title: Health effects of chronic noise exposure in pregnancy and childhood: a systematic review initiated by ENRIECO.
abstract: BACKGROUND
  Chronic noise is an environmental pollutant and well-known to cause annoyance and sleep disturbance. Its association with clinical and subclinical adverse health effects has been discussed.
  
  
  OBJECTIVE
  This systematic review aimed to examine associations between chronic noise exposure during pregnancy or childhood and health outcomes in early and late childhood.
  
  
  METHODS
  Following a systematic electronic literature search (MEDLINE, EMBASE), an additional hand search and a critical evaluation of potential articles by 2 independent reviewers, 29 studies were included: 12 on pregnancy/birth outcomes with samples ranging from 115 to 22,761 and 17 on cardiovascular and immune-mediated health outcomes in childhood with samples ranging from 43 to 1542. Evidence levels (3 to 2++) were rated according to the Scottish Intercollegiate Guidelines Network.
  
  
  RESULTS
  Chronic noise exposure during pregnancy was not associated with birth weight, preterm birth, congenital anomalies, perinatal and neonatal death based on 6 cohort, 4 case-control, and 2 cross-sectional studies (highest evidence level 2+). There was some evidence supporting an association of chronic noise exposure with increased systolic blood pressure and stress hormone levels in urine and saliva in children evaluating 2 cohort and 15 cross-sectional studies (highest evidence level 2-).
  
  
  CONCLUSIONS
  There seemed to be no associations between chronic noise and pregnancy outcomes based on studies with evidence levels up to 2+. Associations between chronic noise and health in children were based mainly on cross-sectional studies. However, the studies included in this comprehensive systematic review showed a high variation in study design, outcome, exposure and confounder assessments.
authors.affiliation: Institute of Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Germany. cynthia.hohmann@charite.de
authors.forename: Cynthia
authors.initials: C
authors.lastname: Hohmann
authors.forename: Linus
authors.initials: L
authors.lastname: Grabenhenrich
authors.forename: Yvonne
authors.initials: Y
authors.lastname: de Kluizenaar
authors.forename: Christina
authors.initials: C
authors.lastname: Tischer
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
authors.forename: Chih-Mei
authors.initials: CM
authors.lastname: Chen
authors.forename: Carel
authors.initials: C
authors.lastname: Thijs
authors.forename: Mark
authors.initials: M
authors.lastname: Nieuwenhuijsen
authors.forename: Thomas
authors.initials: T
authors.lastname: Keil
mesh_terms: D000305:Adrenal Cortex Hormones / Q000097:blood; D001724:Birth Weight; D001794:Blood Pressure; D002395:Catecholamines / Q000097:blood; D002648:Child; D005260:Female; D047109:Fetal Development; D006339:Heart Rate; D006801:Humans; D009622:Noise / Q000009:adverse effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012140:Respiratory Tract Diseases / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones; D002395:Catecholamines