DÄ internationalArchive5/2009Health Consequences of Aircraft Noise: In reply

Correspondence

Health Consequences of Aircraft Noise: In reply

Dtsch Arztebl Int 2009; 106(5): 71. DOI: 10.3238/arztebl.2009.0071b

Kaltenbach, M; Maschke, C

LNSLNS Our article says that "Laboratory tests are of only limited value." This is not a statement of exclusion. With regard to the development of hypertension, studies in sleep laboratories do not permit reliable conclusions about chronic diseases.

The meaningfulness of any study has its limits. To deduce guide values, the results of all meaningful studies have to be evaluated. That is exactly what we did.

All studies of hypertension have shown significant results, as shown in table 1. The odds ratios reported there reach significance if the accompanying confidence interval does not include 1. This is the case in nine studies. The results of the Aydin study also reach significance.

The 2001 "synopsis," of which Spreng was a co-author and which was commissioned by Fraport, says that "the basis for the assessment (of the night) is the avoidance of additional noise related awakening." In their 2007 article, the authors of the "synopsis" do not "see any reason to deviate from earlier findings." Only in the context of the expansion of Frankfurt airport, a cortisol model by Spreng was cited, to provide a reason for the preventive guide value. To date, the validity of this models has not been verified.

Acute sleep disruption (awakening) due to brief noise events (<60 seconds) can be predicted more precisely on the basis of the maximum noise level than the constant volume. However, awakening reactions are not appropriate for a health assessment that includes chronic diseases. Avoiding awakening reactions is not sufficient to prevent chronic health impairments. One of the article's main intentions is to raise attention for the fact that these recent research results have to be borne in mind.

The guide values in table 3 were deduced by using toxicology results. The lowest level of the first significant noise level class was interpreted as "no observed adverse effect level" and assigned to the preventive guide value. The top level of the first significant noise level class was interpreted as "lowest observed adverse effect level" and assigned to the critical tolerance value.

The "synopsis" does not show which method the authors used to gain their guide values. Further, it is not clear whether the "synopsis" underwent a similar peer review procedure as the article published in the Ärzteblatt. It is not enough to rely on earlier research results—the results of more recent studies will always have to be taken into account. This is the case especially for chronic health impairments that cannot be reliably identified by using laboratory results only. DOI: 10.3238/arztebl.2009.0071b


Unfortunately, our co-author Rainer Klinke has passed away in the meantime.

Prof. Dr. med. Martin Kaltenbach; PD Dr. Ing. Christian Maschke
Address for correspondence: Falltorweg 8, 63303 Frankfurt, Germany
martinkaltenbach@arcor.de

Conflict of interest statement
The authors of both the letter and the reply declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.
1.
Kaltenbach M, Maschke C, Klinke R: Gesundheitliche Auswirkungen von Fluglärm. Dtsch Arztebl Int 2008; 105(31, 32): 548–56. VOLLTEXT
1. Kaltenbach M, Maschke C, Klinke R: Gesundheitliche Auswirkungen von Fluglärm. Dtsch Arztebl Int 2008; 105(31–32): 548–56. VOLLTEXT