# name
WHO Environmental Noise Guidelines for the European Region: A
                Systematic Review on Environmental Noise and Adverse Birth
                Outcomes

# metadata.dc.description.abstract[].value
Introduction: Three recent systematic reviews suggested a
                relationship between noise exposure and adverse birth outcomes.
                The aim of this review was to evaluate the evidence for the
                World Health Organization (WHO) noise guidelines and conduct an
                updated systematic review of environmental noise, specifically
                aircraft and road traffic noise and birth outcomes, such as
                preterm birth, low birth weight, being small for gestational age
                and congenital malformations. Materials and methods: We reviewed
                again all the papers on environmental noise and birth outcomes
                included in the previous three systematic reviews and conducted
                a systematic search on noise and birth outcomes to update
                previous reviews. Web of Science, PubMed and Embase electronic
                databases were searched for papers published between June 2014
                (end date of previous systematic review) and December 2016 using
                a list of specific search terms. Studies were also screened in
                the reference list of relevant reviews/articles. Further
                inclusion and exclusion criteria for the studies provided by the
                WHO expert group were applied. Risk of bias was assessed
                according to criteria from the Newcastle-Ottawa quality
                assessment scale for case-control and cohort studies. Finally,
                we applied the GRADE principles to our systematic review in a
                reproducible and appropriate way for judgment about quality of
                evidence. Results: In total, 14 studies are included in this
                review, six studies on aircraft noise and birth outcomes, five
                studies (two with more or less the same population) on road
                traffic noise and birth outcomes and three related studies on
                total ambient noise that is likely to be mostly traffic noise
                that met the criteria. The number of studies on environmental
                noise and birth outcomes is small and the quality of evidence
                generally ranges from very low to low, particularly in case of
                the older studies. The quality is better for the more recent
                traffic noise and birth outcomes studies. As there were too few
                studies, we did not conduct meta-analyses. Discussion: This
                systematic review is supported by previous systematic reviews
                and meta-analyses that suggested that there may be some
                suggestive evidence for an association between environmental
                noise exposure and birth outcomes, although they pointed more
                generally to a stronger role of occupational noise exposure,
                which tends to be higher and last longer. Very strict criteria
                for inclusion and exclusion of studies, performance of quality
                assessment for risk of bias, and finally applying GRADE
                principles for judgment of quality of evidence are the strengths
                of this review. CONCLUSIONS: We found evidence of very low
                quality for associations between aircraft noise and preterm
                birth, low birth weight and congenital anomalies, and low
                quality evidence for an association between road traffic noise
                and low birth weight, preterm birth and small for gestational
                age. Further high quality studies are required to establish such
                associations. Future studies are recommended to apply robust
                exposure assessment methods (e.g., modeled or measured noise
                levels at bedroom facade), disentangle associations for
                different sources of noise as well as daytime and nighttime
                noise, evaluate the impacts of noise evens (that stand out of
                the noise background), and control the analyses for confounding
                factors, such as socioeconomic status, lifestyle factors and
                other environmental factors, especially air pollution.

# metadata.dc.relation.isformatof[].value
Reproducció del document publicat a:
                http://dx.doi.org/10.3390/ijerph14101252

# metadata.dc.relation.ispartof[].value
International Journal of Environmental Research and Public
                Health, 2017, vol. 14, num. 10, p. E1252

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
WHO Environmental Noise Guidelines for the European Region: A
                Systematic Review on Environmental Noise and Adverse Birth
                Outcomes