1. Towards WHO Guidelines on Environmental Noise
Joerdis Wothge
Consultant on Noise, Living and Working Environments
World Health Organization, European Centre for Environment and Health
Evidence of health effects of noise
European Commission - 9th Noise Expert Group Meeting
30th November 2017, Brussels, Belgium

2. Overview

3. Overview 1 Introduction 2 Guideline Development Process
3 Differences to prior Guidelines
4 Current status
Sleep disturbance and annoyance related to road traffic noise contribute most to the burden of disease

4. Overview 1 Introduction 2 Guideline Development Process
3 Differences to prior Guidelines
4 Current status
Sleep disturbance and annoyance related to road traffic noise contribute most to the burden of disease

5. Overview 1 Introduction 2 Guideline Development Process
3 Differences to prior Guidelines
4 Current status
Sleep disturbance and annoyance related to road traffic noise contribute most to the burden of disease

6. Overview 1 Introduction 2 Guideline Development Process
3 Differences to prior Guidelines
4 Current status
Sleep disturbance and annoyance related to road traffic noise contribute most to the burden of disease

7. Overview
1 Introduction 2 Guideline Development Process 3 Differences to prior Guidelines 4 Current status 5 Target Audience

8. Burden of disease
At least 100 million people in the EU are affected by road traffic noise above the assessment threshold specified in the END (55dB)
Over 83 million Europeans are exposed to harmful levels of noise from night-time road traffic (above 50 dB)
At least one million healthy years of life are lost due to road traffic noise in Western Europe
Sleep disturbance and annoyance related to road traffic noise contribute most to the burden of disease

9. Burden of disease
At least 100 million people in the EU are affected by road traffic noise above the assessment threshold specified in the END (55dB Lden)
Over 83 million Europeans are exposed to harmful levels of noise from night-time road traffic (above 50 dB)
At least one million healthy years of life are lost due to road traffic noise in Western Europe
Sleep disturbance and annoyance related to road traffic noise contribute most to the burden of disease
Source: WHO/JRC, 2011; EEA, 2017

10. Burden of disease
At least 100 million people in the EU are affected by road traffic noise above the assessment threshold specified in the END (55dB Lden)
Over 83 million Europeans are exposed to harmful levels of noise from night-time road traffic (above 50 dB Lnight)
At least one million healthy years of life are lost due to road traffic noise in Western Europe
Sleep disturbance and annoyance related to road traffic noise contribute most to the burden of disease
Source: WHO/JRC, 2011; EEA, 2017

11. Burden of disease
At least 100 million people in the EU are affected by road traffic noise above the assessment threshold specified in the END (55dB Lden)
Over 83 million Europeans are exposed to harmful levels of noise from night-time road traffic (above 50 dB Lnight)
At least 1.6 million healthy years of life are lost due to road traffic noise in Western Europe
Sleep disturbance and annoyance related to road traffic noise contribute most to the burden of disease
Source: WHO/JRC, 2011; EEA, 2017

12. WHO noise guidelines
Represent the most widely accepted set of public health recommendations, intended to assist policy-makers, health-care providers, and other relevant stakeholders to make informed decisions for the protection of public health
Based on a comprehensive and objective assessment of the available evidence
Generally intended for worldwide use, and therefore recognize the heterogeneity on technological feasibility, economic development and other political and economical factors
WHO adopted internationally recognized standards and methods to ensure that guidelines are free from biases and meet public health needs
2009

13. WHO noise guidelines
2009

14. WHO noise guidelines

15. WHO environmental noise guidelines for the European Region
WHO noise guidelines
WHO environmental noise guidelines for the European Region

16. Guideline Development Process

17. Development of new guidelines
Systematically review scientific evidence on:
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

18. Development of new guidelines
Systematically review scientific evidence
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

19. Development of new guidelines
Systematically review scientific evidence
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

20. Development of new guidelines
Systematically review scientific evidence
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

21. Development of new guidelines
Systematically review scientific evidence
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

22. Development of new guidelines
Systematically review scientific evidence
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

23. Development of new guidelines
Systematically review scientific evidence
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

24. Development of new guidelines
Systematically review scientific evidence
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

25. Critical health outcomes
Health outcomes included in the reviews
Critical health outcomes

26. Critical health outcomes Important health outcomes
Health outcomes included in the reviews
Critical health outcomes
Important health outcomes

27. Critical health outcomes Important health outcomes
Health outcomes included in the reviews
Cardiovascular Disease
Annoyance
Sleep disturbance
Cognitive Impairment
Hearing Impairment & Tinnitus
Critical health outcomes
Important health outcomes

28. Critical health outcomes Important health outcomes
Health outcomes included in the reviews
Cardiovascular Disease
Annoyance
Sleep disturbance
Cognitive Impairment
Hearing Impairment & Tinnitus
Diabetes & metabolic diseases
Adverse birth outcomes
Quality of life, well-being
Critical health outcomes
Important health outcomes

29. Noise sources considered
Sources: Umweltbundesamt, BASt, dpa/Bernd von Jutrczenka, dpaheute
First three have been most commonly reported on. Wind turbine and Leisure noise are new features.

30. Noise sources considered
Road traffic
Sources: Umweltbundesamt, BASt, dpa/Bernd von Jutrczenka, dpaheute
First three have been most commonly reported on. Wind turbine and Leisure noise are new features.

31. Noise sources considered
Railway
Road traffic
Sources: Umweltbundesamt, BASt, dpa/Bernd von Jutrczenka, dpaheute
First three have been most commonly reported on. Wind turbine and Leisure noise are new features.

32. Noise sources considered
Railway
Road traffic
Sources: Umweltbundesamt, BASt, dpa/Bernd von Jutrczenka, dpaheute
First three have been most commonly reported on. Wind turbine and Leisure noise are new features.
Aircraft

33. Noise sources considered
Railway
Wind turbines
Road traffic
Sources: Umweltbundesamt, BASt, dpa/Bernd von Jutrczenka, dpaheute
First three have been most commonly reported on. Wind turbine and Leisure noise are new features.
Aircraft

34. Noise sources considered
Railway
Wind turbines
Road traffic
Sources: Umweltbundesamt, BASt, dpa/Bernd von Jutrczenka, dpaheute
Leisure
First three have been most commonly reported on. Wind turbine and Leisure noise are new features.
Aircraft

35. Noise sources considered
Railway
Wind turbines
Road traffic
Sources: Umweltbundesamt, BASt, dpa/Bernd von Jutrczenka, dpaheute
Leisure
First three have been most commonly reported on. Wind turbine and Leisure noise are new features.
Aircraft

36. Guideline Development Process – Initial Process Overview
See next slide for processes in
between initial approval for development and final approval by GRC
Start
End

37. Guideline Development Process – Initial Process Overview
Decision to produce Environmental Noise Guidelines
Initial approval by GRC
Initial approval for development
Final approval by GRC
Relevant internal approvals ADG, LLP
Proofread, Publish, Dissemination
See next slide for processes in
between initial approval for development and final approval by GRC
Start
End

38. Guideline Development Process – Initial Process Overview
Decision to produce Environmental Noise Guidelines
Initial approval by GRC
Initial approval for development
Final approval by GRC
Relevant internal approvals ADG, LLP
Proofread, Publish, Dissemination
See next slide for processes in
between initial approval for development and final approval by GRC
Start
End

39. Guideline Development Process – Initial Process Overview
Decision to produce Environmental Noise Guidelines
Initial approval by GRC
Initial approval for development
Final approval by GRC
Relevant internal approvals ADG, LLP
Proofread, Publish, Dissemination
Guideline process can take up to 3 to 4 years
See next slide for processes in
between initial approval for development and final approval by GRC
Start
End

40. Guideline Development Process - guideline groups and main steps

41. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Guideline Groups

42. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Guideline Groups
Main steps

43. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Guideline Groups
Main steps

44. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Management of Conflict of Interest
Guideline Groups
Main steps

45. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Management of Conflict of Interest
Systematic Review Process
Guideline Groups
Main steps

46. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Management of Conflict of Interest
Systematic Review Process
Guideline Groups
Main steps

47. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

48. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

49. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

50. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

51. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

52. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

53. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

54. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

55. Systematic Reviews Cardiovascular diseases Effects of sleep
Cognitive impairment
Hearing impairment and tinnitus
Diabetes and metabolic effects
Adverse birth outcomes
Quality of life, mental health and wellbeing
Interventions
Systematic reviews to be published in June

56. Grading the evidence

57. Grading the evidence
Assessment of the overall quality of evidence by Systematic Review Teams:

58. Grading the evidence
Assessment of the overall quality of evidence by Systematic Review Teams:
Study limitations
Inconsistency of results
Indirectness of evidence
Imprecision
Publication bias
Magnitude of effect
Plausible confounding
Dose-response gradient

59. Grading the evidence OVERALL QUALITY OF EVIDENCE
Assessment of the overall quality of evidence by Systematic Review Teams:
Study limitations
Inconsistency of results
Indirectness of evidence
Imprecision
Publication bias
Magnitude of effect
Plausible confounding
Dose-response gradient
OVERALL QUALITY OF EVIDENCE

60. Grading the evidence OVERALL QUALITY OF EVIDENCE High quality
Assessment of the overall quality of evidence by Systematic Review Teams:
Study limitations
Inconsistency of results
Indirectness of evidence
Imprecision
Publication bias
Magnitude of effect
Plausible confounding
Dose-response gradient
OVERALL QUALITY OF EVIDENCE
High quality
Moderate quality
Low quality
Very low quality

61. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Management of Conflict of Interest
Systematic Review Process
Guideline Groups
Main steps

62. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Management of Conflict of Interest
Systematic Review Process
From Evidence to Recommendations
Guideline Groups
Main steps

63. Guideline Development Process - guideline groups and main steps
WHO steering group
Guideline Development Group
External review group
Systematic Review Teams
Management of Conflict of Interest
Systematic Review Process
From Evidence to Recommendations
Guideline Groups
Main steps

64. Developing recommendations
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

65. Developing recommendations
Factors to be considered
Balance of Benefits and harms
Values and Preferences
Resource Use
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

66. Developing recommendations
Factors to be considered
Quality of Evidence
Balance of Benefits and harms
Values and Preferences
Resource Use
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

67. Developing recommendations
Factors to be considered
Quality of Evidence
Balance of Benefits and harms
Values and Preferences
Resource Use
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

68. Developing recommendations
Factors to be considered
Quality of Evidence
Balance of Benefits and harms
Values and Preferences
Resource Use
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

69. Developing recommendations
Factors to be considered
Quality of Evidence
Balance of Benefits and harms
Values and Preferences
Resource Use
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

70. Developing recommendations
Types of Recommendations
Factors to be considered
Quality of Evidence
Balance of Benefits and harms
Values and Preferences
Resource Use
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

71. Developing recommendations
Types of Recommendations
Factors to be considered
Strong recommendation
Quality of Evidence
Balance of Benefits and harms
Values and Preferences
Resource Use
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

72. Developing recommendations
Types of Recommendations
Factors to be considered
Strong recommendation
Conditional recommendation
Quality of Evidence
Balance of Benefits and harms
Values and Preferences
Resource Use
‘strong’: the guideline is based on the confidence that the desirable effects of adherence to the recommendation outweigh the undesirable consequences. The quality of the evidence combined with certainty about the values, preferences, benefits and feasibility inform this recommendation, which should be implemented in most circumstances; or
‘conditional’: there was less certainty about the combined quality of evidence, values and preferences of individuals and populations affected, benefits and feasibility of this recommendation meaning there may be circumstances or settings in which it will not apply.

73. Differences to Prior Guidelines

74. Existing Guidelines

75. Fundamental differences
Differences between the guidelines at a glance.

76. Fundamental differences
1 New, strictly evidence-based methodology
Including meta-analysis and systematic reviews
Internationally recognized standards to ensure guidelines are of high methodological quality
2 Modified style of recommendations
Exact exposure values for every considered health outcome
Guideline values defined separately for each noise source in 5 dB(A) steps
Differences between the guidelines at a glance.

77. Fundamental differences
1 New, strictly evidence-based methodology
Including meta-analysis and systematic reviews
Internationally recognized standards to ensure guidelines are of high methodological quality
2 Modified style of recommendations
Exact exposure values for every considered health outcome
Guideline values defined separately for each noise source in 5 dB(A) steps
Differences between the guidelines at a glance.

78. Fundamental differences
1 New, strictly evidence-based methodology
Including meta-analysis and systematic reviews
Internationally recognized standards to ensure guidelines are of high methodological quality
2 Modified style of recommendations
Exact exposure values for every considered health outcome
Guideline values defined separately for each noise source in 5 dB(A) steps
Differences between the guidelines at a glance.

79. Fundamental differences
1 New, strictly evidence-based methodology
Including meta-analysis and systematic reviews
Internationally recognized standards to ensure guidelines are of high methodological quality
2 Modified style of recommendations
Exact exposure values for every considered health outcome
Guideline values defined separately for each noise source in 5 dB(A) steps
Differences between the guidelines at a glance.

80. Fundamental differences
1 New, strictly evidence-based methodology
Including meta-analysis and systematic reviews
Internationally recognized standards to ensure guidelines are of high methodological quality
2 Modified style of recommendations
Exact exposure values for every considered health outcome
Guideline values defined separately for each noise source in 5 dB(A) steps
Differences between the guidelines at a glance.

81. Fundamental differences
1 New, strictly evidence-based methodology
Including meta-analysis and systematic reviews
Internationally recognized standards to ensure guidelines are of high methodological quality
2 Modified style of recommendations
Exact exposure values for every considered health outcome
Guideline values defined separately for each noise source in 5 dB(A) steps
Differences between the guidelines at a glance.

82. Fundamental differences
3 Expansion of noise sources
Including transportation noise, wind turbine and leisure noise
4 Expansion of number of health outcomes
Adverse birth outcomes, diabetes, obesity, stroke, etc.
Incidence, prevalence and mortality considered separately where possible
5 Inclusion of effects of intervention measures mitigating noise exposure
Differences between the guidelines at a glance.

83. Fundamental differences
3 Expansion of noise sources
Including transportation noise, wind turbine and leisure noise
4 Expansion of number of health outcomes
Adverse birth outcomes, diabetes, obesity, stroke, etc.
Incidence, prevalence and mortality considered separately where possible
5 Inclusion of effects of intervention measures mitigating noise exposure
Differences between the guidelines at a glance.

84. Fundamental differences
3 Expansion of noise sources
Including transportation noise, wind turbine and leisure noise
4 Expansion of number of health outcomes
Adverse birth outcomes, diabetes, obesity, stroke, etc.
Incidence, prevalence and mortality considered separately where possible
5 Inclusion of effects of intervention measures mitigating noise exposure
Differences between the guidelines at a glance.

85. Fundamental differences
3 Expansion of noise sources
Including transportation noise, wind turbine and leisure noise
4 Expansion of number of health outcomes
Adverse birth outcomes, diabetes, obesity, stroke, etc.
Incidence, prevalence and mortality considered separately where possible
5 Inclusion of effects of intervention measures mitigating noise exposure
Differences between the guidelines at a glance.

86. Fundamental differences
3 Expansion of noise sources
Including transportation noise, wind turbine and leisure noise
4 Expansion of number of health outcomes
Adverse birth outcomes, diabetes, obesity, stroke, etc.
Incidence, prevalence and mortality considered separately where possible
5 Inclusion of effects of intervention measures mitigating noise exposure
Differences between the guidelines at a glance.

87. Fundamental differences
3 Expansion of noise sources
Including transportation noise, wind turbine and leisure noise
4 Expansion of number of health outcomes
Adverse birth outcomes, diabetes, obesity, stroke, etc.
Incidence, prevalence and mortality considered separately where possible
5 Inclusion of effects of intervention measures mitigating noise exposure
Differences between the guidelines at a glance.

88. Current Status

89. Development of new guidelines
Systematically review scientific evidence
Health effects of environmental noise
Effectiveness of interventions to reduce exposure and improve health
Provide evidence-based recommendations
Exposure—response relationships
Effectiveness of interventions

90. Systematic Reviews Evidence:
Most health evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise: more annoyance and sleep disturbance than other types of noise
 Substantial benefit expected from markedly reducing noise
 Separate recommendations for road, rail and aircraft noise (Lden, Lnight)

91. Systematic Reviews Evidence:
Most health evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise: more annoyance and sleep disturbance than other types of noise
 Substantial benefit expected from markedly reducing noise
 Separate recommendations for road, rail and aircraft noise (Lden, Lnight)

92. Systematic Reviews Evidence:
Most health evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise: more annoyance and sleep disturbance than other types of noise
 Substantial benefit expected from markedly reducing noise
 Separate recommendations for road, rail and aircraft noise (Lden, Lnight)

93. Systematic Reviews Evidence:
Most health evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise: more annoyance and sleep disturbance than other types of noise
 Substantial benefit expected from markedly reducing noise
 Separate recommendations for road, rail and aircraft noise (Lden, Lnight)

94. Transportation noise
Most health evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise is % HA / % HSD than other types of transportation noise
Individual recommendations for road, rail and aircraft noise for Lden, Lnight
 Substantial benefit expected from markedly reducing noise

95. Transportation noise Evidence:
Most health evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise is % HA / % HSD than other types of transportation noise
Individual recommendations for road, rail and aircraft noise for Lden, Lnight
 Substantial benefit expected from markedly reducing noise

96. Transportation noise Evidence:
Most evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise is % HA / % HSD than other types of transportation noise
Individual recommendations for road, rail and aircraft noise for Lden, Lnight
 Substantial benefit expected from markedly reducing noise

97. Transportation noise Evidence:
Most evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise more % HA / % HSD than other types of transportation noise
Individual recommendations for road, rail and aircraft noise for Lden, Lnight
 Substantial benefit expected from markedly reducing noise

98. Transportation noise Evidence:
Most evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise more % HA / % HSD than other types of transportation noise
Individual recommendations for road, rail and aircraft noise for Lden, Lnight
 Substantial benefit expected from markedly reducing noise

99. Transportation noise Evidence:
Most evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise more % HA / % HSD than other types of transportation noise
 Individual recommendations for road, rail and aircraft noise for Lden, Lnight
 Substantial health benefits expected from markedly reducing noise

100. Transportation noise Evidence:
Most evidence on road traffic noise, followed by aircraft noise, little on railway noise
Aircraft noise more % HA / % HSD than other types of transportation noise
 Individual recommendations for road, rail and aircraft noise for Lden, Lnight
 Substantial health benefits expected from markedly reducing noise

101. Leisure noise Evidence:
Very low quality evidence coming directly from studies relating leisure noise exposure to health outcomes
Difficulty in properly assessing exposure and development of hearing impairment / tinnitus
Strong supportive evidence from occupational noise field
 Concern about young population being exposed
 Benefit from reducing exposure
 Some low cost measures available

102. Leisure noise Evidence:
Very low quality evidence coming directly from studies relating leisure noise exposure to health outcomes
Difficulty in properly assessing exposure and development of hearing impairment / tinnitus
Strong supportive evidence from occupational noise field
 Concern about young population being exposed
 Benefit from reducing exposure

103. Leisure noise Evidence:
Very low quality evidence coming directly from studies relating leisure noise exposure to health outcomes
Difficulty in properly assessing exposure and development of hearing impairment / tinnitus
Strong supportive evidence from occupational noise field
 Concern about young population being exposed
 Benefit from reducing exposure

104. Leisure noise Evidence:
Very low quality evidence coming directly from studies relating leisure noise exposure to health outcomes
Difficulty in properly assessing exposure and development of hearing impairment / tinnitus
Strong supportive evidence from occupational noise field
 Concern about young population being exposed
 Benefit from reducing exposure
 Some

105. Leisure noise Evidence:
Very low quality evidence coming directly from studies relating leisure noise exposure to health outcomes
Difficulty in properly assessing exposure and development of hearing impairment / tinnitus
Strong supportive evidence from occupational noise field
 Concern about young population being exposed
 Benefit from reducing exposure

106. Wind turbine noise Evidence:
Very low quality evidence on health outcomes, partly different for annoyance
Noise exposure assessment is an issue
Hard to dissociate noise impacts from other considerations such as visual aspects, infrasound, amplitude modulation, etc.
Aware of new studies currently taking place that may add on to this body of evidence
 Concern from population living in vicinity to wind turbines

107. Wind turbine noise Evidence:
Very low quality evidence on health outcomes, partly different for annoyance
Noise exposure assessment is an issue
Hard to dissociate noise impacts from other considerations such as visual aspects, infrasound, amplitude modulation, etc.
Aware of new studies currently taking place that may add on to this body of evidence
 Concern from population living in vicinity to wind turbines

108. Wind turbine noise Evidence:
Very low quality evidence on health outcomes, partly different for annoyance
Noise exposure assessment is an issue
Hard to dissociate noise impacts from other considerations such as visual aspects, infrasound, amplitude modulation, etc.
Aware of new studies currently taking place that may add on to this body of evidence
 Concern from population living in vicinity to wind turbines

109. Wind turbine noise Evidence:
Very low quality evidence on health outcomes, partly different for annoyance
Noise exposure is difficult to assess
Hard to dissociate noise impacts from other considerations such as visual aspects, infrasound, amplitude modulation, etc.
Aware of new studies currently taking place that may add on to this body of evidence
 Concern from population living in vicinity to wind turbines

110. Wind turbine noise Evidence:
Very low quality evidence on health outcomes, partly different for annoyance
Noise exposure is difficult to assess
Hard to dissociate noise impacts from other considerations such as visual aspects, infrasound, amplitude modulation, etc.
Aware of new studies currently taking place that may add on to this body of evidence
 Concern from population living in vicinity to wind turbines

111. Wind turbine noise Evidence:
Very low quality evidence on health outcomes, partly different for annoyance
Noise exposure is difficult to assess
Hard to dissociate noise impacts from other considerations such as visual aspects, infrasound, amplitude modulation, etc.
Aware of new studies currently taking place that may add on to this body of evidence
 Concern from population living in vicinity to wind turbines

112. Wind turbine noise Evidence:
Very low quality evidence on health outcomes, partly different for annoyance
Noise exposure is difficult to assess
Hard to dissociate noise impacts from other considerations such as visual aspects, infrasound, amplitude modulation, etc.
Aware of new studies currently taking place that may add on to this body of evidence
 Concern from population living in vicinity to wind turbines

113. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

114. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

115. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

116. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

117. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
Most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

118. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
Most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

119. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
Most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

120. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
Most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

121. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
Most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

122. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
Most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

123. Noise interventions Evidence:
Most evidence for road traffic, and less for aircraft
Little/no evidence for rail, wind and leisure noise
Most studied health outcomes: annoyance / sleep disturbance
Implementation of interventions:
Effectiveness of implementation is context specific
Resources needed for implementation highly variable
Importance of community involvement
General recommendation: health should be encouraged to be considered in noise abatement measures and policy
Sources: betonform.com, Goettinger Tageblatt / Hinzmann

124. Target audience Geographical region: WHO European Region
But: Recommendations may also be applied to countries outside WHO European Region

125. Target audience
Technical experts, decision-makers (local, national, international level)
Health impact assessment, environmental impact assessment practitioners and researchers
Authorities and non-governmental organizations engaged in risk communication and general awareness raising
Geographical region: WHO European Region
But: Recommendations may also be applied to countries outside WHO European Region

126. Target audience
Technical experts, decision-makers (local, national, international level)
Health impact assessment, environmental impact assessment practitioners and researchers
Authorities and non-governmental organizations engaged in risk communication and general awareness raising
Geographical region: WHO European Region
But: Recommendations may also be applied to countries outside WHO European Region

127. Target audience
Technical experts, decision-makers (local, national, international level)
Health impact assessment, environmental impact assessment practitioners and researchers
Authorities and non-governmental organizations engaged in risk communication and general awareness raising
Geographical region: WHO European Region
But: Recommendations may also be applied to countries outside WHO European Region

128. Target audience
Technical experts, decision-makers (local, national, international level)
Health impact assessment, environmental impact assessment practitioners and researchers
Authorities and non-governmental organizations engaged in risk communication and general awareness raising
Geographical region: WHO European Region
But: Recommendations may also be applied to countries outside WHO European Region

129. Target audience
Technical experts, decision-makers (local, national, international level)
Health impact assessment, environmental impact assessment practitioners and researchers
Authorities and non-governmental organizations engaged in risk communication and general awareness raising
Geographical region: WHO European Region
But: Recommendations may also be applied to countries outside WHO European Region

130. Thank you for your attention
The END
Thank you for your attention
130