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Road traffic noise was associated with an OR of 1.17 (95% CI: 1.101.25) for noise levels of >70dB, an OR of 1.23 (95% CI: 1.191.28) was found for aircraft noise levels of 50 to <55dB, and in case of railway noise, the OR was 1.15 (95% CI: 1.081.22) for noise levels of 60 to <65dB. Moreover, we have shown that white noise exposure, despite application of similar sound pressure levels and despite presence of a continuous band of frequencies in white (or pink) noise, displayed no adverse cardiovascular effects in mice [86], suggesting that the noise pattern (e.g., crescendo and diminuendo character, tantamount to increasing and decreasing intensity/loudness, of aircraft noise as well as particular breaks) may be of importance as well. This review elucidates the mechanisms underlying the relationship between noise exposure and cerebrocardiovascular and psychological disorders, focusing on mental stress signaling pathways including activation of the autonomous nervous system and endocrine signaling and its association with inflammation, oxidative stress, and vascular dysfunction. Interestingly, these effects were not seen in the control scenario with white noise, implicating that the stress-inducing character of aircraft noise exposure rather than noise exposure per se is crucial in determining adverse effects. Noise-induced annoyance has been proposed to play an intermediary role in disease development, i.e., the degree to which noise causes interference, annoyance, and mental stress may mediate the pathophysiological consequences and disease risk [10, 11]. Recently, two comprehensive animal models in mice were established to study the molecular, nonauditory consequences of noise exposure. All rights reserved. We used the search terms: noise exposure in combination with cardiovascular disease, cardiovascular, psychological, psychiatric, depression, and anxiety, following an initial rapid review and selection of the articles based on the authors expertise. Furthermore, environmental noise exposure has been established as a phenomenon causing annoyance and mental stress reactions, resulting in sympathetic and endocrine stress reactions (i.e., increased stress hormone levels) and psychological disorders such as depression and anxiety, all of which further impair cerebrocardiovascular function [6]. High noise levels (octave band noise: 80-100dB, 8-16kHz, 8h/d for 20d; 8 rats/group) increased plasma levels of stress hormones (corticosterone, adrenaline, noradrenaline, endothelin-1) and caused oxidative stress (increased malondialdehyde levels and decreased superoxide dismutase activity) in rats leading to an adverse cardiovascular phenotype as evidenced by severe endothelial dysfunction [85]. Noise triggers a stress response in the amygdala, a region of the brainstem. In the following, an overview of studies for these endpoints shall be given. This concept is well supported by a recent human study linking emotional stress with increased risk of cardiovascular disease by demonstrating that increased amygdala activity, a brain region involved in stress, is associated with arterial inflammation (increased plaque burden) by 18F-fluorodexoyglucose PET/CT scanning technique [72]. A systematic review and meta-analysis,, S. Jimenez-Fernandez, M. Gurpegui, F. Diaz-Atienza, L. Perez-Costillas, M. Gerstenberg, and C. U. Correll, Oxidative stress and antioxidant parameters in patients with major depressive disorder compared to healthy controls before and after antidepressant treatment: results from a meta-analysis,, M. K. Wium-Andersen, C. J. Kobylecki, S. Afzal, and B. G. Nordestgaard, Association between the antioxidant uric acid and depression and antidepressant medication use in 96 989 individuals,, T. Rowland, B. I. Perry, R. Upthegrove et al., Neurotrophins, cytokines, oxidative stress mediators and mood state in bipolar disorder: systematic review and meta-analyses,, J. Siegrist and H. Sies, Disturbed redox homeostasis in oxidative distress: a molecular link from chronic psychosocial work stress to coronary heart disease?, T. Meyer and P. H. Wirtz, Mechanisms of mitochondrial redox signaling in psychosocial stress-responsive systems: new insights into an old story,, N. Xia and H. Li, Loneliness, social isolation, and cardiovascular health,, S. Schiavone, V. Jaquet, L. Trabace, and K. H. Krause, Severe life stress and oxidative stress in the brain: from animal models to human pathology,, T. Mnzel and A. Daiber, Environmental stressors and their impact on health and disease with focus on oxidative stress,. Alongside these observations, further studies indicated that noise exposure causes autonomic imbalance by, e.g., increased heart rate, increased blood pressure, and sympathetic activation or parasympathetic withdrawal as well as increased arterial stiffness [7781]. In a field study of 75 healthy adults, Schmidt et al. Furthermore, traffic noise exposure is also associated with mental health symptoms and psychological disorders such as depression and anxiety, which further increase maladaptive coping mechanisms (e.g., alcohol and tobacco use). Aircraft noise exposure caused an increased stress response as indicated by increased levels of cortisol, noradrenaline, dopamine, angiotensin II, and endothelin-1. Accordingly, traffic noise annoyance was shown to be an effect modifier or to be directly related to ischemic heart disease, hypertension, atrial fibrillation, myocardial infarction, stroke, and symptoms of cardiovascular disease [1018]. These results have been confirmed in the prospective German Heinz Nixdorf Recall (HNR) study, showing that road traffic noise was associated with an increased RR of high depressive symptoms at follow-up of 1.29 (95% CI: 1.031.62 for >55 vs. 55dB(A)) [64]. As a consequence, noise exposure may promote maladaptive coping mechanisms and decrease stress resistance, further negatively affecting cerebrocardiovascular function. A. El-Gohary, Effect of noise stress on cardiovascular system in adult male albino rat: implication of stress hormones, endothelial dysfunction and oxidative stress,, T. Mnzel, A. Daiber, S. Steven et al., Effects of noise on vascular function, oxidative stress, and inflammation: mechanistic insight from studies in mice,, S. Krller-Schn, A. Daiber, S. Steven et al., Crucial role for Nox2 and sleep deprivation in aircraft noise-induced vascular and cerebral oxidative stress, inflammation, and gene regulation,, M. M. Haines, S. A. Stansfeld, R. F. S. Job, B. Berglund, and J. Read the winning articles. Yes, it does. Underlying mechanisms of noise-induced mental stress are centered on increased stress hormone levels, blood pressure, and heart rate, which in turn favor the development of cerebrocardiovascular disease such as stroke, arterial hypertension, ischemic heart disease, and myocardial infarction. is a PI of the DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany. Environmental Noise-Induced Effects on Stress Hormones, Oxidative Stress, and Vascular Dysfunction: Key Factors in the Relationship between Cerebrocardiovascular and Psychological Disorders, Center for Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany, Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany, German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany, Oxidative Medicine and Cellular Longevity, E. van Kempen, M. Casas, G. Pershagen, and M. Foraster, WHO Environmental Noise Guidelines for the European Region: a systematic review on environmental noise and cardiovascular and metabolic effects: a summary,. Adapted from Babisch [, (a) Degrees of overall annoyance according to different sources of noise. This review is based on a selective search of publications in PubMed from 2005 to 2019 with focus on systematic reviews, meta-analyses, and primary studies. Mice that were subjected to daily restraint and cage-switch stress for one week developed severe inflammation and hypertension [89, 90]. Taken together, it has been proposed that autonomic perturbation and sympathoadrenal activation induced by chronic noise stress may lead to increased levels of circulating stress hormones and subsequent oxidative stress-induced endothelial dysfunction, an early predictor for atherosclerosis, accompanied by the release of proinflammatory mediators and activation of prothrombotic pathways [70, 71]. Anecdotally, this matches my audiologists observation that noise sensitivity is not correlated with our degree of hearing loss. The direct pathway refers to effects on the auditory system by exposure to high levels of noise (e.g., hearing loss and tinnitus). Adapted from Beutel et al. The authors declare that there is no conflict of interest regarding the publication of this paper. The case-control study by Generaal et al. Thus, besides the direct adverse cerebrocardiovascular effects of noise, an indirect pathway of adverse noise effects can be assumed causing cerebrocardiovascular disease via causing psychological disorder such as depression and anxiety. [, Noise causes annoyance and stress responses characterized by activation of the hypothalamic-pituitary-adrenal axis, oxidative stress-induced endothelial dysfunction, inflammation, thrombosis, and altered gene expression. Adapted from Mnzel et al. Another cross-sectional analysis based on data from the GHS including 15,010 subjects could demonstrate that depression and generalized anxiety disorder increased dose-dependently with the degree of total noise annoyance (highest annoyance rating of all analyzed categories of noise including aircraft, road traffic, and railway noise), even after adjustment for sex, age, and socioeconomic status [19]. Our finding that the average hearing thresholds did not differ in noise sensitive and non-noise sensitive subjects is in concordance with previous studies.. Of note, uncoupling and downregulation of neuronal NO synthase was observed, which will ultimately lead to impaired neuronal NO signaling and dysregulation of this important neuronal signaling molecule may explain, at least in part, the cognitive impairment in school children in response to noise [88]. Likewise, human data also support this concept as a meta-analysis (23 studies, 4,980 subjects) revealed a 0.55 of 1 standard deviation increase in oxidative stress markers among individuals with depression compared with those without depression, which was further supported by a negative correlation between depression and antioxidant status [91]. found a RR of 1.08 (95% CI: 1.011.15) for the incidence of ischemic heart disease per 10dB increase in road traffic noise exposure for the relationship of road traffic noise, starting as low as 50dB [1]. 2019, Article ID 4623109, 13 pages, 2019. https://doi.org/10.1155/2019/4623109, 1Center for Cardiology-Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany, 2Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany, 3German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany. Recently, two Dutch studies analyzed the influence of traffic noise on depression and anxiety [66, 67]. The same authors also demonstrated that road traffic noise exposure ( the median of noise levels) applied at specific frequencies may exert different impact on the risk for prevalent hypertension in 820 residents of central Taiwan with the 125Hz frequency component displaying the most pronounced hypertensive effects (OR: 4.08, 95% CI: 1.5710.63) [83]. Furthermore, several studies have indicated substantial associations between traffic noise exposure and metabolic abnormalities, showing that higher exposure is associated with increased risk of obesity and diabetes mellitus [5457], both well-established risk factors for cerebrocardiovascular [58, 59] and psychological disorders [60, 61]. Head, Chronic aircraft noise exposure, stress responses, mental health and cognitive performance in school children,, P. J. Marvar and D. G. Harrison, Stress-dependent hypertension and the role of T lymphocytes,, P. J. Marvar, A. Vinh, S. Thabet et al., T lymphocytes and vascular inflammation contribute to stress-dependent hypertension,, P. Palta, L. J. Samuel, E. R. Miller III, and S. L. Szanton, Depression and oxidative stress: results from a meta-analysis of observational studies,, C. N. Black, M. Bot, P. G. Scheffer, P. Cuijpers, and B. W. J. H. Penninx, Is depression associated with increased oxidative stress? In addition, Chang et al. [, Associations between total noise annoyance, (a) atrial fibrillation, (b) depression, and generalized anxiety in the Gutenberg Health Study. Similar findings were obtained by two other meta-analyses by Vienneau et al. Given this framework, chronic noise annoyance/stress may impair adaptation and increase stress vulnerability, leading to decreased stress resistance in order to cope with the stressor [15]. Results from a NORAH case-control study revealed that stroke risk was increased by 1.7% (OR: 1.017, 95% CI: 1.0031.032) for road traffic noise and by 1.8% (OR: 1.018, 95% CI: 1.0011.034) for railway noise per 10dB increase [42]. Our tax ID number is 13-1882107. The more recent study from 2017, based on data from the large Hypertension and Exposure to Noise near Airports (HYENA) study from 6 European countries, found that an increase in nocturnal aircraft noise exposure per 10dB was associated with an OR of incident hypertension of 2.63 (95% CI: 1.215.71) [31]. Won, W. Lee, P. K. Jung, and J. Roh, Occupational noise annoyance linked to depressive symptoms and suicidal ideation: a result from nationwide survey of Korea,, S. A. M. Rizk, N. E. Sharaf, H. Mahdy-Abdallah, and K. S. A. ElGelil, Some health effects of aircraft noise with special reference to shift work,, T. Mnzel, M. Srensen, F. Schmidt et al., The adverse effects of environmental noise exposure on oxidative stress and cardiovascular risk,, A. Daiber, S. Krller-Schn, K. Frenis et al., Environmental noise induces the release of stress hormones and inflammatory signaling molecules leading to oxidative stress and vascular dysfunctionSignatures of the internal exposome,, A. Tawakol, A. Ishai, R. A. P. Takx et al., Relation between resting amygdalar activity and cardiovascular events: a longitudinal and cohort study,, F. P. Schmidt, M. Basner, G. Kroger et al., Effect of nighttime aircraft noise exposure on endothelial function and stress hormone release in healthy adults,, N. Toda and M. Nakanishi-Toda, How mental stress affects endothelial function,, A. H. Miller and C. L. Raison, The role of inflammation in depression: from evolutionary imperative to modern treatment target,, F. Schmidt, K. Kolle, K. Kreuder et al., Nighttime aircraft noise impairs endothelial function and increases blood pressure in patients with or at high risk for coronary artery disease,, B. Bjor, L. Burstrom, M. Karlsson, T. Nilsson, U. Naslund, and U. Wiklund, Acute effects on heart rate variability when exposed to hand transmitted vibration and noise,, S. L. Lusk, B. Gillespie, B. M. Hagerty, and R. A. Ziemba, Acute effects of noise on blood pressure and heart rate,, A. S. Haralabidis, K. Dimakopoulou, F. Vigna-Taglianti et al., Acute effects of night-time noise exposure on blood pressure in populations living near airports,, T. Y. Chang, Y. Results from a cohort study in Athens, Greece,, T. Y. Chang, C. S. Liu, B. Y. Bao, S. F. Li, T. I. Chen, and Y. J. Lin, Characterization of road traffic noise exposure and prevalence of hypertension in central Taiwan,, J. Selander, M. E. Nilsson, G. Bluhm et al., Long-term exposure to road traffic noise and myocardial infarction,, N. Roswall, O. Raaschou-Nielsen, M. Ketzel et al., Long-term residential road traffic noise and NO, M. Srensen, Z. J. Andersen, R. B. Nordsborg et al., Road traffic noise and incident myocardial infarction: a prospective cohort study,, H. Hritier, for the SNC study group, D. Vienneau et al., Transportation noise exposure and cardiovascular mortality: a nationwide cohort study from Switzerland,, H. W. Davies, K. Teschke, S. M. Kennedy, M. R. Hodgson, C. Hertzman, and P. A. Demers, Occupational exposure to noise and mortality from acute myocardial infarction,, A. Seidler, M. Wagner, M. Schubert et al., Myocardial Infarction Risk Due to Aircraft, Road, and Rail Traffic Noise: Results of a CaseControl Study Based on Secondary Data,, M. Sorensen, M. Hvidberg, Z. J. Andersen et al., Road traffic noise and stroke: a prospective cohort study,, A. L. Hansell, M. Blangiardo, L. Fortunato et al., Aircraft noise and cardiovascular disease near Heathrow airport in London: small area study,, J. I. Halonen, A. L. Hansell, J. Gulliver et al., Road traffic noise is associated with increased cardiovascular morbidity and mortality and all-cause mortality in London,, A. L. Seidler, J. Hegewald, M. Schubert et al., The effect of aircraft, road, and railway traffic noise on stroke - results of a case-control study based on secondary data,, A. Seidler, M. Wagner, M. Schubert et al., Aircraft, road and railway traffic noise as risk factors for heart failure and hypertensive heart disease-a case-control study based on secondary data,, W. T. Yang, V. S. Wang, L. T. Chang et al., Road traffic noise, air pollutants, and the prevalence of cardiovascular disease in Taichung, Taiwan,, A. W. Correia, J. L. Peters, J. I.

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