Burden of Disease from Environmental Noise Dr Rokho
Burden of Disease from Environmental Noise Dr Rokho Kim WHO Regional Office for Europe European Centre for Environment and Health Bonn, Germany Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 Relationship between noise and health Distal cause Land use planning and implementation Transportation vehicles design and use Proximal cause Railway and tram noise Aircraft noise
Building design and use Outcome Hearing impairment, tinnitus Road traffic noise Road and railway design and use Education and public awareness Physiological pathway Direct effect -Inner ear damage
-Startle response Indirect effect Annoyance, sleep disturbance Cognitive impairment -Distraction -Stress reaction -Sleep deprivation Cardiovascular disease Indoor and neighborhood noise Unintentional injuries Leisure noise Quiet Please: The Future of EU Noise Policies
Brussels, 25 May 2011 WHOs work on noise and health Briefing pamphlets for local authorities Evidence-based policy guidance with limit values Guidelines for Community Noise (CNG) Night Noise Guidelines for Europe (NNG) Evidence review and health impact assessment Burden of disease from environmental noise
Aircraft noise and health Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 WHO and EC collaborations on noise DG SANCO supported WHO for NNG development Joint ventures between WHO and JRC: Burden of diseases from environmental noise Aircraft noise and health Training of noise experts in the EU, accession countries and newly independent states Standardization of methods to estimate burden of disease within the framework of CNOSSOS-EU Joint workplan of WHO, DG ENV, JRC, and EEA Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 Briefing pamphlets Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011
WHO Guidelines for Community Noise Environment Critical health effect Recommended maximum sound level dB(A) Leq Outdoor living areas Annoyance 55 - 50 Indoor dwellings Speech intelligibility 35 Bedrooms Sleep disturbance
30 School classrooms Disturbance of communication 35 Industrial, commercial and traffic areas Hearing impairment 70 Music through earphones Hearing impairment 85 Hearing impairment 100
Ceremonies and entertainment Occupational environment Hearing impairment 85 Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 WHO Night Noise Guidelines for Europe No substantial biological effects up to 30 dB Lnight Night Noise Guideline (NNGL) 40 dB Lnight Interim Target (IT) 55 dB Lnight Public health concern due to increased risk of cardiovascular diseases Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 Burden of disease from environmental noise
Health outcomes considered Cardiovascular disease Cognitive impairment Sleep disturbance Tinnitus Annoyance Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 Exposure distribution in the population IF = (PePex RRx) - 1 (PePex RRx) Impact fraction Exposure-response relationship Relative risk (or absolute risk)
Method of calculating burden of disease Disease burden estimates per disease Incidence Disease burden mortality, Attributable incidence, attributable to risk DALYs mortality, DALYs factor Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 DALYs (Disability-Adjusted Life Years) The sum of years of life lost due to ill-health, disability or early death DALYs = YLD + YLL Years Lived with Disability + Years of Life Lost One DALY is equivalent to one year of healthy life lost. Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011
Results Every year in the EU cities, at least: 61 000 DALYs for ischaemic heart disease 45 000 DALYs for cognitive impairment 903 000 DALYs for sleep disturbance 22 000 DALYs for tinnitus 654 000 DALYs for annoyance 1~1.6 million healthy life years are lost every year from traffic noise in the EU cities. Sleep disturbance and annoyance related to road traffic noise comprise the main burden. Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 Conclusion Noise pollution is a major environmental and public health burden, second only to the air pollution. Quantification of disease burden provides health arguments for further improvement of the EU Noise Policy.
Existing WHO guidelines are useful for policy-makers, but: WHO Night Noise Guidelines (2009) is only for night noise; WHO Guidelines for Community Noise (1999) needs update; No guidelines address new issues like wind turbine noise. Upcoming revisions of the EU directives on noise can provide opportunities to base the EU Noise Policy on updated limit values using harmonized noise indicators (Lden and Lnight). WHO will work with the EU and the Member States to develop suitable guidelines on noise following up the Parma Declaration. Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011 For further information The Parma Declaration on Environment and Health: We call upon all stakeholders to work together to reduce childrens exposure to noise, including that from personal electronic devices, recreation and traffic, especially in residential
areas, at child care centres, kindergartens, schools and public recreational settings. We urge and offer our assistance to WHO to develop suitable guidelines on noise. http://www.euro.who.int/en/who-we-are/policy-documents/parma-declaration-on-environmentand-health WHO/Europe Noise and Health Programme http://www.euro.who.int/en/what-we-do/health-topics/environmental-health/noise Burden of disease from environmental noise http://www.euro.who.int/__data/assets/pdf_file/0008/136466/e94888.pdf Night noise guidelines for Europe http://www.euro.who.int/noise Guidelines for community noise http://whqlibdoc.who.int/hq/1999/a68672.pdf !Thank you very much Quiet Please: The Future of EU Noise Policies Brussels, 25 May 2011
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