Do Quiet Areas Afford Greater Health-Related Quality of Life than Noisy Areas?

kids making noise and disturbing mom working at home
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The protection of living environments is for the public good and a legitimate aim of a democratic society. For example, the European Convention on Human Rights Article 8 states that: “Everyone has the right to respect for his private and family life, his home and his correspondence”, and further, that both an individual’s health and wellbeing should be considered in the face of negative environmental factors [1]. Scientific research into the harmful effects of noise exposure is ongoing [2,3,4], and adopting the World Health Organisation’s (WHO) definition of noise, Article 8 can be interpreted as a right of individuals to be protected from noise unnecessarily intruding into their home environments. However, the reality of modern living is that, in many cities and towns, the opportunities to live in homes unencumbered by noise are limited. The European Union indicates that up to 30% of Europeans may be exposed to unsafe levels of noise [5], and that, as a conservative estimate, at least one million healthy life years are lost annually due to traffic noise in Europe alone [4].

Given that noise can adversely impact on health [3,4], and the development of viable models incorporating causal mechanisms representing logical relationships between noise and health [6], it is appropriate that legislative bodies develop policies designed to protect individuals from unnecessary and harmful exposure to noise. Sound is mostly treated as a “waste product”, occupying the first of two approaches to environmental acoustics described by Truax and Barrett: the energy-based environmental noise management approach [7]. The other approach, the subjective listener-centrered model, encapsulates the concept of the soundscape [8], or the acoustic environment as perceived and understood by people [9]. The EU’s noise directive (2002/49/EC) combines both approaches, being established not only to protect people from harmful noise, but also to identify and guard areas considered quiet. It should be noted that the term “quiet”, is not synonymous with silence; its standard usage implies an absence or masking of industrial noise, and/or the presence of natural sounds such as water flow, birdsong, or wind. Furthermore, the absence of human-generated sounds may be quantified in terms of percentage-time inaudible [10], useful when considering greenbelt, life-style, or rural areas, in which sound pressure measures (e.g., dB(A)) provide inadequate representations of soundscapes [11].

In relation to noise mitigation, it appears that, for the most part, what is judged an acceptable level of noise exposure is largely a societal decision, and not a scientific or legislative one. That is, decisions are made by individuals as to how best distribute resources relative to their needs, by choosing where they live. Consequently, individuals choosing to live in quiet areas can become aggravated when industrialization or other developments threaten their local soundscapes. Unfortunately, however, individuals more susceptible to noise impacts may not always have the financial resources to be able to live in quieter areas, possibly to the detriment of their health and wellbeing. Thus, in many respects, soundscapes can be considered tradable commodities, where tranquility and quiet have value, and noise a cost [12]. For example, research suggests that, all else being equal, a house in the vicinity of a major road can be expected to be worth 8–10% less than a comparable house situated away from the road, with a “noise discount” of around half-a-percent per decibel difference [13], or 1% per dB(A) where noise exceeds 55 dB(A) [14]. Whereas the last centuries have recorded a general social trend towards urbanisation, some are now noting that whilst an urban drift persists, albeit at a reducing rate, a countertrend of ruralisation is also emerging [15]. Such a trend is likely explained by the intrinsic qualities of rural areas, reliably described as “peace and quiet”, and “space and greenness” [15], and some argue that suburban drift can likewise be framed as an effort to move closer to nature [16]. To aid in the protection of quiet areas, and to facilitate access thereof, legislation such as the European Union’s noise directive (2002/49/EC) seeks to preserve quiet areas. Such legislation is guided by an increasing body of evidence indicating the health benefits of quieter areas, and the health costs of noisier areas.

In reading the literature to date, it is apparent that most research focuses directly on the negative impacts of sound (i.e., noise), with relatively fewer studies considering, or directly focusing on, the positive impacts of sound [7]. This “negative” bias to environmental sound is likewise reflected in legislation. For example, in New Zealand, public health and the protection thereof is central to the Resource Management Act (1991; amended 2005) wherein Section 16 describes a “Duty to avoid unreasonable noise”, and Sections 322 to 324 and 326 to 328 of the Act empower local authorities to issue an abatement notice containing the prescribed particulars to an occupier of land from where “unreasonable noise” is emanating [17]. Furthermore, New Zealand’s Health Act (1956) empowers local authorities to abate any nuisance or condition that can be considered either injurious to health or offensive [18]. Noise nuisance is defined by the New Zealand’s Health Act (1956) as “…where any noise or vibration occurs in or is emitted from any building, premises, or land to a degree that is likely to be injurious to health.”, and nuisance more generally as “…a repetitive activity which causes damage to the plaintiff’s land or his enjoyment of it.” [19]. No reference to, and the specific protection of, environmental sounds that promote health and wellbeing can be found in current New Zealand legislation, though more generally, Section 7 (Part C) of the Resource Management Act (1991) directs local authorities to regard the maintenance and enhancement of amenity when managing resources [17].

In considering the legislative approaches embedded in New Zealand policy, it is noted that two common themes emerge from legal approaches to nuisance, namely degraded amenity (i.e., “enjoyment”) or insult to health (i.e., “injurious”). However, these two themes are not mutually exclusive. The WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”, where physical, mental and social well-being are themselves dependent upon restorative environments, that is, environments high in amenity. However, the complex interplay between health and amenity is rarely acknowledged in noise-related legislation. Furthermore, the operationalisation of health in the noise context is neither standardised nor straightforward, especially if measurements embody the biomedical approaches emphasis of morbidity and mortality. Normative approaches conceptualise health as optimal functioning relative to sociocultural factors, and relying largely upon self-referential assessments, stipulate health as a precondition of wellbeing, or health-related quality of life [20]. Such an approach can, to a greater degree, better document the relationship between sound, amenity, and health by framing specific domains of health-related quality of life (HRQOL) as measuring the influence of an individual’s health status on their global wellbeing. In relation to noise, the WHO (2009) Noise Guidelines (Europe) supports the use of HRQOL measures, stating that “The effects of noise are strongest for those outcomes that, like annoyance, can be classified under “quality of life rather than illness” (p. 92) [3]. The WHO reports that noise-induced annoyance and sleep disturbance can, when chronic, compromise positive wellbeing and HRQOL [2,3,4]. Brown [7] emphasises the positive contribution of soundscapes to quality of life, and identifies significant gaps in research examining the potential restorative value of soundscapes, and their impact upon quality of life and wellbeing.

While investigations into noise and health generally concur that while noise can have a negative impact on populations, the quantification of this impact is made difficult by the multivariate nature of the relationship. Whereas simple bivariate relationships between noise level and human response are no longer considered valid approaches to the protection of the health of the public [21,22], the multiplicity of physical, social, and psychological variables have dictated that other approaches need to be explored. Dratva et al. [23] suggest that noise annoyance measures may be superior to noise level when mitigating the harmful impacts of noise. Conversely, low levels (or an absence) of annoyance may be indicative of soundscapes worthy of preserving, especially if they have restorative potential. This exploratory study generates dose (annoyance)-response (HRQOL) functions by utilising data from four New Zealand localities, specifically selected for their differing soundscapes, to further investigate the impacts of sound on health and wellbeing. The study’s main objective can be articulated as the comparison of quiet and noise areas along dimensions of HRQOL.


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