What are the effects of aircraft noise on our health?

A 2010 survey revealed that half of French people consider transportation noise to be the main source of noise pollution. And according to a survey by INRETS which became IFSTTAR, then Université Gustave Eiffel) dating back to 2005, 6.6% of French people stated that they were disturbed by aircraft noise.

In a 2004 report, France’s High Council for Public Hygiene considered that this noise represents a public health issue, both in terms of annoyance and its effects on sleep. However, more data was needed to issue recommendations: hence the creation of the Debats (Discussion on the Health Effects of Aircraft Noise) research program.

This program, under the supervision of the Airport Pollution Control Authority (Acnusa), entrusted to Université Gustave Eiffel and launched in 2009, has delivered a lot of results, some of which have just been published. Here is a small overview of its observations...

One survey, three approaches

Debats was implemented around three major French airports (Paris-Charles-de-Gaulle, Lyon-Saint-Exupéry and Toulouse-Blagnac), and aimed to better quantify the effects of aircraft noise on the physical and mental health of residents. It features three complementary components:

• a so-called ecological study, examining the associations between the average level of exposure to aircraft noise and different health indicators, at the level of municipalities located near the airports;

• an individual, longitudinal study, investigating the physiological and pathophysiological effects of aircraft noise, following a little more than a thousand local residents for four years;

• a clinical study, specifically, a statistical study of limited scope, undertaken with a sub-sample of around a hundred residents, and characterising the effects of aircraft noise on sleep quality in more detail.

More deaths related to cardiovascular diseases

The first, “ecological” study was undertaken on 161 municipalities: 108 around Paris-Charles-de-Gaulle airport, 22 around Toulouse-Blagnac and 31 around Lyon-Saint-Exupéry. For each, this study used mortality data assessed by Inserm’s Epidemiology Centre on Medical Causes of Death for the 2007-2010 period, and the noise maps produced by Aéroports de Paris and the French Civil Aviation Authority (in 2003, 2004 and 2008 respectively for the three airports).

According to the results,and having taken confounding factors into account (age, sex, population density, air pollution, etc.), a 10-decibel (dBA)) rise in exposure to aircraft noise was associated with a 18% higher risk of mortality for all cardiovascular diseases, 24% specifically for ischemic heart diseases, and 28% specifically for myocardial infarction. However, no significant association was found with stroke mortality.

While it confirms the results of previous studies, this data does not allow for any conclusions regarding effects at an individual level: that is why the two other individual studies were set up, one following local residents for four years, the other examining the sleep quality of a small sample of people.

An affected health status

After a random selection from a phone directory in the major noise zones defined around the three airports, 1,244 residents aged over 18 were included in the 2013 longitudinal study, with 992 participating in the 2015 follow-up and 811 seen again in 2017.

The participants were surveyed in their homes by an interviewer from Université Gustave Eiffel on their lifestyle, health (self-evaluation), any psychological issues, annoyance from aircraft noise, sleep quality, and cardiovascular health. Certain physiological parameters were also measured (blood pressure, heart rate and salivary cortisol concentration). Here are the observations.

After taking potential confounding factors into account (i.e. factors that could lead to errors regarding the strength of the association between exposure and the health event under study), and only using the data collected in 2013 for now, it was noted that a 10 dB(A) increase in noise level was associated with:

• a risk of deleterious effects on self-rated health increased by 55% in men (but not in women, where no significant association was shown);

• higher annoyance than predicted by the former European reference curve, but weaker than predicted by the WHO model used by the European Union since 2020. This annoyance depended on many factors other than the noise itself (age, expectations in terms of atmospheric and noise pollution, sensitivity to noise, fear of a plane crash, etc.);

• a risk of sleeping less than six hours per night increased by 60%, and the risk of being tired in the morning upon waking up increased by 20%;

• a risk of chronic stress, translating as a 15% decrease in hourly variation of saliva cortisol and a 16% increase in cortisol levels at bedtime – no significant effect on cortisol concentrations was noted upon waking up;

• a risk of hypertension increased by 34% in men (but not in women, where no significant association was shown), tempered as expected by age and BMI (body mass index);

• lastly, psychological distress was not directly associated with aircraft noise but with annoyance due to aircraft noise: we observed that risk of psychological distress increased by 80% in participants slightly annoyed by aircraft noise, and increased fourfold for those who declared being highly annoyed, compared to those who reported not being annoyed at all.

Objectively measured sleep disorders

At the end of the home interviews, the interviewers asked residents if they would agree to participate in a second study, focused on their sleep and requiring the installation of several measurement instruments. In total, 112 people accepted, 79 of which were followed up in 2015 and 62 in 2017.

Alongside the data collected as part of the longitudinal individual study, at their homes we performed: acoustic measurements inside and outside the bedroom over seven days and nights; actigraphic measurements over seven nights and heart rate measurements during one night; and measurement of continuous individual noise exposure over 24 hours.

These instruments made it possible to observe, in association with a 10 dB(A) increase in aircraft noise and/or ten aircraft noise events:

• risk of sleeping less than six hours a night (short sleep) increased from 10 to 80% and of spending more than nine hours in bed (sleep deprivation adaptation mechanism) increased from 10 to 60%;

• risk of sleep onset insomnia (more than 30 minutes needed to fall asleep) increased from 10 to 30%;

• risk of sleep maintenance insomnia (waking for more than 30 minutes total while sleeping) increased from 10 to 30%;

• lastly, increase in the amplitude of the heart rate (by 0.34 beats per minute) when a passing aircraft causes the noise level to rise by 10 dB(A).

Strengthened conclusions

For now, only the results from analysis of the individual data collected in 2013 have been the subject of scientific publications – those based on data collected in 2015 and 2017 and on all the data as a whole remain confidential until publication in international journals. All the same, it is clear that the initial data from Debats confirms what has already been observed by other research teams overseas.

The results particularly strengthen the conclusions of the most important study undertaken to date, regarding the effects (hypertension and cardiovascular diseases) of noise generated by air and road traffic near six major European airports (in Milan, Berlin, Stockholm, London, Amsterdam and Athens).

Lastly, by improving knowledge of the health situation in France, Debats should make it possible to respond to the demands of local residents near major airports and evaluate the potential benefits of noise pollution reduction measures.

Thanks to Anses, Acnusa, DGAC, la DGPR, DGS and Université Gustave Eiffel who provided funding for Debats, as well as Marie Lefèvre, Clémence Baudin (IRSN), Ali-Mohamed Nassur (Action contre la faim), Liacine Bouaoun (IARC), Bruitparif, Marie-Christine Carlier (HCL), Patricia Champelovier (Univ Eiffel), Lise Giorgis-Allemand (Univ Eiffel), Aboud Kourieh (Univ Eiffel), Jacques Lambert and Damien Léger (Centre du sommeil et de la vigilance de l’Hôtel Dieu) for their contributions.