title: Road traffic noise effects on cardiovascular, respiratory, and metabolic health: An integrative model of biological mechanisms.
abstract: BACKGROUND
  Road traffic noise is a major public health issue, given the documented association with several diseases and the growing number of exposed persons all over the world. The effects widely investigated pertain to cardiovascular health, and to a lesser extent to respiratory and metabolic health. The epidemiological design of most studies has made it possible to ascertain long-term associations of urban noise with a number of cardiovascular, respiratory, and metabolic disorders and diseases; additionally, time series studies have reported short-term associations.
  
  
  OBJECTIVE
  To review the various biological mechanisms that may account for all long-term as well as short-term associations between road traffic noise and cardiovascular, respiratory, and metabolic health. We also aimed to review the neuroendocrine processes triggered by noise as a stressor and the role of the central nervous system in noise-induced autonomic responses.
  
  
  METHODS
  Review of the literature on road traffic noise, environmental noise in general, psychosomatics, and diseases of the cardiovascular, respiratory, and metabolic systems. The search was done using PubMed databases.
  
  
  CONCLUSIONS
  We present a comprehensive, integrative stress model with all known connections between the body systems, states, and processes at both the physiological and psychological levels, which allows to establish a variety of biological pathways linking environmental noise exposure with health outcomes.
  
  
  CONCLUSIONS
  The long- and short-term associations between road traffic noise and health outcomes found in latest noise research may be understood in the light of the integrative model proposed here.
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain. Electronic address: albervive@yahoo.es.
authors.forename: Alberto
authors.initials: A
authors.lastname: Recio
authors.affiliation: National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Linares
authors.affiliation: Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Banegas
authors.affiliation: National School of Public Health, Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Díaz
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology*; D004781:Environmental Exposure; D006801:Humans; D024821:Metabolic Syndrome / Q000209:etiology*; D009624:Noise, Transportation / Q000009:adverse effects*; D012140:Respiratory Tract Diseases / Q000209:etiology*
keywords: Cardiovascular disease; Diabetes; Immune system; Noise; Psychosomatics; Respiratory disease