1、附录 英文文献原文 Traffic noise causes a lot of concern in the population. It annoys, disturbs sleep andcan cause cardiovascular problems in chronically noise-exposed subjects.Approximately 50 million people in the European community are exposed to soundlevels from road traffic at home, that are suspected o
2、f increasing the risk ofcardiovascular disorders. The noise effects hypothesis is based on the general stressmodel. The mechanism includes arousal of the sympathetic and endocrine system.Heart rate, blood pressure, stress hormones and classical biological risk factors of ischaemic heart disease (IHD
3、) are affected by the noise. In epidemiological studies,subjects who live in noise exposed areas show a higher prevalence of high bloodpressure and IHD (including myocardial infarction). It is estimated thatapproximately 3 per cent of IHD cases in the general population may be attributed totraffic n
4、oise. 1. Introduction It is common experience that noise is unpleasant and affects the quality of life. Itdisturbs and interferes with activities of the individual including concentration,communication, relaxation and sleep (WHO, 2000a and 2000b； Schwela, 2000).Besides the psychosocial effects of co
5、mmunity noise, there is concern about theimpact of noise on public health, particularly regarding cardiovascular outcomes(Suter, 1992； Passchier-Vermeer and Passchier, 2000； Stansfeld et al., 2000a).Nonauditoryhealth effects of noise have been studied in humans for a couple of decadesusing laborator
6、y and empirical methods. Biological reaction models have beenderived which are based on the general stress concept (Henry and Stephens, 1977；Isinget al., 1980； Lercher, 1996). The noise-hypothesis is nowadays wellestablished, and large-scale epidemiological studies have been carried out for a longti
7、me (Babisch, 2000).Studies suggest, that transportation noise is associated with adversecardiovascular effects, in particular ischaemic heart disease. Other important healthendpoints that have intensively been investigated in relation to chronic noiseexposure are disrupted sleep (Ouis, 1999； Passchi
8、er-Vermeer, 2003a and 2003b),mental health (Stansfeld et al., 2000b), and effects on the endocrine system (Isingand Braun, 2000； Babisch 2003). This article focuses on the impact of ambient noiseon the prevalence and incidence of hypertension and ischaemic heartdiseases(including myocardial infarcti
9、on) as severe health endpoints. 1.1. Traffic noise level The A-weighted long-term average sound pressure level is used to describe the noiseexposure at the facades of the peoples homes (LAeq). A distinction is often madebetween the exposure during the day (6-22 hr) and the night (22-6 hr). To assess
10、 anoverall indicator of the noise exposure, a weighted average was usually calculated(Ldn), giving a 10 dB(A) penalty to the night period. The new directive of theEuropean Union on the assessment and management of environmental noiseconsiders a weighted long-term average (Lden) of the sound pressure
11、 levels duringday (e. g. 7-19 hr), evening (e. g. 19-23 hr, penalty 5 dB(A) and night (e. g. 23-7 hr,penalty 10 dB(A) and an un-weighted night-time noise indicator (Lnight) (Directive2002/49/EC, 2002).In Table 1 the distributions of residential noise due to road and rail traffic inGermany are given
12、(Umweltbundesamt, 2001). Based on model calculations,approximately 16 per cent of the German population live in noisy zones (WHORegional Office Europe, 2000) where the road traffic noise level outdoors exceeds 65 dB(A) during the day and 55 dB(A) during the night. For such noise levels considerable
13、annoyance occurs (WHO European Centre for Environment and Health, 1995), and the cardiovascular risk tends to increase (Babisch, 2002). Only afew European countries have assessed the noise exposure completely. In EuropeanUnion countries approximately 13 per cent of the population are exposed to such
14、levels at the facades of their houses due to road traffic (EEA, 1999). For the wholeof Europe the estimate is approximately 20 per cent (Schwela） 1.2. Noise annoyance Figure 1 shows the relationships between the noise level (outdoors) and thepercentage of highly annoyed people due to road, air and r
15、ail traffic. The doseresponsecurves are taken from Miedema and Vos (1998). They are derived frommeta-analyses considering a large number of social surveys that were carried out over the recent decades in different countries. For the same noise level, aircraft noise is more annoying than road traffic
16、 noise and railway noise. However, there are limitations regarding the universal applicability of the curves in different environmental and cultural settings (Ouis, 2002； Diaz et al., 2001； Finegold and Finegold, 2003). Therefore it was suggested by a WHO working group on noise and health indicators
17、 that countries should assess their individual dose-response curves(WHO, 2003).From the results of nationwide representative surveys carried out regularly in Germany, it is known that road traffic noise is the predominant source of annoyance for the population. Table 2 gives the results of the year
18、2000 (Ortscheid and Wende,2002). Eighteen percent of the population are highly annoyed by road traffic noise(categories extremely and very on a five-point scale). Annoyance due to noise from neighbours (6.5 percent) and air traffic (5.7 percent) follow next in the ranking. 2. Noise and stress The au
19、ditory system is continuously analysing acoustic information, which is filtered and interpreted by different cortical and sub-cortical brain structures. The limbic system, including the hippocampus and the amygdala, plays an important role in the emotional processing pathways (Spreng, 2000). It has
20、a close connection to the hypothalamus that controls the autonomic nervous system and the hormonal balance of the body. In laboratory studies, changes in blood flow, blood pressure and heart rate were found as well as increases in the release of stress hormones including the catecholamines adrenaline and noradrenaline, and the corticosteroid cortisol (Babisch, 2003； Berglund and Lindvall, 1995； Maschke et al., 2000). Such changes also occur during sleep without involvement of cortical structures due to the capacity
