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Namasivaya Navin RB, Balaji D, Gowthame K, Prabakaran S, Rajasekaran S, Karthika SR. Ent Manifestations in Sculptors of South Chennai, India: A Cross Sectional Observational Study. Indian J Otolaryngol Head Neck Surg 2024; 76:437-442. [PMID: 38440447 PMCID: PMC10908744 DOI: 10.1007/s12070-023-04179-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/22/2023] [Indexed: 03/06/2024] Open
Abstract
Despite the National Occupational Safety and Legislation Act 2020's implementation, reports of workplace accidents are rising in India. Various ear, nose, and throat conditions have been linked to a wide range of physico-chemical variables. Due to a lack of training, inadequate knowledge, a lack of awareness of occupational health and safety risks, or a lack of accessibility to or use of personal protective equipment (PPE), sculptors are frequently exposed to a variety of physical, compound and unplanned risks, chemical, and accidental hazards. The study aimed to assess the various ear, nose and throat manifestations like noise induced hearing loss, occupational rhinitis and non-infectious pharyngitis among the sculptors working in the southern part of Chennai. This observational study was performed in a total of 110 sculptors. Demographic data like age, education, duration of occupation, use of PPE like face mask, ear plug during work hours, whether sculpting is a family occupation or first generation sculptor. A detailed history and thorough ENT examination was performed with pure tone audiometry (PTA), diagnostic nasal endoscopy (DNE) and videolaryngoscopy (VLS). If any problem is detected they will be treated accordingly. Most of them (70%) were in the age group of 21-40 years but 71% of them are sculptors for more than 15 years which infers introduction to the occupation at an early age. The reason for this could be more than 80% of them possessed the heritage of sculpting as their family occupation. Duration of occupation was significantly associated with chronic rhinitis (P value was 0.002) and NIHL (P value was 0.002) whereas education and use of PPE like face mask or ear plugs were not associated with ENT manifestations. This study focuses on the sculptors' working habits, their ignorance of safety precautions, and an assessment of the numerous ENT ailments. These manifestations showed a strong correlation to exposure time. To prevent the issues from becoming more severe, regular medical monitoring is required for early detection and intervention.
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Affiliation(s)
- R. B. Namasivaya Navin
- Department of Otorhinolaryngology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu 603103 India
| | - D. Balaji
- Department of Otorhinolaryngology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu 603103 India
| | - K. Gowthame
- Department of Otorhinolaryngology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu 603103 India
| | - S. Prabakaran
- Department of Otorhinolaryngology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu 603103 India
| | - S. Rajasekaran
- Department of Otorhinolaryngology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu 603103 India
| | - S. R. Karthika
- Department of Otorhinolaryngology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Kelambakkam, Chennai, Tamilnadu 603103 India
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Manukyan AL, Melkonyan MM, Sukiasyan LM, Vardanyan SO, Hunanyan LS, Yenkoyan KB, Harutyunyan SH. The regulatory effects of mesedin and beditin alpha2-adrenoblockers on the functional activity of the nervous, cardiovascular, and endocrine systems in rats under the hypoxic conditions. Naunyn Schmiedebergs Arch Pharmacol 2024:10.1007/s00210-024-02968-1. [PMID: 38277039 DOI: 10.1007/s00210-024-02968-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/17/2024] [Indexed: 01/27/2024]
Abstract
One of the reasons of the development of pathologies causing death is hypoxia. The purposes of this study were (1) to study some physiological and biochemical mechanisms of α2-adrenoblockers, which ensure the tissue resistance increase to hypoxia; (2) to offer new drugs contributing to the increase of tissues' stability towards the hypoxic affection; and (3) to submit new medications to surpass by their anti-hypoxic activity of those already used in modern medicine and have some advantages. The reactivity of postsynaptic vascular α2-adrenoceptors was determined on the damaged spinal cord expressed by the blood pressure increase in response to intravenous administration of azepexole that selectively binds to α2-adrenoceptors. Determination of the systemic hemodynamic values and the vascular resistance to the blood flow was performed by the method with plastic microspheres of marked isotopes. pO2 in the blood and the oxygen-transporting function were determined in a sample of 0.1 ml of blood in 30, 90, and 180 min after the α2-adrenoblockers' injections. It has been found that one of the major hemodynamic effects of mesedin and beditin was an improvement in cardiac output, as well as a prolonged increase in coronary blood flow and vasodilation of the heart vessels. Some anti-hypoxic mechanisms of the studied α2-adrenoblockers are an improvement of blood oxygen-transporting function followed by tissue oxygenation and the increased level of corticosterone and resistance to hypoxia. Revealing the mechanisms of action of the postsynaptic α2-adrenoceptors suggests that mesedin and beditin are potentially effective therapeutic means for many hypoxic conditions.
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Affiliation(s)
- Ashkhen L Manukyan
- Department of Medical Chemistry, Yerevan State Medical University After M. Heratsi, Koryun 2, 0025, Yerevan, Armenia.
- Cobrain Center, Yerevan State Medical University After M. Heratsi, 0025, 2 Koryun Str., Yerevan, Armenia.
| | - Magdalina M Melkonyan
- Department of Medical Chemistry, Yerevan State Medical University After M. Heratsi, Koryun 2, 0025, Yerevan, Armenia
- Cobrain Center, Yerevan State Medical University After M. Heratsi, 0025, 2 Koryun Str., Yerevan, Armenia
| | - Lilit M Sukiasyan
- Laboratory of Morphological Studies, SRS, Yerevan State Medical University After M. Heratsi, 0025, Yerevan, Armenia
| | - Svetlana O Vardanyan
- Scientific-Technological Center of Organic-Pharmaceutical Chemistry of NAS RA, Institute of Fine Organic Chemistry After A.L. Mnjoyan, 0014, Yerevan, Armenia
| | - Lilit S Hunanyan
- Department of Medical Chemistry, Yerevan State Medical University After M. Heratsi, Koryun 2, 0025, Yerevan, Armenia
- Cobrain Center, Yerevan State Medical University After M. Heratsi, 0025, 2 Koryun Str., Yerevan, Armenia
| | - Konstantin B Yenkoyan
- Neuroscience Laboratory, Cobrain Center, Yerevan State Medical University After M. Heratsi, 0025, 2 Koryun Str., Yerevan, Armenia
- Department of Biochemistry, Yerevan State Medical University M. Heratsi, 0025, Yerevan, Armenia
| | - Seda H Harutyunyan
- Scientific-Technological Center of Organic-Pharmaceutical Chemistry of NAS RA, Institute of Fine Organic Chemistry After A.L. Mnjoyan, 0014, Yerevan, Armenia
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Zhou Z, Jiang WJ, Li L, Si JQ. The effects of noise exposure on hippocampal cognition in C57BL/6 mice via transcriptomics. Biochem Biophys Res Commun 2024; 690:149257. [PMID: 38016245 DOI: 10.1016/j.bbrc.2023.149257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/27/2023] [Accepted: 11/14/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Noise is an important environmental stressor in the industrialized world and has received increasing attention in recent years. Although epidemiological research has extensively demonstrated the relationship between noise and cognitive impairment, the specific molecular mechanisms and targets remain to be fully explored and understood. METHODS To address this issue, 5-month-old C57BL/6 mice were divided into two groups, with one group exposed to white noise at 98 dB. The effects of noise on cognition in mice were investigated through molecular biology and behavioral experiments. Subsequently, transcriptomic sequencing of the hippocampus in both groups of mice was performed and enrichment analysis of differentially expressed genes (DEGs) was conducted using KEGG and GO databases. Furthermore, LASSO analysis was used to further narrow down the relevant DEGs, followed by enrichment analysis of these genes using KEGG and GO databases. The DEGs were further validated by rt-qPCR. RESULTS Following noise exposure, the hippocampus levels of inflammation-related factors increased, the phosphorylation of Tau protein increased, the postsynaptic density protein decreased, the number of Nissl bodies decreased, and cell shrinkage in the hippocampus increased. Moreover, the behavioral experiments manifest characteristics indicative of a decline in cognitive.A total of 472 DEGs were identified through transcriptomic analysis, and seven relevant genes were screened by the LASSO algorithm, which were further validated by PCR to confirm their consistency with the omics results. CONCLUSION In conclusion, noise exposure affects cognitive function in mice through multiple pathways, and the omics results provide new evidence for the cognitive impairment induced by noise exposure.
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Affiliation(s)
- Zan Zhou
- Department of Physiology, Medical College of Shihezi University, Shihezi, Xinjiang, 832000, China; Department of Physiology, Medical College of Jiaxing University, Jiaxing, Zhejiang, 314000, China; The Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, 832000, Xinjiang, China
| | - Wen-Jun Jiang
- Department of Physiology, Medical College of Jiaxing University, Jiaxing, Zhejiang, 314000, China; Department of Physiology, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310051, China
| | - Li Li
- Department of Physiology, Medical College of Jiaxing University, Jiaxing, Zhejiang, 314000, China.
| | - Jun-Qiang Si
- Department of Physiology, Medical College of Shihezi University, Shihezi, Xinjiang, 832000, China; The Key Laboratory of Xinjiang Endemic and Ethnic Diseases, Medical College of Shihezi University, Shihezi, 832000, Xinjiang, China.
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Huang Z, Qiu W, Zhang V, Wang H, Ye B, Wang Q. Editorial: Noise-induced hearing loss: From basic to clinical research. Front Integr Neurosci 2023; 17:1172081. [PMID: 37006415 PMCID: PMC10064133 DOI: 10.3389/fnint.2023.1172081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/06/2023] [Indexed: 03/19/2023] Open
Affiliation(s)
- Zhiwu Huang
- Department of Otolaryngology Head and Neck Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
- College of Health Science and Technology, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Zhiwu Huang
| | - Wei Qiu
- State University of New York College at Plattsburgh, Plattsburgh, NY, United States
| | - Vicky Zhang
- Department of Linguistics, Faculty of Human Sciences, Macquarie University, Sydney, NSW, Australia
- National Acoustic Laboratories, Sydney, NSW, Australia
| | - Hui Wang
- Department of Otolaryngology and Head and Neck Surgery, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Bin Ye
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Ruijin Hospital, Shanghai Jiao Tong University, Beijing, China
| | - Qixuan Wang
- Department of Otolaryngology Head and Neck Surgery, School of Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Abstract
Music is among the most important artistic, cultural, and entertainment modalities in any society. With the proliferation of music genres and the technological advances that allow people to consume music in any location and at any time, music over-exposure has become a significant public health issue. Music-induced hearing loss has a great deal in common with noise-induced hearing loss. However, there are important differences that make music a unique insult to the auditory system and a unique threat to public health. Its unique properties also make it a potentially valuable asset in sound conditioning paradigms. This review discusses hearing loss from noise and music, comparing and contrasting the two. Recent research on music-induced hearing loss is reviewed, followed by discussion of the differences in music-induced hearing loss between performers and consumers. The review concludes with a discussion of the potential of music as a sound conditioning stimulus to protect against acquired hearing loss.
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Affiliation(s)
- Alison Reynolds
- Department of Speech and Hearing Science, The Ohio State University, 110 Pressey Hall, 1070 Carmack Road, Columbus, OH 43210, USA
| | - Eric C Bielefeld
- Department of Speech and Hearing Science, The Ohio State University, 110 Pressey Hall, 1070 Carmack Road, Columbus, OH 43210, USA.
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Paciello F, Pisani A, Rinaudo M, Cocco S, Paludetti G, Fetoni AR, Grassi C. Noise-induced auditory damage affects hippocampus causing memory deficits in a model of early age-related hearing loss. Neurobiol Dis 2023; 178:106024. [PMID: 36724860 DOI: 10.1016/j.nbd.2023.106024] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 01/30/2023] Open
Abstract
Several studies identified noise-induced hearing loss (NIHL) as a risk factor for sensory aging and cognitive decline processes, including neurodegenerative diseases, such as dementia and age-related hearing loss (ARHL). Although the association between noise- and age-induced hearing impairment has been widely documented by epidemiological and experimental studies, the molecular mechanisms underlying this association are not fully understood as it is not known how these risk factors (aging and noise) can interact, affecting memory processes. We recently found that early noise exposure in an established animal model of ARHL (C57BL/6 mice) accelerates the onset of age-related cochlear dysfunctions. Here, we extended our previous data by investigating what happens in central brain structures (auditory cortex and hippocampus), to assess the relationship between hearing and memory impairment and the possible combined effect of noise and sensory aging on the cognitive domain. To this aim, we exposed juvenile C57BL/6 mice of 2 months of age to repeated noise sessions (60 min/day, pure tone of 100 dB SPL, 10 kHz, 10 consecutive days) and we monitored auditory threshold by measuring auditory brainstem responses (ABR), spatial working memory, by using the Y-maze test, and basal synaptic transmission by using ex vivo electrophysiological recordings, at different time points (1, 4 and 7 months after the onset of noise exposure, corresponding to 3, 6 and 9 months of age). We found that hearing loss, along with accelerated presbycusis onset, can induce persistent synaptic alterations in the auditory cortex. This was associated with decreased memory performance and oxidative-inflammatory injury in the hippocampus, the extra-auditory structure involved in memory processes. Collectively, our data confirm the critical relationship between auditory and memory circuits, suggesting that the combined detrimental effect of noise and sensory aging on hearing function can be considered a high-risk factor for both sensory and cognitive degenerative processes, given that early noise exposure accelerates presbycusis phenotype and induces hippocampal-dependent memory dysfunctions.
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Affiliation(s)
- Fabiola Paciello
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Anna Pisani
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Marco Rinaudo
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Sara Cocco
- Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
| | - Gaetano Paludetti
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Anna Rita Fetoni
- Department of Head and Neck Surgery, Università Cattolica del Sacro Cuore, Roma, Italy; Department of Neuroscience, Unit of Audiology, Università degli Studi di Napoli Federico II, Naples, Italy.
| | - Claudio Grassi
- Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy; Department of Neuroscience, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
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Ruiz-Páez R, Díaz J, López-Bueno JA, Asensio C, Ascaso MS, Saez M, Luna MY, Barceló MA, Navas MA, Linares C. Short-term effects of air pollution and noise on emergency hospital admissions in Madrid and economic assessment. Environ Res 2023; 219:115147. [PMID: 36580986 DOI: 10.1016/j.envres.2022.115147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/07/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
INTRODUCTION The aim of this study was to study the effect of air pollution and noise has on the population in Madrid Community (MAR) in the period 2013-2018, and its economic impact. METHODS Time series study analysing emergency hospital admissions in the MAR due to all causes (ICD-10: A00-R99), respiratory causes (ICD-10: J00-J99) and circulatory causes (ICD-10: I00-I99) across the period 2013-2018. The main independent variables were mean daily PM2.5, PM10, NO2, 8-h ozone concentrations, and noise. We controlled for meteorological variables, Public Holidays, seasonality, and the trend and autoregressive nature of the series, and fitted generalised linear models with a Poisson regression link to ascertain the relative risks and attributable risks. In addition, we made an economic assessment of these hospitalisations. RESULTS The following associations were found: NO2 with admissions due to natural (RR: 1.007, 95% CI: 1.004-1.011) and respiratory causes (RR: 1.012, 95% CI: 1.005-1.019); 8-h ozone with admissions due to natural (RR: 1.049, 95% CI: 1.014-1.046) and circulatory causes (RR: 1.088, 95% CI: 1.039-1.140); and diurnal noise (LAeq7-23h) with admissions due to natural (RR: 1.001, 95% CI: 1.001-1.002), respiratory (RR: 1.002, 95% CI: 1.001-1.003) and circulatory causes (RR: 1.003, 95% CI: 1.002-1.005). Every year, a total of 8246 (95% CI: 4580-11,905) natural-cause admissions are attributable to NO2, with an estimated cost of close on €120 million and 5685 (95% CI: 2533-8835) attributed to LAeq7-23h with an estimated cost of close on €82 million. CONCLUSIONS Nitrogen dioxide, ozone and noise are the main pollutants to which a large number of hospitalisations in the MAR are attributed, and are thus responsible for a marked deterioration in population health and high related economic impact.
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Affiliation(s)
| | - J Díaz
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain.
| | | | - C Asensio
- Universidad Politéctnica de Madrid. Grupo de Investigación en Instrumentación y Acústica Aplicada, Ctra. Valencia Km 7, Campus sur, 28031, Madrid, Spain
| | - M S Ascaso
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
| | - M Saez
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M Y Luna
- Meteorological Statal Agency. (AEMET), Madrid, Spain
| | - M A Barceló
- Research Group on Statistics, Econometrics and Health (GRECS), University of Girona, Girona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - M A Navas
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
| | - C Linares
- Climate Change, Health and Urban Environment Reference Unit, Carlos III Institute of Health (Instituto de Salud Carlos III/ISCIII), Madrid, Spain
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Abstract
The hippocampus has a well-established role in spatial and episodic memory but a broader function has been proposed including aspects of perception and relational processing. Neural bases of sound analysis have been described in the pathway to auditory cortex, but wider networks supporting auditory cognition are still being established. We review what is known about the role of the hippocampus in processing auditory information, and how the hippocampus itself is shaped by sound. In examining imaging, recording, and lesion studies in species from rodents to humans, we uncover a hierarchy of hippocampal responses to sound including during passive exposure, active listening, and the learning of associations between sounds and other stimuli. We describe how the hippocampus' connectivity and computational architecture allow it to track and manipulate auditory information - whether in the form of speech, music, or environmental, emotional, or phantom sounds. Functional and structural correlates of auditory experience are also identified. The extent of auditory-hippocampal interactions is consistent with the view that the hippocampus makes broad contributions to perception and cognition, beyond spatial and episodic memory. More deeply understanding these interactions may unlock applications including entraining hippocampal rhythms to support cognition, and intervening in links between hearing loss and dementia.
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Affiliation(s)
| | - Meher Lad
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - William Sedley
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Timothy D Griffiths
- Biosciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK; Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK; Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, USA
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Hahad O, Bayo Jimenez MT, Kuntic M, Frenis K, Steven S, Daiber A, Münzel T. Cerebral consequences of environmental noise exposure. Environ Int 2022; 165:107306. [PMID: 35635962 DOI: 10.1016/j.envint.2022.107306] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/09/2022] [Accepted: 05/15/2022] [Indexed: 06/15/2023]
Abstract
The importance of noise exposure as a major environmental determinant of public health is being increasingly recognized. While in recent years a large body evidence has emerged linking environmental noise exposure mainly to cardiovascular disease, much less is known concerning the adverse health effects of noise on the brain and associated neuropsychiatric outcomes. Despite being a relatively new area of investigation, indeed, mounting research and conclusive evidence demonstrate that exposure to noise, primarily from traffic sources, may affect the central nervous system and brain, thereby contributing to an increased risk of neuropsychiatric disorders such as stroke, dementia and cognitive decline, neurodevelopmental disorders, depression, and anxiety disorder. On a mechanistic level, a significant number of studies suggest the involvement of reactive oxygen species/oxidative stress and inflammatory pathways, among others, to fundamentally drive the adverse brain health effects of noise exposure. This in-depth review on the cerebral consequences of environmental noise exposure aims to contribute to the associated research needs by evaluating current findings from human and animal studies. From a public health perspective, these findings may also help to reinforce efforts promoting adequate mitigation strategies and preventive measures to lower the societal consequences of unhealthy environments.
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Affiliation(s)
- Omar Hahad
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany; Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
| | - Maria Teresa Bayo Jimenez
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Marin Kuntic
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Katie Frenis
- Boston Children's Hospital and Harvard Medical School, Department of Hematology/Oncology, Boston, MA, USA
| | - Sebastian Steven
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Andreas Daiber
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), partner site Rhine-Main, Mainz, Germany
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