In the Greater Rotterdam Area a second study on Noise and Health has been carried out in 2007 and 2008. In 2004 a first studywas carried out and in that study it was reported that around 12 per cent of the people living in the Greater Rotterdam Areawere highly annoyed by noise mainly caused by traffic. The number of people that were sleep disturbed and suffered from highblood pressure was reported as well and amounted to 6 percent for sleep disturbance and 3 percent was suffering fromhypertension.The 2004 study took place within the regularly framework of the Rotterdam Regional Council of Governments EnvironmentalMonitoring program, a program that reports yearly about the environmental performance indicators in the Greater RotterdamArea. Beside this yearly report a theme report over the last years is published as well. Last years theme report was on AirQuality and Energy. In 2007 the board of this program decided that in 2008 the theme should be Noise and Health. The 2008study is not only an update of the 2004 study but is more detailed and more comprehensive as well and based on recent insightsin health effects caused by long lasting noise. This paper comprises only a selection of the 2008 report.

1 Introduction

Speaking about noise monitoring one might think that thispaper is going to be about measuring noise in the field. Forinstance nearby airports, noisy high- or railways or othermajor noise sources, but in this paper this is not the case.This paper goes into measuring noise indicators that areused to report the subsequent effects of noise. There are alot of varying indicators which can be used like m2 ofexposed (quiet) area, length of acoustic barriers alongsideroads, length of constructed quiet road surfaces, amounts ofcomplaints, et cetera. All sorts of indicators like keyperformance indicators, process indicators and sourceindicators are used in the reports about the environmentalsituation and trends in the Greater Rotterdam Area. In thispaper a brief glance will be given in the monitoring methodthat is carried out in the Greater Rotterdam Area.

The Greater Rotterdam Area also called the Rijnmondregion (which is the Rhine delta) is the region around thecity of Rotterdam and its harbour. Within the GreaterRotterdam Area 18 municipalities are situated. DCMR EPAcarries out the environmental tasks for these 18municipalities (including the city of Rotterdam) but also forthe province of South Holland in this region. In this regionabout 1.2 million people are living and more than 20.000enterprises are active, varying from a bakery or a butcher togiant refineries and chemical industries such as the DutchAnglo enterprise Royal Shell.. A lot of transhipment ofcontainers and minerals take place in the Rotterdamharbour. The Rotterdam harbour is the largest harbour inEurope and one of the largest in the world. DCMR EPAnoise section works on noise caused by industry, road andrail traffic, airports, recreational activities, music, dance andsports events, building and construction works. More aboutthe noise section can be found at DCMR EPAs websitewww.dcmr.nl . More about the harbour of Rotterdam canbe found at www.portofrotterdam.com

Since 1994 the provincial and local authorities in theRotterdam area had already realised that joint monitoring ofthe regional environmental situation was essential to aneffective environmental policy. Since then, fourteen socalled monitoring reports on the Greater Rotterdam Areahave been published. In the early years the environmentalquality appeared to improve visibly. More recently,however, on balance no further progress has been made.

The explanation for this is that in the nineties, the easyenvironmental problems could be solved through stringentsource policy; the initiative at that time lay with the majorpolluters. As a consequence of this the difficult problemsremained. Problems which were mostly caused by diffusesources. For example noise nuisance is caused, among otherthings, by road and air traffic, and industry, while shippingtraffic and road traffic are important sources of airpollution. Since there are usually a number of authoritiesresponsible for tackling these diffuse sources, effectivecooperation between these authorities is a prerequisite.Thus within the framework of drafting monitoring reports(briefly called MSR), the most important authorities in theGreater Rotterdam Area environmental field arerepresented. By jointly sketching an integral picture of theenvironmental situation in the region these authorities canalso jointly take those measures which are necessary inorder to tackle the diffuse sources. The Rijnmond RegionalAir Quality Action Programme is a good example of this.Special attention is devoted to road and shipping traffic,and private households, as well as to industry.

Figure 1: Greater Rotterdam Area

The goal of MSR is twofold. In the first place MSR aims attracking the progress of environmental policy in the regionand indicating new developments relating to environmentalquality, free from value judgements. In this way MSRcontributes to the policy cycles of the authorities that worktogether in MSR. Administrators and their staff thus obtaininformation which enables them to place, evaluate and, ifnecessary, adjust their policies in a broader context. On thebasis of this information they can also formulate new policyor speed up its implementation. Where no verifiable policyobjectives are available, indicators in any case perform awarning function so that timely adjustments are still

possible. In the second place, MSR informs residents andthe business sector about the state of the environment in theRotterdam region and its recent developments. In this wayMSR fulfils the obligation that authorities have, in theframework of the rhus treaty, to supply environmentalinformation to their residents. Furthermore, MSR respondsto the societal need for transparent government.

This paper only goes into the noise indicators that werereported over the past years. Special attention will be givento the reports of 2008. This paper gives also a briefcomparison between three Dutch cities on noise relatedhealth effects.

2 Noise indicators

The first MSR reports (2000 till 2004) comprised a lot ofinformation about noise. Because the acoustic zoning ofindustrial areas had just been finished a lot of informationwas available to report. Reported was the number of noisecomplaints that was registered by the Central MonitoringRoom of the DCMR EPA. Separate as well consolidatednoise map with the noise contours of the noise of industry,roads, railways and airports together were reported. Theresult of a survey among the citizens of the GreaterRotterdam Area that compared the annoyance caused bynoise, feelings of unsafely, stench and particulate matterwas reported as well.

Figure 2: Combined Noise Map Greater Rotterdam Area

The Noise maps showed us that there was hardly a quietplace in the Rotterdam area to be found. The whole areawas covered by a blanket of noise. The most importantsource was road traffic noise and this would increase moreand more if mitigations stayed behind. From 1996sanitation programs on traffic noise, industrial noise andrailway noise were started. Till now only the sanitation onindustrial noise has been finalized. The other sanitationprograms are still going on. The sanitation on traffic noiseis planned to end in 2020.The noise indicators that are currently used in the GreaterRotterdam Area are the total number of complaints, but thenumber of complaints per noise sort as well (traffic noise,railway noise, airport noise et cetera), number of exposedpeople, number of exposed houses, natural areas with noiselevels lower than 40 dB(A), number of allowances forbuilding houses or other vulnerable objects with a highnoise burden

Figure 3: Quiet areas in the greater Rotterdam Area < 40 dB(A)The preferable noise limit amounts 50 dB and themaximum limit for constructing houses amounts, accordingto the Dutch Noise Act, 55 dB but in some specialcircumstances housing can be realised in areas with ahigher noise load.

Figure 4: Complaints noise(lawaai), stench(stank) and dust(stof)From 2004 the numbers of annoyed and highly annoyedpeople were used as a noise indicator and the number ofpeople suffering from hypertension and sleep disturbance aswell. Notwithstanding these noise indicators the MSRorganization is always looking for more appropriateindicators to affect citizens, politicians and policies andother stakeholders. This because the decibel (dB) is notunderstood by the public and the politicians. They cannotimagine what 50 dB implies. Therefore the MSRorganization looked for other descriptors like health effectsand economical effects.Health effects of long lasting noise in the Greater|Rotterdam Area were reported for the first time in 2004and economical effects were reported for the first time in2006. These reports were based on rough information aboutthe noise exposure and the number of noise exposedhouses. In 2008 more detailed information becameavailable because in the Greater Rotterdam Area 10municipalities, including the city of Rotterdam, have noisemaps according to the END 2002/49/EC. All those 10municipalities are situated within an agglomeration asmeant in the END.

Figure 5: Traffic Noise Map Rotterdam 2007

For the 2008 survey these noise maps were used and forthose cities that were not enforced to draft a noise mapaccording to the noise directive 2002/49/EC additionalnoise calculations have been made by the Noise Section ofDCMR EPA. With this information new more accuratenumbers of exposed houses were calculated by the DCMREPA.. As usual in urbanized areas traffic noise is the mostdominant noise source and therefore responsible for mosthealth effects in the Greater Rotterdam Area.

3 The 2008 Survey on Noise

3.1 Actors and methods

The calculation of the noise contours was mainly done bythe Noise Section of DCMR EPA. The counting of housesand other sensitive objects was done by this section as well.This information was delivered to the Rotterdam HealthService. The Rotterdam Health Service estimated thenumber of annoyed, highly annoyed, sleep disturbed peopleand the number of people that suffer from hypertension.They have done the estimations on DALYs (DisabledAdjusted Life Years). Expressed in an easier way one couldsay the DALY is the only quantitative indicator of burdenof disease that reflects the total amount of healthy life lostto all causes, whether from premature mortality or fromsome degree of disability during a period of time.Beside representatives of the MSR team, the survey wasguided by a temporary working group which existed of theNoise Section of DCMR EPA, the Rotterdam HealthService, the Amsterdam Health Service, the province ofSouth Holland and the Dutch National Institute for Healthand Environment (RIVM).

Estimating the annoyed and highly annoyed people the socalled Miedema curves have been used. The estimation ofpeople that are sleep disturbed was based on the Miedemacurves as well. The formulas are known and officiallyrecognized on an international level as well and can befound in literature (Miedema 2003). Estimations todetermine the number of people that were suffering fromhypertension (high blood pressure) and myocardial infarctwere done with the so called PAR approach. Determinationof the number of deaths was done by the method which isgiven in literature (Kempen 2005/Knol 2005). MSR haspassed over the scientific discussions about hypertensionoriginated by traffic noise and taken it for granted. Toestimate the amount of myocardial infarctions the Babisch(2006) findings were used, see table 1.

Average Sound Pressure levelduring the day (6-22 h)[dB(A)]

Relative risk OR

60 - 65 1,05>66 - 70 1,09>70 - 75 1,19>75 - 80 1,47Table 1: Risk Myocardial Infarction Traffic Noise (Babisch 2006)

It must be noticed that during the study done in 2004 acumulated noise map was used to estimate the subsequenthealth effects. In the 2008 study separate noise maps fortraffic noise, industrial noise, railway noise and airportnoise were used as enforced by the END. This hampers agood comparison between both studies.

3.2 Health effects Greater Rotterdam

As mentioned before using the noise maps data gives abetter thus more accurate number of houses. This will meanthat all calculations done on annoyance, high annoyance etcetera result in more accurate figures. All differences foundcan be explained by this phenomenon.

Figure 6: Annoyed and Highly Annoyed people in Greater Rotterdam Areafor respectively road traffic noise, railway noise, airport noise and

industrial noise

Within this study the percentage of annoyed and highlyannoyed people has been estimated on calculations(according to Miedema) and on the other hand based on aquestionnaire that was set out in 2005. Its widely knownthat the outcomes of calculated effects often are lower thanthe outcomes based on questionnaires. In figure 6 theresults of the annoyed and highly annoyed people based oncalculations is presented. In figure 7 the national numbersare given based on questionnaires done by Franssen (2004).

The percentage of the calculated annoyed (A) and thehighly annoyed (HA) that was found in this study wascompared to the Dutch situation. In the Netherlandsapproximately 4 per cent is highly annoyed because oftraffic noise and in the Greater Rotterdam Area we foundapproximately 16 per cent. Compared with the outcomes of2004 we see a predictable difference. The number ofannoyed and highly annoyed people has decreased. This ismainly caused by the more accurate numbers of houses dueto the more detailed calculations

Figure 7: Annoyed and highly annoyed people in the Netherlands forrespectively road,rail,air, industry, recreation and neighbour noise

Looking to the sleep disturbed people in the GreaterRotterdam Area its found that about 7 per cent is sleepdisturbed and 3 per cent severe sleep disturbed by trafficnoise. These figures are based on calculations. Using thequestionnaire outcomes we can notice a remarkabledifference; the percentage for sleep disturbance amounts toalmost 15 per cent!

Figure 8: Percentage Highly Annoyed people in the Greater RotterdamArea for respectively traffic and railway noise (acc. to Miedema curves).

According to scientific studies there is enough evidencebetween long lasting exposure to traffic noise and getting amyocardial infarction. Its not amazing that some of thosepeople that were hit by this immediately or on short or longterm will die. Notwithstanding that most results point in thedirection that such a relation is present still discussions aregoing on about the relation between long lasting trafficnoise and hypertension. In a number of cases hypertensioncould lead to hart infarctions and strokes and subsequentlyto death. In the Greater Rotterdam area we took thesediscussions for granted and we estimated the numbers ofpeople that are suffering from hypertension and people thatdie because of long lasting traffic noise. The numbers ofpeople that suffer from hypertension are some thousandsand some tens of people dies per annum.The number of DALYs per 100.000 inhabitants in theGreater Rotterdam Area was calculated as well. For trafficnoise the number of DALYs amounts more than 120 per100.000 inhabitants. Compared to the national situation thisis rather high because on national level a number of 165DALYs occurs for traffic noise versus 185 in the GreaterRotterdam Area. The total amount of DALYs in TheGreater Rotterdam Area amounts 260 per 100.000inhabitants.

Figure 9: Numbers of DALY's in the Greater Rotterdam Area forrespectively road, railway, airport and industrial noise

3.3 Comparison between Dutch towns

Besides reporting the situation in the Greater RotterdamArea it was decided to compare the four largest cities(Amsterdam, Rotterdam, The Hague and Utrecht) in theNetherlands. Unfortunately the data of the noise map of thecity of The Hague wasnt sufficient so it became acomparison between the three largest cities in theNetherlands. The team that was working on this studydecided to make an additional report about the comparisonbetween the four cities later in 2008. Comparing the figuresof the comparison, see figure 10, there are similaroutcomes. The figures do not differ a lot.

Percentage inhabitants (20 years and older)ROTTERDAM AMSTERDAM UTRECHT

Road

Annoyed 19,1 17,2 18,5

HighlyAnoyed

7,9 7,2 7,4

Rail

Annoyed 1,8 1,8 3,7

HighlyAnoyed

0,4 0,5 1,0

Airport

Annoyed 0,7 4,5 -

HighlyAnoyed

0,2 1,5 -

Industry

Annoyed 9,7 - -

HighlyAnoyed

4,0 - -

Table 2: annoyed and highly annoyed in 3 Dutch cities

Within the boundaries of Amsterdam and Utrecht there arehardly enterprises and Rotterdam has a lot of enterprises

High annoyance

Severe sleep -disturbance

(more than 23.000). The city of Utrecht does not have anairport. These facts are the reason that a comparison onthese two noise sorts is not reported in the table. The highernumber of annoyed people caused by railway noise inUtrecht is obvious because Utrecht is the national railwayinterchange of the Netherlands.

Figure 10: number of highly annoyed people in three Dutch cities forrespectively road, rail, airport and industrial noise

A comparison of DALYs was made as well between thethree cities. This is shown in table 3 and figure 11. Becausethe data of Amsterdam on sleep disturbance was notsufficient no calculations have been made. A comparison ofthe remaining cities in the Dutch situation is given in figure11. The figure shows that in Utrecht per 100.000inhabitants there is more sleep disturbance than inRotterdam or in the whole of the Netherlands. This ismainly caused by railway noise.

ROTTERDAM AMSTERDAM UTRECHT

High annoyedRoad 715 881 284

Railway 39 59 38

Airport 16 177 -

Industry 364 - -

Severe sleep disturbedRoad 363 - 164

Railway 27 - 23

Table 3: Calculated DALY's in 3 Dutch cities

Figure 11: DALYs Rotterdam, Utrecht and Netherlands

5 Conclusions

In the Greater Rotterdam Area a high number of annoyed,highly annoyed people is present. 19 per cent of the peopleis exposed to 60 dB or more. The percentage for theNetherlands as a whole amounts 8 per cent. Based on doseresponse curves the results show that about 8 per cent of thepeople living in the Greater Rotterdam Area are sleepdisturbed and 3 per cent of them even severe sleepdisturbed. A survey done with a questionnaire show apercentage of 15 per cent sleep disturbed people. The samephenomenon is visible with the annoyed and highlyannoyed people. Based on dose-response curves it can beconcluded that around 7 per cent is annoyed and 3 per centhighly annoyed but based on questionnaire its found thatthe number of highly annoyed people amountsapproximately 12 per cent. A explanation for the founddifferences will be lacking in this paper. Thousands ofpeople are suffering from hypertension and some tens ofpeople are dying because of long lasting noise. Thosefigures are a minimum because its known that thesemethods result in an underestimation. As aforementionedthere is a remarkable difference in outcomes based oncalculations combined with dose response relations andoutcomes based on questionnaires.

AcknowledgmentsThe author acknowledges the support given by JP vanNieuwenhuizen for his assistance during the editorial workand also the members of the monitoring team of the DCMREPA for making the figures in this paper available.

References

Babisch 2006: Transportation noise and cardiovascular risk.Review and synthesis of epidemiological studies. Dose-effectcurve and risk estimation. WaBoLu 01-06. DessauUmweltbundesamt, 2006Franssen 2004, Dongen JEF van, Ruysbroek JHM, Vos F,Stellato R: Hinder door milieufactoren en de beoordeling van deleefomgeving in Nederland. Inventarisatie Verstoringen 2003.

High annoyance

Severe sleep -disturbance

Met opmaak: Nederlands (standaard)