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INTRODUCTION

Noise is a physical atmospheric pollutant. Ambient noise is defined as all exterior sounds that are damaging or unwanted and originate from human activities, including noise from transportation (road, railway, and airplane traffic) and industrial activities.1

Noise pollution is a social and public health problem with important implications for quality of life, in particular for populations living in large urban areas, and there is growing evidence on long-term health effects including cardiovascular disease, neurocognitive effects in children, and other conditions. Multiple studies point to a significant association between urban noise and clinical cardiovascular outcomes such as acute myocardial infarction and stroke.2–4 It is estimated that 3% of the burden of ischemic heart disease in large cities can be attributed to traffic noise.5

According to the Organization for Economic Cooperation and Development (OECD),6 130 million people are exposed to noise levels above the safety standards established by the World Health Organization (WHO)7 and the U.S. Environmental Protection Agency (EPA) of 65 dB(A) during the day, and 55 dB(A) during the night. In 1974, the EPA estimated that nearly 100 million Americans lived in areas where the daily average noise levels exceeded those identified as being safe.8 In 1991, it was estimated that environmental noise had increased by 10% in the decade of the 1980s.9 In the 2000 United States Census, 30% of Americans complained of noise, and 11% found it to be bothersome. Among those who complained, noise was sufficiently bothersome to make nearly 40% want to change their place of residence.10

In the European Union (EU), 40% of the population is exposed to traffic noise levels over 55 dB(A), 20% exposed over 65 dB(A) during the day, and 30% exposed over 55 dB(A) at night.11 Traffic noise is the most prevalent type of ambient noise and these exposure levels in the EU have an estimated burden of 61,000 disability adjusted life years (DALYs) and 1.6 million healthy life years lost,12 making ambient noise the second most harmful environmental factor for health in the EU, behind air pollution. More specifically, in the countries of Western Europe 61,000 life years have been lost from ischemic heart disease, 45,000 due to cognitive problems in children, 900,000 due to sleep disorders, 22,000 due to tinnitus, and around 650,000 life years due to “discomfort.”13 In more recent exposure estimates, at least 100 million people in the European Union are affected by traffic noise.14

Hearing disorders and nonauditory health effects of noise have been studied for decades. In the United States and Europe, 26% of adults have a bilateral hearing disorder that impairs their ability to hear in noisy environments, and a further 2% have substantial unilateral hearing issues.15 Age-adjusted prevalence of hearing disorders is similar in Asia.16 In 2001, it was estimated that 12.5% of American children between the ages ...

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