Cardiovascular effects of environmental noise: research in Austria

Cardiovascular effects of noise rank second in terms of disability-adjusted life year (DALYs) after annoyance. Although research during the past decade has consolidated the available data base, the most recent meta-analysis still shows wide confidence intervals - indicating imprecise information for public health risk assessment. The alpine area of Tyrol in the Austrian part of the Alps has experienced a massive increase in car and heavy goods traffic (road and rail) during the last 35 years. Over the past 25 years small-, middle-, and large-sized epidemiological health surveys have been conducted - mostly within the framework of environmental health impact assessments. By design, these studies have emphasized a contextually driven environmental stress perspective, where the adverse health effects on account of noise are studied in a broader framework of environmental health, susceptibility, and coping. Furthermore, innovative exposure assessment strategies have been implemented. This article reviews the existing knowledge from these studies over time, and presents the exposure-response curves, with and without interaction assessment, based on standardized re-analyses and discusses it in the light of past and current cardiovascular noise effects research. The findings support relevant moderation by age, gender, and family history in nearly all studies and suggest a strong need for consideration of non-linearity in the exposure-response analyses. On the other hand, air pollution has not played a relevant role as a moderator in the noise-hypertension or the noise-angina pectoris relationship. Finally, different noise modeling procedures can introduce variations in the exposure response curves, with substantive consequences for public health risk assessment of noise exposure

Noise exposure and health effects in children: results from a contextual soundscape perspective

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Association and moderation of self-reported hypotension with traffic noise exposure: A neglected relationship

In a short-term experimental study about one-third of subjects exposed to noise shows both increases and decreases in blood pressure. While the association of noise with hypertension is established it is not yet known whether hypotension is associated with noise in field studies. In a cross-sectional study the association of self-reported hypotension and low blood pressure readings with traffic noise was examined in adults (age 25-65, N = 1989, participation = 62%). Noise exposure was based on both, short and long-term day/night recordings and standard noise mapping. Questionnaire data on socio-demographics, housing, life-style, noise and weather sensitivity, health status, mental and physical symptoms were available to adjust for potential confounding and testing for moderation. Non-linear multiple regression was applied to estimate the association between the two outcomes and overall noise exposure. We did not observe a stable relation between noise and low blood pressure readings since the number of subjects based on the recommended cut-off points (5 th percentile or 110 (100)/60 mmHg) was too small. However, self-reported hypotension was non-linearly associated with noise exposure ( P = 0.044) in the presence of a strong sex × age effect modification ( P < 0.0001). Another significant moderation by noise were observed with reported symptoms of exhaustion ( P = 0.03). Weather sensitivity showed a significant interaction with noise sensitivity ( P = 0.02) and also a non-linear interaction with age ( P = 0.02). The results remained stable after adjustment for variables known to be associated with constitutional hypotension. The exposure-effect curve ascends around sound levels of 55 dBA. The results suggest a novel moderated association of noise with self-reported hypotension, predominantly in weather sensitive women with symptoms of exhaustion. Further and larger studies are needed to replicate the potential moderating effect of noise on persons with constitutional hypotension

Hypotension and Environmental Noise: A Replication Study

Up to now, traffic noise effect studies focused on hypertension as health outcome. Hypotension has not been considered as a potential health outcome although in experiments some people also responded to noise with decreases of blood pressure. Currently, the characteristics of these persons are not known and whether this down regulation of blood pressure is an experimental artifact, selection, or can also be observed in population studies is unanswered. In a cross-sectional replication study, we randomly sampled participants (age 20–75, N = 807) from circular areas (radius = 500 m) around 31 noise measurement sites from four noise exposure strata (35–44, 45–54, 55–64, &gt;64 Leq, dBA). Repeated blood pressure measurements were available for a smaller sample (N = 570). Standardized information on socio-demographics, housing, life style and health was obtained by door to door visits including anthropometric measurements. Noise and air pollution exposure was assigned by GIS based on both calculation and measurements. Reported hypotension or hypotension medication past year was the main outcome studied. Exposure-effect relationships were modeled with multiple non-linear logistic regression techniques using separate noise estimations for total, highway and rail exposure. Reported hypotension was significantly associated with rail and total noise exposure and strongly modified by weather sensitivity. Reported hypotension medication showed associations of similar size with rail and total noise exposure without effect modification by weather sensitivity. The size of the associations in the smaller sample with BMI as additional covariate was similar. Other important cofactors (sex, age, BMI, health) and moderators (weather sensitivity, adjacent main roads and associated annoyance) need to be considered as indispensible part of the observed relationship. This study confirms a potential new noise effect pathway and discusses potential patho-physiological routes of actions

Delineation of Several DR-Restricted Tetanus Toxin T Cell Epitopes

We have characterized five human T cell clones specific for tetanus toxin. The combination of different techniques allowed us to precisely map two T cell epitopes within fragments 830-843 and 1273-1284 of tetanus toxin, as formally demonstrated by the use of corresponding synthetic peptides. The three other T cell clones were specific for regions 2-602, 604-742, and 865-1315 of tetanus toxin, respectively. The five T cell clones were shown to be restricted to HLA-DR Ag. Furthermore, the allele of HLA-DR utilized by the various epitopes has been determined. The use of HLA-DR-transfected L cells as APC directly demonstrated that two epitopes, one of which represented by fragment 1273-1284, were recognized in association with HLA-DRw52a. For the other three T cell epitopes, the data strongly suggested they were recognized in association with HLA-DR5. Finally, a sixth T cell clone was shown to be specific for tetanus toxoid, the vaccinal preparation of tetanus toxin, and not for other tetanus toxin fragments. This indicated that immunization with tetanus toxoid probably elicits a T cell response directed only in part against native tetanus toxin.

Fortbestehensprognose

Groß PJ, Amen M. Fortbestehensprognose. In: Auge-Dickhut S, Moser U, Widmann B, eds. Praxis der Unternehmensbewertung. Vol Loseblatt, 16. Journal, Dezember 2004, Abschnitt 5.9. München: Olzog Verlag; 2004: 1-52