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8 CHAPTER TWO HEALTH EFFECTS OF AVIATION NOISE Trying to identify, measure, and quantify any potential mean systolic blood pressure; however, some effects were effects of aviation noise on health is a complex and difficult observed in terms of an increase in the percentage of individ- field of study. Variations on how to identify and/or measure uals with hypertension. the noise exposure itself (single dose, long-term average, number of events above a certain level, etc.), and attempting Most reviewers concluded that previous reviews were not to separate the effects from other life events are difficult at carried out in a systematic way, which makes them prone to best. For example, lifestyles, life's stressors, hereditary bias. Reviewers pointed out the tendency for some studies to factors, and genetic composition are just a few factors that inadequately report noise exposure data. In 2002, for example, may distort potential results of an aviation noise health Van Kempen et al. concluded that whereas "noise exposure effects study. can contribute to the prevalence of cardiovascular disease, the evidence for a relation between noise exposure and ischemic Given this complexity, the large amount of research pub- heart disease is still inconclusive, because of the limitations lished during the past 30 years has produced considerable of exposure characterization, adjustment for important con- variability of results; often, some are quite controversial. The founders, and occurrence of publication bias." absence of one internationally acceptable "exposure-effect" or "dose-response" relationship is largely the result of the lack No differences in systolic and diastolic blood pressure have of one obvious "best choice" research methodology. been found in cross-sectional studies comparing areas near an airport with calm, suburban areas; therefore, aircraft noise lev- After reviewing all new research, reviewing previous els were not a factor in these two subject areas. One should research with new thought, and collaborative efforts to identify note that cross-sectional studies are notoriously difficult to health effects related solely to aviation noise were completed, interpret. They often report conflicting results, generally do not four main subject areas were identified: cardiovascular effects, identify a cause and effect relationship, and often do not report aviation noise effects and children, aviation noise effects on a dose-response relationship between the cause and effect. hospitals and care facilities, and potential hearing impairment. Each is discussed separately here. AVIATION NOISE EFFECTS AND CHILDREN CARDIOVASCULAR EFFECTS Another particular concern over the last 30 years is the potential health effect on children owing to exposure to or Several recent studies have reviewed previous literature, interference from aviation noise. Published studies include either through compilation or re-review of original data, the effects of aircraft noise and mental disturbances by which suggest that increased hypertension or other cardiovas- means of a cross-sectional study in two contrasting geo- cular effects may be associated with particular long-term graphical regions. Although noise levels were not reported, noise exposure. For example, in 2000 at a World Health they are likely to be very high, as military aircraft fly as low Organization expert task force meeting, a weak association as 75 m with very high onset rates. Neither psychiatric between long-term environmental noise exposure and hyper- disorders nor environmental factors showed any relation- tension was suggested, but no dose-response relationship ship to noise; however, psychophysiological parameters could be established (Guidelines for Community Noise 2000). (e.g., heart rate and muscle tension) did demonstrate some It concluded that cardiovascular effects may be associated relationship to noise. with long-term exposure; however, the associations are weak and the effect is somewhat stronger for ischemic heart dis- Other recent studies have focused on relationships between ease than for hypertension. Another example, a study by noise exposure during pregnancy and low birth weights; Passchier-Vermeer and Passchier (2000) reviewed existing however, no association was found between personal noise literature that stated there was sufficient scientific evidence exposure (measured in decibels) and birth weight (Wu et al. that noise exposure can induce hearing impairment, hyper- 1996; Passchier-Vermeer and Passchier 2000). Other possible tension, and ischemic heart disease. It concluded there were noises (e.g., occupational, traffic noise, and history of listening no obvious effects from noise exposure on mean diastolic and to amplified music) also showed no effect on infant birth