The pathogenesis of allergies can be stimulated by adjuvant effects--i.e. air pollutants such as NOx and particles from diesel engines as well as noise--the latter especially during night-time. During sleep, noise signals which are associated with danger (i.e. lorry noise) have the potential to trigger stress reactions even if the noise level is low. Increases of cortisol in the first half of the night seem to play an important role.--In a blind interview study, the combined effects of chronic exposure to traffic related air pollution and noise, upon the risk of skin and respiratory diseases in children were studied. All children between 5-12 years, who had consulted one of two participating pediatricians were included in the study. The pediatricians' diagnoses of 400 children were analysed together with their parents answers on the density of road traffic on their street and several confounding factors. Multiple regression analyses resulted in relative risks of asthma, chronic bronchitis and neurodermitis, which increased significantly with increasing traffic load. A comparison with the literature on such effects caused by air pollution alone, showed that traffic noise during the night might have an adjuvant effect on the pathogenesis of the mentioned diseases.
In noise effect research often the awakening reaction is maintained to be the only important health related reaction. The main argument is that sleep represents a trophotropic phase ("energy storing"). In contrast to this awakening reactions or lying awake belong to the ergotropic phase ("energy consuming"). Frequent or long awakening reactions endanger therefore the necessary recovery in sleep and, in the long-run, health. Findings derived from arousal and stress hormone research make possible a new access to the noise induced nightly health risk. An arousal is a short change in sleeping condition, raising the organism from a lower level of excitation to a higher one. Arousals have the function to prevent life-threatening influences or events through activation of compensation mechanisms. Frequent occurrences of arousal triggered by nocturnal noise leads to a deformation of the circadian rhythm. Additionally, the deep sleep phases in the first part of the night are normally associated with a minimum of cortisol and a maximum of growth hormone concentrations. These circadian rhythms of sleep and neuroendocrine regulation are necessary for the physical as well as for the psychic recovery of the sleeper. Noise exposure during sleep which causes frequent arousal leads to decreased performance capacity, drowsiness and tiredness during the day. Long-term disturbances of the described circadian rhythms have a deteriorating effect on health, even when noise induced awakenings are avoided.
Mainly dependent on level and dynamic increase sound produces over-shooting excitations which activate subcortical processing centers (e.g. the amygdala, functioning as fear conditioning center) besides cortical areas (e. g. arousing annoyance, awakenings) as well. In addition there exist very close central nervous connections between subcortical parts of the auditory system (e.g. amygdala) showing typical plasticity effects (sensitization) and the hypothalmic-pituitary-adrenal (HPA)-axis. Using that causal chain noise induce cortisol excretion even below the awakening threshold. Thus repeated noise events (e.g. overflights during night time) may lead to accumulation of the cortisol level in blood. This can happen because its time-constant of exponential decrease is about 50 to 10 times larger than that one for adrenaline and noradrenaline. This fact and the unusual large permeability of cortisol through the cell membranes opens a wide field of connections between stress-dependent cortisol production and the disturbance of a large number of other endocrine processes, especially as a result of long-term stress activation by environmental influences such as environmental noise. Based upon a physiological model calculating the cortisol accumulation starting at a nightly threshold of physiological over-proportional reactions around Lmax = 53 dB(A) the number of tolerable noise events (over-flights in a nightly time range) can be estimated for given indoor peak sound pressure levels, keeping the cortisol increase within the normal range. Examples of results for 8 hours in the night are for instance number and level combinations (NAL-values) of 13 events with 53 dB(A) indoor peak level or 6 events with 70 dB(A) indoor peak level respectively.
