Noise Is the New Secondhand Smoke

NOISE IS THE NEW SECONDHAND SMOKE

[00:00:00] Carolyn McCulley: Sometimes, this is how my home office sounds when I'm working. The windows are closed. It's the early evening departure bank for Europe out of Washington Dulles International Airport. I simply set my iPhone next to my laptop and just worked on some emails as I captured the sounds of different planes passing overhead.

[00:00:22] This is the United flight to Rome in a Boeing 767-424ER. The engines have a high whining sound.

[00:00:35] Now, a few minutes later, here comes the United flight to Paris in a Boeing 777-224. This plane definitely has a sound signature for me. I can pick it out very easily. The engines growl. And yes, the windows really were closed as I recorded those flights.

[00:00:57] My windows are standard construction with a sound transmission class rating, also called STC, of 29. They don't block much, if any, sound at all. To have truly soundproofed windows, you'd have to increase that STC rating a great deal. An increase from STC 28 to 38 means 90 percent of the noise is reduced. A change from STC 28 to 43 represents a noise reduction of over 95%.

[00:01:31] But it's not just the windows that need to be soundproofed to insulate your home from noise. The walls and attic need better insulation and soundproofed wall assemblies and roofs. So do the doors. And when a giant jet is crossing over your home at low altitude, all the soundproofing in the world may not make a difference because you can still feel that plane passing overhead.

[00:01:55] Historically, the aviation industry referred to this sound intrusion as annoyance. And back in the 1970s, the FAA set a specific threshold of what it considers significant noise exposure. But today, more than 40 years later, the public health community uses a different term—harmful. I'm Carolyn McCulley, and this is the Noisy Skies podcast, brought to you by The Aloft Group.

[00:02:24] This episode is titled: Noise is the New Secondhand Smoke.

[00:02:35] Jamie Banks: Noise is the new secondhand smoke really refers to the fact that people are being exposed involuntarily to something that can harm them, just like cigarette smoke did. And, you know, it all relates to the costs that people are paying with their health, their well-being, their quality of life, sometimes even their pocketbook, for something that they never wanted to begin with.

[00:02:59] Carolyn McCulley: That's Dr. Jamie Banks. She is the founder and president of Quiet Communities, a nonprofit that works to address harmful noise across several industries. 

[00:03:09] Jamie Banks: My background is as a healthcare scientist, and I bring very much a public health lens to looking at problems of noise and related pollution. I also serve as the chair of the Noise and Health Committee of the American Public Health Association.

[00:03:28] I did health care work for decades and focusing on health outcomes, health economics, policy issues, and I decided to move into environment in 2007. But, basically, I decided that that area, as well as other areas, really needed evidence-based resources for communities to present their situations on an evidence basis.

[00:03:57] And so I started Quiet Communities in 2013 to bring those kinds of resources to communities. And very quickly started to hear from people, mainly professionals, who were interested in all different sources of noise and their health effects and their environmental effects. And so Quiet Communities really became a coalition of scientists, medical professionals, and attorneys, you know, and others, but really that's our core professional group.

[00:04:35] Carolyn McCulley: The FAA defines annoyance as “the general adverse reaction of people to noise that causes interference with speech, sleep, the desire for a tranquil environment, and the ability to use the telephone, radio, or television satisfactorily.” But that definition puts the locus on the reaction, not on the source or its impact.

[00:04:58] Jamie Banks: The older definition is that noise is unwanted sound. And when you think of noise in that way, it's very easy to say, Oh, it's just subjective. That's somebody who's just complaining because they don't like that particular noise. But objectively, we know today from decades of science that noise can cause harm, hearing harm in terms of tinnitus, hearing damage or loss, hyperacusis, non-auditory harm in terms of increase in risk of cardiovascular disease, metabolic disruptions, as well as psychological anxiety, depression.

[00:05:36] And then we know that noise impairs learning and work productivity. So there are objectively things that harm us that need to be paid attention to, and calling noise a nuisance or an annoyance really trivializes those potentially serious health impacts. If it's coming right through your walls and windows and it's disturbing, you have no refuge in your home.

[00:06:05] Carolyn McCulley: In June 2023, I read an article in the New York Times that was very unsettling. It was titled: Noise Could Take Years Off Your Life, Here's How. The article said, when researchers analyzed the brain scans and health records of hundreds of people at Massachusetts General Hospital, they made a stunning discovery.

[00:06:29] Those who lived in areas with high levels of transportation noise were more likely to have highly activated amygdalas, arterial inflammation, and, within five years, major cardiac events. The associations remained even after researchers adjusted for other environmental and behavioral factors that could contribute to poor cardiac health.

[00:06:53] Like air pollution, socioeconomic factors, and smoking. In fact, noise may trigger immediate heart attacks. Higher levels of aircraft noise exposure in the two hours preceding nighttime deaths have been tied to heart related mortality. Yikes! I definitely wanted to know more about this. So I reached out to a number of the people who were sources for this article.

[00:07:21] Dr. Peter James was one of them. He is an epidemiologist and associate professor at Harvard Medical School and Harvard T. H. Chan School of Public Health. I told him that after reading this article, I was giving serious thought to moving out of the neighborhood and home that I love. It's not always as noisy as what I had recorded in my home office.

[00:07:44] But the majority of the aviation noise is in the evening and overnight hours. So this data about nighttime deaths is very concerning. 

[00:07:53] Peter James: For many people, they can't afford to move out of their home. That's not a realistic solution to the problem. And so I think we need to recognize and quantify that noise and different types of environmental exposures like noise truly can manifest as health outcomes.

[00:08:09] They're not a fluffy thing. This is a real biological thing. And so what we need to do then is to build in those externalities, right? So if it's going to be the airports and the airlines that are exposing people to this level of noise, then they should remediate it or they should pay for it, for the impacts, right?

[00:08:28] Carolyn McCulley: I actually knew about the negative effects of loud noise exposure on our hearing, but I was not aware of the effects of noise on cardiovascular health. Nor did I think about noise pollution as a public health problem. But this actually is not a new concept. It's an old concept that went dormant. 

[00:08:46] Jamie Banks: Noise was declared a public health problem in 1968 by then Surgeon General William Stewart.

[00:08:52] And shortly thereafter, the Clean Air Act identified noise as a pollutant, along with other air pollutants. And then shortly after that came the Noise Control Act, under which the EPA formed its office of Noise Abatement and Control. And recognizing that noise was a public health problem, it was charged with certain mandatory duties—helping to educate, funding research, noise labeling for products, a quiet product program. So all of these things went on for about 10 years, and then stopped once that office lost its funding in 1982.

[00:09:32] And so much of our knowledge from that time was lost. There are people today, even at EPA, who don't remember that there was a noise control program. 

[00:09:43] Carolyn McCulley: In the 1970s, the EPA, the Environmental Protection Agency, coordinated all federal noise control activities through its Office of Noise Abatement and Control.

[00:09:54] On its website, the EPA says it phased out the office's funding in 1982 as part of a shift in federal noise control policy to transfer the primary responsibility of regulating noise to state and local governments. However, the Noise Control Act of 1972 and the Quiet Communities Act of 1978 were never rescinded by Congress and remain in effect today, although they are essentially unfunded.

[00:10:26] This policy decision has had a significant impact on U. S. research. Here again is Peter James. 

[00:10:33] Peter James: I've been an environmental epidemiologist now for 15 years and I've been going to big international meetings for a while on environmental epidemiology. In every single one of these meetings, we see studies on noise in Europe and Canada, where they're doing very sophisticated modeling of noise, looking at health outcomes.

[00:10:50] And on the other side of the coin, in the U. S., we have very few studies. And I think one of the reasons why is, you know, we have this Noise Pollution and Abatement Act of 1972 that was supposed to, you know, have teeth to regulate noise pollution. But Congress actually ended up cutting funding for that noise control program.

[00:11:06] And I think since then, we really don't have federal policy. We also lack funding for modeling noise exposure and really measuring noise, who's exposed to noise and at what level. And without modeling exposure, without the funding there, we really don't have a lot of ability as researchers to create exposure models and follow people forward in time.

[00:11:26] And to understand how noise is associated with health outcomes. And so what is the biological reason that Americans would respond to noise differently than non-Americans? That makes no sense to me. You know, there's no reason to believe that biological pathways mediating the effects of noise on human health differ in the U.S. compared to those of other countries. However, U.S.-based evidence is crucial to guide U.S. legislation. 

[00:11:47] Carolyn McCulley: How does noise affect our bodies? Dr. Daniel Fink, a retired internist and founder of the Quiet Coalition, described it very vividly this way: “In nature, loud sounds are rare and may include thunderstorms, earthquakes,

[00:12:08] volcanic eruptions, 

[00:12:13] waterfalls,

[00:12:17] and certain animal sounds.

[00:12:21] In nature, loud noise often indicates danger and causes fight or flight responses.”

[00:12:29] Mathias Basner: That's a reason why the definition was just changed. Daniel Fink was very active in promoting that. The new definition is noise is unwanted and/or harmful sounds. And the important thing about this addition, “and/or harmful,” is often times we're exposed to noise levels, and we don't think that they're harmful for us. But they are harmful. The other thing is, if it's just unwanted sounds, you're just sensitive. Get a grip on yourself. You are the problem. It's not the noise exposure that's the problem. But if you have sound pressures at a certain level and over a certain period of time, you're going to be harmed no matter what.

[00:13:09] Carolyn McCulley: That's Dr. Matthias Basner. He is a professor of psychiatry at the University of Pennsylvania. His specialty is sleep and chronobiology. He studied in Germany, and his first job in the late ’90s was as a research associate at the German Aerospace Center. At the time, the center identified that the growth of air traffic was shifting more flights into the nighttime period, especially for the shipping industry.

[00:13:36] So the center wanted to know more about the effects of aviation noise on sleep. That job launched his career. Today, he is leading the FAA-funded research on aviation noise and sleep. 

[00:13:49] Mathias Basner: Noise effects researchers don't really have a home in terms of funding in the United States. We haven't had a home since 1982.

[00:13:57] So I think it's a great thing that FAA is doing this research, especially given the tremendous amount of research that has come out over the last 10 years, with lots of epidemiological evidence showing that noise exposure is associated not only with cardiovascular disease, but with diabetes, obesity, neurodegenerative disease, cancer.

[00:14:18] The evidence is getting better and better every day, but also just research of the biological plausibility that noise is actually the root cause of these long term health consequences.

[00:14:30] Carolyn McCulley: The FAA is funding Dr. Basner's research as part of its own civil aviation noise policy review efforts. On its noise policy review website, the FAA says that since the mid 1970s, the number of people exposed to significant aviation noise in the U.S. has declined from roughly 7 million to just over 400,000 today. That's primarily due to the transition to quieter aircraft. At the same time, the number of enplanements, which is one person flying on a single commercial flight, has increased from approximately 200 million in 1975 to over 850 million today.

[00:15:12] So yes, the planes have become quieter, but the number of passengers and flights have been trending upward. Also, the FAA's metric for significant aviation noise is much higher than other global standards. Now, this is also a complex sound metric, so I'm going to ease into describing it here. If you're a sound engineer, just bear with me a moment as I make my point. I will catch up and make it more accurate.

[00:15:38] The FAA's threshold for significant aviation noise is a formula, averaging to 65 decibels, or dB. But the World Health Organization's guidelines for Europe state that average aircraft noise exposure above about 45 dB are associated with adverse health effects. In fact, the WHO, the World Health Organization, was even more specific about aviation noise at night, strongly recommending reducing average nighttime aviation noise levels to below 40 dB.

[00:16:12] This is a huge difference. Decibels are a logarithmic measurement. If a decibel value increases by just 3 decibels, the sound energy doubles. So, to have a 20 to 25 decibel variance in what the U. S. calls significant aviation noise And what the WHO thinks is significant for adverse health effects is a tremendous policy gap.

[00:16:39] Also, learning the jargon of sound metrics is a whole job in itself. The FAA's noise measurement is actually 65 DNL, not decibel. DNL stands for Day Night Average Sound Level, a noise metric that reflects a person's cumulative exposure to sound over a 24-hour period. DNL takes into account both the amount of noise from each aircraft operation, as well as the total number of operations flying throughout the day.

[00:17:08] And then applies an additional 10-decibel weighting for nighttime flights between 10 p.m. and 7 a.m. The WHO, on the other hand, references specific weighted day-part measurements of 45 Lden during the day and 45 Lnight at night. So these are not identical metrics. We will learn more about these sound metrics and the FAA's review of them in an upcoming episode.

[00:17:36] For now, I'm using the simpler concept of decibels to make an overall point of comparison about public health. The facts are actually, in my opinion, worse for sleeping humans. Because multiple flights louder than 65 decibels get averaged in with the relative silence in between the flights to create that 24-hour average.

[00:17:59] The average is not what arouses sleeping humans. It's the individual noise of individual flights. But the FAA is funding much needed research on noise and sleep in the U.S., which we now know is rare. So let's get back to that study, which is called the National Sleep Study. After Mathias conducted two successful pilot field studies, the National Sleep Study was launched.

[00:18:26] The study selected participants and screened out those who were under 21, severely obese, had a sleep disorder such as sleep apnea, were hearing impaired, had cardiac arrhythmia, worked night shifts, had dependents who needed frequent care at night, or were pregnant. Then these participants were sent physiological monitoring gear and a sound recording system to document the maximum sound pressure level of an aircraft overflight, as measured inside the bedroom, and a participant's probability to wake up, which was inferred by changes in heart rate and body movements.

[00:19:05] Mathias Basner: Just from the research that we did at the German Aerospace Center, people would wake up often in the morning and just say, Hey, you know, I fell asleep right away. And then I can’t recall waking up during the night and here I am, right? And then you look at the physiological data and oh my God, some of them woke up basically every aircraft noise event that we played back, right?

[00:19:24] The awakenings are not long enough to regain consciousness, but just the physiological fragmentation of the sleep is just wreaking havoc. On the system and your sleep will not be as recuperative. The dipping of the blood pressure will not be as profound. And this is what we believe can lead to the long-term health consequences.

[00:19:44] The National Sleep Study, actually, we have completed 403 subjects around 77 major U. S. airports, and the data acquisition finished in October 2023. So we are now at the point where we're analyzing these data, which is a little bit more than 2,000 subject nights, which is a crazy amount of data. 

[00:20:05] Carolyn McCulley: The National Sleep Study final report is due at the end of October 2025.

[00:20:11] But there's another study by Dr. Peter James that was just published in December 2023 looking at large data sets. Peter drew from the existing data that the National Park Service and the National Nurses Study had collected for several years. The National Park Service has hundreds of noise monitors in both their parks and urban areas to monitor all kinds of noise.

[00:20:34] And the first cohort in the National Nurses Study has nearly 50 years of data. 

[00:20:39] Peter James: This is just a general noise model for the entire U.S., not just aviation noise or traffic noise. It’s trying to model what's the level of noise at every point in the U.S. and so that was really helpful because I work with these large prospective cohort studies, like the Nurses Health Study, which is the cohort that is featured in that paper.

[00:20:58] That cohort is 121,000 female nurses that have been enrolled since 1976 and been followed every two years. These people have been in the study for decades, right? And so we have really good information on cardiovascular disease incidents from medical record review. We have other potential covariates, like their socioeconomic status, their jobs, their smoking, their diet, etc.

[00:21:21] So we can really well characterize these participants over time and follow up for disease for our work. And for my work specifically, we also have the residential mailing addresses, right? And so we know where they've lived. Every two years when they update their mailing address, we know where they were living.

[00:21:37] And so we can take that address and geocode it. We can create a latitude and longitude to put a point on a map and then overlay this National Park Service noise model to say, here's what your exposure to noise was at a given address. And we can follow you forward over time and say, is that level of noise associated with higher or lower risk of cardiovascular disease, right?

[00:21:58] And in fact, we found that most of the metrics, whether we looked at median nighttime noise, daytime noise, or that nighttime weighted noise, in general, we saw the same associations. They were all associated with negative health outcomes in this paper, specifically looking at cardiovascular disease, heart attacks, and stroke.

[00:22:15] And I think, again, what surprised me is that we saw consistent findings across all our metrics of noise. I was expecting nighttime to be the strongest, but we saw all those metrics were associated with increased risk for cardiovascular disease. And that could be just because they're so correlated with each other.

[00:22:30] A place that's noisy in the day is also noisy at night, usually. But in this case, we had a very clear story of all the noise metrics and how they were associated with increased risk of cardiovascular disease.

[00:22:41] Carolyn McCulley: Of course, an episode like this begs the question, what can I do to protect myself? I asked that of everyone I interviewed.

[00:22:49] My personal approach in recent years has been to drown out the overnight flights with two sources of noise—a fan to mask the lower sounds of a plane moving through air, and a white noise machine at a higher pitch to mask the whining engines. But Mathias is not sure that adding noise in the bedroom is the way to go.

[00:23:09] Mathias Basner: Funny that you ask, because we're just running a study on that topic. Me being somebody who has studied the adverse effects of noise on sleep and health my whole career, I was befuddled when I started hearing that people are putting white noise machines into their bedrooms or they're listening to YouTube videos of ocean sounds the whole night.

[00:23:28] That simply didn't make sense to me. I mean, earplugs, yes, that kind of makes sense, right? But we actually did a systematic review of the literature relative to the white noise machines. And there's only a handful of study, very low quality, often only a handful of people, only self report, etc. So we had to conclude that there's really no sufficient evidence right now to either say, yes, it is working or it is not working.

[00:23:56] And may potentially even be harmful for both sleep and actual hearing. Which is why we are running a very controlled laboratory study right now. I mean, there must be something because so many people are using it. And I tell them, okay, if you're using it for falling asleep, make sure you put it on a timer.

[00:24:17] Or if you use it the whole night, make sure you use it at the lowest level that is still working for you, because one worry is that our auditory system is translating the sound pressure fluctuations into electrical signals that are then being transported to the brain. That's an active process and it requires energy.

[00:24:35] It generates metabolites. Some of these metabolites are not healthy and they need to be removed from the auditory system in order not to create any harm. And the best time for that is the nighttime when we're sleeping, because sound pressures are typically lower than during the daytime and this is a time to do some cleanup work.

[00:24:54] Actually, this is one of the major functions of sleep. And that's a very recent finding that there's a glymphatic spaces in the brain. They open up and all these metabolites, some of them that have been implicated in neurodegenerative disease, are being flushed out of the system like the trash collection, so to say.

[00:25:12] So if you really want to, use it at the lowest level possible. And if you only need it to be able to fall asleep, put it on a timer and then wait for the results of our research study. 

[00:25:25] Carolyn McCulley: Jamie Banks is not sure what will come out of the FAA's National Sleep Study or its noise policy review. We will look into the specifics of that noise policy review in an upcoming episode.

[00:25:36] But in Jamie's mind, there is no question that the current standard, based on decades old research, needs to be changed.

[00:25:43] Jamie Banks: There are studies that show that the body does not develop tolerance to noise. So even if you manage to put it out of your head, your body is still hearing it in some way and reacting.

[00:25:55] The Neighborhood Environmental Survey that the FAA published results on in 2021 showed that 12. 3 percent of people were highly annoyed at around 46 decibels DNL. It certainly informs us that 65 DNL is way too high. We already know from the science that 65 DNL exposure is dangerous. 

[00:26:22] Carolyn McCulley: In the meantime, Jamie is focused on funding and restarting the EPA's noise control program.

[00:26:28] This is something all noise-impacted communities can champion as well. 

[00:26:33] Jamie Banks: So the EPA is legally obliged to follow the law. And in this case, we're talking about the Noise Control Act of 1972 and its sister act, which is the Quiet Communities Act of 1978. And fulfill its obligations to implement and enforce those laws.

[00:26:51] And so we petitioned EPA in 2017 to do that, to reactivate the noise control program. And received a return receipt in the mail, but no action. About a year and a half ago, maybe now, we did have some high level discussions with EPA about restarting the noise control program. And there was some receptivity, but it really didn't go anyplace.

[00:27:18] There's a lot of other competing interests, to be fair, climate being one of them. A big one. And so we decided as a group, our legal advisory council, to bring suit, asking the EPA to meet its responsibilities under the Noise Control Act. So we're currently in litigation, and I can't really discuss anything about that, but we want EPA to obey and enforce the law.

[00:27:46] EPA can certainly ask Congress to fund the program. The public can ask the White House to make this a strategic priority, given how many people are at risk from even everyday noise sources. There are typically discretionary funds not getting used within the agency that maybe could be applied to starting up the program.

[00:28:10] It wouldn't take much to do something.

[00:28:22] Carolyn McCulley: As a nation, we cannot fix all noise issues, but with evidence-based research and political will, we can find and fix a lot of noise issues. The U.S. Airspace is owned by its citizens. And the FAA has the authority to manage it for safety and efficiency, but the growth of an industry, even one as vital and necessary as air transportation, should not come at the expense of the health and well-being of its tax-paying and ticket-buying consumers.

[00:28:54] The FAA's mission of aviation safety should include public health safety.

[00:29:06] Noisy Skies is brought to you by The Aloft Group. Aloft draws on decades of aviation experience to help communities navigate the complexity of aviation noise. To learn more about how The Aloft Group can help your community, visit NoisySkies.org.

[00:29:24] If you want to go deeper into any aspect of aviation noise, you should check out the Aviation Noise and Emissions Symposium from UC Davis. The three-day event will be held in Palm Springs, California, from March 4th to 6th. There are options to attend in person and virtually. In fact, the title of this episode comes from a paper written by The Quiet Coalition's Daniel Fink.

[00:29:49] He will be there this year presenting a talk titled, Reframing Community Exposures To Better Capture Aviation-Related Health Effects. The theme of this year's symposium is Tackling Noise and Emissions Challenges Together. The symposium unites aviation industry professionals, environmental and community advocates, policy makers, and forward-thinking technology pioneers in a common mission.

[00:30:20] Carolyn McCulley: This episode was written and edited by me, Carolyn McCulley. Thanks as well to our show's Founding Patrons: Edward Bursk, Kim and Janet Hanneman, Andrea and Joe Dulek, Jim and Susan White, Cristina Conti, John Yeatman, Julia Falk, Cheri and Marc Korstvedt, John and Catherine Fraga, Chris Loeser, Ted and Gayle Deeley, Chris McCann, Kathy Estep, Charles Lamb, and Val Sekhar.

[00:30:49] Got questions or comments for the show? We'd love to hear from you. Drop us a line at info@noisyskies.org. And then join me next time, wherever you get your favorite podcasts. Thanks for listening.