Health risks caused by environmental noise in Europe

Quantifying the health impacts of exposure to noise pollution

Noise health risk assessments are used to estimate and communicate the risks to health of exposure to noise pollution. They can also be used to estimate the health benefits of changes in exposure resulting from the introduction of policies, mitigation measures or other initiatives. Box 1 outlines the key steps in conducting a noise health risk assessment at the European level using noise data submitted under the Environmental Noise Directive (END).

Various environmental health indicators can be used to quantify the health risks of exposure to noise pollution. They range from a simple indicator of the number of people exposed above the World Health Organization (WHO) recommended noise levels to more complex indicators that show the number of people suffering specific health outcomes or that integrate several health effects into a single number.

The suitability of one indicator over another depends on the policy questions to be answered, the audience to which the results will be communicated, and the uncertainties associated with each indicator, as well as the availability of data, resources and expertise (van Kamp et al., 2018).

This briefing applies three indicators (Table 1) to assess the health risks of environmental noise at the European level using END data and the methodology described in Implications of environmental noise on health and well-being (ETC/ACM, 2018). The indicators can be used to inform the development of future targets aiming to reduce the health impacts of noise.

Table 1 Indicators for monitoring the health impacts of noise at European level. 

Number of people above WHO recommended noise levels

The Environmental noise guidelines for the European region (WHO Europe, 2018), define long-term noise exposure levels above which a relevant increase in negative health effects occur, expressed in terms of the indicators L_den and L_night for road, rail and aircraft sources.

The WHO recommendations provide a basis for estimating the number of people exposed to unhealthy noise levels from different sources of environmental noise (Table 2). The numbers presented at European level correspond to the number of people above the END reporting thresholds (i.e. 55 dB L_den and 50 dB L_night). This means that in reality there may be more people exposed to unhealthy noise levels than those that can be assessed with the current END thresholds.

This indicator highlights that noise from road traffic remains a major environmental health problem in Europe: more than 100 million people are exposed to day-evening-night noise levels above the WHO recommended levels. The major proportion of the people affected live in urban areas.

Table 2 Number of people exposed to harmful noise levels based on the number exposed above the END thresholds, i.e. 55 dB L_den and 50 dB L_night, EEA-33 (excluding Turkey)

Note: Negative health effects start to occur below the END thresholds. WHO recommends reducing noise levels to 53 dB L_den and 45 dB L_night for road traffic, 54 dB L_den and 44 dB L_night for rail traffic, and 45 dB L_den and 40 dB L_night for air traffic.
Source: EEA (2020).

Number of people affected by the specific health effects of noise

The WHO environmental noise guidelines (WHO Europe, 2018) also provide exposure response functions for health outcomes, including annoyance and sleep disturbance, as well as risk ratios for cardiovascular health outcomes. These provide the basis for quantifying the number of people suffering from specific health effects due to noise.

The range and magnitude of negative health impacts of noise in Europe are significant, with many suffering effects such as annoyance, sleep disturbance, ischaemic heart disease, mortality due to ischaemic heart disease and even learning impairments in children (Table 3). People in urban areas are most badly affected, and the main source contributing to negative health effects is road traffic noise.

Long-term exposure to environmental noise is estimated to contribute to 48 000 new cases of heart disease and 12 000 premature deaths every year in Europe. In addition, 22 million people suffer high annoyance and 6.5 million people suffer high sleep disturbance. It is estimated that more than 12 000 schoolchildren suffer learning impairments due to aircraft noise.

Table 3 Estimated number of people suffering from various health effects due to environmental noise in 2017, EEA-33 (excluding Turkey)

	High annoyance	High sleep disturbance	Ischaemic heart disease	Premature mortality (a)	Reading impairment in children
Road
Inside urban areas	12 525 000	3 242 400	29 500	7 600
Outside urban areas	4 625 500	795 500	10 900	2 500
Railway
Inside urban areas	1 694 700	795 500	3 100	800
Outside urban areas	1 802 400	962 900	3 400	900
Aircraft
Inside urban areas	848 300	168 500	700	200	9500
Outside urban areas	276 000	84 600	200	50	2800
Industry
Inside urban areas	87 200	23 400	200	50
Outside urban areas	No data	No data	No data	No data
All (b)	21 859 100	6 478 300	47 900	12 100	12 300

Notes: Based on number of people exposed above the END thresholds and areas covered under the END.
(^a) Refers to mortality due to ischaemic heart disease. Premature mortality refers to deaths occurring before a person reaches an expected age.
(^b) There may be double counting for annoyance and sleep disturbance because of combined effects of multiple sources. Double counting is estimated to be no more than 13 % for annoyance and 16 % for sleep disturbance. Double counting for ischaemic heart disease and mortality is estimated to be negligible (ETC/ACM, 2018).
Source: EEA (2020).

Burden of disease

The WHO has developed methods to quantify the burden of disease from environmental noise using DALYs (WHO and JRC, 2011). The DALY estimates how much disease affects the life of the population by combining the burden from:

• mortality, in terms of years lost because of premature death due to disease

• morbidity, in terms of years of life lived adversely affected by disease.

One DALY corresponds to one lost year of healthy life, attributable to morbidity, mortality or both (see Box 2). The sum of DALYs across a population provides a measurement of the gap between actual health status and an ideal situation in which the entire population lives to an advanced age, free of disease and disability (WHO Europe, 2016).

The most important causes of disability due to environmental noise are annoyance and sleep disturbance. High annoyance account for 30-50 % of all years lived with disability, and high sleep disturbance account for 20-55 %, depending on the source and disability weight used (Table 4). While annoyance and sleep disturbance are not severe health outcomes, the large number of people affected, illustrated by the use of DALYs, demonstrates the relevance of this indicator.

Table 4 Estimated number of DALYs due to road, rail and aircraft in areas covered under the END, EEA-33 (excluding Turkey) 

Notes: Light orange shading indicates the type of disease is included in the International Statistical Classification of Diseases (WHO, 2019). The disability weights used for calculating high annoyance and high sleep disturbance are those specified by the JRC and WHO (2011) and van Kamp et al. (2018) and are indicated as ranges.
Source: EEA (2020).