Alexandros Haralabidis - Academia.edu (original) (raw)
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Papers by Alexandros Haralabidis
The objective of this study was to ,compare ,the blood pressure (BP) measurements ,during night t... more The objective of this study was to ,compare ,the blood pressure (BP) measurements ,during night time sleep of a non-invasive, near-continuous, radial BP instrument to a conventional ambulatory blood pressure monitoring (ABPM) device in a field study setting, in which individuals were not controlled for moving. In order to assess ,the validity of the ,radial BP meter in a
Occupational and Environmental Medicine, 2011
Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of... more Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of hypertension, cardiovascular disease and the use of sedatives and hypnotics. Our aim was to assess the use of medication in relation to noise from aircraft and road traffic. This cross-sectional study measured the use of prescribed antihypertensives, antacids, anxiolytics, hypnotics, antidepressants and antasthmatics in 4,861 persons living near seven airports in six European countries (UK, Germany, the Netherlands, Sweden, Italy, and Greece). Exposure was assessed using models with 1 dB resolution (5 dB for UK road traffic noise) and spatial resolution of 250×250 m for aircraft and 10×10 m for road traffic noise. Data were analysed using multilevel logistic regression, adjusting for potential confounders. We found marked differences between countries in the effect of aircraft noise on antihypertensive use; for night-time aircraft noise, a 10 dB increase in exposure was associated with ORs of 1.34 (95% CI 1.14 to 1.57) for the UK and 1.19 (1.02 to 1.38) for the Netherlands but no significant associations were found for other countries. For day-time aircraft noise, excess risks were found for the UK (OR 1.35; CI: 1.13 to 1.60) but a risk deficit for Italy (OR 0.82; CI: 0.71 to 0.96). There was an excess risk of taking anxiolytic medication in relation to aircraft noise (OR 1.28; CI: 1.04 to 1.57 for daytime and OR 1.27; CI: 1.01 to 1.59 for night-time) which held across countries. We also found an association between exposure to 24hr road traffic noise and the use of antacids by men (OR 1.39; CI 1.11 to 1.74). Our results suggest an effect of aircraft noise on the use of antihypertensive medication, but this effect did not hold for all countries. Results were more consistent across countries for the increased use of anxiolytics in relation to aircraft noise.
The effect modifying impact of annoyance due to aircraft noise and road traffic noise on the rela... more The effect modifying impact of annoyance due to aircraft noise and road traffic noise on the relationships between the aircraft noise level and road traffic noise level on the prevalence of hypertension was investigated in 4861 subjects of the HYENA study (HYpertension and Exposure to Noise near Airports). Different models were investigated either including the noise level and noise annoyance variables separately, or simultaneously, or together with an interaction term referring to the same noise source for the noise level and the noise annoyance. Significant effect modification was found with respect to the association between aircraft noise and hypertension. The association was stronger in more annoyed subjects. No clear interaction was found with respect to road traffic noise. The comparison of the magnitude of the main effects (per standard deviation or inter-quartile range) of noise level and noise annoyance variables revealed stronger associations with hypertension for the noise levels. There is some indication that the noise level has a stronger predictive meaning for the relationship between noise exposure and hypertension than the reported noise annoyance (main effects). The results from the Hyena study support the hypothesis that noise annoyance acts as an effect modifier of the relationship between the noise level and hypertension.
The Journal of the Acoustical Society of America, 2012
In the cross-sectional hypertension and exposure to noise near airports study the relationship be... more In the cross-sectional hypertension and exposure to noise near airports study the relationship between road traffic noise, aircraft noise and hypertension and annoyance was investigated. The data collection comprised a variety of potentially exposure modifying factors, including type of housing, location of rooms, window opening habits, use of noise-reducing remedies, shielding due to obstacles, lengths of exposure. In the present paper the quantitative role of these factors on the relationship between road and aircraft noise exposure and outcomes was analyzed. Multiple logistic and linear regression models were calculated including these co-factors and related interaction terms with noise indicators, as well as stratified analyses. Type of housing, length of residence, location of rooms and the use of noise reducing remedies modified the relationship between noise and hypertension. However, the effects were not always in the direction of a stronger association in higher exposed subjects. Regarding annoyance, type of housing, location of rooms, noise barriers, window opening habits, noise insulation, the use of noise reducing remedies, hours spent at home during daytime were significant effect modifiers. The use of noise-reducing remedies turned out to be indicators of perceived noise disturbance rather than modifiers reducing the annoyance.
Journal of Epidemiology & Community Health, 2011
To study the association between exposure to transportation noise and blood pressure (BP) reducti... more To study the association between exposure to transportation noise and blood pressure (BP) reduction during night-time sleep. Methods: 24-hour ambulatory BP measurements at 15-minutes intervals were carried out on 149 persons living near 4 major European airports. Noise indicators included total and source-specific equivalent indoor noise, total number of noise events, annoyance scores for aircraft and road-traffic nighttime noise. Long-term noise exposure was also determined. Multivariate linear regression analysis was applied. Results: The pooled estimates show that the only noise indicator associated consistently with a decrease in BP dipping is road traffic noise. The effect shows that a 5dB increase in measured road traffic noise during the study night is associated with 0.8% (-1.55,-0.05) less dipping in diastolic BP. Noise from aircrafts was not associated with a decrease in dipping, except for a non-significant decrease noted in Athens where the aircraft noise was higher. Noise from indoor sources did not affect BP dipping.
Epidemiology, 2009
ABSTRACT Long-term exposure to noise from aircraft and road traffic is associated with effects on... more ABSTRACT Long-term exposure to noise from aircraft and road traffic is associated with effects on well-being such as sleep disturbance and annoyance and with pathophysiological outcomes such as hypertension. Within the framework of the HYENA (Hypertension and Exposure to Noise near Airports) project, we investigated the effect of long-term exposure to aircraft and road noise on the usage of selected prescribed medication. Use of prescribed medication for hypertension, stomach ulcer, cancer, sleep disorders, psychiatric disorders and respiratory diseases was measured by a cross-sectional survey of 4,861 persons 45-70 years of age, who had lived at least 5 years (3 years for Greece) near any of six major European airports. Exposure was assessed using detailed models with a resolution of 1dB (5dB for UK road traffic noise) and spatial resolution of 250×250 m2 for aircraft noise and 10×10 m2 for road traffic noise. An increased risk of taking anti-hypertensive and anxiolytic medication was found for those exposed to aircraft noise at night, after adjustment for major confounders, but not for the other drugs under investigation. A 10dB increase in night-time aircraft noise exposure was associated with an odds ratio (OR) of 1.10 (95% CI, 1.02-1.20) in taking anti-hypertensives and OR of 1.29 (95% CI, 1.03-1.62) for taking anxiolytics. A higher risk of taking anxiolytics was observed for women vs men (OR = 2.52; 95%CI: 1.68-3.79) and differences were observed between countries. Results indicate excess risks of using anti-hypertensive and anxiolytic medication related to long-term exposure to aircraft noise. The association found between aircraft noise and anxiolytic use is consistent with the hypothesis suggesting that health effects of noise are stress-mediated.
Environmental Health Perspectives, 2005
An increasing number of people live near airports with considerable noise and air pollution. The ... more An increasing number of people live near airports with considerable noise and air pollution. The Hypertension and Exposure to Noise near Airports (HYENA) project aims to assess the impact of airport-related noise exposure on blood pressure (BP) and cardiovascular disease using a cross-sectional study design. We selected 6,000 persons (45-70 years of age) who had lived at least 5 years near one of six major European airports. We used modeled aircraft noise contours, aiming to maximize exposure contrast. Automated BP instruments are used to reduce observer error. We designed a standardized questionnaire to collect data on annoyance, noise disturbance, and major confounders. Cortisol in saliva was collected in a subsample of the study population (n = 500) stratified by noise exposure level. To investigate short-term noise effects on BP and possible effects on nighttime BP dipping, we measured 24-hr BP and assessed continuous night noise in another subsample (n = 200). To ensure comparability between countries, we used common noise models to assess individual noise exposure, with a resolution of 1 dB(A). Modifiers of individual exposure, such as the orientation of living and bedroom toward roads, window-opening habits, and sound insulation, were assessed by the questionnaire. For four airports, we estimated exposure to air pollution to explore modifying effects of air pollution on cardiovascular disease. The project assesses exposure to traffic-related air pollutants, primarily using data from another project funded by the European Union (APMoSPHERE, Air Pollution Modelling for Support to Policy on Health and Environmental Risks in Europe).
Environment International, 2009
In the HYENA study (HYpertension and Exposure to Noise near Airports) noise annoyances due to air... more In the HYENA study (HYpertension and Exposure to Noise near Airports) noise annoyances due to aircraft and road traffic noise were assessed in subjects that lived in the vicinity of 6 major European airports using the 11-point ICBEN scale (International Commission on Biological Effects of Noise). A distinction was made between the annoyance during the day and during the night. L(den) and L(night) were considered as indicators of noise exposure. Pooled data analyses showed clear exposure-response relationships between the noise level and the noise annoyance for both exposures. The exposure-response curves for road noise were congruent with the EU standard curves used for predicting the number of highly noise annoyed subjects in European communities. Annoyance ratings due to aircraft noise, however, were higher than predicted by the EU standard curves. The data supports other findings suggesting that the people's attitude towards aircraft noise has changed over the years, and that the EU standard curve for aircraft noise should be modified.
European Heart Journal, 2008
Within the framework of the HYENA (hypertension and exposure to noise near airports) project we i... more Within the framework of the HYENA (hypertension and exposure to noise near airports) project we investigated the effect of short-term changes of transportation or indoor noise levels on blood pressure (BP) and heart rate (HR) during night-time sleep in 140 subjects living near four major European airports.
The objective of this study was to ,compare ,the blood pressure (BP) measurements ,during night t... more The objective of this study was to ,compare ,the blood pressure (BP) measurements ,during night time sleep of a non-invasive, near-continuous, radial BP instrument to a conventional ambulatory blood pressure monitoring (ABPM) device in a field study setting, in which individuals were not controlled for moving. In order to assess ,the validity of the ,radial BP meter in a
Occupational and Environmental Medicine, 2011
Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of... more Studies on the health effects of aircraft and road traffic noise exposure suggest excess risks of hypertension, cardiovascular disease and the use of sedatives and hypnotics. Our aim was to assess the use of medication in relation to noise from aircraft and road traffic. This cross-sectional study measured the use of prescribed antihypertensives, antacids, anxiolytics, hypnotics, antidepressants and antasthmatics in 4,861 persons living near seven airports in six European countries (UK, Germany, the Netherlands, Sweden, Italy, and Greece). Exposure was assessed using models with 1 dB resolution (5 dB for UK road traffic noise) and spatial resolution of 250×250 m for aircraft and 10×10 m for road traffic noise. Data were analysed using multilevel logistic regression, adjusting for potential confounders. We found marked differences between countries in the effect of aircraft noise on antihypertensive use; for night-time aircraft noise, a 10 dB increase in exposure was associated with ORs of 1.34 (95% CI 1.14 to 1.57) for the UK and 1.19 (1.02 to 1.38) for the Netherlands but no significant associations were found for other countries. For day-time aircraft noise, excess risks were found for the UK (OR 1.35; CI: 1.13 to 1.60) but a risk deficit for Italy (OR 0.82; CI: 0.71 to 0.96). There was an excess risk of taking anxiolytic medication in relation to aircraft noise (OR 1.28; CI: 1.04 to 1.57 for daytime and OR 1.27; CI: 1.01 to 1.59 for night-time) which held across countries. We also found an association between exposure to 24hr road traffic noise and the use of antacids by men (OR 1.39; CI 1.11 to 1.74). Our results suggest an effect of aircraft noise on the use of antihypertensive medication, but this effect did not hold for all countries. Results were more consistent across countries for the increased use of anxiolytics in relation to aircraft noise.
The effect modifying impact of annoyance due to aircraft noise and road traffic noise on the rela... more The effect modifying impact of annoyance due to aircraft noise and road traffic noise on the relationships between the aircraft noise level and road traffic noise level on the prevalence of hypertension was investigated in 4861 subjects of the HYENA study (HYpertension and Exposure to Noise near Airports). Different models were investigated either including the noise level and noise annoyance variables separately, or simultaneously, or together with an interaction term referring to the same noise source for the noise level and the noise annoyance. Significant effect modification was found with respect to the association between aircraft noise and hypertension. The association was stronger in more annoyed subjects. No clear interaction was found with respect to road traffic noise. The comparison of the magnitude of the main effects (per standard deviation or inter-quartile range) of noise level and noise annoyance variables revealed stronger associations with hypertension for the noise levels. There is some indication that the noise level has a stronger predictive meaning for the relationship between noise exposure and hypertension than the reported noise annoyance (main effects). The results from the Hyena study support the hypothesis that noise annoyance acts as an effect modifier of the relationship between the noise level and hypertension.
The Journal of the Acoustical Society of America, 2012
In the cross-sectional hypertension and exposure to noise near airports study the relationship be... more In the cross-sectional hypertension and exposure to noise near airports study the relationship between road traffic noise, aircraft noise and hypertension and annoyance was investigated. The data collection comprised a variety of potentially exposure modifying factors, including type of housing, location of rooms, window opening habits, use of noise-reducing remedies, shielding due to obstacles, lengths of exposure. In the present paper the quantitative role of these factors on the relationship between road and aircraft noise exposure and outcomes was analyzed. Multiple logistic and linear regression models were calculated including these co-factors and related interaction terms with noise indicators, as well as stratified analyses. Type of housing, length of residence, location of rooms and the use of noise reducing remedies modified the relationship between noise and hypertension. However, the effects were not always in the direction of a stronger association in higher exposed subjects. Regarding annoyance, type of housing, location of rooms, noise barriers, window opening habits, noise insulation, the use of noise reducing remedies, hours spent at home during daytime were significant effect modifiers. The use of noise-reducing remedies turned out to be indicators of perceived noise disturbance rather than modifiers reducing the annoyance.
Journal of Epidemiology & Community Health, 2011
To study the association between exposure to transportation noise and blood pressure (BP) reducti... more To study the association between exposure to transportation noise and blood pressure (BP) reduction during night-time sleep. Methods: 24-hour ambulatory BP measurements at 15-minutes intervals were carried out on 149 persons living near 4 major European airports. Noise indicators included total and source-specific equivalent indoor noise, total number of noise events, annoyance scores for aircraft and road-traffic nighttime noise. Long-term noise exposure was also determined. Multivariate linear regression analysis was applied. Results: The pooled estimates show that the only noise indicator associated consistently with a decrease in BP dipping is road traffic noise. The effect shows that a 5dB increase in measured road traffic noise during the study night is associated with 0.8% (-1.55,-0.05) less dipping in diastolic BP. Noise from aircrafts was not associated with a decrease in dipping, except for a non-significant decrease noted in Athens where the aircraft noise was higher. Noise from indoor sources did not affect BP dipping.
Epidemiology, 2009
ABSTRACT Long-term exposure to noise from aircraft and road traffic is associated with effects on... more ABSTRACT Long-term exposure to noise from aircraft and road traffic is associated with effects on well-being such as sleep disturbance and annoyance and with pathophysiological outcomes such as hypertension. Within the framework of the HYENA (Hypertension and Exposure to Noise near Airports) project, we investigated the effect of long-term exposure to aircraft and road noise on the usage of selected prescribed medication. Use of prescribed medication for hypertension, stomach ulcer, cancer, sleep disorders, psychiatric disorders and respiratory diseases was measured by a cross-sectional survey of 4,861 persons 45-70 years of age, who had lived at least 5 years (3 years for Greece) near any of six major European airports. Exposure was assessed using detailed models with a resolution of 1dB (5dB for UK road traffic noise) and spatial resolution of 250×250 m2 for aircraft noise and 10×10 m2 for road traffic noise. An increased risk of taking anti-hypertensive and anxiolytic medication was found for those exposed to aircraft noise at night, after adjustment for major confounders, but not for the other drugs under investigation. A 10dB increase in night-time aircraft noise exposure was associated with an odds ratio (OR) of 1.10 (95% CI, 1.02-1.20) in taking anti-hypertensives and OR of 1.29 (95% CI, 1.03-1.62) for taking anxiolytics. A higher risk of taking anxiolytics was observed for women vs men (OR = 2.52; 95%CI: 1.68-3.79) and differences were observed between countries. Results indicate excess risks of using anti-hypertensive and anxiolytic medication related to long-term exposure to aircraft noise. The association found between aircraft noise and anxiolytic use is consistent with the hypothesis suggesting that health effects of noise are stress-mediated.
Environmental Health Perspectives, 2005
An increasing number of people live near airports with considerable noise and air pollution. The ... more An increasing number of people live near airports with considerable noise and air pollution. The Hypertension and Exposure to Noise near Airports (HYENA) project aims to assess the impact of airport-related noise exposure on blood pressure (BP) and cardiovascular disease using a cross-sectional study design. We selected 6,000 persons (45-70 years of age) who had lived at least 5 years near one of six major European airports. We used modeled aircraft noise contours, aiming to maximize exposure contrast. Automated BP instruments are used to reduce observer error. We designed a standardized questionnaire to collect data on annoyance, noise disturbance, and major confounders. Cortisol in saliva was collected in a subsample of the study population (n = 500) stratified by noise exposure level. To investigate short-term noise effects on BP and possible effects on nighttime BP dipping, we measured 24-hr BP and assessed continuous night noise in another subsample (n = 200). To ensure comparability between countries, we used common noise models to assess individual noise exposure, with a resolution of 1 dB(A). Modifiers of individual exposure, such as the orientation of living and bedroom toward roads, window-opening habits, and sound insulation, were assessed by the questionnaire. For four airports, we estimated exposure to air pollution to explore modifying effects of air pollution on cardiovascular disease. The project assesses exposure to traffic-related air pollutants, primarily using data from another project funded by the European Union (APMoSPHERE, Air Pollution Modelling for Support to Policy on Health and Environmental Risks in Europe).
Environment International, 2009
In the HYENA study (HYpertension and Exposure to Noise near Airports) noise annoyances due to air... more In the HYENA study (HYpertension and Exposure to Noise near Airports) noise annoyances due to aircraft and road traffic noise were assessed in subjects that lived in the vicinity of 6 major European airports using the 11-point ICBEN scale (International Commission on Biological Effects of Noise). A distinction was made between the annoyance during the day and during the night. L(den) and L(night) were considered as indicators of noise exposure. Pooled data analyses showed clear exposure-response relationships between the noise level and the noise annoyance for both exposures. The exposure-response curves for road noise were congruent with the EU standard curves used for predicting the number of highly noise annoyed subjects in European communities. Annoyance ratings due to aircraft noise, however, were higher than predicted by the EU standard curves. The data supports other findings suggesting that the people's attitude towards aircraft noise has changed over the years, and that the EU standard curve for aircraft noise should be modified.
European Heart Journal, 2008
Within the framework of the HYENA (hypertension and exposure to noise near airports) project we i... more Within the framework of the HYENA (hypertension and exposure to noise near airports) project we investigated the effect of short-term changes of transportation or indoor noise levels on blood pressure (BP) and heart rate (HR) during night-time sleep in 140 subjects living near four major European airports.