In the modern mechanised world noise is everywhere. As professionals in otology we all know the damaging effects of excessive noise on the inner ear. What are less appreciated are the adverse health effects of long-term exposure to lower levels of environmental noise. A recent report from the World Health Organization and European Commission1 estimates the "Burden of disease from environmental noise" in terms of healthy life years lost. It is clear from the data presented that the effects of environmental noise are felt in parts of the body remote from the ear. It is estimated that disability adjusted life years (DALYs) lost from environmental noise in western Europe are 61000 years for ischaemic heart disease, 45 000 years for cognitive impairment of children, 903 000 years for sleep disturbance, 22 000 years for tinnitus and 654 000 years for annoyance.
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