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Vytautas Magnus Univrsity Lithuanian Research Centre for Agriculture and Forestry VYTAUTAS MAGNUS UNIVRSITY LITHUANIAN RESEARCH CENTRE FOR AGRICULTURE AND FORESTRY Inga BENDOKIENĖ ESTIMATION OF EXPOSURE TO ROAD TRAFFIC NOISE AND ITS RELATION TO THE RISK OF HYPERTENSION IN WOMEN Summary of Doctoral Dissertation Biomedical Sciences, Ecology and Environmental Sciences (03 B) Kaunas, 2011 The right of doctoral studies was granted to Vytautas Magnus University jointly with Lithuanian Research Centre for Agriculture and Forestry on July 15, 2003, by the decision No. 926 of the Government of the Republic of Lithuania. Dissertation was performed at Vytautas Magnus University in 2005-2011. Scientific Supervisor: Prof. habil. dr. Regina Graţulevičienė (Vytautas Magnus University, Biomedical Sciences, Ecology and Environmental Sciences 03 B) Council of defence of the doctoral dissertation: Chairman Prof. habil. dr. Romaldas Juknys (Vytautas Magnus University, Biomedical Sciences, Ecology and Environmental Sciences 03 B) Members Prof. habil. dr. Pranas Baltrėnas (Vilnius Gediminas Technical University, Technological Sciences, Environmental Engineering and Landscape Management 04T) Doc. habil. dr. Regina Rėklaitienė (Lithuanian University oh Health Sciences, Biomedical Sciences, Public Health 09B) Prof. habil. dr. Vida Stravinskienė (Vytautas Magnus University, Biomedical Sciences, Ecology and Environmental Sciences 03 B) Prof. dr. Jonė Venclovienė (Vytautas Magnus University, Biomedical Sciences, Ecology and Environmental Sciences 03 B) Oponents: Prof. habil. dr. Remigijus Ozolinčius (Lithuanian Research Centre for Agriculture and Forestry, Biomedical Sciences, Ecology and Environmental Sciences 03B) Prof. habil.dr. Abdonas Tamošiūnas (Lithuanian University oh Health Sciences, Biomedical Sciences, Public Health 09B) The official defence of the dissertation will be held at 2 p.m. on December 16, 2011 at a V. Čepinskis lecture the hall No 605 in 2nd House of Vytautas Magnus University. Address: Vileikos st. 8, LT-44404, Kaunas, Lithuania. Phone: +370 37 327904 Summary of doctoral dissertation was sent out on November 16, 2011 The dissertation is available at M. Maţvydas National Library of Lithuania and the libraries of Vytautas Magnus University and Institute of Forestry, Lithuanian Research Centre for Agriculture and Forestry. 2 INTRODUCTION Environmental noise management is an important part of the European Union policy. The current European Union environmental policy is focused on the noise level reduction. This is reflected in the adopted Directive 2002/49/EC on the environmental noise assessment and management. The directive obliges Member States to draw up strategic noise maps describing the existing noise levels in major cities and providing information on the measures necessary to improve the state. In the areas where the noise level exceeds the allowable limits it is recommended to develop plans to reduce noise and to take appropriate measures for noise level management. For the majority of the urban population the transport-related and industrial noise is one of the biggest local environmental problems. Road transport noise in urban areas is growing significantly. Deterioration quality of the living environment leads to the increase of public health problems (Clark et al., 2006). People who live in a noisy environment suffer from annoyance, sleeplessness and later on for them might arise circulatory and nervous system disorders and progression of chronic disease (Berglund et al., 2000; Stansfeld et al., 2005; Muzet, 2007). Urban environmental noise sources can be different – road motor vehicles, industries, or the domestic noise emitted by householders. Nevertheless, the transport contributions to the overall increase in ambient noise levels are highest (European ..., 1995; de Kluizenaar et al., 2007; Kropp et al., 2007). The growing traffic flow requires investigation in noise reduction as it is very important to the people who live near busy main streets (Baublys et al., 2003). Environmental noise, caused by traffic, industrial and recreational activities, is one of the main environmental problems and the source of an increasing number of complaints from the local population. The European Commission has recognized the importance of monitoring of noise exposure, and also acknowledged the necessity of substantive investigations for appropriate policies to control noise through legislation. The main goal of the local action is to reduce noise to the level which is safe to the most susceptible resident’s health. (Kaminskas, 2001). In recent years, to improve the environmental exposure assessment and noise modeling are used Geographic Information System (GIS). This tool allows an accurate assessment of noise levels in different areas of the city and to predict the noise level changes in the future. Using GIS to determine the population exposure, it is possible to simulate the data geographically and therefore an individual noise exposure to large groups of people can be evaluated without time-consuming and expensive measurements (Jarup, 2004). In recent decades, usage GIS in epidemiological studies has began for the evaluation of the environmental impact on the population health (Nuckols et al., 2004). GIS is used for the connection of the individual exposure with its consequences - damage to health (Elliott et al., 2001; Nieuwenhuijsen, 2004). Scientific studies have shown that noise has a significant impact on human health, promoting chronic disease progression (Job, 1999; Guski, 1999; Stallen, 1999; Babisch, 2000, 2002; Schwela, 2000; Van Kempen et al., 2002). Noise, identified as sound waves that can cause health problems, is seen as an environmental stressor. Noise level, life and other characteristics of the noise can act differently on the human health. Effects can be anything from annoyance, sleeplessness or stress to serious health problems - hearing impairment, cardiovascular disease, even death. Living near a main 3 road, where dominated permanent exposure to noise, people complain by disturb sleep, increased irritability (Pearson et al., 1995; Miedema et al., 2001). The long-term exposure to noise and other environmental factors in susceptible individuals can lead to irreversible health problems - develop coronary heart disease or arterial hypertension (Lundberg, 1999; Babisch, 2000; Belojevic et al., 2008). Therefore, recently was paid a high politicians and public health professionals focus on the harmful environmental factors, including noise, and to the identification and exploration of the opportunities to control them (WHO, 2000). Epidemiological studies have shown that residence more than 10 years in a noisy environment, increases the risk for hypertension approximately by 2-fold (Bluhm et al., 2007; Barregard et al., 2009). Residential environmental noise impact is greater when a person works in the noisy work environment (Passehier- Vermmer et al., 2000). Noise at work is recognized as a one of the hypertension risk factors (Hirai et al., 1991; Fogar et al., 1994; Hessel, 1994; Powazki et al., 2002; Davis et al., 2005). Age of the population is also associated with the prevalence of hypertension. Most cases of hypertension occur in older than 50 years ages (Barregard et al., 2009), but hypertension occurs at a younger age also. There is only few publicized research to determine the effect of residential noise on the health of young people. In order to create a program for the prevention of hypertension and to propose reasonable measures, it is important to assess the prevalence of hypertension among young and middle-aged population, to identify potential risk factors and their control methods. In the investigation of noise impact on arterial hypertension, it is necessary accurately determine individual noise exposure, to link the exposure with health status by using of modern data collection system GIS, and to assess the strength of the relationship between exposure levels and the risk of hypertension. The author of this work by using GIS, geocoded the study participants’ addresses linked them to the residential vehicle traffic noise level, created noise maps and conducted data analysis. To assess the noise exposure of individual women of reproductive age and the relationship with hypertension, the author carried out an epidemiological study. By using GIS and noise measurement and modeling data, individual noise exposure in Kaunas was evaluated, and traffic flow analysis and composition was estimated. Women's Health data of this environmental epidemiological study were collected by using the European Commission's 6th Framework Programme (FP6) Hiwate methodology. Objective and goals of the research. The aim of this research is to estimate and evaluate the motor noise level in the Kaunas city, and by controlling influence of confounding factors, to determine the residential noise impact on the risk of hypertension among 20-45 age women. To achieve this objective the following tasks were set up: 1. To assess the impact of traffic composition on the noise level in Kaunas city. 2. To determine the daily noise level variation in the different traffic intensity streets using a linear regression equation. 3. To identify the factors that may influence the relationship between noise and hypertension risk in women. 4. To assess relationship between noise exposure and the risk of hypertension controlling for influence of confounding factors. 4 The research is based on the hypothesis that road traffic noise can influence hypertension risk among women 20-45 years age. Statements for defence. 1. Noise
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