title: Burden of Sleep Disturbance Due to Traffic Noise in Bulgaria.
abstract: Sleep disturbance is a risk factor for somatic, psycho-social and spiritual dysfunction. It is also arguably the most deleterious effect of traffic noise pollution. Quantification of its burden is an anchor element of environmental policy making but no data are currently available for Bulgaria where the preponderance of dangerous nighttime noise exposure is highest in Europe.
  
  
  
  The aim of this study was to quantify the socio-economic burden of severe sleep disturbance due to traffic noise (road, aircraft and railway) in Bulgaria.
  
  
  
  The official World Health Organization methodology used in Europe was applied in order to estimate this annual loss expressed as disability-adjusted life-years (DALYs) and their corresponding monetary value (assuming € 12 000 per DALY).
  
  
  
  Results showed that severe sleep disturbance due to all traffic sources was associated conservatively with 15 468 DALYs (8 839 - 22 097) and € 185 615 861 (€ 106 066 206 - € 265 165 516) lost in 2012, with road traffic being the single most important noise source.
  
  
  
  In conclusion, severe sleep disturbance due to traffic noise bears a heavy environmental and socio-economic burden in Bulgaria which prompts vigorous political action and greater involvement in environmental research. In order to increase the accuracy of future burden of disease analyses other studies would need to establish exposure-response functions based on population-based socio-acoustic surveys in the country.
authors.affiliation: Department of Hygiene and Ecomedicine, PhD student
authors.forename: Angel M
authors.initials: AM
authors.lastname: Dzhambov
authors.affiliation: Department of Health Management, Health Economics and General Medicine
authors.forename: Donka D
authors.initials: DD
authors.lastname: Dimitrova
authors.affiliation: Department of Healthcare Management, Faculty of Public Health, Medical University - Plovdiv, Bulgaria
authors.forename: Vanina K
authors.initials: VK
authors.lastname: Mihaylova-Alakidi
mesh_terms: D001336:Automobiles; D002031:Bulgaria / Q000453:epidemiology; D006801:Humans; D009622:Noise / Q000009:adverse effects*; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000209:etiology*