More than Hearing Loss: How Noise Affects Your Health

Ms. Lowe is a Communication Specialist at the University of Delaware Disaster Research Center.

More than 50 years ago, the newly formed Environmental Protection Agency (EPA) enacted a landmark statute to mitigate one of the most prevalent and damaging types of pollution to human health. It’s likely not the hazard you’re thinking of, though—the Noise Control Act of 1972, addressed noise pollution.1,2

While the consequences of prolonged exposure to loud noise had long been accepted, this novel bill emphasized that the noises of everyday life, such as noise from transportation and machinery, affected peoples’ health, especially those living in urban areas. It also went beyond addressing noise-induced hearing loss, one of the hazard’s most commonly associated risks. The Noise Control Act of 1972 went on to fund research that showed noise pollution profoundly affected people’s overall wellbeing.

Noise pollution is broadly defined as “unwanted or disturbing sound” that interferes with normal activities and disrupts or diminishes one’s quality of life.3 The fact that this type of pollution is less tangible than others—in the sense that people cannot see, taste, or smell it—might explain why this public issue is still underestimated more than 50 years later. A growing body of research from across the globe shows that both chronic and intermittent noise doesn’t just damage your hearing; it has effects throughout the body that can undermine your quality of life.4  Here is what you need to know.

Hearing Loud and Clear

Noise takes a unique pathway through the body that begins when sound waves enter your ears. These vibrations bounce and move through your ear canal until they reach the cochlea, a small snail-shaped structure filled with fluid and lined with thousands of nerve endings, which transform the subtle motions into electrical impulses that travel along the auditory nerve.1,4–6 The brain interprets these signals, allowing us to recognize and identify sound. Unpleasant noise triggers the amygdala, the part of your brain that detects danger. This journey to the brain is just the beginning of a chain reaction that can cause harm to the body.

The Anatomy of Noise

Put simply, noise pollution stresses the autonomic nervous system, the involuntary part of this nervous system that controls the function of our organs.7–9 When the amygdala is chronically overactivated, it can cause two fundamental bodily systems to overreact: the endocrine system, which regulates and maintains hormones, and the sympathetic nervous system, which activates your “fight-or-flight” response.1,8,9 Research shows that this chain of events affects several fundamental facets of your health in addition to your hearing. 

Cardiovascular health. The combined response of the endocrine and sympathetic nervous systems can trigger several reactions throughout your body, including releasing too much cortisol and adrenaline into the bloodstream, raising your heart rate, and increasing inflammatory cell production.1,9–11 Over time, this response damages the inner lining of blood vessels, a condition known as endothelial dysfunction, which is associated with various forms of cardiovascular disease, including stroke, high blood pressure, and heart attacks.1,10–12 

Sleep. Noise has a major impact on sleep, which can have short- and long-term effects on your health.8 Some experts consider sleep disturbance the most severe nonauditory effect of environmental noise exposure because of its cascading effects throughout the body.10 Nighttime noise, even if it does not wake the person, can fragment or shorten sleep and trigger the stress response mentioned above.1,11 These patterns affect your health in numerous health ways and even increase the risk of overall mortality.14,15

Immunity. Though the exact mechanism is unclear, noise pollution may affect the body’s immune system.16–18 A recent review published in the Journal of Environmental Science and Health showed that noise can cause some changes in the immune system, such as the proliferation of immune cells and the production of antibodies.18 This cause and effect can inhibit the function and effectiveness of other systems and organs, which can make your body more susceptible to pathogens.16 New research also suggests that not all noise is created equal. Different exposure durations and intensities of noise may exert various effects on this immune response with “short-term or low-intensity noise” enhancing immune function and “long-term or high-intensity noise” suppressing it.16–19

Mental health. The psychological impact of noise pollution can be considerable.17,20 What might begin as an annoyance or nuisance, such as a slammed door or a train rushing by, can manifest as a distraction, discomfort, or even anger.21 Your body’s stress response is activated, if only briefly. When noise pollution becomes constant, however, people may feel helpless and frustrated. This can escalate into chronic stress, a known risk factor for mental health disorders.1,20,21 This emotional state can directly impact your short-and long-term health and overall quality of life. In addition to constant exhaustion, people facing persistent noise pollution can also experience mood changes, decreased cognitive performance, and impaired social behavior.22

Not All Noise Is Equal

Decibels, abbreviated as dB, are the unit of measure for sound. It ranges from zero, the softest sound a person can detect with normal hearing, to 140, which is considered the threshold for pain.24 Put simply, the louder the sound, the higher the decibel value. However, there is more nuance to this equation. The potential for noise to affect your health is based on three main factors: how loud the noise is, how close the source is, and how long you hear it.25–27

These factors are illustrated in the decibel scale (Figure 1), which is logarithmic, not linear. This means that loudness is not directly proportional to sound intensity (i.e., noise level). In other words, the sense of loudness in the ear generally doubles with every 10 dB increase.1,23 This also means that regular exposure to even just a few decibels above moderate levels can trigger reactions that harm your health.1,28 The general consensus among experts is to keep environmental noise moderate at most.25 The World Health Organization (WHO) and the National Institute on Deafness and Other Communication Disorders (NIDOCD) recommend keeping environmental noise levels at or below 70 dB.4,27 

Whether you’re exposed to noise that lasts a long time, such as attending a concert, or short or intermittent sounds, like the blast of fireworks, both have the potential to cause damage.25,27 This is why it’s important to be aware of the noise levels around you. You don’t need to have a sound meter, though, to discern when it reaches dangerous levels. The NIDOCD recommends using these benchmarks to gauge whether noise is at a safe volume:27

  1. You must raise your voice to be heard.
  2. You can’t hear or understand someone three feet away from you.
  3. Speech around you sounds muffled or dull after you leave the noisy area.
  4. After you hear the noise, you may experience pain, buzzing, or ringing in your ears. This condition, called tinnitus, can last for a few minutes or a few days.29

 

However, remember that volume is not the only factor in how dangerous a noise can be. The risks of such exposure can be difficult to interpret since they largely depend upon the source and sound quality.30 To account for the distance from the source of the sound and the length of time you are exposed to it, a good rule of thumb is to avoid noises that are too loud, too close, or last too long.23,27 

Safety and Prevention

We’ve all heard the saying, “An ounce of prevention is worth a pound of cure.” This is especially true for the hazards of noise pollution. Its impact on your health is cumulative, and sometimes, as in the case of noise-induced hearing loss, permanent.25–27,30 Luckily, there are several ways to reduce your risk.

Know your noise. Start by understanding your risk factors and exposure to noise pollution. Some “hotspots” might immediately come to mind, such as construction sites and downtown or urban areas, but more subtle sources, such as dogs barking or the rattling of home appliances, can also trigger reactions in your body. To get an exact benchmark of noise in your area, consider downloading a sound level meter application to your phone. With this information in mind, you can choose the most effective precautions for your lifestyle.

Reduce exposure. If possible, reduce your exposure to loud and ambient noise.31,32 This might include taking a break from noisy activity, distancing yourself from its source, and decreasing your time in noisy areas. Don’t forget about recreational noise. For personal devices that require headphones, experts recommend setting the volume at no more than 50 percent.26,32

Choose your tools. If you cannot reduce your exposure to noise pollution, there are several ways to dampen the noise around you. A 2016 study showed that earplugs and earmuffs can reduce noise by 15 to 30dB when used properly.33 Changes around your home can also be helpful. Double-pane glass can dampen noise from outside the home. Heavy curtains can block out traffic noise while also dampening reverberation inside rooms, which can help you hear more clearly.32 Rugs and carpets can do the same. Adding insulation to certain areas, such as rooms with noisy appliances, can help eliminate the source of noise altogether.

Bottom Line

Without major regulatory changes, the severity of noise pollution isn’t likely to change.1,30 For now, the onus is on the individual. Still, advocacy and awareness efforts are paving the way for change. The EPA has ranked noise second only to air pollution as the environmental exposure most harmful to public health.34–36 In 2017, researchers from the National Institute for Occupational Safety and Health collaborated with acoustics engineers and medical experts to create an iOS-based sound level meter app that measures and characterizes occupational noise exposure. For now, the power to reduce the impact of noise pollution is in your hands.

Sources
  1. Baumgaertner E, Kao J, Lutz E, et al. Noise could take years off your life. Here’s how. New York Times. 9 Jun 2023. Accessed 19 Jul 2024. https://www.nytimes.com/interactive/2023/06/09/health/noise-exposure-health-impacts.html
  2. United States Environmental Protection Agency. Summary of the Noise Control Act. Updated 6 Sep 2023. Accessed 19 Jul 2024. https://www.epa.gov/laws-regulations/summary-noise-control-act
  3. United States Environmental Protection Agency. Clean Air Act Title IV – Noise Pollution. Updated 8 Aug 2023. Accessed 19 Jul 2024. https://www.epa.gov/clean-air-act-overview/clean-air-act-title-iv-noise-pollution 
  4. World Health Organization. Compendium of WHO and other UN guidance on health and environment, 2024 update. 2024. Accessed 19 Jul 2024. https://iris.who.int/bitstream/handle/10665/378095/9789240095380-eng.pdf?sequence=1
  5. National Institute on Deafness and Other Communication Disorders.How do we hear? Updated 16 Mar 2022. Accessed 19 Jul 2024. https://www.nidcd.nih.gov/health/how-do-we-hear
  6. Bartel L, Mosabbir A. Possible mechanisms for the effects of sound vibration on human health. Healthcare (Basel). 2021;9(5):597.
  7. Cleveland Clinic. Endocrine system. Updated 23 Nov 2023. Accessed 19 Jul 2024. https://my.clevelandclinic.org/health/body/21201-endocrine-system
  8. Cleveland Clinic. Sympathetic nervous system (SNS). Updated 6 Jun 2022. Accessed 19 Jul 2024. https://my.clevelandclinic.org/health/body/23262-sympathetic-nervous-system-sns-fight-or-flight
  9. Summer J, Singh A. How noise can affect your sleep satisfaction. Sleep Foundation. Updated 7 Mar 2024. Accessed 21 Jul 2024. https://www.sleepfoundation.org/noise-and-sleep
  10. Moreyra, A, Subramanian, K, Mi, Z. et al. The impact of exposure to transportation noise on the rates of myocardial Infarction in New Jersey. JACC. 2022;9(9):1148.
  11. Münzel T, Gori T, Babisch W, Basner M. Cardiovascular effects of environmental noise exposure. Eur Heart J. 2014;35(13)829–836.
  12. Hahad O, Kröller-Schön S, Daiber A, Münzel T. The cardiovascular effects of noise. Dtsch Arztebl Int. 2019;116(14):245–250.
  13. Cleveland Clinic. Endothelium. Updated 10 Jul 2022. Accessed 19 Jul 2024. https://my.clevelandclinic.org/health/body/23471-endothelium
  14. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Sleep duration and all-cause mortality: a systematic review and meta-analysis of prospective studies. Sleep. 2010;33(5):585–592.
  15. Oswald I, Taylor AM, Treisman M. Discriminative responses to stimulation during human sleep. Brain. 1960;83:440–453.
  16. Zhang A, Zou T, Guo D, et al. The immune system can near noise. Front Immunol. 2021;11:619189.
  17. Halperin D. Environmental noise and sleep disturbances: a threat to health? Sleep Sci. 2014;7(4):209–212.
  18. Abouee-Mehrizi A, Rasoulzadeh Y, Kazemi T, Mesgari-Abbasi M. Inflammatory and immunological changes caused by noise exposure: a systematic review. J Environ Sci Health C Toxicol Carcinog. 2020;38(1):61–90.
  19. Zheng KC, Ariizumi M. Modulations of immune functions and oxidative status induced by noise stress. J Occup Health. 2007;49(1):32–38.
  20. Hahad O, Kuntic M, Al-Kindi S, et al. Noise and mental health: evidence, mechanisms, and consequences. J Expo Sci Environ Epidemiol. 2024. Epub ahead of print.
  21. Roberts K. The not so silent saboteur: how noise affects your mental health. PortagePath Behavioral Health. 7 Jun 2023. Accessed 21 Jul 2024. https://www.portagepath.org/not-so-silent-saboteur/
  22. Stansfeld SA, Matheson MP. Noise pollution: non-auditory effects on health. Br Med Bull. 2003;68:243–257. 
  23. Hearing Health Foundation. What are safe decibels? Accessed 22 Jul 2024. https://hearinghealthfoundation.org/keeplistening/decibels
  24. Plutchik R. Auditory pain thresholds for intermittent, “beat” and steady signals. Percept Mot Skills. 1963;16:863–870.
  25. American Speech-Language-Hearing Association. Loud noise dangers. Accessed 20 Jul 2024. 2019. https://www.asha.org/public/hearing/loud-noise-dangers/
  26. American Speech-Language-Hearing Association. Audiology Information Series: Noise. 2019. Accessed 20 Jul 2024. https://www.asha.org/siteassets/ais/ais-noise.pdf
  27. National Institute on Deafness and Other Communication Disorders. Noise-Induced Hearing Loss. Updated 16 Mar 2022. Accessed 21 Jul 2024. https://www.nidcd.nih.gov/health/noise-induced-hearing-loss
  28. Vienneau D, Saucy A, Schäffer B, et al. Transportation noise exposure and cardiovascular mortality: 15-years of follow-up in a nationwide prospective cohort in Switzerland. Environ Int. 2022;158:106974.
  29. National Institute on Deafness and Other Communication Disorders. Tinnitus. Updated 16 Mar 2022. Accessed 21 Jul 2024. https://www.nidcd.nih.gov/health/tinnitus
  30. Baumgaertner E. Are you exposed to too much noise? Here’s how to check. New York Times. 9 Jun 2023. Accessed 25 Jul 2024. https://www.nytimes.com/2023/06/09/health/noise-sound-exposure.html
  31. Oiamo TH, Luginaah IN, Baxter J. Cumulative effects of noise and odour annoyances on environmental and health related quality of life. Soc Sci Med. 2015;146:191–203.
  32. Roberts C. When your hearing isn’t great even at home, there are things you can do. Washington Post. 22 Jul 2024. Accessed 29 Jul 2024. https://www.washingtonpost.com/wellness/2024/07/22/hearing-loss-tv-background-noise/
  33. Ramakers GGJ, Kraaijenga VJC, Cattani G, et al. Effectiveness of earplugs in preventing recreational noise-induced hearing loss: A randomized clinical trial. JAMA Otolaryngol Head Neck Surg. 2016;142(6):551–558.
  34. Tolotto M. Noise pollution. European Environmental Bureau. Mar 2020. Accessed 29 Jul 2024. https://eeb.org/work-areas/air-and-noise-pollution/noise-pollution/
  35. World Health Organization. Environmental Noise Guidelines for the European Region. 1 Oct 2018. Accessed 29 Jul 2024. https://www.who.int/europe/publications/i/item/WHO-EURO-2018-3287-43046-60243
  36. Dutchen S. Noise and health. Harvard Medicine Magazine. Mar 2022. Accessed 29 Jul 2024. https://magazine.hms.harvard.edu/articles/noise-and-health
  37. National Institute for Occupational Safety and Health. NIOSH noise: a 50-year timeline of research and intervention. 19 Jan 2022. Accessed 25 Jul 2024. https://blogs.cdc.gov/niosh-science-blog/2022/01/19/noise-50/

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