Abstract:
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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. |