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A 34 VOLUME 113 | NUMBER 1 | January 2005 • Environmental Health Perspectives

Focus | Decibel Hell

Environmental Health Perspectives • VOLUME 113 | NUMBER 1 | January 2005 A 35

I t’s not difficult for a person to encounter

sound at levels that can cause adverse health

effects. During a single day, people living in

a typical urban environment can experience a

wide range of sounds in many locations, includ-

ing shopping malls, schools, the workplace,

recreational centers, and the home. Even once-

quiet locales have become

polluted with noise. In

fact, it’s difficult today to

escape sound completely.

In its 1999 Guidelines forCommunity Noise, the

World Health Organization

(WHO) declared, “World-

wide, noise-induced hear-

ing impairment is the most prevalent irreversible

occupational hazard, and it is estimated that 120

million people worldwide have disabling hearing

difficulties.” Growing evidence also points to

many other health effects of too much volume.

The growing noise pollution problem has

many different causes. Booming population

growth and the loss of rural land to urban sprawl

both play a role. Other causes include the lack of

adequate anti-noise regulations in many parts of

the world; the electronic nature of our age, which

encourages many noisy gadgets; the rising num-

ber of vehicles on the roads; and busier airports.

The U.S. Environmental Protection Agency

(EPA) has long identified

transportation—passenger

vehicles, trains, buses,

motorcycles, medium and

heavy trucks, and aircraft—

as one of the most pervasive

outdoor noise sources, esti-

mating in its 1981 NoiseEffects Handbook that more

than 100 million people in the United States

are exposed to noise sources from traffic near

their homes.

Some experts define noise simply as “unwant-

ed sound,” but what can be unwanted for one

person can be pleasant or even essential sound to

to another—consider boom boxes, car stereos,

The Effectsof Living in aNoisy World

Decibel Hell

drag races, and lawn mowers in this con-text. Sound intensity is measured in deci-bels (dB); the unit A-weighted dB (dBA) isused to indicate how humans hear a givensound. Zero dBA is considered the point atwhich a person begins to hear sound. A softwhisper at 3 feet equals 30 dBA, a busyfreeway at 50 feet is around 80 dBA, and achain saw can reach 110 dBA or more atoperating distance. Brief exposure to soundlevels exceeding 120 dBA without hearingprotection may even cause physical pain.

Mark Stephenson, a Cincinnati, Ohio–based senior research audiologist at theNational Institute for Occupational Safetyand Health (NIOSH), says his agency’s def-inition of hazardous noise is sound thatexceeds the time-weighted average of 85dBA, meaning the average noise exposuremeasured over a typical eight-hour workday. Other measures and definitions areused for other purposes. For example,“sound exposure level” accounts for varia-tions in sound from moment to moment,while “equivalent sound level” determinesthe value of a steady sound with the samedBA sound energy as that contained in atime-varying sound.

Growing VolumeIn the United States, about 30 millionworkers are exposed to hazardous soundlevels on the job, according to NIOSH.Industries having a high number ofworkers exposed to loud sounds includeconstruction, agriculture, mining, manu-facturing, utilities, transportation, andthe military.

Noise in U.S. industryis an extremely difficultproblem to monitor, ac-knowledges Craig Moulton,a senior industrial hygienistfor the Occupational Safetyand Health Administration(OSHA). “Still,” he says,“OSHA does require thatany employer with workersoverexposed to noise pro-vide protection for thoseemployees against theharmful effects of noise.Additionally, employers mustimplement a continuing,effective hearing conserva-tion program as outlined inOSHA’s Noise Standard.”

Meanwhile, there is noevidence to suggest thingshave gotten any quieter forresidents since the EPApublished its 1981 hand-book. “For many people inthe United States, noise hasdrastically affected the quali-ty of their lives,” says ArlineL. Bronzaft, chair of theNoise Committee of theNew York City Council ofthe Environment and a psy-chologist who has done pio-neering research on theeffects of noise on children’sreading ability. “My daughter lives near LaGuardia airport in New York City, and shecan’t open a window or enjoy her backyard in

the summer because of the airplane noise.” Indeed, the term secondhand noise is

increasingly used to describe noise that isexperienced by people who did not produceit. Anti-noise activists say its effect on peo-ple is similar to that of secondhand smoke.“Secondhand noise is really a civil rightsissue,” says Les Blomberg, executive direc-tor of the Noise Pollution Clearinghouse,an anti-noise advocacy group based inMontpelier, Vermont. “Like secondhandsmoke, it’s put into the environment with-out people’s consent and then has effects onthem that they don’t have any control over.”

Secondhand noise can also have a nega-tive effect in the workplace. “Workers in theconstruction trades get exposure to noisenot just from what they are doing but alsofrom what is going on around them,” saysRick Neitzel, director of communicationsfor the National Hearing ConservationAssociation. “Electricians, for example, havea reputation as being a member of a quiettrade, but if they work all day next to alaborer who is using a jackhammer, it’sgoing to have a harmful effect.”

Even disregarding other people’s noise,there are any number of household tools


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On the street. Booming bass is quickly becoming the sound-track of urban life.

On the increase. Our technological society encourages the propagation of noisy devices, andchildren are being exposed earlier than ever to an abundance of electronic noise.


and appliances that can produce harmfulsound levels in the comfort of one’s ownhome. According to the fact sheet “Noise inthe Home” produced by the League for theHard of Hearing, dishwashers, vacuumcleaners, and hair dryers can all reach orexceed 90 dBA.

Our modern industrialized society hasspawned ubiquitous entertainment andsports industries with their boom boxes,“personal stereos” (Gap Kids now evenoffers a jacket with a built-in radio andspeakers conveniently attached right in thehood), surround-sound movie theaters,loud TV commercials, and even loudercommercials at sports stadiums crammedfull of thousands of noisy fans. In drag rac-ing, a growing international sport, aGerman team of audio engineers set an ear-splitting record of 177 dB–sound pressurelevel in 2002. Popular “boom cars”equipped with powerful stereo systems thatare usually played with the volume and bassturned up abnormally high and the carwindows rolled down can hit 140–150dBA. Listening to music at a level of 150dBA would be like standing next to aBoeing 747 airplane with its engines at fullthrottle, according to statistics provided byNoise Free America, an anti-noise advocacygroup.

Even the countryside is not immune tothe impact of noise pollution. According tothe New York Center for AgriculturalMedicine and Health in Cooperstown, astaggering 75% of farmworkers have somekind of hearing problem, largely the resultof long-term exposure to loud equipment.

The United States is not the only coun-try where noise pollution is affecting thequality of life. In Japan, for instance, noisepollution caused by public loudspeakermessages and other forms of city noise haveforced many Tokyo citizens to wearearplugs as they go about their daily lives.In Europe, about 65% of the population isexposed to ambient sound at levels above55 dBA, while about 17% is exposed tolevels above 65 dBA, according to theEuropean Environment Agency.

“The noisy problems associated with airtravel are concentrated in communitiesaround airports, whereas motorways orhigh-speed trains—traveling, for instance,from north to south Europe—have thepotential to disturb thousands of peopleliving along the route day after day,” saysKen Hume, a principal lecturer in humanphysiology at the Manchester MetropolitanUniversity in England.

Noise is indeed everywhere, and expertsexpect no decrease in noise levels, given thepowerful impact of technology on modern

life. “In the past three decades, we havebuilt noisier and noisier devices that are notsubject to any regulations,” Blomberg says.“Think about it. The car alarm is a seven-ties invention, as is the leaf blower. The

stereo sound systems we have in our cars aremuch louder than the sound system theBeatles used for their concerts in the sixties.All they had back then were three-hundred-amp speakers.”


Counting Decibels

Device/Situation dBA*Grand Canyon at night, no birds, no wind 10Quiet room 28–33Computer 37–45Floor fan 38–70Refrigerator 40–43Normal conversation 40Forced-air heating system 42–52Radio playing in background 45–50Clothes washer 47–78Dishwasher 54–85Bathroom exhaust fan 54–55Microwave oven 55–59Normal conversation 55–65Laser printer 58–65Hair dryer 59–90Window fan on “high” setting 60–66Alarm clock 60–80Vacuum cleaner 62–85Push reel mower 63–72Sewing machine 64–74Telephone 66–75Food disposal 67–93Inside car with windows closed, traveling at 30 miles per hour 68–73Handheld electronic game 68–76Inside car with windows open, traveling at 30 miles per hour 72–76Electric shaver 75Air popcorn popper 78–85Electric lawn edger 81Electric can opener 81–83Gasoline-powered push lawn mower 87–92Average motorcycle 90Air compressor 90–93Weed trimmer 94–96Leaf blower 95–105Circular saw 100–104Maximum output of stereo 100–120Chain saw 110Average snowmobile 120Average fire crackers 140Average rock concert 140

* Measurements are approximate and may vary by source.Sources: National Institute on Deafness and Other Communication Disorders, Environmental ProtectionAgency, Noise Pollution Clearinghouse.

Scary Sound EffectsNumerous scientific studies over the yearshave confirmed that exposure to certainlevels of sound can damage hearing.Prolonged exposure can actually change thestructure of the hair cells in the inner ear,resulting in hearing loss. It can also causetinnitus, a ringing, roaring, buzzing, orclicking in the ears. The American TinnitusAssociation estimates that 12 millionAmericans suffer from this condition, withat least 1 million experiencing it to theextent that it interferes with their dailyactivities.

NIOSH studies from the mid to late1990s show that 90% of coal miners havehearing impairment by age 52—comparedto 9% of the general population—and70% of male metal/nonmetal miners willexperience hearing impairment by age 60(Stephenson notes that from adolescenceonward, females tend to have better hearingthan males). Neitzel says nearly half of allconstruction workers have some degree ofhearing loss. “NIOSH research also revealsthat by age twenty-five, the average carpen-ter’s hearing is equivalent to an otherwisehealthy fifty-year-old male who hasn’t beenexposed to noise,” he says.

“Noise has an insidious effect in that themore exposure a person has to noise, themore the hearing loss will continue to grow,”says Josara Wallber, disabilities services liaison

for the National Technical Institute for theDeaf in Rochester, New York. “Hearing lossis irreversible. Once hearing is lost, it’s lostforever.”

William Luxford, medical director ofthe House Ear Clinic of St. VincentMedical Center in Los Angeles, points outone piece of good news: “It’s true that con-tinuous noise exposure will lead to the con-tinuation of hearing loss, but as soon as theexposure is stopped, the hearing loss stops.So a change in environment can improve aperson’s hearing health.”

For many young people, changing theirenvironment and their behavior would be awise and healthy move. That’s becauseaudiologists are fitting more and more ofthem with hearing aids, says Rachel Cruz, aresearch associate at the House Ear Clinic.She says audiologists are blaming this dis-turbing development on youth’s penchantfor listening to loud music, especially withthe use of headphones.

Research is catching up with this anec-dotal evidence. In the July 2001 issue ofPediatrics, researchers from the Centers forDisease Control and Prevention reportedthat, based on audiometric testing of 5,249children as part of the Third NationalHealth and Nutrition Examination Survey,an estimated 12.5% of American childrenhave noise-induced hearing thresholdshifts—or dulled hearing—in one or both

ears. Most children with noise-inducedhearing threshold shifts have only limitedhearing damage, but continued exposure toexcessive noise can lead to difficulties withhigh-frequency sound discrimination. Thereport listed stereos, music concerts, toys(such as toy telephones and certain rattles),lawn mowers, and fireworks as producingpotentially harmful sounds.

For the baby boom generation, on theother hand, a change of environment maybe too late. “Many baby boomers beganlosing their hearing when the amplificationof popular music came into vogue in thenineteen sixties,” says Cruz. “We are start-ing to see that a lot of musicians and audioengineers who have been involved withpopular music for a long time are havinghearing problems.” Cruz is gathering datafor a research study to examine how theseprofessionals’ occupational sound exposuresaffect their hearing over a span of years.

Beyond the EarsThe effects of sound don’t stop with theears. Nonauditory effects of noise exposureare those effects that don’t cause hearingloss but still can be measured, such as ele-vated blood pressure, loss of sleep, increasedheart rate, cardiovascular constriction,labored breathing, and changes in brainchemistry. According to the WHOGuidelines for Community Noise, “thesehealth effects, in turn, can lead to socialhandicap, reduced productivity, decreasedperformance in learning, absenteeism in theworkplace and school, increased drug use,and accidents.”

The nonauditory effects of noise werenoted as early as 1930 in a study publishedby E.L. Smith and D.L. Laird in volume 2of the Journal of the Acoustical Society ofAmerica. The results showed that exposureto noise caused stomach contractions inhealthy human beings. Reports on noise’snonauditory effects published since thatpioneering study have been both contradic-tory and controversial in some areas.

Data pertaining to whether noise canincrease the risk of damage to the fetus is acase in point. A study published by L.D.Edmonds, P.M. Layde, and J.D. Ericksonin the July–August 1979 issue of theArchives of Environmental Health found nosignificant data suggesting an effect of noiseon fetal development in pregnant womenwho lived near airports. But in the October1997 issue of Pediatrics, the Committee onEnvironmental Health of the AmericanAcademy of Pediatrics published a policystatement based on a review of research onthe potential health effects of noise on thefetus and the newborn. The committee


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On the job. Occupational noise is pervasive throughout many industries and may cause seriousdamage despite regulations to protect workers’ hearing.


concluded that excessive noise exposure inutero may result in high-frequency hearingloss in newborns and further that excessivesound levels in neonatal intensive care unitsmay disrupt the natural growth and devel-opment of premature infants. It recom-mended that noise-induced health effectson fetuses and newborns are clinical andpublic health concerns that merit furtherstudy.

Studies have revealed that as childrengrow they are exposed to sounds that canthreaten their health and cause learningproblems. For instance, in the September1997 issue of Environment and Behavior,Cornell University environmental psychol-ogists Gary Evans and Lorraine Maxwellreported that the constant roar of jet air-craft could cause higher blood pressure,boosted stress levels, and other effects withpotential life-long ramifications amongchildren living in areas under the flightpaths of airport.

Other human and animal studies alsohave linked noise exposure to chronicchanges in blood pressure and heart rate.For example, in the July–August 2002 issueof the Archives of Environmental Health, ateam of government and universityresearchers concluded that exposure tosound “acts as a stressor—activating physi-ological mechanisms that over time canproduce adverse health effects. Although allthe effects and mechanisms are not eluci-dated, noise may elevate systolic blood pres-sure, diastolic blood pressure, and heartrate, thus producing both acute and chron-ic health effects.”

Noise has also been shown to affectlearning ability. In 1975 Bronzaft collabo-rated on a study of children in a school nearan elevated train track that showed howexposure to noise can affect children’s read-ing ability. Half of the students in the studywere in classrooms facing the train trackand the other half were in classrooms in theschool’s quieter back section. The findings,published in the December 1975 issue ofEnvironment and Behavior, were that stu-dents on the quieter side performed betteron reading tests, and by sixth grade theywere a full grade point ahead of the stu-dents in the noisier classrooms.

Bronzaft and the school principal per-suaded the school board to have acousticaltile installed in the classrooms adjacent tothe tracks. The Transit Authority also treat-ed the tracks near the school to make themless noisy. A follow-up study published inthe September 1981 issue of the Journal ofEnvironmental Psychology found that chil-dren’s reading scores improved after theseinterventions were put in place. “After we

did the study, more than twenty-five otherstudies were done examining the effect ofnoise on children’s learning ability,”Bronzaft says. “They have all found thesame thing to be true: noise can affect chil-dren’s learning.”

The EPA reported in the Noise EffectsHandbook that surveys taken in communi-ties significantly affected by noise indicatedthat interruption of sleep was the underly-ing cause of many people’s complaints.Research has shown that unwanted sound ismost annoying at the times when peopleexpect to rest or sleep, that it can interruptor delay sleep, and that it can have subtleeffects on sleep, such as causing shifts from

deeper to lighter sleep stages. “The researchis pretty solid that noise can prevent peoplefrom getting a good night’s sleep,” Humesays. “I believe that sleep deprivation canhave negative health effects when it becomesa chronic problem.”

Fighting for QuietWorldwide, airports have become a flashpoint for community frustration over noisepollution. In September 2002, officials atthe Frankfurt am Main Airport in Germanyreceived 56,330 noise-related complaints, a30% increase over the same month in 2001.The same year, residents living near a ruralairport outside London, England, were

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On the go. Transportation sound is perhaps the largest contributor to urban noise pollution.

submitting 100 petitions daily, objecting toproposals for three new runways at the site.

In March 2003, representatives fromeight neighborhoods in Portland, Oregon,showed up for a city council hearing con-vened to discuss dozens of expansion proj-ects for Portland International Airport. Theairport was already a busy one: in 2002 ithandled 12.2 million passengers and about29,000 containers of air cargo. “Theimpacts are tremendous on the neighbor-hoods under the flight paths,” testified oneneighborhood representative, Jean Ridings.“People move in and move [right back] out.It’s becoming a disaster.” In response, theairport has initiated a multiyear, multimil-lion-dollar effort to study the sound impactof the airport, which locals hope will lead toa plan to reduce airport noise.

Noise Free America is seeking to file aclass-action lawsuit against the makers ofboom car equipment. Ted Rueter, NoiseFree America’s director and an assistantprofessor of political science at DePauwUniversity in Greencastle, Indiana, saysone group member has written a legal briefon the topic and has approached several

public-interest law firms seeking represen-tation, with no takers so far. Rueter saysNoise Free America will continue to pursuethe suit.

A lot of money is being made from dis-turbing the peace, charges Mark Huber,communications director for Noise FreeAmerica. “By using paid lobbyists inWashington, D.C., and in state legislatures,the automobile and entertainment indus-tries are quietly removing obstacles protect-ing the public against noise,” Huber says.“Try to get a noise control law passedthrough a state legislature and see whathappens. We tried to get a boom car lawenacted in the Virginia General Legislature,but right here in Richmond there are atleast fifty car clubs, all of which are politi-cally active. So our legislation disappeared.”

Stephen McDonald, vice president ofgovernment affairs for the Washington,D.C.–based Specialty Equipment MarketAssociation (SEMA), denies that any power-ful lobby exists and is working against thebest interests of society. SEMA representsmanufacturers, distributors, retailers, andinstallers of specialty automotive equipment,

including boom car equipment. “Ourprime focus is representing the interests ofbusinesses that sell exhaust systems,”McDonald says. “But that doesn’t mean wewant the products to increase noise to alevel where it becomes objectionable. Wedo need to strike a balance, though,between what is acceptable for a neighbor-hood and what’s fair to people who want tocustomize their cars.”

Anti-noise activists say that Europe andseveral countries in Asia are more advancedthan the United States in terms of combatingnoise. “Population pressure has promptedEurope to move more quickly on the noiseissue than the United States has,” Hume says.In the European Union, countries with citiesof at least 250,000 people are creating noisemaps of those cities to help leaders determinenoise pollution policies. Paris has already pre-pared its first noise maps. The map data,which must be finished by 2007, will be fedinto computer models that will help test thesound impact of street designs or new build-ings before construction begins.

In the United States, the Noise ControlAct of 1972 empowered the EPA to deter-mine noise limits to protect the publichealth and welfare, and to establish a noisecontrol office. Congress did establish theOffice of Noise Abatement and Control(ONAC), as well as federal standards forbusiness, industries, and communities, andit did begin researching the effects of soundexposures. In 1982, however, the Reaganadministration defunded the office. “Weare no longer doing research on noise,” saysKenneth Feith, an EPA senior scientist andpolicy advisor. “We just don’t have themoney or staff to do it.”

Activists believe that closing the ONAChas had a tremendous negative effect at thestate and local level. “The U.S. has long sincegiven up its lead in regulating noise, andbecause of that there has been no consistencyin implementing local noise regulations,”Huber says. The Noise Control Act, thoughstill on the books, is essentially toothless.

In the mid-1990s, people in the boroughof Queens, New York, who lived under theflight paths of La Guardia Airport, tooktheir concerns about noise to RepresentativeNina Lowey (D–NY). “I could see that noiseis a serious public health issue, and so Idecided to do something about it,” Loweysays. In 1997 the congresswoman intro-duced legislation that’s become known asthe Quiet Communities Act (HR 536),which provided for the refunding of theONAC and for $21 million to be spentannually on noise reduction. Among othermeasures, the money would be used to carryout a national noise assessment program to


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On the way up. Problems from airplane and airport noise are increasing as more and more flightstake off over residential areas.


identify trends in noise exposure andresponse, develop and disseminate informa-tion and public education materials on thehealth effects of noise, and establish region-al technical assistance centers, which woulduse the resources of universities and privateorganizations to assist state and local noisecontrol programs.

“More and more communities are beingaffected by airports, trains, and railways,”Lowey says. “We need a national office to coor-dinate policy. That’s common sense to me. Thefederal government has to play a larger role onthe noise issue. Otherwise, we will continue tolag behind other parts of the world in combat-ing noise.” While Lowey remains optimisticthat the legislation will eventually pass, othersources doubt that it will happen, noting thatthe proposed legislation has been introducedand rejected several times.

Activists in other countries say theytoo want the United States to play a more

leading role on the noise issue. “Re-estab-lishing the ONAC would be a huge movein the right direction,” says Hans Schmid,the Vancouver, Canada–based president ofthe Right to Quiet Society. “That willshow that the United States is seriousabout the noise issue. If the United Statesleads, other countries, especially Canada,will follow.”

But as in other areas of environmentalhealth, merely having a more powerful gov-ernment agency in place that can set moreregulations is not the ultimate answer,according to other experts. Regulations pro-vide an important foundation, Stephensonsays, but better education of workers, con-sumers, businesses, and citizens is critical.“We’ve found that in some factories as many asone-third of the workers who have significanthearing loss don’t wear hearing protectors, eventhough the factory has a comprehensive hear-ing conservation program in place,” he says.

Bronzaft stresses that governmentsworldwide need to increase funding fornoise research and do a better job coordi-nating their noise pollution efforts so theycan establish health and environmentalpolicies based on solid scientific research.“Governments have a responsibility toprotect their citizens by curbing noisepollution,” she says.

Feith agrees. “The EPA had a successfuleducational program in the nineteen seven-ties in which we went to schools and edu-cated students about noise,” he says.“When students took the message home,they helped increase the sensitivity to thenoise issue. We need more programs likethat to educate the public about noise.”

In the meantime, some facilities aredoing what they can to help themselves to aquieter environment. Although peace andquiet are essential prerequisites for a healingenvironment, a Mayo Clinic study pub-lished in the February 2004 issue of theAmerican Journal of Nursing showed thatpeak noise levels during the clinic’s morn-ing shift change rivaled the excruciatingsound of a jackhammer. The study furthershowed that a few simple changes—forexample, holding staff reports at shiftchange in an enclosed room (rather than atthe nurses’ station) and replacing roll-typepaper towel dispensers with quieter mod-els—reduced peak noise levels at shiftchange by 80%.

Similarly, the din of overhead pagers,which can reach 80 dBA, inspired the devel-opers of the Woodwinds Health Campus inWoodbury, Minnesota, to build the facilitywith a staff location sensor and badge sys-tem, among other sound-friendly features.Staff can be located in just about any area ofthe Woodwinds campus without beingpaged. “We have developed an innovativeapproach to reducing noise in our hospitalwhile fostering a healing environment,” saysCindy Bultena, executive lead of healingand clinical coordination for Woodwinds.“Our change sounds simple enough, but it’sa very radical one for hospitals.”

By delivering their patients and stafffrom decibel hell, facilities like Woodwindsand the Mayo Clinic have scored one smallvictory in the ongoing battle against noisepollution. Their initiative, moreover, showsthat given the pervasiveness and harmfuleffects of noise, governments, communities,and organizations worldwide will need to becreative and aggressive in addressing whatwill certainly continue to be one of the 21stcentury’s most important environmentalhealth issues.

Ron ChepesiukPhot

odis

cFocus | Decibel Hell

On the mend? Hospitals can be some of the noisiest public locations, but some health care facilitiesare actively fighting noise in the interest of better patient care.

113n1 focus rpp - noiseoff · german team of audio engineers set an ear-splitting record of 177...

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