CPRE Leicestershire

The Leicestershire Branch of the Campaign to Protect Rural England

Formerly the Council for the Protection of Rural England

The adverse health impacts of 'community' noise

CPRE's Tranquillity Maps and the more recent 'intrusion' maps indicate how little space there is in which peace and solitude is to be found these days. The rate of erosion of these pockets of relative peace is cause for alarm. Dense blankets of noise from our transport systems are the main sources of noise nuisance at a community level and in the county the regional airport imposes much of this burden. Noise must be recognised as a potential health hazard.

Techniques and methodologies for measuring noise have many drawbacks and offer little in the way of improving the lives of those blighted by widespread noise nuisance and everything for those who wish to continue with noise emitting activities. However, the adverse health effects can be detected at what might be termed 'the other end' through epidemiological studies. Perhaps the best known example of the community-wide disbenefit of transport noise was the recent 'West London Schools Study', jointly funded by The Department of Health and the Department of the Environment, Transport and the Regions. Much work on lowered educational attainment as a result of environmental noise has been carried out not only here ^(1)(2)(3) but in many other countries too⁽⁴⁾. There is now a wealth of unequivocal evidence that aircraft noise in particular is a chronic stressor impairing the cognitive development of children. To quote 'The Lancet' article cited, 'Schools exposed to high levels of aircraft noise are not healthy educational establishments.' The main effect on school populations exposed to community noise is a lowering of reading age, reflected by inferior/lagging performance in SATs tests. Stansfield and Haines stated that 'These results suggest that children in Britain exposed to high levels of aircraft noise at school are being taught in a disadvantaged learning environment that has negative consequences for cognitive development and well-being.'

The research cited above also measured certain physiological changes in a subsample of the school population under study. These children were tested for overnight urinary catecholamines (adrenaline, noradrenaline) and cortisol. These are the hormonal substances associated mainly with stress reactions. Cortisol is a blood pressure and insulin regulator, among other functions. Adrenaline output increases heart-rate and raises blood sugar levels. Noradrenaline acts mainly by raising blood pressure as a result of small artery constriction.

It goes without saying that chronic elevated levels of these hormonal substances can have adverse health consequences - a lot more serious in the long term than delayed educational attainment. While some research was devoted to reviewing the noise standards used for assessing community standards, others researched environmental health impacts⁽⁵⁾ by carrying out more direct investigations into what was happening physiologically to people, and this research has been gathering pace. Fairly recently, research into noise standards famously produced a paper published by Civil Aviation Authority experts⁽⁶⁾ that suggested sleep disturbance due to aircraft noise only became significant above a ridiculously high level. Thankfully, this report has been thoroughly discredited⁽⁷⁾. The author stated that the level of noise cited was 'unlikely to produce sleep disturbance'. Strangely, in 1961 a report stated that precisely the same level of noise would disturb a sleeper. The level of noise in question? An alarm clock two feet from the head of a sleeper!⁽⁸⁾

More recently, the DfT has been persuaded to release the latest ANASE Report⁽⁹⁾ Readers can be forgiven for thinking 'Well, my Granny could have told you that.' when reading the contents of this report. This latest report concludes that people in 2005 were more noise sensitive than were in 1982⁽¹⁰⁾ It contains gems such as 'Analysis of the ANASE survey data has shown that as the sound level indicator... increases, the annoyance levels of respondents also increase...' It also points out that 'Our analysis showed that respondent's household income and SEG were the most important influences on the level of annoyance.' That is, the section of the community (higher Socio-Economic Groups) having the confidence and functional competence are more likely to make their feelings known.

While it may be seen that the aviation industry tends to play down the degree of aircraft noise on exposed communities, the research into the adverse health consequences is much clearer and less prone to obfuscation.

It is known that aircraft overflights during the night increase cortisol levels.⁽¹¹⁾ Cortisol secretion not only is increased below the awakening threshold but accumulates causing raised blood levels with repeated overflights. More overflight disturbance per night = more cortisol in your system.

Another physiological indicator of stress due to lack of restorative sleep is interleukin-6. IL-6 is associated with the inflammatory process and sleep deprivation elevates levels of this substance.⁽¹²⁾ Sustained sleep deprivation leads to reduced emotional and physical well-being - aches and pains - which correlate with raised IL-6 levels.⁽¹³⁾

As is becoming clearer, health impairment due to environmental noise is not something to be treated lightly. This was brought home recently in this study: 'Relation between sleep quality and quantity, quality of life, and risk of developing diabetes in healthy workers in Japan: the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study.' HAYASHINO Y, FUKUHARA S, SUZUKAMO Y, OKAMURA T, TANAKA T, UESHIMA H. BMC Public Health 2007;7(1):129.
...the conclusion of which stated 'Medium and high frequencies of difficulty initiating sleep, but not difficulty in maintaining sleep or in sleep duration, are associated with higher risks of diabetes in relatively healthy Asian workers, even after adjusting for a large number of possible further factors.'

The research team leader, Professor Hayashino, was asked this question:

'I live in England in an area overflown by aircraft 24/7. The airport concerned is Britain's prime pure cargo airport and we have approximately seventy-five overflights each night, between 2300-0700. The main problem is not so much being awoken but the delayed onset of sleep, night after night, aircraft noise being something you cannot easily habituate to. The result is that a section of the population is chronically tired as a result of this. Would it be fair to extrapolate from your team's research that there is the potential for a raised incidence of diabetes in the population exposed to high levels of nocturnal aircraft noise?'⁽¹⁴⁾

The reply was as follows:

'It sounds fair to extrapolate our work if quality of sleep is low in the population exposed to high level of nocturnal aircraft noise. I suppose that aircraft noise may be associated with not only risk of diabetes, but also risks of other chronic disease. So it also is interesting to conduct a research to examine whether living close to an airport is associated with future risk of diabetes, hypertension, coronary artery disease, and so on.
Sincerely yours,
Yasuaki Hayashino, MD, PhD, MPH'

In early December 2007, notice was received of another team's research confirming these results. Short sleep duration increases insulin resistance and decreases glucose tolerance. It seems likely that our 24/7 lifestyle is a significant causal factor in the Type II diabetes epidemic. Here is the full synopsis of the research carried out at Columbia University.

While the experts employed by the aviation sector mostly play-down the effects of aircraft noise the medical evidence cannot be sidelined or blanked out. Having said that, the evidence is out there but no one appears to be funding epidemiological surveys. Sleep has an undoubted and undisputable restorative role - though we all know that because our Grannies told us so.

The pathological effects of unpredictable patterns of noise, particular transport noise disturbing sleep, have psychological effects as well - typically anxiety and depression. The most extreme effect in this range is Selye Syndrome, where endocrine hyperactivity results in cardiovascular changes, gastric ulcers, plus a range of non-specific changes resulting in very poor health.⁽¹⁵⁾ This extreme condition is reserved for those regularly exposed to noise impulses of 70dB(A) or more. Thankfully, it is not a common condition.

So, is there a community health problem for those living adjacent to busy roads and railways, or under East Midlands Airport's arrival and departure routes? The airport is particularly important as a stressor as it gives no relief to residents by having the diurnal rhythm characteristic of road and rail, a pattern giving some relief at night. To our knowledge no epidemiological work has been undertaken to measure higher than normal rates of hypertensive disease or stress-related conditions in populations exposed to environmental noise. The settlements adjacent to East Midlands Airport and the nexus of major roads in the area of M1 Junctions 23 and 24 would seem to provide a suitable laboratory, ripe for investigation. Perhaps a survey to ascertain where prescriptions for drugs to aid sleep are above normal might be an inexpensive research tool to start with?

...which is precisely what a team in the Netherlands has done.⁽¹⁶⁾ Research carried out in the vicinity of Schipol Airport, Amsterdam, has established that there is an association between community exposure to aircraft noise, the use of sleep medication (both prescribed and non-prescribed) poor general health and the use of medication for cardiovascular diseases. The Amsterdam study showed that 'exposure to aircraft noise at levels above 50dB(A)LDEN may contribute to a poorer health status' which is actually a fairly low level of noise exposure. This ought to be sending out a signal to a 'Nanny State' that proclaims to hold community health dear. The message so far seems to be 'don't smoke, don't over-indulge with high carbohydrate and fatty foods and take plenty of exercise'. It will be a long time before the benefits of tranquility and restorative sleep are added to this regimen. OK, knowing that noise can harm your health is one thing but what can be done to prevent it at source or mitigate its effects? Noisy neighbours can be dealt with effectively using legislation designed to protect us from such nuisances. Yapping dogs and even early morning crowing cockerels can also be dealt with quite effectively through legislation. Even noisy model aeroplanes come under such jurisdiction. Full-sized aircraft however are immune from prosecution and only very lightweight measures exist⁽¹⁷⁾ to ameliorate aircraft noise nuisance. For practical purposes this legislation might as well not exist since East Midlands Airport flies throughout the night in ever increasing numbers and appears to be unique in the UK in this respect.

Since prevention is better than cure CPRE Leicestershire did pursue a course of action whereby the Secretary of State was invited to use his powers under section 78 of the 1982 Civil Aviation Act to curb night flying at East Midlands Airport.⁽¹⁸⁾ Unfortunately, he and his successors have declined to do so, resulting in the deplorable state of affairs we have today.

The campaign group DEMAND⁽¹⁹⁾ have been fighting for the designation of EMA under s.78 and success can only be achieved if people adversely affected by aircraft noise make their voices heard. Anyone not living under a flight path, or next to a busy road or railways where two-tone locomotive horns have to be sounded might be wondering what all the fuss is about. Those living directly beneath or adjacent to flight paths will no doubt graphically describe the effects of delayed onset of sleep and sleep fragmentation due to repeated aircraft noise, night after night, if asked!

The diagram below shows cumulative aircraft tracks over several days, with aircraft departing to the east and arriving on EMA's runway from the west.

Diagram showing cumulative aircraft tracks over several days, with
aircraft departing to the west and arriving on EMA's runway from the east

Environmental noise is a product of the 24/7 society, resulting mainly from activities associated with ever-growing consumerism and global trade. It doesn't have to be this way; those not afflicted by this form of nuisance often have a scathing attitude to those who are and who do complain. Selfishness and lack of consideration for others being the root of this aspect of the problem. For example, busy highways don't have to be exceptionally noisy - they can be paved with low noise emission surfaces, though often the tender for maintenance will go to the bidder offering the lowest cost to the highway authority. Obviously, this requires a level of awareness beforehand to ensure that work is carried out to the appropriate standard.

The health problems arising from road noise have been recognised by the EU and measures are already in place to control noise from tyres. The legislation on tyre noise will be tightened imminently and significant benefits should arise. More information on road and other environmental noise issues being tackled with the EU.

Finally, for an historic overview of noise and its effects on society, the following paper will be of interest. It was published in March 2007 in the US Southern Medical Journal.

Haines, M.M., Stansfeld, S.A., Job, R.F.S., Berglund, B. & Head, J. (2001a). Chronic aircraft noise exposure, stress responses mental health and cognitive performance in school children. Psychological Medicine, 31, 265-277.
Haines, M.M., Stansfeld, S.A., Job, R.F.S, Berglund, B. & Head, J. (2001b). A follow-up study of the effects of chronic aircraft noise exposure on child stress responses and cognition. International Journal of Epidemiology, 30, 839-845.
Haines, M.M., Stansfeld, S.A., Brentnall, S., Head, J., Berry, B., Jiggins, M., & Hygge, S. (2001c). West London Schools Study: the effect of chronic aircraft noise exposure on child health. Psychological Medicine, 31, 1385-1396.
Haines, M.M., Stansfield, S. A., et al. Aircraft and road traffic noise and children's cognition and health: a cross-national study. The Lancet, Vol 365, June 4th, 2005.
Porter, D.N., Berry, B. F., Flindell, I.H., Health Effect Based Noise Assessment Methods: A Review and Feasibility Study. National Physical Laboratory, NPL Report CMAM 16, Sept. 1998.
Ollerhead, J.B. et al. Report of a field study of aircraft noise and sleep disturbance. DfT for the UK Department of Safety, Environment and Engineering, CAA, December 1992.
Terminal 5 Rebuttal by Professor Holland which included a critique by Dr. B. Berglund (see refs. 1,2 and 3 above). Brigitta Berglund is a joint author of the WHO Community Noise Report.
Wilson Committee on the Problem of Noise, Noise: Final Report, Cmnd 2056, London, HMSO, 1963,
Attitudes to Noise From Aviation Sources in England, MVA Consultancy, October 2007.
United Kingdom Aircraft Noise Index Study, published in 1985.
Spreng, M. Noise induced nocturnal cortisol secretion and tolerable overhead flights. Dept. Physiology, University of Erlangen, Germany. Noise Health 2004;6(22):35-47
Haack, M,, Sanchez, E., Mullington, J.M., Elevated inflammatory markers in response to prolonged sleep restriction are associated with increased pain experience in healthy volunteers. Beth Isreal Deaconess Medical Centre and Harvard Medical School, Boston. Sleep 2007;30(9):1145-52.
De Jongh et al., 2003 R.F. De Jongh, K.C. Vissers, T.F. Meert, L.H. Booij, C.S. De Deyne and R.J. Heylen, Sustained sleep restriction reduces emotional and physical well-being. Pain, Volume 119, Issue 1-3, Pages 56-64
Private communication, July 18th, 2007.
Cosa, M and Cosa G., Ann Ig 1898;1(1-2): 133-56
Franssen, A.M.,van Wiechen, C.M.A.G., Nagelkerke, N.J.D. and Lebret, E. Aircraft noise around a large international airport and its impact on general health and medication use. Occupational and Environmental Medicine (BMJ) 2004;61:405-413
The 2006 Civil Aviation Act, Chap. 34, 1-4 which amend sections 78 and 38 of the 1982 Aviation Act.
http://www.demand.uk.net/articles-correspondance/Dft-to-CPRE.pdf
http://www.demand.uk.net

STOP PRESS: On December 11th 2007 the HYENA Study was published. This four-year research programme has assessed the relationship between noise from roads and airports and cardiovascular disease. It comes as no surprise that there is a proven relationship, primarily where there is night-time aircraft noise and daily traffic noise. The paper can be read here.