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      Hypertension and Exposure to Noise Near Airports: the HYENA Study

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          Abstract

          Background

          An increasing number of people are exposed to aircraft and road traffic noise. Hypertension is an important risk factor for cardiovascular disease, and even a small contribution in risk from environmental factors may have a major impact on public health.

          Objectives

          The HYENA (Hypertension and Exposure to Noise near Airports) study aimed to assess the relations between noise from aircraft or road traffic near airports and the risk of hypertension.

          Methods

          We measured blood pressure and collected data on health, socioeconomic, and lifestyle factors, including diet and physical activity, via questionnaire at home visits for 4,861 persons 45–70 years of age, who had lived at least 5 years near any of six major European airports. We assessed noise exposure using detailed models with a resolution of 1 dB (5 dB for United Kingdom road traffic noise), and a spatial resolution of 250 × 250 m for aircraft and 10 × 10 m for road traffic noise.

          Results

          We found significant exposure–response relationships between night-time aircraft as well as average daily road traffic noise exposure and risk of hypertension after adjustment for major confounders. For night-time aircraft noise, a 10-dB increase in exposure was associated with an odds ratio (OR) of 1.14 [95% confidence interval (CI), 1.01–1.29]. The exposure–response relationships were similar for road traffic noise and stronger for men with an OR of 1.54 (95% CI, 0.99–2.40) in the highest exposure category (> 65 dB; p trend = 0.008).

          Conclusions

          Our results indicate excess risks of hypertension related to long-term noise exposure, primarily for night-time aircraft noise and daily average road traffic noise.

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          Most cited references41

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          2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension.

          Hypertension is estimated to cause 4.5% of current global disease burden and is as prevalent in many developing countries, as in the developed world. Blood pressure-induced cardiovascular risk rises continuously across the whole blood pressure range. Countries vary widely in capacity for management of hypertension, but worldwide the majority of diagnosed hypertensives are inadequately controlled. This statement addresses the ascertainment of overall cardiovascular risk to establish thresholds for initiation and goals of treatment, appropriate treatment strategies for non-drug and drug therapies, and cost-effectiveness of treatment. Since publication of the WHO/ISH Guidelines for the Management of Hypertension in 1999, more evidence has become available to support a systolic blood pressure threshold of 140 mmHg for even 'low-risk' patients. In high-risk patients there is evidence for lower thresholds. Lifestyle modification is recommended for all individuals. There is evidence that specific agents have benefits for patients with particular compelling indications, and that monotherapy is inadequate for the majority of patients. For patients without a compelling indication for a particular drug class, on the basis of comparative trial data, availability, and cost, a low dose of diuretic should be considered for initiation of therapy. In most places a thiazide diuretic is the cheapest option and thus most cost effective, but for compelling indications where other classes provide additional benefits, even if more expensive, they may be more cost effective. In high-risk patients who attain large benefits from treatment, expensive drugs may be cost effective, but in low-risk patients treatment may not be cost-effective unless the drugs are cheap.
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            Blood pressure measuring devices: recommendations of the European Society of Hypertension.

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              Noise pollution: non-auditory effects on health.

              Noise is a prominent feature of the environment including noise from transport, industry and neighbours. Exposure to transport noise disturbs sleep in the laboratory, but not generally in field studies where adaptation occurs. Noise interferes in complex task performance, modifies social behaviour and causes annoyance. Studies of occupational and environmental noise exposure suggest an association with hypertension, whereas community studies show only weak relationships between noise and cardiovascular disease. Aircraft and road traffic noise exposure are associated with psychological symptoms but not with clinically defined psychiatric disorder. In both industrial studies and community studies, noise exposure is related to raised catecholamine secretion. In children, chronic aircraft noise exposure impairs reading comprehension and long-term memory and may be associated with raised blood pressure. Further research is needed examining coping strategies and the possible health consequences of adaptation to noise.
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                Author and article information

                Journal
                Environ Health Perspect
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                0091-6765
                March 2008
                11 December 2007
                : 116
                : 3
                : 329-333
                Affiliations
                [1 ] Department of Epidemiology and Public Health, Imperial College London, St Mary’s Campus, Norfolk Place, London, United Kingdom
                [2 ] Department of Environment and Health at the Federal Environmental Agency (UBA), Berlin, Germany
                [3 ] National Institute of Public Health and Environmental Protection (RIVM), Bilthoven, the Netherlands
                [4 ] Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden
                [5 ] Department of Hygiene and Epidemiology, National and Kapodistrian University of Athens, Athens, Greece
                [6 ] Environmental Epidemiologic Unit, Regional Agency for Environmental Protection (ARPA), Piedmont Region, Grugliasco, Italy
                [7 ] Laboratory of Prevention, Nurses School, National and Kapodistrian University of Athens, Athens, Greece
                Author notes
                Address correspondence to L. Jarup, Department of Epidemiology and Public Health, Imperial College London, St Mary’s Campus, Norfolk Place, London W2 1PG, UK. Telephone: 44 20 7594 3337. Fax: 44 20 7594 3196. E-mail: l.jarup@ 123456imperial.ac.uk

                The authors declare they have no competing financial interests.

                Article
                ehp0116-000329
                10.1289/ehp.10775
                2265027
                18335099
                ad7eb52d-4ce9-45b6-b6e9-3752643de8d0
                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
                History
                : 17 August 2007
                : 10 December 2007
                Categories
                Research

                Public health
                noise,hypertension,road traffic,blood pressure,aircraft
                Public health
                noise, hypertension, road traffic, blood pressure, aircraft

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