Academic journal article Environmental Health Perspectives

Saliva Cortisol and Exposure to Aircraft Noise in Six European Countries

Academic journal article Environmental Health Perspectives

Saliva Cortisol and Exposure to Aircraft Noise in Six European Countries

Article excerpt

BACKGROUND: Several studies show an association between exposure to aircraft or road traffic noise and cardiovascular effects, which may be mediated by a noise-induced release of stress hormones.

OBJECTIVE: Our objective was to assess saliva Cortisol concentration in relation to exposure to aircraft noise.

METHOD: A multicenter cross-sectional study, HYENA (Hypertension and Exposure to Noise near Airports), comprising 4,861 persons was carried out in six European countries. In a subgroup of 439 study participants, selected to enhance the contrast in exposure to aircraft noise, saliva Cortisol was assessed three times (morning, lunch, and evening) during 1 day.

RESULTS: We observed an elevation of 6.07 nmol/L [95% confidence interval (CI), 2.32-9.81 nmol/L] in morning saliva Cortisol level in women exposed to aircraft noise at an average 24-hr sound level ([L.sub.Aeq,24h]) > 60 dB, compared with women exposed to [L.sub.Aeq,24h] [less than or equal to] 50 dB, corresponding to an increase of 34%. Employment status appeared to modify the response. We found no association between noise exposure and saliva Cortisol levels in men.

CONCLUSIONS: Our results suggest that exposure to aircraft noise increases morning saliva Cortisol levels in women, which could be of relevance for noise-related cardiovascular effects.

KEY WORDS: cardiovascular disease, gender differences. Environ Health Perspect 117:1713--1717 (2009). doi:10.l289/ehp.0900933 available via [Online 20 July 2009]


Transportation noise is a significant and increasing problem in urban areas worldwide (World Health Organization 2000). There is mounting evidence of an association between road traffic as well as aircraft noise and cardiovascular outcomes (Babisch 2006; Babisch et al. 2005; Belojevic et al. 2008a; Bluhm et al. 2007; de Kluizenaar et al. 2007; Eriksson et al. 2007; Rosenlund et al. 2001; van Kempen et al. 2002; Willich et al. 2006). One proposed biological mechanism implies that noise causes a release of stress hormones, which in turn adversely affect cardiovascular risk factors (Babisch et al. 2001; Ising and Kruppa 2004; Spreng 2000). An intermediary mechanism may involve the metabolic syndrome in which a disturbed hypothalamus-pituitary-adrenal axis regulation has been assumed to play an important role (Chandola et al. 2006). The glucocorticoid hormone Cortisol is the main secretory product of the neuroendocrine cascade and a valid indicator of stress (Evans et al. 2001; Miki et al. 1998; Schulz et al. 1998). The Cortisol profile normally shows a diurnal variation, high in the morning and low at night (Hofman 2001). After long-time stressful exposure, the ability to down-regulate Cortisol may be inhibited (Spreng 2000).

Stress hormone studies on community noise exposure have generally been performed using urine and blood measurements (Babisch 2003; Babisch et al. 2001; Dallman 1993; Evans et al. 2001; Maschke 2003; Miki et al. 1998; Pruessner et al. 1999; Schulz et al. 1998). Saliva Cortisol measurements are easy to perform, reliably reflect free Cortisol levels in blood (Hofman 2001), and have recently been used in a few studies on exposure to road traffic and aircraft noise (Poll et al. 2001; Stansfeld et al. 2001; Waye et al. 2003). In two review articles, the relationship between road traffic noise as well as aircraft noise and Cortisol was investigated (Babisch 2003; Ising and Kruppa 2004). Six of the 14 studies reviewed showed an increase in Cortisol level related to exposure, but these were mainly based on urine measurements and had small sample sizes. Only two of the studies used saliva Cortisol measures, and the results were inconclusive (Poll et al. 2001; Stansfeld et al. 2001). Thus, the association between community noise exposure and Cortisol levels is still unclear, particularly regarding exposure-response relationships and gender differences. …

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