward, former Surgeon General of USA) Contact: wolfgang.babisch@uba.de 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 9
Epidemiological Reasoning Biological model Laboratory experiments on humans (acute effects) Animal experiments (long-term effects) Epidemiological studies (long-term effects on humans) - Occupational (high exposures) - Environmental (moderate exposures) 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 10
Prevalence and Incidence of Ischaemic Heart Diseases Odds ratio 3.00 2.75 2.50 2.25 2.00 1.75 1.50 Study Amsterdam1977a-m-air Amsterdam1977a-f-air Amsterdam1977b-m-air Amsterdam1977b-f-air Doetinchem1979-f-road Bonn1981-mf-road Erfurt1983-mf-road Groningen1989-mf-road Groningen1989-mf-air Caerphilly1988-m-road Tyrol1992-mf-road Berlin1992a-m-road Berlin1992b-m-road Berlin1992c-m-road Speedwell1993-m-road Tokyo1997-f-road CaerSpeed1999-m-road Spandau2003-mf-road Stockholm2004-m-air Berlin2005-m-road Berlin2005-f-road 1.25 1.00 0.75 Review 50.5 0.50 52.5 55.5 57.5 60.5 62.5 65.5 67.5 70.5 72.5 75.5 77.5 Leq,6-22h [db(a)] 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 11
Lengths of Residence Total sample Sub-sample >10/15 years of residence 1.8 1.8 1.6 1.6 Odds ratio 1.4 1.2 1 +95% CI Pooled -95% CI Odds ratio 1.4 1.2 1 +95% CI Pooled -95% CI 0.8 0.8 0.6 0.6 <=60 61-65 66-70 71-75 76-80 <=60 61-65 66-70 71-75 76-80 Lday [db(a)] Lday [db(a)] >70 db(a): OR = 1.25, p = 0.086 >70 db(a): OR = 1.44, p = 0.020 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 12
Road Traffic Noise Exposure in Germany Percentage [%] 18 16 14 12 10 8 6 4 2 0 At risk >45-50 >50-55 >55-60 >60-65 >65-70 >70-75 >75 Traffic noise level, L day,16h [db(a)] Source: Umweltbundesamt, 2001 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 13
EU Environmental Noise Directive 2002/49/EC Noise mapping Informing the public Action plans Until 2007 for communities > 250,000 inhabitants Until 2012 for communities < 250,000 inhabitants Noise metrics: L den (L day, L eve, L night ), L night National calculation methods (road, rail, air, industry) Harmonisation Until 2008 for communities > 250,000 inhabitants Until 2013 for communities < 250,000 inhabitants Reporting to the EU Commission (number of people affected) 5 es Assises Nationales de la Qualité de l'environment Sonore, Reims 2007 - W. Babisch: Page 14