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This editorial refers to ‘Are air pollution and traffic noise independently associated with atherosclerosis: the Heinz Nixdorf Recall Study’†, by H. The great majority of the world's population is continuously exposed to some level of air pollution from transportation, household sources, agriculture, and industry, and many are also exposed to ambient noise from the same sources. Air pollution includes a variety of gaseous species, such as carbon monoxide and nitrogen oxides, as well as suspended particulate matter of various sizes. Kalsch and colleagues examined the associations of 1-year average particulate air pollution and traffic noise with the TAC score in 4238 participants in the Heinz–Nixdorf Recall Study, who were also well characterized in terms of both lifestyle and clinical cardiovascular risk factors. The results of Kalsch et al.2 appear to suggest that there may be independent associations of night-time traffic noise and particulates on TAC, but their approach can only yield estimates with small biases if all confounders are included and if measurement errors—the differences between the data and the unknown true values—are also small. The study by Kalsch and colleagues provides new evidence on the associations of pre-clinical atherosclerosis with long-term particulate air pollution and traffic noise, complementing previous studies which have more often focused on short-term exposures and acute cardiovascular events. Tinnitus can be caused by a number of factors, including age, circulatory problems or injury, including significant exposure to damaging levels of sound. Consult a doctor if tinnitus comes on suddenly and is accompanied by hearing loss or dizziness. Every living soul wanted to set out in a calm and pleasurable place after a long houra€™s working day.A  Having a home in noisy and crowdy place can create a few illnesses and sickness which ultimately causes hypertension. In old days, our ancestors use to visit lush green garden in the early morning, enjoying the voice of chirping birds and nature pleasant sounds. The existence of bus stands, airports, auto stand and many other noise making stands in the residential creates lot noise and fuss in the environment.
As mentioned above industrialization has created not only noise pollution but many other types too.
It has been estimated that globally ?3 million premature deaths are attributable to outdoor air pollution each year,1 but it is the ubiquity of air pollution and ambient noise, as much as the likely magnitudes of associated risks, which makes them important as potential causes of cardiovascular diseases. Many of these have been shown in isolation to have adverse effects on cardiovascular health at higher doses, such as those experienced by active smokers of tobacco.4 Observational studies also provide substantial evidence of effects on cardiovascular health at lower levels of exposure due to ambient air pollution, particularly for the risk of acute events such as myocardial infarction5 or heart failure6 in response to short-term increases in pollution over days or hours.
First, the statistical evidence is not particularly strong for the associations with traffic noise.
In the case of modelled particulates and traffic noise, however, uncertainties are present in the model parameters and underlying data, in the approximation of each individual's location by their residential address, in any smoothing that may occur due to the choice of spatial resolution, and in the choice of time scale. It is often repeated that in the special case of random measurement errors in a single exposure, estimates of associations are biased towards the null hypothesis of no effect. However, there remain important methodological challenges in estimating the separate effects of long-term air pollution and traffic noise on cardiovascular outcomes. In some cases the noise can become extremely loud and can interfere with hearing normal external sounds.
A sudden ear ringing may be the result of a newly prescribed medication, in which case the prescribing physician should be alerted to the problem.


A Noise is an undesirable sound that causes pollution by producing irritation and frustration in the atmosphere. Large and heavy machinery installed there creates lot of noise which irritates and makes the place a hell to live for the people in the surroundings.
Because they share common sources, air pollution and ambient noise are correlated, and this means that any association of cardiovascular disease with either exposure may be masked or confounded by the other. Overall average traffic noise over 24 h and distance to a highly trafficked road were not associated with TAC.
Confounding is one of the most important sources of bias in observational studies; an association between an exposure and an outcome is confounded by a third variable when the latter is associated with the exposure and, independently, with the outcome of interest. It is therefore possible that random and systematic errors in modelled particulates and traffic noise are actually large, so that measurement error may pose a particularly difficult methodological challenge in studies of this nature.
In general, however, there may be bias either towards or away from the null, and in extreme cases this can even change the apparent direction of an association. Larger studies are certainly needed to provide estimates which have greater statistical precision, but validation of modelled individual exposures must also become routine, so that the estimates can be shown to be unbiased, as well as precise.
His work includes various books, articles for "The Plain Dealer" in Cleveland and essays for Oxford University Press.
Tinnitus can often be treated, with the method of treatment varying depending on the underlying cause. Finally, tinnitus can occur as side effect of a variety of medications, including aspirin in high doses, quinine, diuretics, cancer medications, and several common antibiotics. With the frequent difficulty of determining a diagnosis or underlying cause, solutions to tinnitus can be elusive. Noise pollution is not acknowledged as pollution by numerous people in our society as in light of the fact it has no physical existence.
But now, ordinarily talking, industrialization, urbanization and contemporary civilization are the nexus wellsprings of noise pollution in Pakistan. Population is increasing and cities are expanding towards the industrial areas which used to be far located from the cities.
Despite this, most studies have considered traffic noise or air pollution separately, and the study by Kalsch and colleagues2 is one of a limited number that have attempted to disentangle their effects on cardiovascular outcomes.3 Although their results are suggestive of independent effects of long-term particulate air pollution and night-time traffic noise on thoracic aortic calcification (TAC), they should be interpreted cautiously.
For example, traffic noise and particulates may confound the associations of each other with TAC because they have a common source (road traffic), and because each is hypothesized to have a causal relationship with thoracic aortic calcification (Figure 1).
These biases are more difficult to predict, and may be larger, when there are multiple sources of error, when the errors in two or more variables are correlated, when one variable is measured with much less error than the other, and when there are important systematic errors (e.g. Previous work has suggested that the relationship of cardiovascular mortality to both ambient air pollution and cigarette smoke is attenuated at higher concentrations,14 and that estimates of the burden of disease due to particulate air pollution are sensitive to the shape of the response of cardiovascular outcomes to the concentration of particulates.15 Secondly, adjustment for intermediate causes of TAC, including blood pressure, only ‘slightly’ reduced the magnitudes of the associations with TAC score (numerical results were not given). Ryan holds degrees from the University of Cincinnati and Indiana University and certifications in emergency management and health disaster response.


It is intangible pollution so people do not bother about it and consider any initiative to reduce this.
The advancing source of noise pollution is the increased transportation and vehicles, specifically in the enormous urban communities.
Although 24-h traffic noise was not associated with TAC at the P =0.05 level of statistical significance, the CIs for these estimates are too wide to conclude that night-time noise is more important than noise at other times of day.
The associations of TAC with traffic noise and particulates are also likely to be confounded by lifestyle risk factors, such as smoking and obesity, because these factors, as well as proximity to road traffic, are associated with socio-economic position. One common original cause of tinnitus is frequent exposure to loud noise earlier in life, whether occupational (such as working around jackhammers or airliners without sufficient ear protection, or sitting in front of the brass and percussion sections in a symphony orchestra) or recreational (attending too many rock concerts or continually cranking up portable music players).
Engines, transports, autos, motorbikes, trucks and rickshaws with their fumes and horns have created heightened intensity of noise in the atmosphere.
Figure 1, analysed using the DAGitty graphing tool,10 has arrows in green to show the direction of hypothesized causal relationships of particulates and traffic noise with TAC. Without such validation, however, estimates of associations must be interpreted with caution, even when the statistical evidence is otherwise strong.
Long-term exposure of this kind can result in permanent hearing loss due to damage to the tiny hairs in the inner ear that receive vibrations through the air. A tiny thing that creates a sound of 120db noise which is unbearable to human ears is they are sensitive to catch the sound of 85db. In traffic and while driving on the road, they drive without any tolerance and patience which pumps them to keep their hands more on horn rather than steering. Sequences of arrows in red (in any direction) show the pathways by which other variables may be confounders; confounding can be controlled for by statistical adjustment for any set of factors which block these pathways. It is again important not to overinterpret this finding, but it suggests that there could be a greater role for inflammation or other unmeasured intermediate factors, and leaves open the possibility of direct effects on atherosclerosis by respirable particulates which are small enough to enter the blood stream.
On the other hand, many patients over 60 years of age who have hearing loss from hereditary causes may also experience tinnitus as an associated symptom. This high intense level of noise not just hurts the individuals on the streets and yet shakes the all the people comfort in the society.
An effort should be made to boost up roadside plantation on immediate basis as trees are very helpful in reducing the pollution because they are good absorber of noise.A  So in such situations we need to take steps on individual basis and try to eliminate it from our society. Hence, the total effect of particulates (or of traffic noise) on TAC can be estimated by adjusting for traffic noise (respectively, particulates), in addition to lifestyle factors and socio-economic status.



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03.02.2014 admin



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