Table 4.
Summary of findings for noise exposure and heart rate
| Outcomes | Relative or absolute effects(95% CI) | No. of participants(studies) | Certainty of the evidence(GRADE) |
|---|---|---|---|
| Heart rate – cross-sectional assessed with: exposure to road traffic noise | [30]: Quiet residence, noisy kindergarten vs quiet residence, quiet kindergarten: MD: -1.58 bpm, 95% CI: –5.00, 1.84Noisy residence, quiet kindergarten vs quiet residence, quiet kindergarten: MD: 2.44 bpm, 95% CI: –1.17, 6.05Noisy residence, noisy kindergarten vs quiet residence, quiet kindergarten: MD: 1.91 bpm, 95% CI: –1.36, 5.18[75]:Noisy (61–69 dBA) vs quiet (≤60 dBA): MD –2.14 bpm, 95% CI: –2.21, –2.07Very noisy (≥70 dBA) vs quiet (≤60 dBA): MD –3.91 bpm, 95% CI: –4.00, –3.82[101]: association between Lden and blood pressureLden <55 dBA: referenceLden 55–60 dBA: 0.66, 95% CI: 0.49, 0.83Lden > 60 dBA: 1.19, 95% CI: 0.95, 1.44 | 90,206(3 observational studies) | ⊕○○○VERY LOW *,† |
| Heart rate – cohort assessed with: exposure to road traffic noise | [92]:Beta of estimated change in SBP per dBA: –0.02, 95% CI: –0.13, 0.08 | 853(1 observational study) | ⊕○○○VERY LOW †,‡ |
| Heart rate – cross-sectional assessed with: exposure to air traffic noise | [57]: 150 m vs 75 m areasBoys: MD: 4.60, 95% CI: 2.25, 6.95Girls: MD: 1.20, 95% CI: –1.14, 3.54[76]:Exposed (>60 dBA) vs unexposed (<55 dBA): MD: 2.80, 95% CI: 0.42, 5.18 | 634(2 observational studies) | ⊕○○○VERY LOW †,$,|| |
| Heart rate – cohort assessed with: exposure to air traffic noise | [92]: Beta of estimated change in HR per dBA for pooled cohorts:At school Leq 7-23h: 0.05, 95% CI: –0.06, 0.15At home Leq 7-23h: 0.02, 95% CI: –0.08, 0.13At home Leq 23-7h: 0.03, 95% CI: –0.07, 0.12 | 853(1 observational study) | ⊕○○○VERY LOW †,‡ |
| Heart rate – cross-sectional assessed with: exposure to occupational noise | [138]:increase in heart rate per 1 dBA: 0.17, 95% CI: NR[48]:High noise >70 dBA vs low noise <50 dBA: MD: 7.23, 95% CI: 4.41, 10.05[62]:Engine room crew (1–4 y service) vs Engine room crew (5–9 y service): MD: 5.10, 95% CI: 3.59, 6.61 Engine room crew (1–4 y service) vs Engine room crew (10–14 y service): MD: 8.50, 95% CI: 7.24, 9.76Engine room crew (1–4 y service) vs Engine room crew (15–19 y service): MD: 5.80, 95% CI: 4.38, 7.22 Engine room crew (1–4 y service) vs Engine room crew (20+ y service): MD: 8.30, 95% CI: 7.12, 9.48Deck crew (1–4 y service) vs Deck crew (5–9 y service): MD: –3.10, 95% CI: –4.19, –2.01 Deck crew (1–4 y service) vs Deck crew (10–14 y service): MD: 6.60, 95% CI: 5.52, 7.68 Deck crew (1–4 y service) vs Deck crew (15–19 y service): MD: 2.40, 95% CI: 1.17, 3.63Deck crew (1–4 y service) vs Deck crew (20+y service): MD: 5.70, 95% CI: 4.90, 6.50[82]:Exposed (88–107 dBA) vs unexposed: MD: 3.29, 95% CI: 2.88, 3.70[143]:beta per 1 dBA increase in Leq: 0.5 dBA, 95% CI: 0.04, 0.09[77]:<10 yrs exposed vs <10 yrs controls: MD: 10.50, 95% CI: 2.89, 18.1110–20 yrs exposed vs 10–20 yrs: controls: MD: 10.10, 95% CI: 4.22, 15.98>20 yrs exposed vs >20 yrs control: MD: 7.80, 95% CI: 3.62, 11.98 | 553(6 observational studies) | ⊕○○○VERY LOW ¶ |
| Heart rate – cohort assessed with: exposure to occupational noise | MD 8.91 bpm higher (95% CI 1.71 higher to 16.1 higher) | 913(4 observational studies) | ⊕○○○VERY LOW # |
| Heart rate – case-control assessed with: exposure to railway noise | [139]: area under curve of heart rate; 36 trains/night vs 20 trains/night Low vibration 36 trains (real) vs low vibration 20 trains (real): MD: 35.50, 95% CI: –26.44, 97.44 Low vibration 36 trains (fake) vs low vibration 20 trains (fake): MD: 4.80, 95% CI: –35.39, 44.99High vibration 36 trains (real) vs high vibration 20 trains (real) : MD: 32.90, 95% CI: –14.13, 79.93 High vibration 36 trains (fake) vs high vibration 20 trains (fake): MD: 9.60, 95% CI: –22.60, 41.80 | 24(1 observational study) | ⊕○○○VERY LOW †,||,** |
| Heart rate – cross-sectional assessed with: exposure to ambient noise | [143]:With each 1 dBA increase in Leq SD increased: 0.5bpm, 95% CI: 0.04, 0.9 | 22(1 observational study) | ⊕○○○VERY LOW ||,†† |
| Heart rate – cohort assessed with: exposure to ambient noise | [29]:Social (room conversation) vs Social (hall conversation): MD: 3.20, 95% CI: –9.59, 15.99 Ambient (environmental sounds) vs Ambient (background sound): MD: 4.00, 95% CI: –8.68, 16.68[144]:Leq ≥ 65 dBA vs Leq < 65 dBA: MD: 5.70, 95% CI: 5.31, 6.09 | 130(2 observational studies) | ⊕○○○VERY LOW †,||,‡‡ |
| Heart rate – cohort assessed with: exposure to lab-simulated noise | [137]:Music (85 dBA in fetus) vs control: MD: 6.86, 95% CI: –2.82, 16.54 Voice (74 dBA in fetus) vs control: MD: 5.72, 95% CI: –3.71, 15.16 | 20(1 observational study) | ⊕○○○VERY LOW †,||,$$ |
| Heart rate – clinical trial assessed with: exposure to lab-simulated noise | Noise 60 vs control: MD: 0.42, 95% CI: –0.92, 1.76[52,79,80,148] Noise 60 vs control: MD: 0.08, 95% CI: –1.74, 1.89[52,79] | 275(4 observational studies) | ⊕○○○VERY LOW †,||,|||| |
CI: confidence interval; GRADE, Grading of Recommendations, Assessment, Development, and Evaluation; MD: mean difference; NR: not reported; SPL: sound pressure level. GRADE Working Group grades of evidence. High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of the effect. Explanations *Critical concern with confounding. Moderate concern with measurement of exposure. Serious concerns with missing data and measurement of outcome. †Concerns with imprecision because the 95% CI cannot exclude the potential for harm. ‡Moderate concerns with measurement of exposure and missing data. $Critical concerns with confounding, measurement of exposure, missing data and measurement of outcome. ||Concerns for imprecision since a small sample included does not meet the optimal information size and suggests fragility of the estimate. ¶Critical concern with confounding and measurement of outcome. Moderate concern with exposure assessment. Serious concern with missing data. #Critical concern with confounding. Moderate concerns with measurement of exposure, missing data and measurement of outcome. **Critical concern with confounding. Moderate concern with missing data. ††Moderate concern with measurement of exposure and missing data. Serious concern with measurement of outcome. ‡‡Critical concern with confounding. Concerns for imprecision because the small sample included does not meet the optimal information size and suggests the fragility of the estimate. ||||Critical concern with confounding. Moderate concern with missing data. Serious concern with measurement of outcome.