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Annoyance
Today, we consider noise annoyance as the most prominent and immediate impact reaction to aviation noise. In other words, aircraft noise is well known as an environmental stressor negatively affecting human health. It is essential to understand the underlying mechanisms in order to tackle and (re)act on the problem of harmful effects of environmental conditions such as noise exposure.
Model of the impact of environmental noise
The link between aircraft noise annoyance and health outcomes
The WHO review highlighted annoyance as a potential mediator of long-term health impacts (WHO, 2018). The WHO states that noise annoyance leads to anger, disappointment, dissatisfaction, withdrawal, perceived loss of control or even helplessness, depression, anxiety, distraction, agitation or exhaustion and sleep disturbance (WHO, 2018). Noise provokes – through an indirect pathway – disturbance, cognitive and emotional responses summarised in the annoyance reaction (Babisch, 2002). These responses are accompanied by neuroendocrine and neural activations, which might contribute to prolonged stress reactions, that in turn can induce health relevant biological changes. In this way, the multi-dimensional annoyance structure might be related to, or even contribute to various undesirable health outcomes or even to manifest disorders.
On the other hand, in particular with regard to mental health, it is suggested that health impairments may amplify annoyance responses to noise instead or besides the contribution of noise annoyance to the development of mental health outcomes. However, there is evidence that the relationship between annoyance and health is more complex and probably reciprocally related to each other. Still, the causal pathway is not yet fully understood.
After the WHO (2018) guidelines on environmental noise were published (based on reviews of evidence published between 2000 and 2015), ANIMA reviewed articles beyond the WHO cut-off date on this topic to collate findings on the potential relationship and further understand this issue. Beside research on the relationship between aircraft noise exposure and health outcomes, studies included in the ANIMA review investigated the relationship between aircraft noise annoyance and cardiovascular diseases, sleep, quality of life, mental health-related measures and physical activity.
Below, the number of studies identified in the ANIMA review in addition to the WHO report (2018) and related to the association between aircraft noise annoyance and further health outcomes together with their key messages are reported.
Annoyance and hypertension
Three studies found a positive association between noise annoyance and hypertension; one study indicated that the relative risk of hypertension among subjects reporting annoyance was significantly higher than in those not reporting annoyance. The second study showed that only people with higher noise annoyance levels had an increased risk of hypertension and the third study found that more highly annoyed people use antihypertensive medication compared to people who are not highly annoyed. A fourth study investigating the relationship between noise annoyance and cardiovascular diseases observed no significant association between blood pressure levels and aircraft noise annoyance.
In summary, the measures differed substantially and, as all the studies are cross-sectional, the evidence is not sufficient to draw consistent causal conclusions.
Annoyance and sleep quality
Two studies investigated the link between annoyance and sleep quality and sleep disturbance; results of both studies – although differing in measures – indicate a possible association between self-reported sleep measures and aircraft noise annoyance.
Annoyance and mental health
Two studies focused on mental health and wellbeing-related measures. One longitudinal study observed the relationship between aircraft noise annoyance and mental health-related quality of life (QoL). One cross-sectional study examined the relationship between aircraft noise annoyance and psychological distress.
The former study found a negative association between mental health-related quality of life and annoyance. Analysing the causal pathway revealed annoyance to exacerbate future mental health-related QoL for given noise levels. Also, a reciprocal association between annoyance and mental health-related QoL was observed. Additionally, mental health-related QoL seemed to negatively influence future annoyance ratings.
The second study found no association between noise exposure and psychological distress. However, psychological distress was linked to aircraft noise annoyance, with a substantial increase in distress for people who were extremely annoyed.
Annoyance and physical activity
One longitudinal study showed that transportation noise annoyance is negatively associated with physical activity; a decrease in moderate physical activity was seen to be a result of a long-time noise annoyance (ten-year follow-up).
Conclusion
Results indicate that, to a certain extent, individual appraisals of noise contribute more to negative health outcomes than noise levels themselves. Some studies point out that noise annoyance might serve as a mediator between noise exposure and health outcomes. Long-term studies and more complex conceptual models are needed to further investigate the causal relationship between noise exposure, noise annoyance and further health outcomes.