The Burden of Disease Due to Road Traffic Noise in Hesse, Germany.

Road-traffic-noise exposition is widespread in Germany and can have harmful health effects. As guidance for informed decision-making, we estimated the environmental burden of disease attributable to road-traffic noise in Hesse, Germany as disability-adjusted life-years (DALYs). Using detailed road-traffic-noise exposure data provided by the Hessian Agency for Nature Conservation, Environment, and Geology (HLNUG), we calculated the DALYs due to road-traffic noise > 40 dB(A) L24h (unweighted average 24 h noise level) and other noise metrics for endpoints with known dose-response functions and evidence in the literature (NORAH-study on disease risks and WHO reviews): cardiovascular disease, depressive disorders, road-traffic annoyance, and sleep disturbance. We calculated the population-attributable fractions (PAF) for road-noise-related cardiovascular disease (hypertensive heart disease, ischemic heart disease, and stroke) and depressive disorders in the population using published relative risk estimates. We multiplied the PAFs with the Hessian proportion of the 2015 WHO DALY estimates for Germany in people aged ≥ 40 years. For high annoyance and high sleep disturbance, we used published dose-response functions to determine the burden for residents of all ages. For Hesse, we found a total of 26,501 DALYs attributable to road-traffic noise or 435 DALY per 100,000 persons for the reference year, 2015. Further, we estimated that a hypothetic uniform road-traffic-noise reduction of 3 dB would prevent 23% of this burden of disease.