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The U.S. EPA recommendations—adopted in 1974 and mirrored by the World Health Organization (WHO) (Berglund et al. 1999)—may be considered a truly “safe” level for protection against hearing loss. In contrast, the U.S. Occupational Safety and Health Administration’s 8-hr workplace regulation of 90 dBA may result in a 25% excess risk of hearing impairment among workers exposed over a working lifetime [National Institute of Occupational Safety and Health (NIOSH) 1998]. Other limits may be needed or appropriate for preventing additional health effects not described here or for emerging sources of noise (e.g., wind turbines) that are substantially different from historical noise sources. For example, the WHO recently adopted a set of health-based guidelines for nighttime noise exposure that are much lower than previously recommended levels (WHO 2009). Sources of noise. Primary sources of noise in the United States include road and rail traffic, air transportation, and occupational and industrial activities [National Academy of Engineering (NAE) 2010]. Additional individual-level exposures include amplified music, recreational activities (including concerts and sporting events), and firearms. Personal music player use appears to be common among adolescents (Kim et al. 2009; Vogel et al. 2011) and may involve potentially harmful sound levels (Breinbauer et al. 2012). Exposures from recreational activities and music are not “noise” in the sense of being unwanted sound, but adverse health effects are possible even from desirable sounds.
Data on the prevalence of noise exposures in the United States are dated and inadequate. The most recent national surveys of community and occupational noise exposures occurred in the early 1980s (NIOSH 1988; Simpson and Bruce 1981). Current estimates of workers exposed to “hazardous” levels of workplace noise (an 8-hr LEQ of ≥ 85 dBA) range from 22 to 30 million (NIOSH 2001; Tak et al. 2009). This wide range in estimates for the working population, which is more closely tracked than the general public, should give some indication as to the tremendous uncertainty in community estimates. The limited data available suggest that a substantial portion of the U.S. population may be at risk of noise-related health effects and that modern 24-hr societies are increasingly encroaching on “quiet” periods (e.g., night). An annual level of 55- to 60-dBA LDN may increase risk of hypertension (van Kempen and Babisch 2012). In 1981, Simpson and Bruce (1981)estimated that at least 92.4 million people (46.2% of the U.S. population) were exposed at or above this level. Applying the 1981 U.S. EPA estimate of exposure prevalence to the current U.S. population (315 million in March 2013) ( U.S. Census Bureau 2010), and assuming noise levels have not changed since then, we estimate that at least 145.5 million people were at potential risk of hypertension due to noise in 2013. Lower levels (e.g., 50–55 dBA, to which a larger fraction of the population is exposed) may increase risk of myocardial infarction (Willich et al. 2006). Recent studies of individuals’ noise exposures (Flamme et al. 2012) indicate that a substantial fraction of U.S. adults may be exposed to noise levels above the U.S. EPA 70-dBA LEQ
(24) limit. Neitzel et al. (2012) sampled > 4,500 adults in New York City and estimated that 9 of 10 exceeded the recommended U.S. EPA limit. The Neitzel et al. (2012) study is the most comprehensive quantitative estimate of annual noise exposures in a large sample of U.S. residents in decades, and it represents a basis for developing contemporary estimates of urban U.S. noise exposures. There are 16 metropolitan statistical areas in the United States with a population of > 4 million for which the New York City estimates might be considered representative. These areas comprised a total population of 80,621,123 in 2012 (U.S. Census Bureau 2010), or 25.6% of the U.S. population. By applying the New York City exposure prevalence estimates ofNeitzel et al. (2012) to these 16 largest urban agglomerations, we estimate that at least 72.6 million urban U.S. residents were exposed to annual LEQ(24) levels of > 70 dBA in 2010. By comparison, the U.S. EPA estimated in 1981
that 66 million people, or 33% of the U.S. population (not just urban dwellers), were exposed above the recommended limit (Simpson and Bruce 1981). Applying the 1981 U.S. EPA estimate to 2013 census data, and again assuming no change in noise levels over that time, we estimate that 104 million individuals had annual LEQ(24) levels of > 70 dBA in 2013 and were at risk of NIHL and possibly other noise-related health effects. Unfortunately, given the lack of assessment of noise exposure in health surveillance programs in the United States, it is difficult to evaluate these estimated health impacts against observed health effects, and for some health effects metrics other than the LEQ (24) (e.g., the LDN) are likely more appropriate.