Table 15. Summary of the assessment of the strength of the road traffic noise recommendation
| Factors influencing the strength of recommendation | Decision |
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| Quality of evidence | Average exposure (Lden)\nHealth effects\n• Evidence for a relevant RR increase for incidence of IHD at 59 dB Lden was rated high quality.\n• Evidence for the incidence of hypertension was rated low quality.\n• Evidence for a relevant absolute risk of annoyance at 53 dB Lden was rated moderate quality.\n• Evidence for a relevant RR increase for reading and oral comprehension was rated very low quality. |
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| World Health Organization | Interventions
• Evidence on effectiveness of interventions to reduce noise exposure and/or health outcomes from road traffic noise is of varying quality. |
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| Regional Office for Europe | Night-time exposure (Lnight)\nHealth effects\n• Evidence for a relevant absolute risk of sleep disturbance related to night noise exposure from road traffic at 45 dB Lnight was rated moderate quality. |
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| Interventions
• Evidence on effectiveness of interventions to reduce noise exposure and/or sleep disturbance from road traffic noise is of varying quality. |
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| Balance of benefits versus harms and burdens | Health benefits can be gained from markedly reducing exposure of the population to road traffic noise; benefits outweigh the harms of interventions to reduce continuous road traffic noise. |
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| Values and preferences | Quiet areas are valued by the population, especially by those affected by continuous noise exposure. Some variability is possible between those who benefit from interventions to reduce road traffic noise and those who finance the interventions. |
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| Equity | Risk of exposure to road traffic noise is not equally distributed. |
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| Resource use and implications | No comprehensive cost–effectiveness analysis data are available; nevertheless, a wide range of solutions exists and several are being implemented, showing that effective interventions are both feasible and economically reasonable. |
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| Decisions on recommendation strength | • Strong for guideline level for average noise exposure (Lden)\n• Strong for guideline value for average night noise exposure (Lnight)\n• Strong for specific interventions to reduce noise exposure |
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