Road Traffic Noise: Exposures

Negative impact based on moderate quality evidence and high resource implications.



Traffic noise refers to environmental noise (rolling, propulsion) associated with the use of roads [General Multilingual Environmental Thesaurus]. 

Traffic noise is the main cause of environmental noise in most European cities [Khomenko 2022], and is regarded as an important cause of annoyance [Ising 2004]. Increased exposure to traffic-related noise has been reported to increase the risks of adverse health outcomes, and biological mechanisms describing the pathways to such outcomes have been proposed [Recio 2016]. 



Exposure to traffic noise is negatively correlated with health outcomes.



A total of 14 reviews [Nedellec 2009; Hegewald 2020; Smith 2022; Dzhambov 2018; Sivakumaran 2022; Chen 2023; Zare Sakhvidi 2018; Lan 2020], including over 390 studies were identified. The studies investigated the relationship between traffic exposure and various health outcomes, including cardiovascular, endocrine, mental, cancer and reproductive outcomes.

Outcome: Paediatric

  • Increased noise exposure was associated with increased post-neonatal mortality, asthma attacks, bronchitis, asthma hospitalisations, respiratory hospitalisations, and emergency medical examinations [Nedellec 2009].

Outcome: Mental health and wellbeing

  • Aircraft noise significantly increases the risk of depression [Hegewald 2020].
  • Road traffic had no significant effect on the risk of depression [Hegewald 2020].
  • Transportation noise was negatively associated with self-reported sleep [Smith 2022].
  • There was a significant association between traffic noise and more severe anxiety [Lan 2020].
  • The effect of road traffic noise on mental health and well-being is inconclusive [Clark 2018]

Outcome: Cardiovascular

Outcome: Diabetes

Outcome: Neurologic

  • Aircraft noise exposure was associated with an increased risk of stroke and adverse neurological outcomes [Chen 2023].

Outcome: Reproductive

  • Exposure to aircraft noise was associated with increased risks of preterm birth, low birth weight and congenital anomalies [Nieuwenhuijsen 2017].
  • Exposure to road traffic noise was associated with increased risks of low birth weight, preterm birth and small for gestational age [Nieuwenhuijsen 2017]. 

Outcome: Cancer

  • Prolonged and continuous noise exposure was associated with an increased incidence of acoustics neuroma and breast cancer [Abbasi 2022].


  • High-quality (prospective) studies assessing all traffic noise sources in the same population should be conducted.
  • Future studies should consider the consequences of exposure to multiple stressors and their interactions with sleep.
  • Dose-response associations between environmental noise exposure and health outcomes should be further investigated.
  • Validated state-of-the-art exposure-assessment methods should be used to model the individual level of noise exposure to allow for robust comparisons.
  • Future studies should address the impact of confounders.
  • Lower noise thresholds should be adopted in future regulation.

Strength of the Evidence

Strength of the Evidence

Thirteen reviews provided information on reporting quality. The quality of the evidence for reported outcomes were judged as high in two reviews [Wu 2023; Liu 2022], moderate in two reviews [Smith 2022; Zare Sakhvidi 2018], low in three reviews [Dzhambov 2018; Chen 2023; Renner 2021], and very low in two reviews [Sivakumaran 2022; Clark 2018].

The quality of evidence was very low to low in two reviews [Lan 2020; Nieuwenhuijsen 2017]. The risk of bias in one review was reported as low in one review [Abbasi 2022], and low-to-moderate in another [Hegewald 2020].

Resource Implications

Resource Implications

None of the identified reviews reported on resource implications, but the ability to redesign roads and reduce noise requires moderate to high resources.

Related Resources

Related Resources

Reference to Reviews

Reference to Reviews

Nedellec 2009. “Decrease in the health impact of road traffic in French urban areas attributable to European emissions standards Euro IV and V. I. Meta-analysis of epidemiological studies to derive the exposure-response function in children.” Environment, Risks & Health. Volume 8, number 1, January-February 2009. Page(s): 22-34. DOI: 10.1684/ers.2009.0216. 

Hegewald 2020. “Traffic Noise and Mental Health: A Systematic Review and Meta-Analysis.International journal of environmental research and public health vol. 17,17 6175. 25 Aug. 2020, doi:10.3390/ijerph17176175.

Smith 2020. “Environmental Noise and Effects on Sleep: An Update to the WHO Systematic Review and Meta-Analysis.” Environmental health perspectives vol. 130,7 (2022): 76001. doi:10.1289/EHP10197.

Dzhambov 2018. “Residential road traffic noise as a risk factor for hypertension in adults: Systematic review and meta-analysis of analytic studies published in the period 2011-2017.Environmental pollution (Barking, Essex : 1987) vol. 240 (2018): 306-318. doi:10.1016/j.envpol.2018.04.122.

Sivakumaran 2022. “Impact of Noise Exposure on Risk of Developing Stress-Related Health Effects Related to the Cardiovascular System: A Systematic Review and Meta-Analysis.” Noise & health vol. 24,114 (2022): 107-129. doi:10.4103/nah.nah_83_21.

Wu 2023. “The association between road traffic noise and type 2 diabetes: a systematic review and meta-analysis of cohort studies.Environmental science and pollution research international vol. 30,14 (2023): 39568-39585. doi:10.1007/s11356-023-25926-5.

Chen 2023. “Environmental noise exposure and health outcomes: an umbrella review of systematic reviews and meta-analysis.European journal of public health, ckad044. 8 Apr. 2023, doi:10.1093/eurpub/ckad044.

Zare Sakhvidi 2018. “Association between noise exposure and diabetes: A systematic review and meta-analysis.Environmental research vol. 166 (2018): 647-657. doi:10.1016/j.envres.2018.05.011.

Lan 2020. “Transportation noise exposure and anxiety: A systematic review and meta-analysis.Environmental research vol. 191 (2020): 110118. doi:10.1016/j.envres.2020.110118.

Nieuwenhuijsen 2017. “WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Adverse Birth Outcomes.International journal of environmental research and public health vol. 14,10 1252. 19 Oct. 2017, doi:10.3390/ijerph14101252.

Liu 2022. “Dose-response association between transportation noise exposure and type 2 diabetes: A systematic review and meta-analysis of prospective cohort studies.” Diabetes/metabolism research and reviews vol. 39,2 (2023): e3595. doi:10.1002/dmrr.3595.

Abbasi 2022. “Noise exposure and the risk of cancer: a comprehensive systematic review.Reviews on environmental health, 10.1515/reveh-2022-0021. 6 Sep. 2022, doi:10.1515/reveh-2022-0021.

Renner 2021. “Epidemiologische Studien zu chronischen Straßenlärm-Expositionen und dem Blutdruck: Ein systematischer Review mit Metaanalysen” [Epidemiological Studies on the Association between Chronic Exposure to Road Traffic Noise and Blood Pressure: A Systematic Review with Meta-Analyses]. Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) vol. 83,5 (2021): 384-397. doi:10.1055/a-1165-1797.

Clark 2018. “WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Quality of Life, Wellbeing and Mental Health.International journal of environmental research and public health vol. 15,11 2400. 29 Oct. 2018, doi:10.3390/ijerph15112400.