Final Version Theme Report Noise And Health In The Greater Rotterdam Area-en-2008

Noise, Health and Money The price of noise

2008 MSR Theme report June 2008 By: The theme group Noise MSR2008

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MSR Theme report - Noise, Health and Money

Table of contents Summary

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Appendices 1. Appendix: Data Processing

43

1

Introduction

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2.

Appendix: Questionnaires Surveys

45

2

Legal framework

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3.

Appendix: Annoyance Caused by Noise Method

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2.1 Legislation and regulations 2.2 Future developments

9 10

4.

Appendix: Sleep Disturbance Method

49

3

Noise and health

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5.

Appendix: High Blood Pressure and Heart Attacks

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3.1 3.2 3.3 3.4 3.5 3.6 3.7

General Annoyance Sleep disturbance Cardiovascular disease Disability Adjusted Life Years: DALYs Childhood learning performance Quietness and health

11 11 12 13 13 14 14

6.

Appendix: Disability Adjusted Life Years: DALYs

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Results of noise and health

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4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9

Noise levels in Rijnmond Noise levels in Rotterdam, Amsterdam and Utrecht Annoyance caused by noise in Rijnmond Annoyance caused by noise in Rotterdam, Amsterdam and Utrecht Sleep disturbance in Rijnmond Sleep disturbance in Rotterdam and Utrecht Cardiovascular disease in Rijnmond Disability Adjusted Life Years : DALYs in Rijnmond Disability Adjusted Life Years : DALYs in Rotterdam, Amsterdam and Utrecht

15 15 16 18

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Discussion regarding noise and health

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6

Economy

25

18 19 20 20 21

6.1 General 6.2 Method 6.3 Results of the economic effects

25 25 25

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Framework of measures

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7.1 7.2 7.3 7.4 7.5

European Union Central Government Province Municipalities District water boards

29 29 31 33 35

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Recommendations

37

9

Literature list

39

10 Glossary

41 Table of contents

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MSR Theme report - Noise, Health and Money

Summary Noise is an important subject in the Netherlands and certainly also in Rijnmond. On the one hand there is the large number of people who are annoyed by noise and on the other there are new statutory obligations, and because the legislation is continually changing, noise will be a subject that will be of increasing importance in the coming years. The Central Government, the provinces and some municipalities must address noise. The Province of Zuid-Holland and ten out of sixteen Rijnmond municipalities had to supply noise maps to the Central Government by 30 June 2007. Moreover, these municipalities and the Province must submit actions plans by 18 July 2008 at the latest. In these action plans, municipalities must indicate how they are going to tackle problem areas and how they will protect their quiet areas. The ten Rijnmond municipalities concerned are Albrandswaard, Barendrecht, Capelle aan den IJssel, Maassluis, Ridderkerk, Rotterdam, Rozenburg, Schiedam, Spijkenisse and Vlaardingen. Rijnmond has information available regarding the noise levels generated by road traffic, rail traffic, aircraft and industry. Other matters, such as noise pollution resulting from events and noise produced by neighbours are not included in this study. Road traffic noise makes the greatest contribution to noise levels, followed by industrial noise, then rail noise and aircraft noise. When compared to national figures, the noise levels in Rijnmond are higher. In Rijnmond, the percentage of inhabitants exposed to more than 60 dB as a result of road traffic is considerably higher, being 19% when compared to 8% in the Netherlands as a whole. The noise pollution surveys carried out by the Province of Zuid-Holland show that 12% of the people questioned experience road traffic noise as being very annoying. This is followed by the annoyance caused by aircraft (4%) and industry (3%). This survey investigated the health effects of exposure to industrial, road, rail and aircraft noise in the Rijnmond area. Moreover, a comparison of these effects has been made for the cities of Rotterdam, Utrecht and Amsterdam. Increased noise levels lead not only to annoyance, but can also lead to a wide range of health effects, such as sleep disturbance and cardiovascular disease. Almost 8% of the population of Rijnmond experience a degree of sleep disturbance. More than 3% even suffer from severe sleep disturbance. This disturbance results in a feeling of tiredness, sleepiness, a drop in performance, an increase in irritation and disrupts the recovery function of sleep. Due to the ongoing scientific discussion, it is not possible to present exact figures for cardiovascular disease. However, it can be stated that thousands of people suffer from raised blood pressure due to exposure to road traffic noise. High blood pressure can lead to more serious effects such as a stroke or a heart attack, and even death. For Rijnmond this would mean some tens of people annually. The consequences for health of exposure to noise are comparable between the cities. However, city dwellers experience more health effects related to noise than the average person in the Netherlands.

Based on the noise maps, it is possible to calculate the number of DALYs resulting from severe annoyance and severe sleep disturbance. A DALY is a unit representing the number of healthy years of life a population group looses due to disease. By using this unit, it is possible to make a comparison with other diseases and cities. Every year in Rijnmond, approximately 2,630 life years (260 per 100.000 inhabitants) are lost as a result of severe annoyance and sleep disturbance due to road traffic, rail traffic, aircraft and industrial noise. As a comparison: for all of the Netherlands this is approximately 170 DALYs per 100,000 inhabitants. Of these sources, in Rijnmond road traffic with 1,880 DALYs is by far the most important. However, the DALYs mentioned resulting from the annoyance caused by noise are the result of using a conservative calculation method, and in reality they could be higher. The reason for this is that the calculation method uses exposure-response relationships and not the data from surveys into annoyance. For the Netherlands, it is estimated that 4% of the people are severely annoyed by road traffic noise, while the surveys using questionnaires show that approximately 25% experience severe annoyance. It should be clear that, in addition to human distress, this also represents an enormous loss due to visits to the doctor, hospital admissions and the like. An amount of € 78,500 can be assumed for every lost year of life. For the given figures of 2,630 DALYs, this means a loss to society of more than € 200 million. The economic effects of noise levels on dwellings are determined using the calculation of the reduction in value of the dwelling due to the high noise levels. The idea behind this is that house prices can be used to derive a price tag for the reduction in the enjoyment of property. The Environmental and Nature Planning Office (MNP) has carried out a study into this aspect and used foreign studies and a recent Dutch survey. For a noise level of less than 45 dB, no depreciation is assumed, and as the noise levels increase, the (percentage) depreciation increases accordingly. Using the results of the MNP study, an estimate has been made of the influence of noise on the house prices in Rijnmond. To be able to do this, several assumptions have been made and restrictions introduced. The resulting depreciation due to road traffic is estimated to be approximately 1.5 billion euros. This means on average € 2,900 per dwelling. The loss in value for dwellings that are exposed to

Summary

The effects of (severe) annoyance, (severe) sleep disturbance and cardiovascular disease have been calculated for this survey. Annoyance and sleep disturbance have been calculated using a generally accepted method. However, it is also generally accepted that this method underestimates the actual number of people who experience annoyance and /or sleep disturbance. This means that the calculated percentages/ numbers in this survey must be considered to be minimum figures. With respect to the exact correlation between exposure to noise and cardiovascular disease, there is still considerable discussion. However, it is clear that noise has an influence on high blood pressure and on the

chance of a heart attack. Knowledge in the area of noise and health is still developing and it is expected that in the future a generally accepted calculation method will become available to establish this relationship. For the time being, the data related to cardiovascular disease are presented with a degree of caution.

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high noise levels will of course be higher than for houses situated in a quiet residential neighbourhood. The method employed is still reasonably rough and therefore, together with the Tilburg University, work is being done on refining the calculation method. For this survey, use is made of the Hedonic Pricing Method. Here it is assumed that the market value of houses is determined by a wide variety of quality aspects, such as noise quality, the ‘greenness’ of the neighbourhood and criminality. Using very extensive statistical processes, it is possible to derive the value of separate influencing factors, including therefore noise, from the price of dwellings. Thus, the annoyance caused by noise has an effect on health and on the value of the neighbourhood. Therefore enough reason to address noise pollution. When searching for opportunities to reduce noise, everyone should bear their own responsibility. Here you can see a certain layering: some measures must be taken at the European level, others at the local level. For an important part, the measures must be worked out and executed via the action plans. The action plans should be updated every five years to allow a response to be made to social developments. A wide variety of measures can be considered such as reducing traffic levels, lowering the maximum speed limit, limitations on accessibility for certain types of vehicle and the reservation of building-free zones alongside roads and industrial estates. In addition, the noise aspects of the municipality’s own fleet of vehicles and that of its suppliers can be evaluated.

MSR Theme report - Noise, Health and Money

Via the implementation of the action plans, the coming years will see a lot of work being done to make Rijnmond quieter. It is possible that this report can still play a role in detailing or implementing the plans. If this is too late for this year’s action plan, in 2013, the authorities must draw up a new action plan. In this report we recommend that the possibilities available at the supralocal level should also be used. It is for instance possible to jointly request action from Brussels for the more rapid (obligatory) replacement of the existing tyres by quieter tyres, or requirements related to the noise produced by cars and trucks. The Central Government can put effort into the accelerated payment and execution of ISV2 projects (these projects are related to the investment budget for urban renewal).

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A second important aspect is harmonisation with other policy domains such as air. When determining the priorities of the activities, the preference should be for those measures that have a positive effect on multiple policy domains. With respect to air, various regional agreements have been made in the Rijnmond Regional Action Programme for Air Quality. A large number of action points also have an effect in the area of noise, which makes regional harmonisation with respect to noise also desirable and which offers additional opportunities. Possibly this can result in an integrated Rijnmond Regional Action Programme Air and Noise. At a later stage, the climate can also become part of this programme, in particular for traffic.

The effects of the measures taken must be monitored. A number of possible indicators that can be used here have been mentioned in the theme report, such as the (geographic) calculation of the noise levels in Rijnmond, the health damage and the economic effects. In addition to these and other indicators, it is necessary to keep up to date with more general developments, such as the use of quieter tyres and the European obligations with respect to making passenger cars and commercial vehicles quieter. Proper monitoring provides insight into the noise situation and can also provide insight into the effects of the measures (from the action plans) that are taken to combat noise pollution. It is therefore important to link the measures from the action plans to the MSR. In this way, the MSR can serve as a good basis for drawing up the 2013 action plan, as there will then be insight into the effectiveness of the measures that have already been taken. The following additional indicators are proposed: n n n n

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n



n n



n



Health effects of noise (in DALYs); Economic effects of noise levels; Noise barriers along national trunk roads and provincial roads; Quiet asphalt on national trunk roads (ZOAB - very porous asphalt); Quiet asphalt on provincial and municipal roads (DGD - thin noise-reducing top layers); Clean and quiet vehicles for various government organisations (see also the trend analysis in the chapter concerned with social context); Clean and quiet vehicles for companies and private individuals; Indicators that are in line with the implementation of the various (municipal) action plans; Indicators that are in line with the noise aspect of the environmental objectives for companies. n

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Introduction Noise in the spotlight Sound is very important to people. It has very important functions with respect to communication and as a warning signal, and it can also be very pleasant, for instance in the form of music. However, when sound is unwanted it becomes noise, which is annoying and on the national scale noise is the most frequently reported cause of inconvenience and annoyance, and as a result remains an important subject. Moreover, the noise levels, in part due to the compaction of the built-up area, are continually increasing. This is no different in Rijnmond. In Rijnmond, the number of complaints related to noise from companies is increasing. Noise is also becoming important politically due to the obligations and opportunities there are to make and implement policy in this respect. Moreover, if you ask a Dutch person chosen at random what he or she considers to be most important, then the answer will almost always be ‘health’. This explains why noise in relationship to health has been chosen as the theme for this report. However, the consequences depend on an individual’s personal characteristics, as the perception and assessment of noise differs. In addition, the report also investigates the economic effects of noise.

Process This report has been drawn up by a theme working group, consisting of representatives from the DCMR Rijnmond

In addition to monitoring the health effects, it is now also possible to calculate the influence of the environmental aspects of noise. For instance, the health damage due to noise can be calculated. When the level of exposure is known, an effect can be estimated via internationally recognised dose-effect relationships. A calculation has been made of how many inhabitants experience health effects due to exposure to noise from industry and transport. Added value is derived from the comparison of the situation in the four major cities in the Netherlands and from the calculation of the economic consequences. The economic consequences can be subdivided into costs of additional healthcare, the reduction in life expectancy, the reduction in the quality of life and the depreciation in the value of the dwellings. It is not easy to make a correct estimate in this respect, as the costs partially overlap and it is not always possible to make corrections for other factors. The health effects have been calculated, but no economic value has been assigned to them. An initial estimate has been made with respect to the valuation of the dwellings. Together with the University of Tilburg, MSR is working on a study that is exploring the economic effects. This study must refine the calculation further. In this report we have restricted ourselves to the sources that are also addressed in the various noise plans, therefore road traffic, rail traffic, aircraft and industry. Other noise sources, which initially can be considered to be events and festivals, neighbours and sound carriers such as MP3 players, are not addressed in this report. This report is intended to provide a concise overview, which can be used by regional authorities and others, of the noise situation in Rijnmond and the developments to be expected. It also indicates the possible consequences and opportunities. These management opportunities provide regional authorities with the opportunity to develop and implement (future) policy.

How to read this report Initially, this report sketches out a general picture of the current and future legal frameworks. Then it addresses the health effects, followed by the economic effects of high noise levels. Chapter 7 indicates what the various government organisations are already doing or are intending to do in the coming years to reduce the noise levels. Finally, Chapter 8 discusses what more the region can do and what role MSR can or should play here. n

Chapter 1: Introduction

That noise has been placed in the spotlight right now also has some substantive causes. On 1 January 2007, the amended Dutch Noise Abatement Act came into force. The main consequence of this is that municipalities have been assigned tasks and responsibilities in the area of noise. For instance, from now on municipalities are responsible for maintaining noise zones and for deciding on establishing higher limit values. In addition, following on from the European Environmental Noise Directive, a number of specially appointed municipalities are obliged to make noise maps for the sources: road traffic, rail traffic, aircraft and industry. Furthermore, an inventory must be made of the number of people exposed to noise and this must be reported. In short, after focusing on air and water quality, the EU now want to focus more on noise and this has considerable consequences at the regional and local level. Based on these maps, problem areas are identified for which action plans will be drawn up. In these action plans, the municipalities are free to set the plan threshold value themselves and the plans must indicate how the remaining problem areas will be tackled. The plan threshold value is the noise value above which noise-reduction measures will be taken and it can apply to both the entire municipal area or to specific areas. The latter means that a standard noise level is established dependent on the function and nature of the area. Municipalities must involve citizens when drawing up the action plans. An action plan must also indicate how quiet areas will be protected. In addition to this information becoming available - for the majority of the Rijnmond area - new information will also become available related to the health aspects of noise. As a result, the previous MSR report Noise and Health from 2003 requires revision. Therefore, 2008 is an excellent moment to revise the report published in 2003.

Environmental Agency, Rotterdam Public Health Service, Province of Zuid-Holland and the Amsterdam Public Health Service. In addition to information from these organisations, the group used data supplied by various municipalities and the Rotterdam Metropolitan Region. The input from these participants has ensured that the report provides a broad overview of the situation and the policy opportunities.

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MSR Theme report - Noise, Health and Money

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Legal framework Before we can address the aspects mentioned in the introduction, it makes sense to first consider the general legal framework and the expected developments.

2.1 Legislation and regulations Ten out of sixteen Rijnmond municipalities had to supply noise maps to the Central Government by 30 June 2007. Moreover, these municipalities must submit action plans by 18 July 2008, in which they indicate how they are going to tackle problem areas and how they will protect their quiet areas. They are free to set the threshold value themselves above which a problem is considered to exist. This applies to both the entire municipal area and to specific areas. Municipalities must involve citizens when drawing up the action plans. These obligations are derived from the European Environmental Noise Directive. Municipalities must make maps for the following sources: road traffic noise, rail noise, aircraft noise and industrial noise. The maps must show per source and subdivided into noise categories, the number of dwellings exposed to noise within that noise category. Not all dwellings that are affected by noise are mentioned. Only dwellings that are exposed to more than 55 dB during the day and 50 dB at night have to be reported. The ten Rijnmond municipalities that legally fall within the Rotterdam/Dordrecht urban agglomeration are: Albrandswaard, Barendrecht, Capelle aan den IJssel, Maassluis, Ridderkerk, Rotterdam, Rozenburg, Schiedam, Spijkenisse and Vlaardingen.

In the Netherlands, the Dutch Noise Abatement Act (WGH) is the main legislation in the area of noise. The WGH contains a system of rules to combat annoyance caused by noise pollution and to protect the citizen in his/her living environment. The rules are intended to as far as possible prevent or reduce the negative health effects that noise pollution can cause. The WGH and the implementation regulations based on it include standards for the highest allowable noise levels from, among others, road traffic, rail traffic and industry. The regulations assume the highest allowable noise levels (also called preferred limit values) and higher values, which are also called maximum limit values. A noise level below the preferred limit value is considered acceptable, while a noise level above the maximum limit value is not allowed. In a situation in which the preferred limit value is exceeded, a higher value can be specified. This is only possible if the maximum limit value is not exceeded and if certain statutory conditions are met. The Major and Aldermen are authorised to specify higher values for the highest allowable noise level. Here, the Major and Aldermen have a certain degree of freedom with respect to the policy employed. The WGH was changed on 1 January 2007. The main change concerns the decentralisation of the authority to specify higher values for the highest allowable noise level, from the Provincial Executive to the Major and Aldermen. In addition, the grounds for exemption, which were previously set

Chapter 2: Legal framework

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MSR Theme report - Noise, Health and Money

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in the old decrees based on the former WGH, have disappeared. Municipalities now have to decide on higher values and as a result of the statutory grounds for exemption disappearing, they have an additional responsibility to account for their higher value decisions. This obligation to account for their decisions can be relieved by establishing and determining a higher value policy in the form of a policy rule in accordance with the General Administrative Law Act. Decisions for higher values must meet the general principles of sound administration, as laid down in the General Administrative Law Act. Within this context it is important to establish a local higher value policy.

area, or when the houses will be built adjacent to the existing residential area and there is only a limited expansion of the existing residential area.

In the WGH a link has been made with the City and Environmental (Interim) Act. The City and Environment (Interim) Act is the successor to the City and Environment (Experimental) Act. With this act it is possible, under certain conditions, to deviate from the limit values laid down in the WGH. The WGH arranges that the power of authority to deviate based on the City and Environment (Interim) Act only applies with respect to the maximum value laid down in the WGH. Therefore these higher values can be higher than the maximum limit values as indicated in the WGH. The procedure that must be adhered to for specifying higher values than the maximum limit values based on the WGH, has been described in the City and Environment (Interim) Act. Therefore the application of the City and Environment Act cannot lead to additional requirements being placed on industrial estates, the roads or the railways or to the associated managers of these sources.

The council of ministers has agreed to the proposal from Minister Cramer regarding a change in the Environmental Management Act concerned with the introduction of noise production ceilings near national trunk roads and railways. At a large number of points along national trunk roads and railways, the maximum permitted noise values will be established. Then, the railway/ road manager must take measures to stay below this noise ceiling. The road manager can take measures such as charges (charging toll on use), noise barriers, speed limits, etc. to remain below the ceiling. Part of this plan is a scheme for where the current standard is exceeded and a 2 dB extra noise zone for future developments. This legalises a major problem of the current noise legislation, the uncontrolled growth of traffic noise at noisesensitive objects. In the legislative proposal, a stronger link is also made with the options to make the source quieter, such as quiet tyres, quieter (goods) trains and quiet road surfaces. In addition, as a result of the proposed changes, the legislation related to the policy for noise pollution will be less complicated, there will be fewer rules and the standards will be simplified. For this purpose, parts of the Noise Abatement Act will be transferred to the Environmental Management Act.

Companies must comply with the noise regulations laid down in permits or in governmental decrees. However, the various governmental decrees are in the main replaced by the Activities Decree. The noise regulations in the Activities Decree in the main correspond to the noise regulations in the former 8.40 governmental decrees. These and the Document Guide to Industrial Noise and Permitting form the basis for the regulations related to noise in the Activities Decree. For both existing and new companies the preferred limit value of the Noise Abatement Act is included as the noise standard: the long-term average assessment level. For the outdoor level this means a 24-hour value of 50 dB(A), for the indoor level of internal or adjoining dwellings a 24-hour value of 35 dB(A). For the maximum permitted noise levels, values have been set that agree with the limits laid down in the former governmental decrees and those used in common practice when granting permits. These noise levels normally ensure that noise is perceived to be acceptable in the immediate vicinity of the company. In an area that is situated within a zone of an industrial estate, with activities that are seaport bound and necessarily occur in the open air, the ‘sea port standard’ applies to houses that are newly built. The maximum limit value for newly to be built houses is then 60 dB. Municipalities can - under certain conditions - apply the sea port standard if the houses will be built within the framework of restructuring, or planned compaction of an existing residential

2.2 Future developments Until 1 January 2009, municipalities have the possibility to put forward existing houses for remediation due to road traffic noise; after this date the application period for remediation cases is closed. Houses that have not been put forward at that date will fall outside of national regulations and must be remediated at the municipality’s expense.

Recent research, carried out on behalf of the European Commission (EC), shows that quiet tyres are as economic and safe as tyres that make twice as much noise. The contact the car tyres make with the road surface forms the main source of traffic noise on busy roads; it forms the dominant noise source at speeds in excess of 30 - 40 kilometres per hour. In a few years, the EC wants cars to only be fitted with quiet tyres, in order to considerably reduce the severe noise pollution caused by traffic. The EC wants to reduce traffic noise by tackling the problem at the source. The technology to make quiet tyres already exists. With quiet tyres, the traffic will produce half the amount of noise it currently produces. In the Netherlands alone, this will already lead to 300,000 fewer people suffering severe annoyance from traffic noise. In addition, in the Netherlands alone the Central Government could save 200 million euros by, among other things, having to erect fewer noise barriers. The EC is expected to produce a detailed proposal by mid 2008. n

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Noise and health 3.1 General Exposure to noise poses a major health problem in the Netherlands. Both the Dutch Health Council and the World Health Organisation (WHO) have established that excessive noise levels in the living and working environment lead to health problems (GR 2004, Berglund 1999). Transport (road traffic, rail traffic and aircraft) is the main source of environmental noise. The current noise levels in our living environment mainly cause annoyance and sleep disturbance. In addition, exposure to noise can lead to an increased chance of high blood pressure and cardiovascular disease. Moreover, it can exacerbate the complaints of people already suffering a cardiovascular disease. Exposure to noise can also lead to reduced childhood learning performance (Knol 2005, RIVM 2008). The effect of environmental noise on psychological health has not yet been sufficiently mapped out, but there are indications that noise also has an effect on anxiety and depression (Berglund 1999, WHO 2001).

3.2 Annoyance One of the most studied effects of noise is annoyance. A definition of annoyance is “a feeling of discomfort, related to a source, with an individual or group having the conviction that this has a negative effect on them”. In addition, it is the collective term for a wide range of negative reactions such as anger, powerlessness, dejection, anxiety or loss of concentration (Berglund 1999). The WHO defines health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity (WHO 2006). Annoyance influences the physical and mental well-being and is therefore a negative health effect. Annoyance caused by road traffic noise is one of the most stubborn problems. The noise levels will increase further in the coming years. This is mainly the result of the higher population densities, the ongoing urbanisation and the related growth in traffic. The demand for transport is increasing, just like the duration of the exposure (24-hour economy) and the size of the area exposed to noise (Knol 2005, RIVM 2008).

Questionnaire surveys and calculations Annoyance due to noise can be measured by means of questionnaire surveys and can be calculated using exposureresponse relationships (models). It must be noted that at the street and neighbourhood level, the annoyance from in particular aircraft and industry can strongly differ from the general picture. Complaints about noise that are received by organisations give a less correct picture of the annoyance. This is because these complaints only reveal the top of the iceberg where annoyance is concerned. People who experience severe annoyance will complain the most, but in general even this group makes few complaints to organisations. In addition to annoyance, there are after all other factors that also determine whether someone reports a complaint, such as the expectation of whether doing so will actually make any difference. Questionnaire survey into annoyance A questionnaire survey is the most direct and therefore also the best manner to determine the number of people (severely) annoyed by noise (Woudenberg 2006). Research carried out by RIVM and TNO shows that from all sources of noise (transport, industry, recreation and neighbours) road traffic causes the most annoyance. An estimated 3.7 million people in the Netherlands who are 16 years of age and older (29%) experience severe annoyance as a result of one or more forms of road traffic noise. With respect to road traffic, mopeds cause the most annoyance (19%). Severe annoyance due to road traffic noise has increased in the period 1993-2003 (Figure 1) (Franssen 2004). Figure 1 Severe annoyance due to noise in the Netherlands 1993-2003 (Franssen 2004)

Severe noise annoyance The Netherlands 35

30

Percentage

25 1993

20

1998 2003

15

10

5

0 Road traffic Rail traffic

Aircraft

Recreation Industry

Neighbours

Source: Franssen

In the province of Zuid-Holland, approximately every two years a questionnaire (Environmental Perception Survey (MBO) ZuidHolland) is used to measure the annoyance due to noise from road traffic, aircraft and industry at a number of locations that are close to major industries, including Rijnmond. Annoyance due to rail traffic noise is not included in this survey. The last MBO was published in 2005 (MBO 2005). A survey will be carried out once again in 2008.

Chapter 3: Noise and health

The degree of annoyance is not only determined by the noise levels, but also by non-acoustic factors, such as fear of the source, future expectations, controllability of exposure, the voluntariness of the exposure and the sensitivity to noise (Peeters 2007). Non-acoustic factors have approximately as much influence on the annoyance as the noise itself. The great influence of non-acoustic factors does not mean that annoyance due to noise is subjective. Annoyance is an objective effect, just like sleep disturbance and cardiovascular disease. It is however true that annoyance can also be influenced by taking measures against non-acoustic factors (Woudenberg 2006). An example of this is reducing the fear of a source by giving inhabitants the opportunity to visit companies and to get to know them, for instance through “open days”. ‘Annoyance platforms’, in which companies, government and inhabitants participate, can also play a role in reducing the fear of and increasing the trust in companies.

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The survey method used for the MBO Zuid-Holland differs from the TNO-RIVM method. Therefore, the results from the TNO-RIVM surveys cannot simply be compared to the results from the MBO Zuid-Holland (see also the Appendix Questionnaire Surveys). In 1997, 2001 and 2007, Meijers Research carried out surveys to map out the annoyance experienced by people living in the vicinity of Rotterdam Airport (Meijers 2008). The results from the MBO Zuid-Holland and the survey in the vicinity of Rotterdam Airport are discussed in the next chapter. Calculating annoyance The percentage of people who are annoyed due to noise can be calculated using exposure-response relationships (models). Relationships have been derived between the noise levels and the degree of perceived annoyance for aircraft, road traffic and rail traffic. These relationships can be used to calculate the number of people who experience annoyance in a certain area. The ‘Noise Annoyance Method’ appendix indicates how the calculations have been made for the Rijnmond area1 and the cities of Rotterdam, Amsterdam and Utrecht.

MSR Theme report - Noise, Health and Money

It has become clear that the exposure-response relationship of aircraft noise will change. The European Union will investigate in the coming period how much (severe) annoyance is caused by a certain noise level. It is clear that recent studies show that more annoyance occurs than assumed when the current exposureresponse relationships were defined.

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Using the exposure-response relationships it is estimated that in the Netherlands approximately 600,000 people (approximately 4% of the population) are severely annoyed by road traffic noise. That is a lot less than shown by the questionnaires, in which approximately 29% of the participants indicate experiencing severe annoyance (Kempen 2005, Franssen 2004). A possible explanation is that the exposure-response relationships do not take into account a number of sound sources that cause a lot of annoyance, in particular mopeds (which are the most annoying form of road traffic). Another explanation is that the exposureresponse relationships are derived from surveys in which the non-acoustic factors probably differed markedly. The large number of people that the questionnaire survey identified as suffering sever annoyance compared to the calculated numbers (exposure-response relationships) could be linked to the strong influence of certain non-acoustic factors that now play a role in the Netherlands, while in other countries and in the past in the Netherlands they had less influence. Examples are the expectation that in the future the noise levels will increase and a more critical attitude towards the government. The surveys on which the exposure-response relationships are based were carried out in the period between 1965 and 1992. There are also indications that nowadays, people experience more annoyance from the same noise levels than a number of years ago. Calculations using exposure-response relationships are in

particular usable for strategic purposes, to estimate the effect of noise in terms of annoyance. They are also very suitable to allow various scenarios to be compared. They are not suitable for local, small-scale situations or to estimate the effect of changes in noise levels (Woudenberg 2006).

3.3 Sleep disturbance The function of sleep is to provide physical and mental rest. Sleeping saves energy, the body recovers from physical and mental exertion and a good sleep gives a nice feeling. Disturbed sleep can make itself felt during the day in: - a feeling of tiredness or a general reduction in the feeling of well-being; - sleepiness; - deterioration in performance; - increased irritation. Noise during sleep disturbs the recovery function of sleep. The chance of effects being felt as a result of disturbed sleep depends on the amount and type of disturbance and also on how a person deals with the situation. The disturbance of sleep due to something that is undesirable and unpleasant has more influence than when sleep is disturbed by something expected or pleasant (Woudenberg 2006). The Health Council has stated that the unintended influence on sleep due to noise is a serious problem. The consequences of night time noise when sleeping are in particular described for transport noise. Transport noise at night consists, in by far the majority of situations, of separately identifiable noise events, such as the passage of a train, car or aircraft. Biological reactions to environmental noise occur because a person, also when asleep, assesses and processes ‘stimuli’ from the environment. Examples of biological reactions are: reactions of the cardiovascular system (increased heart rate), waking up, increased difficulty in falling asleep and increased movement during sleep. Possibly, night time noise also influences the levels of (stress) hormones during sleep. Night time noise can negatively influence the perceived sleep quality and the general feeling of well-being. It can cause sleepiness and as a result possibly have a negative influence on social contacts and on carrying out tasks that require attention. It can also result in a loss of life years due to fatal accidents at work. Furthermore, night time noise can possibly lead to high blood pressure, cardiovascular disease and depression in women. In the elderly, night time noise can increase the use of sleep-inducing drugs and sedatives (GR 2004). Questionnaire survey into sleep disturbance The Health Council estimated that in 2003 between one hundred thousand and one million adults in the Netherlands experienced severe sleep disturbance (reported by the people themselves) (GR 2004). The results of a national questionnaire carried out by RIVM and TNO showed that in 2003, 12% of the people surveyed experienced severe sleep disturbance due to road traffic noise,

1 Rotterdam Metropolitan Region: Albrandswaard, Barendrecht, Bernisse, Brielle, Capelle aan den IJssel, Hellevoetsluis, Krimpen aan den IJssel, Lansingerland, Maassluis, Ridderkerk, Rotterdam, Rozenburg, Schiedam, Spijkenisse, Vlaardingen, Westvoorne

see Figure 2. This means that approximately 1.5 million people living in the Netherlands of 16 years of age and older experience severe sleep disturbance resulting from road traffic. Mopeds are the largest source of (severe) sleep disturbance (7% severe sleep disturbance) (Franssen 2004).

are the consequence of stress reactions to noise. In the same way as for annoyance and sleep disturbance there are indications that non-acoustic factors influence the stress effects of noise. Research shows that predictability and controllability have a major influence on people’s reaction (Woudenberg 2006).

Figure 2 Percentage of people suffering severe sleep disturbance in the Netherlands (Franssen 2004)

The influence of road traffic noise on the occurrence of heart attacks and of aircraft noise on the occurrence of high blood pressure has now been sufficiently scientifically established. The degree to which road traffic noise influences high blood pressure is still being discussed in scientific circles. This is among other things because in studies into the effects of noise on cardiovascular disease, air pollution has a disruptive effect. This is because high noise levels often go hand in hand with air pollution, which also has an effect on the occurrence of cardiovascular disease. It is possible that effects could be attributed to noise, while they are actually caused by air pollution, but the reverse is also possible. It is expected that in the coming five to ten years many new results will become available with respect to the relationship between noise and cardiovascular disease. This will possibly lead to more insight into the exact relationship between noise and cardiovascular disease.

Severe sleep disturbance The Netherlands 14

12

Percentage

10 1998

8

2003

6

4

2

0 Road traffic Rail traffic

Aircraft

Recreation Industry

Neighbours

Source: Franssen

In 2005, the Zuid-Holland environmental perception survey was the first to ask questions about sleep disturbance due to various noise sources (MBO 2005). With respect to sleep disturbance due to aircraft from Rotterdam Airport, information is available from the questionnaire surveys carried out by Meijers Research (Meijers 2008). The results of these surveys are discussed in the next chapter. Calculation of sleep disturbance The number of people suffering from sleep disturbance due to noise can be calculated using exposure-response relationships (models). These exposure-response relationships are only available for noise produced by road traffic and rail traffic, not for noise produced by aircraft and industry. In a similar way to annoyance, the relationships underestimate the actual number. In questionnaire surveys, the number of people suffering sleep disturbance in the Netherlands due to road traffic noise appears to be 1.5 million, while if exposureresponse relationships are used, the calculations show that there are 300,000 people suffering from sleep disturbance. The results of the models are mainly usable for strategic purposes and for comparing various scenarios (Woudenberg 2006). The ‘Sleep Disturbance Method’ appendix describes how the calculations were made for sleep disturbance caused by road and rail traffic for Rijnmond and the cities of Rotterdam and Utrecht.

Long-term exposure to noise can lead to cardiovascular disease. This mainly concerns effects such as high blood pressure and heart attacks (Berglund 1999, Kempen 2005, RIVM 2008). There are also indications that noise pollution leads to more visits to the doctor, increased use of medication for high blood pressure and more hospital admissions. It is assumed that these health effects

3.5 Disability Adjusted Life Years: DALYs The burden of disease can be expressed in DALYs (Disability Adjusted Life Years). The number of DALYs is the number of healthy life years that a population group looses due to disease. Using DALYs it is possible to compare the influence different diseases have on public health. The calculation of DALYs includes the following aspects of disease: n the number of people suffering the disease; n the severity of the disease; n the time a disease takes; n the reduction in the number of years that people live. The severity of the disease is given with a weighting factor between 0 and 1. Mortality has a weighting factor of 1. Every year that someone dies prematurely due to a certain risk factor is 1 DALY. If a disease has a weighting factor of for example 0.5, this means that a year of living with this disease is considered as being as severe as dying half a year earlier. If for instance a person dies in a fatal car accident when 40 years old, the life expectancy of 80 is shortened by 40 years. Therefore, this person looses 40 years of life and thus 40 DALYs. Or if someone gets diabetes at 30 years of age and dies as a result of this at 60. The weighting factor for diabetes is 0.2. This person therefore looses 30 x 0.2 = 6 DALYs due to the disease and 20 DALYs due to dying prematurely.

Chapter 3: Noise and health

3.4 Cardiovascular disease

The ‘High Blood Pressure and Heart Attack’ appendix indicates the way in which the available scientific information is used to calculate the number of inhabitants of the Rijnmond area who suffer from high blood pressure or have had a heart attack due to transport noise. The numbers for cardiovascular disease that are presented in this report must be considered to give a rough indication of the reality.

13

Therefore a grand total of 26 DALYs. Together, these two people loose 40 + 26 = 66 DALYs (Woudenberg 2006, Hoeymans 2006). Two effects of noise can be expressed in DALYs; these are severe sleep disturbance and severe annoyance. Until recently, mortality resulting from high blood pressure due to noise was also calculated in DALYs (Knol 2005). However, there is scientific discussion concerning the influence of road traffic noise on high blood pressure and with it the calculation of DALYs from this effect. Figure 3 shows the number of DALYs per 100,000 inhabitants due to severe annoyance and severe sleep disturbance resulting from transport noise in the Netherlands in 2000 and 2020. In particular, road traffic plays an important role and is responsible for by far the highest burden of disease: approximately 165 DALYs per 100,000 inhabitants in 2000. It also shows that the burden of disease resulting from severe annoyance and sleep disturbance will increase, for road traffic the number of DALYs will rise to almost 200 per 100,000 inhabitants in 2020. This is in contrast to other (environmental) factors, such as air pollution and traffic accidents, for which it is expected that the burden of disease will drop, see Figure 4. When calculating the DALYs, the basis is the annoyance and sleep disturbance calculated based on the exposure-response relationships. If the percentages found by the questionnaire surveys are taken as the basis, the number of DALYs resulting from severe annoyance and severe sleep disturbance are much higher (Knol 2005). The WHO is currently carrying out further research into the health effects of long-term exposure to noise. The preliminary results show that the number of DALYs due to noise is probably higher than has been known to date. It could even exceed the number of DALYs resulting from air pollution, which means that long-term exposure to noise accounts for the highest number of DALYs within the environmental factors. Figure 3 DALYs per 100,000 inhabitants due to severe annoyance and severe sleep disturbance resulting from transport noise in the Netherlands in 2000 and 2020 (Knol 2005).

The DALYs appendix describes how the disability adjusted life years have been calculated for the Rijnmond area and the cities of Rotterdam, Amsterdam and Utrecht.

3.6 Childhood learning performance There are indications that long-term exposure to transport noise has a negative effect on childhood learning performance. This mainly concerns effects on reading comprehension, attention, long-term memory and problem-solving capabilities. The effects of noise on learning performance have been shown the best for aircraft noise. Research shows for instance that the reading performance of primary school children living in the vicinity of airports is on average lower at higher noise levels. This difference in reading performance is estimated to be equal to children trailing behind by approximately 1 month per 5 dB. This is greater than the average difference in reading levels measured between boys and girls, but smaller than the difference seen between children from well and less-well educated parents (Kempen 2005a, RIVM 2008). It is not yet clear whether the effects are permanent or temporary. As the situation is still unclear in many areas, the effect of noise on the learning performance of children is not considered further in this MSR report.

3.7 Quietness and health In the Netherlands, quietness is becoming ever scarcer. Even in official quiet areas inappropriate noise is increasingly heard, in particular from aircraft and road traffic, while people have increasingly more need for places where there is peace and quiet. Moreover, quiet green spaces can help to recover from stress. Such spaces should preferably be located close to home. But quiet places in the city are also important (GR 2006, RIVM 2008). Because there is still little exact knowledge on the favourable health effects of quiet spaces, this MSR report does not consider the effect of (the absence of) quietness further. n

Figure 4 The burden of disease in the Netherlands due to environmental factors in DALYs (Knol 2005)

DALYs

DALYs

The Netherlands

The Netherlands

14

1600

180

1400

160 140 120

Road traffic Rail traffic

100

Aircraft

80 60

Number per 100,000 inhabitants

Number per 100,000 inhabitants

MSR Theme report - Noise, Health and Money

200

1200 1000

1980 2000

800

2020

600 400

40 200

20 0

0 2000

2020

PM10 long term Source: Knol

(uncertain)

Radon Noise

Traffic accidents UV radiation

Source: Knol

 4

Results of noise and health 4.1 Noise levels in Rijnmond

4.2 Noise levels in Rotterdam, Amsterdam and Utrecht

Figure 5 shows the noise levels in the Rijnmond area (1,182,427 inhabitants)2. Information is available with respect to the noise levels caused by road traffic, rail traffic, aircraft and industry. Road traffic noise makes the greatest contribution to noise levels, followed by industrial noise, then rail noise and aircraft noise. The figures for industry are possibly overestimated. The actual noise levels are probably lower than the calculated noise levels (see the Noise Annoyance Method appendix).

For this MSR report, data concerning noise levels are available from: n Rotterdam (584,058 inhabitants): road traffic, rail traffic, aircraft and industry n Amsterdam (742,884 inhabitants): road traffic, rail traffic and aircraft n Utrecht (288,401 inhabitants)3: road traffic and rail traffic. The figures below show the noise levels due to the various sources in these cities.

Figure 5 Percentage of the population in a noise level class in RIJNMOND

Figure 7 Percentage of the population in a noise level class in ROTTERDAM

Inhabitants in a noise level class

Inhabitants in a noise level class

Rijnmond

Rotterdam

100

100

90

90

80

80 70

60

Road traffic Rail traffic

50

Aircraft Industry

40

Percentage

Percentage

70

60

Rail traffic Aircraft Industry

40

30

30

20

20

10

10

0

Road traffic

50

0 < 50

50-55

55-60

60-65

> 65

Lden

< 50

50-55

55-60

60-65

> 65

Lden

Source: MSR

Source: MSR

Figure 6 shows the noise levels of road traffic in Rijnmond and the Netherlands. This shows that the percentage of the population of Rijnmond in the two highest noise level classes is higher than on average in the Netherlands. In Rijnmond, approximately 19% of the population is exposed to more than 60 dB due to road traffic (Lden); in the Netherlands, this is approximately 8% (Staatsen 2004). Figure 6 Percentage of the population in a noise level class (road traffic) in Rijnmond and the Netherlands

Figure 8 Percentage of the population in a noise level class in AMSTERDAM

Inhabitants in a noise level class

Inhabitants in a noise level class

Amsterdam

Road traffic 100

50

90 80

40

The Netherlands

20

Percentage

Rijnmond

60

Road traffic Rail traffic

50

Aircraft

40 30 20

10

10 0

0 < 50

50-55

55-60

Lden

60-65

< 50

> 65 Source: MSR

(source the Netherlands: Staatsen 2004) 2 3

Population figures: CBS 2007 Population figures: CBS 2007

50-55

55-60

Lden

60-65

> 65 Source: MSR

Chapter 4: Results of noise and health

Percentage

70 30

15

Figure 9 Percentage of the population in a noise level class in UTRECHT

Inhabitants in a noise level class Utrecht 90 80 70

Figure 7 shows that in Rotterdam, industry also makes a considerable contribution to noise in the living environment. Here it must be noted that this is possibly an overestimate. The actual noise levels due to industry are probably lower than the calculated noise levels (see the Noise Annoyance Method appendix). No data concerning industrial noise in Amsterdam and Utrecht are available for this report. Therefore a comparison between the three cities is impossible for this source of noise.

Percentage

60 Road traffic

50

Rail traffic

40 30 20 10 0 < 50

50-55

55-60

60-65

> 65

Lden

Source: MSR

In the same way as for Rijnmond, road traffic is the largest contributor to noise levels in the cities. Utrecht has relatively many inhabitants in the middle noise classes (50-65 dB), while in Rotterdam and Amsterdam a relatively large proportion of the population live in the lowest (less than 50 dB) and highest noise classes (more than 65 dB). This can also be seen in the next figure, which shows the noise levels due to road traffic in the three cities and in the Netherlands.

4.3 Annoyance caused by noise in Rijnmond Questionnaire survey into annoyance in Rijnmond The MBO Zuid-Holland shows that of the three surveyed sources of noise pollution (industry, aircraft and traffic), the people questioned experience the most annoyance from road traffic noise: 12% of the people surveyed consider the noise of traffic very annoying. Of these people, 4% consider the noise of aircraft (Rotterdam Airport and other aircraft) very annoying and 3% the noise caused by industry. Compared to 2003, the percentage of the population who consider noise very annoying has remained approximately the same (Figure 11). No questions were asked about annoyance due to rail traffic noise in the MBO Zuid-Holland (MBO 2005). Figure 11 Percentage of people who experience severe annoyance in RIJNMOND per source of noise (MBO 2005

Severely annoyed (MBO) Rijnmond 20

Figure 10 Comparison of noise levels due to road traffic in three major cities and in the Netherlands

18 16

Inhabitants in a noise level class

14 Percentage

Road traffic 50

40

1997

12

2001 2003

10

2005

8 6

Percentage

4 Rotterdam

30

Amsterdam

2

Utrecht The Netherlands

0 Road traffic

20

Aircraft

Industry Source: MSR

MSR Theme report - Noise, Health and Money

10

16

0 < 50

50-55

55-60

Lden

60-65

> 65 Source: MSR

(source the Netherlands: Staatsen 2004)

When compared to the noise levels in the Netherlands, the percentage of the population in the two highest noise level classes in the three cities is higher. In Rotterdam, approximately 28% of the population are exposed to more than 60 dB due to road traffic (Lden), in Amsterdam this is 30%, and in Utrecht 23%. For comparison: in the Netherlands as a whole, 8% of the population are exposed to more than 60 dB due to road traffic (Lden). Therefore, in the three major cities relatively more people are exposed to a high noise level caused by road traffic than on average in the Netherlands.

National questionnaire surveys show higher percentages of the population experience annoyance, namely 29% experience severe annoyance as a result of road traffic. However, the survey method used for the MBO Zuid-Holland differs from the TNO-RIVM method. Therefore, the results from the surveys cannot simply be compared (see also the Questionnaire Surveys appendix). The annoyance due to aircraft reported in the MBO Zuid-Holland is an average for the whole of Rijnmond and is the result of all aircraft above Rijnmond, therefore not only of aircraft flying from and to Rotterdam Airport. Meijers Research carried out research in 1997, 2001 and 2007 into annoyance caused by aircraft around Rotterdam Airport. The research was carried out in Schiebroek/ Hillegersberg-Zuid, Molenlaankwartier/Hillegersberg-Noord, Overschie, Noordelijk Schiedam, Vlaardingen, Bergschenhoek

and Pijnacker/Berkel en Rodenrijs. Figure 12 shows the results. With respect to 2001, the severe annoyance experienced around Rotterdam Airport has remained the same throughout the area and amounts to 9% in total. In the areas that have the most overflying aircraft, annoyance has increased with respect to 2001 (Meijers Research 2008). Figure 12 Percentage of the population who experience severe annoyance around Rotterdam Airport

Severely annoyed Rotterdam Airport 12

10

Percentage

8 1997 2001

6

2007

4

2

0 Severely annoying

Unbearable

(severe) annoyance in Rijnmond: at least 160,000 inhabitants of 20 years of age and older (15.6%) are annoyed by road traffic, of which at least 62,000 experience severe annoyance (6.1%). This is followed by industry, which causes severe annoyance for approximately 3% of the population (approximately 30,000 inhabitants). Rail traffic and aircraft are each responsible for causing severe annoyance to at least 0.3% of the population (at least 2,600 inhabitants). Questionnaire survey versus calculations of annoyance in Rijnmond The calculated percentage of annoyed and severely annoyed people is smaller than that shown in the questionnaire surveys. For instance, severe annoyance due to road traffic is calculated to be approximately 6%, while the MBO Zuid-Holland shows that 12% of the people surveyed experience severe annoyance due to road traffic. The MBO Zuid-Holland figure is low when compared to national research carried out by TNO-RIVM, which found 29% severe annoyance due to road traffic. However, the survey method used by the MBO Zuid-Holland differs from the TNORIVM method; this means that the results of these two studies cannot be immediately compared (see also the Questionnaire Surveys appendix).

Source: MSR

Calculations of annoyance in Rijnmond Table 1 gives for the various noise sources the calculated percentage of the population that experience (severe) annoyance in Rijnmond. For aircraft, only the aircraft movements flying from and to Rotterdam Airport are included in the calculations. It only includes the noise levels generated by commercial aircraft and not by private planes, helicopters and the like. Figure 13 shows the annoyance and severe annoyance in a graph. In Rijnmond, over 95,000 inhabitants aged 20 years and older suffer severe annoyance from noise generated by transport or industry annually. This corresponds to approximately 10% of the population who are 20 years of age and older. Road traffic is responsible for the most Table 1 Calculated annoyance and severe annoyance in Rijnmond

Percentage of the population (20 years of age and older)



RIJNMOND Road traffic Annoyance Severe annoyance

15.6 6.1

Rail traffic Annoyance Severe annoyance

1.1 0.3

Air traffic Annoyance Severe annoyance

1.1 0.3

The difference in results between the questionnaire surveys and the calculations is in line with the results of surveys on a national scale. Probably, the questionnaire surveys represent the number of people who are annoyed by noise better than the calculations based on exposure-response relationships. The calculated Figure 13 Percentage of annoyance and severe annoyance in RIJNMOND (calculated)

Annoyed inhabitants (20 years of age and older) Rijnmond 16 14

Percentage

12 10 Annoyance Severe annoyance

8 6 4 2

7.9 3.1

0 Road traffic

Rail traffic

Aircraft

Industry Source: MSR

Chapter 4: Results of noise and health

Industry Annoyance Severe annoyance

A major difference is also found for aircraft. The calculations predict 0.3% severe annoyance, while the MBO Zuid-Holland finds 4% severe annoyance. Therefore, the exposure-response relationships underestimate (severe) annoyance. Furthermore, for aircraft the calculations only include the noise levels created by commercial aircraft, while in the questionnaire surveys people also include the noise from smaller aircraft and helicopters in their answers.

17

4.4 Annoyance caused by noise in Rotterdam, Amsterdam and Utrecht Questionnaire survey into noise annoyance in Rotterdam The figure below gives the results for the city of Rotterdam from the environmental perception surveys for Zuid-Holland. The results are comparable to those for the entire Rijnmond area: the people surveyed experience most annoyance from road traffic noise: 13% of the people surveyed consider the noise of traffic very annoying. This is followed by the annoyance caused by aircraft (Rotterdam Airport and other aircraft) with 3% and as last the annoyance caused by industry (2%) (Figure 14). No questions were asked about annoyance due to rail traffic noise in the MBO Zuid-Holland (MBO 2005). Figure 14 Percentage of the population who experience severe annoyance in ROTTERDAM per source of noise (MBO 2005)

Calculations of annoyance in Rotterdam, Amsterdam and Utrecht Table 2 gives the calculated percentage of the population who experience annoyance or severe annoyance due to noise in Rotterdam, Amsterdam and Utrecht. Figure 15 gives the severe annoyance in the three cities in a graph. Figure 15 Percentage of severe annoyance in the three cities (calculated)

Severely annoyed inhabitants (20 years of age and older) 10 9 8 7 Percentage

numbers are however suitable for making comparisons between larger areas, such as Rijnmond, the three major cities and the Netherlands.

Rotterdam

6

Amsterdam

5

Utrecht

4 3 2 1 0

Severe annoyed (MBO)

Road traffic

Rail traffic

Aircraft

Industry Source: MSR

Rotterdam 18 16 14 12 Percentage

1998 2001

10

2003 2005

8 6 4 2 0 Road traffic

Aircraft

Industry Source: MSR

Table 2 Calculated annoyance and severe annoyance among the population (20 years of age and older)

MSR Theme report - Noise, Health and Money



18



Percentage of the population (20 years of age and older) ROTTERDAM

AMSTERDAM

UTRECHT

The table and graph show that road traffic is responsible for most annoyance in the three cities. Rotterdam has the highest percentage of its population that suffer severe annoyance due to road traffic, Utrecht the highest percentage that suffer severe annoyance due to rail traffic and Amsterdam the highest percentage that suffer severe annoyance due to air traffic. If severe annoyance due to road and rail traffic is considered together (with the assumption that it is not the same inhabitants who are annoyed by both road and rail traffic), then it is found that severe annoyance in Rotterdam, Amsterdam and Utrecht is comparable: at least 8% of the inhabitants suffer severe annoyance from road and rail traffic noise. No comparison can be made for the annoyance caused by industrial noise, as only data concerning Rotterdam are available for this report. The calculations show that industry in Rotterdam makes a relevant contribution to the severe annoyance suffered: approximately 4% of the population are severely annoyed by industrial noise. In this case, this might be an overestimate. The actual noise levels due to industry are probably lower than the calculated noise levels. The experienced annoyance will therefore probably also be lower than the calculated annoyance (see the Noise Annoyance Method appendix). The results from the questionnaire survey confirm this. The MBO Zuid-Holland of 2005 established that approximately 2% of the population suffered severe annoyance due to industry in Rotterdam (see Figure 14).

Road traffic Annoyance 19.1 17.2 Severe annoyance 7.9 7.2

18.5 7.4

Rail traffic Annoyance 1.8 1.8 Severe annoyance 0.4 0.5

3.7 1.0

Air traffic Annoyance 0.7 4.5 Severe annoyance 0.2 1.5

-

4.5 Sleep disturbance in Rijnmond

Industry Annoyance 9.7 - Severe annoyance 4.0 -

-

Questionnaire survey into sleep disturbance in Rijnmond In 2005, for the first time in the MBO Zuid-Holland a question was asked about sleep disturbance due to noise. This was done by

giving a rating, where 1 stands for “my sleep is severely disturbed” and 10 for “my sleep is not disturbed at all”. Figure 16 gives the percentage of people surveyed that gave an unacceptable rating. Approximately 12% of the respondents gave an unacceptable rating for sleep disturbance caused by road traffic, 3% gave an unacceptable rating for sleep disturbance caused by aircraft and 4% assessed the sleep disturbance caused by industry with an unacceptable rating.

contribution causing at least 7.2% of the population to suffer from sleep disturbance and 3.1% to suffer from severe sleep disturbance. Figure 17 Percentage of the population that suffer from (severe) sleep disturbance in RIJNMOND

Inhabitants (20 years of age and older) with sleep disturbance Rijnmond 8

Figure 16 Percentage of unacceptable ratings for sleep disturbance in RIJNMOND (MBO 2005)

7 6

Insufficient ratings for sleep disturbance Rijnmond

12

Percentage

5

Percentage

14

Road traffic Rail traffic

4 3

10

2

8

1 0

6

Road traffic

Rail traffic Source: MSR

4

2

4.6 Sleep disturbance in Rotterdam and Utrecht Questionnaire survey into sleep disturbance in Rotterdam The Environmental perception survey Zuid-Holland 2005 created a picture of sleep disturbance in Rotterdam. A 1 stood for “my sleep is severely disturbed” and a 10 for “my sleep is not disturbed at all”. Figure 18 gives the percentage of people surveyed that gave an unacceptable failure rating for sleep disturbance. Approximately 15% of the respondents gave an unacceptable rating for sleep disturbance caused by road traffic, 2% gave an unacceptable rating for sleep disturbance caused by aircraft and 4% assessed the sleep disturbance caused by industry with an unacceptable rating.

0 Road traffic

Aircraft

Industry Source: MSR

The questionnaire survey among inhabitants in the areas around Rotterdam Airport shows that 7% of the adults are disturbed in their sleep by commercial aircraft at least several times a month. This happens at least several times a week to 5% of the adults. In addition, 2% of all inhabitants have children whose sleep is disturbed by commercial aircraft. For those who also experience annoyance from by aircraft this is 9%. In 2001, the latter was 6% (Meijers Research 2008). Calculated sleep disturbance in Rijnmond Table 3 and Figure 17 show the percentage of inhabitants of 20 years of age and older that suffer from sleep disturbance and severe sleep disturbance due to road and rail traffic in Rijnmond. In total, in Rijnmond at least 79,000 adults suffer from sleep disturbance due to road or rail traffic, at least 31,000 of whom suffer severe sleep disturbance. Road traffic makes the highest

Figure 18 Percentage of unacceptable ratings for sleep disturbance in ROTTERDAM (MBO 2005)

Unacceptable ratings for sleep disturbance Rotterdam 16

Percentage of the population (20 years of age and older)



RIJNMOND Road traffic Sleep disturbance Severe sleep disturbance Rail traffic Sleep disturbance Severe sleep disturbance



Percentage

12



10 8 6

7.2 3.1

4 2

0.5 0.2

0 Road traffic

Aircraft

Industry Source: MSR

Chapter 4: Results of noise and health

14

Table 3 Calculated (severe) sleep disturbance in Rijnmond

19

Calculated sleep disturbance in Rotterdam and Utrecht The next table gives the percentage of the population of 20 years of age and older who experience sleep disturbance or severe sleep disturbance due to road traffic and rail traffic in Rotterdam and Utrecht. Figure 19 shows the severe sleep disturbance in the two cities in a graph. It was not possible to calculate the sleep disturbance for Amsterdam, as the required information regarding noise levels was unavailable. Table 4 Calculated number of people (20 years of age and older) who suffer (severe) sleep disruption in Rotterdam and Utrecht

Percentage of the population (20 years of age and older)

Road traffic People who suffer sleep disturbance People who suffer severe sleep disturbance

ROTTERDAM

UTRECHT

9.2

10.0

4.0

4.2

Rail traffic People who suffer sleep 0.8 1.6 disturbance People who suffer severe 0.3 0.6 sleep disturbance Figure 19 Percentage of the population who suffer severe sleep disturbance in Rotterdam and Utrecht (calculated)

Inhabitants (20 years of age and older) suffering severe sleep disturbance 5

Percentage

4

3 Rotterdam Utrecht

2

MSR Theme report - Noise, Health and Money

When, with this reservation, calculations are made for cardiovascular disease, it appears that thousands of people have raised blood pressure levels in Rijnmond due to road traffic noise. High blood pressure can lead to more serious effects such as a stroke or a heart attack. A proportion of the people who suffer a stroke or heart attack will die as a result. For Rijnmond this would mean that several tens of people die annually due to noise.

4.8 Disability Adjusted Life Years : DALYs in Rijnmond Based on the calculated number of people suffering severe annoyance and severe sleep disturbance, the number of Disability Adjusted Life Years (DALYs) resulting from noise has been calculated for Rijnmond. Table 5 and Figure 20 show the total number of DALYs and the number of DALYs per 100,000 inhabitants. Every year in Rijnmond, the equivalent of approximately 2,630 life years (260 per 100,000 inhabitants) are lost as a result of people suffering severe annoyance and severe sleep disturbance due to noise caused by transport (road, rail and air) and industry. Road traffic noise makes the largest contribution: the equivalent of 1,880 life years (185 per 100,000 inhabitants) annually. This is somewhat higher than the average in the Netherlands: in the Netherlands road traffic noise is responsible for approximately 165 DALYs per 100,000 inhabitants (Knol 2005). For comparison, Figure 21 gives the number of DALYs due to transport noise (road, rail and air) alongside the number of DALYs due to traffic accidents (traffic fatalities and casualties). The burden of disease due to road, rail and air traffic noise (199 DALYs per 100,000 inhabitants) is a little higher than the burden of disease resulting from traffic casualties (approximately 180 DALYs per 100,000 inhabitants) and a little lower than the DALYs due to traffic fatalities (approximately 270 DALYs per 100,000 inhabitants). The DALYs for traffic accidents are based on national figures (Knol 2005). Table 5 Calculated DALYs in RIJNMOND

1

20

in the previous chapter, the relationship between exposure to road traffic noise and suffering a heart attack is scientifically proven. The relationship between road traffic and high blood pressure is (still) under discussion, but research indicates that such a relationship exists.



0 Road traffic

Rail traffic Source: MSR

The table and graph show that the percentage of the population that suffer severe sleep disturbance in the two cities is rather similar. The main cause is road traffic. In total, at least 4 to 5% of the population suffer from severe sleep disturbance due to road or rail traffic noise.

4.7 Cardiovascular disease in Rijnmond As there is ongoing scientific discussion regarding the exact risks (numerical) of exposure to noise, no exact numbers are given in this subsection. Only orders of magnitude are given. As described

RIJNMOND

DALYs Severe annoyance Road traffic Rail traffic Air traffic Industry

1,251 52 51 608

DALYs per 100,000 inhabitants (20 years of age and older) 123 5 5 61

Severe sleep disturbance Road traffic 629 Rail traffic 39

62 4

Total

260

2,630

Figure 20 Calculated DALYs per 100,000 inhabitants (20 years of age and older) in RIJNMOND

Severe annoyance Road traffic Rail traffic Air traffic Industry

DALYs Rijnmond 140

120 Number per 100,000 inhabitants

Table 6 DALYs in Rotterdam, Amsterdam and Utrecht

100

Severe annoyance

80

Severe sleep disturbance

60

ROTTERDAM

AMSTERDAM

UTRECHT

715 39 16 364

881 59 177 -

284 38 -

Severe sleep disturbance Road traffic 363 - Rail traffic 27 -

164 23

40

Table 7 DALYs per 100,000 inhabitants (20 years of age and older) in Rotterdam, Amsterdam and Utrecht ROTTERDAM AMSTERDAM UTRECHT

20

0 Road traffic

Rail traffic

Aircraft

Industry Source: MSR

Figure 21 DALYs per 100,000 inhabitants due to transport noise and traffic accidents

Severe annoyance Road traffic Rail traffic Air traffic Industry

158 9 4 80

145 10 29 -

147 20 -

Severe sleep disturbance Road traffic 80 - Rail traffic 6 -

DALYs Traffic in Rijnmond 300

85 12

200

150

100

50

0 Traffic noise

Traffic casualties Traffic fatalities Source: MSR

4.9 Disability Adjusted Life Years : DALYs in Rotterdam, Amsterdam and Utrecht

Figure 22 DALYs per 100,000 inhabitants (20 years of age and older) due to road and rail traffic noise in Rotterdam, Utrecht and the Netherlands

DALYs Road traffic and rail traffic 180 160 140 120 Severe annoyance

100

Severe sleep disturbance

80 60 40 20 0 Rotterdam

Utrecht

The Netherlands Source: Knol

Chapter 4: Results of noise and health

Based on the calculated number of people suffering severe annoyance and severe sleep disturbance, the number of DALYs resulting from noise has been calculated for the three cities. It was not possible to calculate the burden of disease resulting from severe sleep disturbance for Amsterdam, as the required information regarding noise levels was unavailable. Table 6 gives the number of DALYs per noise source and per city. Table 7 is corrected for the number of inhabitants of 20 years of age and older in the three cities (DALYs per 100,000 inhabitants). Road traffic noise is responsible for the largest burden of disease. Furthermore, the table shows that in Amsterdam aircraft and in Utrecht rail traffic make a relatively large contribution.

Figure 22 gives the burden of disease due to road and rail traffic noise in Rotterdam, Utrecht and the Netherlands per 100,000 inhabitants. The burden of disease in Rotterdam and Utrecht is of the same order of magnitude. When compared to the Netherlands, the burden of disease in the two cities is higher. In Rotterdam, road and rail traffic noise is responsible for a burden of disease of 253 DALYs per 100,000 inhabitants and in Utrecht for 264 DALYs per 100,000 inhabitants, while on average in the Netherlands road and rail traffic noise are responsible for a burden of disease of 175 DALYs per 100,000 inhabitants. n

Number per 100,000 inhabitants

Number per 100,000 inhabitants

250

(source the Netherlands: Knol 2005)

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MSR Theme report - Noise, Health and Money

 5

Discussion regarding noise and health In 2004, the MSR report Environment and Health Monitoring Noise (pilot Rijnmond region) was published (MSR 2004). This report gives a first overview of the health effects of noise caused by road traffic, rail traffic, aircraft and industry in Rijnmond. Rijnmond now works with a different and better model to map out the noise levels. This model takes account of the screening function of buildings. The result is that the calculated noise levels are in general considerably lower than in 2004. As a result, it is not really possible to make a comparison with the health effects then found. The advantage is that we now have a better picture of the noise levels in Rijnmond. The calculations show that many inhabitants experience severe annoyance and severe sleep disturbance due to noise, that in Rijnmond thousands of people suffer from raised blood pressure due to transport noise and that several tens of people die annually as a result. The calculations of cardiovascular disease should be considered to offer a rough indication. Knowledge regarding the health effects of noise is being developed and in particular in the area of cardiovascular disease it can be expected that new knowledge will become available with respect to dose-effect relationships. In the future, this could give a better picture of the effects of noise on cardiovascular disease, such as high blood pressure and heart attacks. Annoyance and sleep disturbance result in a large number of healthy life years (DALYs) being lost annually. For instance, in Rijnmond the equivalent of approximately 2,630 life years (260 per 100,000 inhabitants) are lost as a result of people suffering severe annoyance and severe sleep disturbance due to noise caused by traffic (road, rail and air) and industry. In the three cities, the consequences for health due to exposure to noise are comparable. As a result of severe annoyance and severe sleep disturbance due to road and rail traffic, the

equivalent of 1,144 life years (253 per 100,000 inhabitants) are lost in Rotterdam every year. In Utrecht, this is the equivalent of 509 life years (264 per 100,000 inhabitants). The equivalent of 1117 life years are lost annually (184 per 100,000 inhabitants) in Amsterdam, as a result of severe annoyance due to road, rail and aircraft noise. The burden of disease in Amsterdam will in reality be higher, as sleep disturbance could not be calculated. For Rotterdam, the noise levels caused by industry and aircraft are also mapped out. Severe annoyance due to these noise sources is also converted into DALYs. In total the equivalent of approximately 1500 life years are lost annually due to traffic and industrial noise in Rotterdam. Within the framework of the European Environmental Noise Directive, in 2007, noise maps have been drafted for a number of municipalities. This also includes the annoyance. In this MSR report, the same noise level data have been used as used for the maps. However, the calculated percentages of annoyed people differ. The main reason for this is that for the noise maps the (severe) annoyance had only to be calculated from 55 dB, while annoyance and severe annoyance already occur at a much lower level (37 respectively 42 dB). Therefore, the percentages of annoyance and severe annoyance experienced in this report are consistently higher than those in the noise maps. For all of these calculations is it important to realise that the calculations based on exposure-response relationships underestimate the actual number of people who experience annoyance or sleep disturbance. In reality, the DALYs are probably higher than that calculated here. It is expected that the noise levels will further increase. As a result, the volume of health effects due to noise will also increase. To prevent this, measures are required that reduce the noise levels. n

Chapter 5: Discussion regarding noise and health

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MSR Theme report - Noise, Health and Money

 6

Economy 6.1 General In the period 1986-1992, the maps concerning industrial noise zoning were published. From that moment, citizens could see the noise levels to which their dwellings were exposed. This information was frequently used to request a reduction in points from the rent tribunals. This was usually because the inhabitants could establish that the noise level was high when compared to similar dwellings elsewhere with the same rent, but also because the people were actually annoyed by the noise. Where this was actually the case, the point deduction was approved, resulting in a lower rent. DCMR received many requests from citizens, rent tribunals and housing corporations. The above illustrates that the noise quality of the surroundings in which a dwelling is situated is a factor that co-determines the rent and even the sales value of the dwelling. In addition to other quality aspects, such as size, situation, type of dwelling, level of facilities in the direct vicinity, green spaces in the neighbourhood, air quality, as well as finish and state of repair, the noise quality of the neighbourhood is a determining factor. The degree to which noise quality is a determining factor for values has been the subject of study in the past decades. Many international studies, but also national studies have been carried out to be able to determine this. At a time in which almost 40% of the Dutch population experience annoyance due to noise caused by traffic, railways, industry, aircraft, construction and other activities, it is evident that this has its price. Not only in terms of health, but also in terms of the loss of income from rent and the sale of real estate. Various methods are available to calculate this loss of income. A description of these methods will not be given here, as it would be too technical and detailed. We suffice with a reference to the report written by the European Commission4 in which the various methods are described. This report is considered to be authoritative by the researchers concerned with this matter. In this report, only the economic consequences of noise are investigated via the valuation of the dwellings. The (additional) costs related to the construction of noise barriers, healthcare etc. are not included here.

6.2 Method

4

The study was carried using the dB(A) value. In the currently prevailing legislation for (rail) road traffic noise, the dose unit Lden in dB is used. The standardisation in the Noise Abatement Act has been adjusted to this. The preferred limit value is now for instance 48 Lden. According to the study, house values start to depreciate where severe annoyance from noise also starts to play a role, which is from approximately 45 dB. In the classes below 45 dB, the NSDI is therefore set to 0. Above this value, the MNP study mentioned above shows that the NSDI progressively increases with the noise levels: Table 8 Development of the NSDI value as a function of the threshold value in dB

Noise level class in dB

NSDI value

<45 45-50 50-55 55-60 60-65 >65

0 1.1 1.3 1.7 1.9 1.9

Foreign studies show that the NSDI values vary between 0.08 and 2.3 with an average value of 0.6. The NMP study determined higher values for locations in Baarn and Soest, in the Netherlands. They state that a possible explanation for this could be that in the densely populated and densely built up Netherlands quietness is scarce and is therefore valued more highly.

6.3 Results of the economic effects Using the results of the MNP study, an estimate has been made of the influence of noise on the house prices in Rijnmond. To be able to do this, several assumptions have been made and restrictions introduced: n For these calculations, only the depreciation in the value of dwellings due to road traffic has been determined. n The introduction of L den and the fixed correction of -2 dB (Noise Abatement Act) is determined based on the situation on national trunk roads. For municipal roads this fixed correction of -2 dB seems to be incorrect. In these calculations, it has been decided not to apply the fixed correction of -2dB for road traffic. The NSDI value per noise level class that is used for the calculations is included in Table 9. n The MNP study does not give NSDI values above 65 dB. For the class equal or greater to 65 dB, these calculations used the same value as used for the 60-65 dB class. Therefore in the class of 65 dB or more this is an underestimate of the depreciation in value due to noise.

Navrud, S. (2002) The State-of-the-Art on Economic Valuation of Noise. Report to the European Commission DG Environment 04-02. Department of economic and social sciences, Oslo: Agricultural University of Norway.

Chapter 6: Economy

In the 2006 MSR report, indicative calculations have been carried out to determine the loss of value of dwellings. These calculations are based on a study carried out by J. Udo, L.H.J.M. Janssen and S. Kruitwagen and is based on the article “Stilte heeft zijn prijs” (ESB 13/01/06, pages 14-16). This study, carried out by the Environmental and Nature Planning Office (MNP), gives an overview of (foreign) studies that in the past decades have formed a picture of the economic damage that noise has caused to the house market and a report is given of a recent Dutch study.

In these studies, the effect of noise levels on the value of houses is expressed in terms of the “Noise Sensitivity Depreciation Index” (NSDI), which indicates the percentage that the value of a house drops when the noise level that the house is exposed to increases by 1 decibel.

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It is assumed that the random test includes sufficient samples and that the study is representative for the Netherlands. In addition, the type of neighbourhoods and type of dwellings studied are also considered to be representative for the Netherlands. n Ethnic and cultural backgrounds have not been taken into consideration. The fact that inhabitants of large cities probably experience less annoyance due to road traffic noise (higher acceptance, more tolerance) than inhabitants of smaller towns has also not been taken into account. n No distinction has been made between rented dwellings and owner-occupied dwellings. n The average price for a dwelling in the Rijnmond area is based on the data originating from the NVM site. The document “Overzicht transactieprijzen woningen bestaande bouw in duizenden euro’s” [Source: The Dutch Association of Real Estate Brokers and Real Estate Experts (NVM)] has been used here. Region 49 (Rotterdam) includes the municipalities Barendrecht, Lansingerland, Capelle a/d IJssel, Krimpen a/d IJssel, Ridderkerk, Rotterdam, Schiedam, Albrandswaard and Vlaardingen. Region 50 (Westland) includes among others Maassluis. Region 51 (Brielle/Goeree) includes among others the municipalities of Brielle, Hellevoetsluis, Rozenburg, Spijkenisse and Westvoorne. The price for the reference year 2006 was determined by taking the average of the three regions. The average price for the reference year 2006 is set at € 229,500.00. This value is lower than the national average (235,200.00 euros). The average value that is used in the calculations ‘MSR 2006’ was set at € 213,000.00. n

Table 9 Development of the NSDI value as a function of the threshold value in dB Lden

MSR Theme report - Noise, Health and Money



26

Noise level class in dB

NSDI value

< 45 45-50 50-55 55-60 60-65 > 65

0 1.1 1.3 1.7 1.9 1.9

The number of dwellings in 2006 within the Rijnmond area is based on the data from the noise maps of the agglomeration municipalities (European Environmental Noise Directive)5 and for the other municipalities on the data from the postcode file. The results of the calculations are compared to the results of ‘MSR 2006’. For the comparison, the following calculations have been made to determine the depreciation in value of dwellings due to road traffic noise: 1. The first calculation concerns the depreciation of value of the housing stock anno 2006 when compared to the (notional) situation that everywhere in Rijnmond the noise levels are less than 45 decibel. 5

2. The second calculation is the same as above but then using the value that is equal to the value used in the calculations ‘MSR 2006’, being 213,000.00 Euros. Calculation results: The first calculation results in the notional situation that the noise levels in the Rijnmond are raised from 45 dB in one go. In 2006, the situation was as follows (see Table 10). Table 10 Distribution of the housing stock over the various noise level classes with respect to road traffic noise

Noise level class in Lden

Number of dwellings

< 45 45-50 50-55 55-60 60-65 > 65 Total

79,392 121,789 113,266 92,608 68,563 48,536 524,154

For this distribution, the depreciation in value resulting from road traffic noise alone is approximately 1.5 billion Euros. This means about € 2,900 per average dwelling. The economic value of a dwelling forms the basis for the Valuation of Real Estate Act (WOZ), the tax reduction related to owning a dwelling and the water board levies. A first order approach for the WOZ income is given in the box below. The WOZ tariff for dwellings in Rijnmond varies between 1.8 and 2.9% (the average is set at 2.5%) which means that the local authorities in the Rijnmond area loose at least € 37.5 million in WOZ income. For this amount, approximately 9,000 km of quiet road surfaces can be laid, which would improve noise quality by at least 2.5 to 4.4 dB. As only 2,000 km of roads are relevant for noise in the Rijnmond area (RVMK 2007), only € 6 - € 10 million need be spent to achieve this improvement. After taking these measures, the surplus income in terms of increased WOZ income is estimated to be € 4.5 million per year, which means that the construction costs can be recovered in approximately 2 years. An additional effect of quiet road surfaces is that the noise is more pleasant as a result of a shift in frequencies. If € 213,000 is used as the value in the calculations instead of € 229,500, then for the same distribution the depreciation in value as a result of just road traffic noise is more than 1.4 billion Euros. This means about € 2,700 per average dwelling. When compared to the results from the MSR 2006, the differences can be explained by the differences between the number of dwellings within the noise level class (see Table 11 for the absolute number per class and the difference). Furthermore,

The ‘Rijnmond municipalities’ that fall within the Rotterdam/ Dordrecht agglomeration are: Rotterdam, Schiedam, Vlaardingen, Maassluis, Rozenburg, Spijkenisse, Albrandswaard, Capelle aan den Jssel, Ridderkerk and Barendrecht.

in the “MSR 2006” calculations, the cumulative noise levels are considered after being corrected for annoyance, and not just the Lden due to road traffic noise. Table 11 Distribution of the housing stock over the various noise level classes with respect to road traffic noise “MSR 2008” and “MSR 2006”

“MSR 2008” “MSR 2006”

Difference

Noise level class Number of Number of “MSR 2008”-”MSR 2006” in Lden dwellings dwellings



< 45 45-50 50-55 55-60 60-65 > 65 Total

79,392 121,789 113,266 92,608 68,563 48,536 524,154

0 5,400 116,389 43,200 70,066 183,600 -90,992 21,600 46,963 91,800 -43,264 345,600

The MSR 2006 calculates that the depreciation in value amounts to approximately 2 billion if the noise levels less than or equal to 45 dB are raised in one go to the situation shown in Table 11. This means about € 3,800 per average dwelling. The difference can be explained by the difference in the number of dwellings in the various noise level classes. Assuming that no dwellings have been built in 2006, it can be stated that due to the increase in the average value of houses situated in the Rijnmond area by € 16,500, the depreciation in value has increased by approximately 110 million euros when compared to the previous year. This means about € 210 per average dwelling. In the coming years, the noise levels will increase further at many places and moreover, more building is occurring at locations where the noise levels are high (the “clean” locations are already mostly built on). The method now employed is still reasonably rough and therefore together with the Tilburg University, work is being done on refining the calculation method. For this survey, use is made of the Hedonic Pricing Method. Using this method the value of among other things the environment is measured. Here it is assumed that the market value of dwellings is determined by quality aspects, such as noise and air quality. Otherwise identical dwellings in a similar environment will yield a lower price when sold if the noise levels are higher. Using statistical processes it is possible to derive the value of separate factors that influence the price of the dwellings. n Chapter 6: Economy

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MSR Theme report - Noise, Health and Money

 7

Framework of measures Research shows that noise has a major effect on the annoyance felt and the health of people in Rijnmond. Moreover, without measures being taken, the number of people who experience annoyance and the disability adjusted life years will increase further due to the increase in (road) traffic and the building of dwellings and other sensitive objects in environmentally impacted areas. In short, it is time for action, and various authorities are already working on this by drafting action plans. This chapter is a first step towards possible measures. The directions in which solutions are sought are reasonably global and must be worked out in more detail by the various responsible authorities. Normally, tailored solutions are concerned. When searching for opportunities to reduce noise, everyone should bear their own responsibility. Here you can see a certain layering: some measures must be taken at the European level, others at the local level. Therefore in this chapter, the recommendations and efforts are ‘peeled back’ increasingly further, ensuring that issues that must be dealt with at a higher level are not mentioned again for the lower authorities. However, an issue that is important for all organisations is that the noise aspects of their own fleet of vehicles and their suppliers can be addressed.

7.1 European Union Recent research, carried out on behalf of the European Commission (EC), shows that quiet tyres are as economic and safe as tyres that make twice as much noise. Noisy tyres cause health damage. The car tyres form the main source of traffic noise on busy roads; they form the dominant noise source at speeds in excess of 30 - 40 kilometres per hour. In a few years, the EC wants cars to only be fitted with quiet tyres, in order to considerably reduce the severe noise pollution caused by traffic. The EC wants to reduce traffic noise by tackling the problem at the source. The technology to make quiet tyres already exists. With quiet tyres, the traffic will produce half the amount of noise it currently produces. In the Netherlands alone, this will already lead to 300,000 fewer people suffering severe annoyance from traffic noise. In addition, in the Netherlands alone the Central Government could save 200 million euros by, among other things, having to erect fewer noise barriers. The EC made a proposal to strengthen the standards for quiet tyres, but this proposal will only be implemented in 2016, which is much too late. It is very desirable to lobby for the acceleration of this process.

7.2 Central Government In July 2007, ProRail presented the noise produced by the major railway lines (where more than 60,000 trains pass annually) using

The minister of Transport, Public Works and Water Management chose a plan threshold for this action plan that is in line with the objective in the Mobility Memorandum. The level of the plan threshold is (Lden) 70 dB for 24 hours. No additional policy has been drawn up for the night. However, the planned measures have a noise-reduction effect during both the day and the night. The problem areas will be tackled using measures such as quieter track constructions (including the use of rail dampers) and screening (screens and barriers). When implementing these measures, the future noise situation will be assumed. In the period 2008-2012 in the Netherlands, approximately 81 thousand m2 of noise screens and barriers will be installed along the main railway lines, where more than 60,000 trains pass annually, and approximately 420 km of quieter track constructions will be laid during management and maintenance projects and during autonomous remediation. For the planning period (2008-2012), a number of concrete projects have been formulated that will be carried out. For Rijnmond this concerns two projects. The first is at Capelle aan den IJssel/ Capelle Schollevaar where in 2010, a 3470-metre section will be fitted with noise barriers. The second section is near Schiedam Nieuwland. This project must also be completed in 2010 and has a total length of 1,400 metres. In management and maintenance projects changes will be made to the major lines. Where still present, jointed rails will be replaced by continuous rails. This eliminates the impact noise when a train (wheel) passes a joint. Furthermore, the use of concrete sleepers (instead of wooden ones) gives a reduction in noise. These sleepers are changed during management and maintenance. Replacing the track constructions has meant that the railway has become 2 to 4 dB quieter at many places. The proportion of quiet track constructions, consisting of concrete sleepers and continuous rail, has increased from 25 to 45% in the period 1994 through to 2005. The Mobility Memorandum (NoMo) formulates, in addition to the approach to tackle the noise problem areas, the social desire for more traffic and transport. The Minister of Transport, Public Works and Water Management wishes to find a balance between the growth in transport on the one hand and the quality of the living environment on the other. The increase in noise that is caused by the increase in train traffic can for instance be compensated by

Chapter 7: Framework of measures

In addition to drawing up legislation and regulations, the European Union addresses various technical aspects related to noise production by in particular traffic. For energy efficiency, the so-called Euro norms are employed. A comparable process can possibly also be started with respect to noise. After all, research shows that for trucks for instance, engine noise is a relevant source. However, it takes several years before such regulations lead to noticeable effects.

a noise map that had been established by the Minister of Transport, Public Works and Water Management. The map indicates how much noise originated from the main railway lines in 2006. The figures for 2006 were determined by raising the figures realised in 2004 by 5%. Based on among other things this map, the action plan identifies the sections of track that are subject to problems of noise and where noise reduction measures are desirable. The noise map is updated every five years. The noise map can be seen by going to www.prorail.nl. A plan threshold was also determined for the execution of this problem area analysis.

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the influx of quieter rolling stock. The growth in rail traffic has been realised in the period 1994 through 2005 without an average increase in noise. This has in part been achieved due to the introduction of quieter rolling stock. In the coming period, the increased use of quiet rolling stock will be encouraged by giving a bonus on top of the user fee. Incidentally in the future, a penalty will be introduced for relatively noisy rolling stock.

dwellings. An inventory has been made of the measures intended for the period 2008-2013. The majority of these projects are recorded in the Long-range plan infrastructure and transport (MIT) or in the Long-range plan infrastructure, space and transport (MIRT). In the coming years, RWS will install a total of approximately 500,000 m2 of noise screens and barriers and approximately 140 kilometres of extra noise-reduction road surfaces.

The table below gives the calculated effects at the national level of the measures that will be taken. Table 12 shows that the effects can in particular be seen at the higher noise levels. This is a result of the decision to take 70 dB as the plan threshold.

Making motor vehicles quieter by reducing the noise emissions of the engine and the vehicle and by using quieter tyres is very effective and cost efficient. Moreover, the polluter pays. These measures will be imposed at the European level. The Dutch authorities have no say in this, but support the source measures at the European level and can stimulate the use of such tyres by providing information.

Table 12 Effects of rail traffic measures Noise level Number of Number of Difference Percentage during dwellings on dwellings after in number difference 24 hours (Lden) noise map measures have of dwellings 2006 been taken



55-59 dB 60-64 dB 65-69 dB 70-74 dB ≥ 75 dB

134,800 80,000 32,800 10,600 2,100

124,000 65,900 22,900 7,000 1,200

10,800 14,100 9,900 3,600 900

8 18 30 34 42

MSR Theme report - Noise, Health and Money

On 26 June 2007, the Directorate General for Public Works and Water Management (RWS) presented the noise generated by the national trunk roads using a noise map. The map indicates how much noise originated from the national trunk roads in 2006. Based on this map and the plan threshold, the RWS has determined in this action plan where the noise problems are and where further research into noise-reduction measures is necessary. RWS has made the noise map and the action plan for national trunk roads available on the website www.rijkswaterstaat. nl/omgevingslawaai. The geographic map can be zoomed into down to street level. The website contains a significant amount of background information about the noise map and the action plan.

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Locations where dwellings are exposed to noise levels higher than 65 dB are identified as being problem locations. In the near future, many measures will already have been taken to reduce the noise levels, often also at problem locations. The measures are being carried out within the framework of: n construction projects or major reconstructions; n road management and maintenance activities; n noise remediation projects. During construction or major reconstruction projects, acoustic studies are carried out, with measures being formulated after a review of the results. During management and maintenance projects an assessment is made of whether measures must be taken. The measures that can be taken are installing noise barriers and laying quieter road surfaces. Noise remediation concerns resolving existing noisy situations. This can be achieved for instance by laying a quieter road surface, installing noise barriers or by insulating

In addition to existing measures, there are also innovative measures. These have been investigated for road and rail traffic within, among others, the framework of the Noise innovation programme (IPG). The products from the IPG are: n Quieter road surfaces, such as two-layer ZOAB (very open asphalt) and the thin top layer; n Quieter vehicles and tyres; n More efficient screening for instance barrier tops, barriers in the central reserve, noise barrier close to the lanes and modular sound barriers. In addition, several projects have been selected in which (supplementary to already present quiet road surfaces) noise barriers will be installed or raised to reduce noise problems. Such a barrier will be installed along the Rotterdam A20 motorway close to the Gordelweg. This will result in the number of dwellings exposed to a noise level in excess of 65 dB dropping from the current 200 to less than 10. Table 13 Management and maintenance projects for national trunk roads National Region trunk road



4 13 15 15 29 38 57

Rijnmond Rijnmond Rijnmond Zuid-Hollandse Waarden Rijnmond Rijnmond Rijnmond

Length (km)

Scheduled (years)

1.4 0.7 6.2 18.2 1.1 0.6 16.3

2012 2012 2007 - 2011 2007 - 2012 2010 - 2012 2007 - 2012 2007 - 2012

Table 14 shows the number of dwellings at the national level that fall within a noise class. The 2006 situation originates from the noise map. The 2013 figures show the situation after the intended measures have been taken. The majority of noise measures are planned at locations exposed to high noise levels, above 65 dB. Therefore, the measures have the largest effect on this group of dwellings. As a result of the measures, a number of dwellings will

move to a lower noise level class. This means that a large number of dwellings will be exposed to a considerably lower noise level in 2013. Table 14 Effects of road traffic measures taken for national trunk roads The volume of Number of dwellings in noise in dB a noise class

55 – 59 60 – 64 65 – 69 More than 70

2006 76,100 21,100 5,200 1,100

2013 69,400 18,000 3,500 600

Reduction (in %) of the number of houses exposed to the noise level

9 15 33 43

7.3 Province In 2007, the Province recorded the noise made by provincial roads and made a noise map. The map indicates how much noise originates from the provincial roads. This map and the plan threshold can be used to determine where the noise problems are and where further research into noise-reduction measures is necessary. After publication, the noise maps were available for inspection from 9 July 2007 through to 20 August 2007 and can now be seen on the Province’s internet site. The plan threshold is the noise value above which noise-reduction measures will be taken. It is recommended to specify the plan threshold value to be 65 dB to be in line with the RWS policy for national trunk roads. The action plan that is currently being drawn up must work this out in more detail with a description of the measures that the Province of Zuid-Holland can take to reduce the noise levels found along the roads. In the first instance, the obligations apply for the roads or sections of the roads where more than 6 million vehicles pass annually (first phase). In a later phase, the roads where more than 3 million vehicles pass annually must be considered (second phase). The action plan was not available when printing this report, so that it is currently sufficient to give the initial impetus to possible measures. The directions in which solution are sought are reasonably global and must be worked out in more detail by the Province. Normally, tailored solutions are concerned.

The possible measures can be divided into traffic measures, source measures for vehicles or road surfaces, and screening measures in the form of barriers or noise insulation for dwellings. Usually, source measures for vehicles are the best, from both the viewpoint of effectiveness (cost effectiveness) and fairness (the polluter pays). Traffic measures Reducing motorised road traffic is not an option as good accessibility by road is an important factor for the location of companies and their employees. It is therefore undesirable to jeopardise this and violate the policy to improve accessibility. Moreover, a reduction in the noise level by 3 dB requires a 50% reduction in traffic. Society does not support such a reduction in traffic. Reducing the maximum speed on (sections of) provincial roads is not an option, as this also reduces the road capacity, while it contributes relatively little to reducing the noise levels. Rerouting the traffic is not an option as this leads to additional mobility and reduced accessibility, it increases the total noise levels in our province and is ineffective as a measure, because the total number of people annoyed by noise will not reduce or will hardly reduce (it merely shifts the problem). In addition to better traffic flow (or improved use of the road capacity), dynamic traffic management also contributes to reducing noise levels, air pollution and fuel consumption. This is because when the traffic flow is improved, vehicles need to accelerate and brake less. This measure is already addressed in the normal provincial mobility policy. It is difficult to estimate the effect of this measure on the noise levels, but it will be relatively limited (maximum approximately 1 dB). Enforcing limitations on the type of vehicles that can use provincial roads faces major practical objections. As opposed

Chapter 7: Framework of measures

The locations exposed to high noise levels along the provincial roads where the most people and the most people who are severely annoyed by noise live, can be the target for noise screens and barriers and a quieter road surface. Noise barriers are already used at various places. They are found in particular along densely populated sections of national trunk roads. As speeds and traffic volumes are usually lower on provincial roads, the noise levels are usually less and therefore relatively fewer noise barriers are installed along provincial roads when compared to national trunk roads. Quieter road surfaces are mainly found on national trunk roads. These surfaces are made from ZOAB (very

porous asphalt). ZOAB reduces the noise considerably, but due to the much higher number of entries and exits, junctions and bends, it is unsuitable for provincial and municipal roads. Moreover, ZOAB has the disadvantage of being slippery in frosty conditions. Therefore, asphalt manufacturers have developed a new type of road surface (quiet surface) in recent years for provincial and municipal roads that has the required mechanical properties (for instance with respect to wear resistance and skid resistance). This quiet road surface consists of two-layer asphalt concrete with a thin wear-resistant and porous noise-reducing top layer (micro top layer). This type of road surface is relatively new and is identified by the abbreviation DGD (Dunne Geluidreducerende Deklaag - thin noise-reducing top layer). It has been used very frequently in the last five years. In particular in the province of Gelderland in de period 2003-2007, a lot of quiet road surface was laid on provincial roads (a length of more than 50 km, but mainly within the framework of the quiet area policy).

31

to city centres, there is often no proper alternative route or alternative mode of transport and in practice, limitations lead to many additional vehicle kilometres, in part over roads not equipped for this type of traffic. Measures focused on the source of noise A measure that the province can take to prevent problems in the future is to retain a building-free zone along the traffic infrastructure, so that the negative effects (in addition to noise, air quality and external safety) due to an increase in traffic will remain limited and standards will not be exceeded. This must be worked out in more detail in spatial plans. Quiet road surfaces also limit the noise at source, which limits the volume and range of the noise. Quiet road surfaces are quieter than regular road surfaces. Laying quiet road surfaces can achieve a noise reduction of at the maximum 6 dB in rural areas and 4 dB in urban areas.

MSR Theme report - Noise, Health and Money

At a short distance from the road noise screens or barriers offer the most noise reduction for people living in the immediate vicinity (immediately behind a 2-metre high barrier approximately 10 dB). Other advantages of barriers are that they can be used at any moment as long as there is room for them or is created for them and that the noise reduction does not decline over the course of time. When developing new districts, during the development process sometimes account is already being taken of a noise barrier integrated in the design. However, there are also objections to barriers. For instance, the noise reduction declines markedly as the distance to the road increases. Furthermore, a building permit is required to build them on municipal land, for which a public inquiry is required. Therefore, the installation of barriers requires the approval of and close collaboration with the municipality involved. The costs of barriers are very high, in particular due to the high costs for the foundations needed to be able to resist high wind loads.

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When compared to quiet asphalt and noise screens or barriers, the cost of house insulation is relatively high, with the exception of low density housing. Moreover, it only offers protection from the noise when the residents are in the house and keep the windows closed. This measure does not contribute to stopping the negative effects on pleasurable living outside of the dwelling. As the Noise Abatement Act lays down that the noise levels must be limited at the facade, this solution has been dropped. Companies In 2007, the DCMR intended to formulate environmental objectives for companies in Rijnmond in the Environmental objectives for companies project. The project mapped out the main environmental problems in the region and their sources. This is also worked out for each sector, which makes it possible to indicate the main environmental problems for each sector.

The first phase in the project is a Spearhead analysis. In this analysis, the environmental problems in the Rijnmond region have been mapped out. Then an indication has been given of the main sources that cause each environmental problem. For this first phase, the various existing (periodic) reports, such as the annual MSR report, the report from the Noise Expertise Centre, the biannual Environmental perception survey Zuid-Holland and the complaints that are reported to the DCMR alarm centre were used. The second phase consisted of formulating objectives for company-oriented tasks, which were translated into the activities for work plans for the Province of Zuid-Holland, the Environmental Activities Programme (MAP). Achieving the environmental objectives takes centre stage in the MAP. The hours employed are divided into a fixed amount of around 60% and a flexible amount of approximately 40%. Together this amounts to a satisfactory level. The fixed amount comprises the actualisation of permits and reports, the execution of preventive and repressive checks and the handling of complaints. The flexible amount comprises the use of instruments (both hard and soft) for realising local and regional environmental objectives. This flexible part is substantiated in project plans per environmental objective. This is translated into the annual work plans. The table below shows the degree to which noise is important for a sector. Table 15 Environmental objectives of companies with provincial authority

Sources Process industry - chemical - refineries - storage and transhipment - dry bulk - energy companies Waste processors - waste incineration - processing hazardous waste - processing other waste - composting companies - landfills - car recyclers

Noise 1 1 0 2 0 1 0 1 0 0 0

Colour code legend: Negligible: Contribution of the sector to the problem <0.1% 0

1 2 3

Limited contribution: Contribution of the sector to the problem 0.1-0.5% Important contribution: Contribution of the sector to the problem 0.5-2.5% High priority: Contribution of the sector to the problem > 2.5%

It goes beyond the aim of this report to indicate per sector how to proceed with addressing the noise levels. In 2009, the MAP system will be evaluated. The evaluation will run from

1 January 2008 through 1 June 2009. The evaluation will pay particular attention to the effectiveness of the system and the set of instruments.

7.4 Municipalities Some municipalities have already drawn up (draft) action plans and others are working on their plans. Based on among other things the (draft) action plans, a first impression can be given of possible measures. The directions in which solutions are sought are reasonably global and must be worked out in more detail by the various municipalities. Normally, tailored solutions are concerned. As for the province, the possible measures can be divided into traffic measures, source measures for vehicles or road surfaces, and screening measures in the form of barriers or noise insulation for dwellings. Before measures are investigated, certainly for municipalities, the recommendation is to first and mainly work on preventing future noise pollution. This means that proper consideration must be given to the subject within the context of spatial planning. However, this policy mainly addresses the location to be developed. However, apart from the annoyance caused by noise at the location of the building, annoyance can be caused elsewhere. It is currently not a legal obligation to investigate the effects of noise outside of the planned area or the area of the reconstruction when making building plans and/or changes to the traffic structure. Normally acoustic studies are made, but only very rarely are measures taken to prevent or compensate for any increase in noise outside of the area being developed. This means that the annoyance that people experience due to noise gradually increases. An example of this is the construction of more dwellings in the inner city. Building these dwellings has consequences for

the volume of traffic and therefore higher noise levels on the access roads. When building in the polder, noise is much less of a problem, but there is a negative effect for nature, the landscape and recreation. By taking a policy-driven approach, municipalities can address a part of this problem by using an area-oriented approach and by internalising the environmental effects in the spatial and traffic and transport planning. Traffic measures Reducing motorised road traffic is not an option as good accessibility by road is an important factor for the location of companies and their employees. It is therefore undesirable to jeopardise this and violate the policy to improve accessibility. Moreover, a reduction in the noise level by 3 dB requires a 50% reduction in traffic. Society does not support such a reduction in traffic. Lowering the maximum speed on (sections of the) roads in the municipality is an option, but because almost all of the applicable roads have become 30-km/h zones or residential areas with restrictions to slow down traffic, little benefit can be gained. Moreover, the roads where it is possible to lower speed limits often carry little traffic and therefore also generate limited noise. Rerouting the traffic leads to additional mobility, but certainly in the inner city it can contribute to tackling persistent problem areas. Installing signs that show the availability of parking places in city centres and in car parks can prevent traffic searching for a parking place. At the regional level, the Rotterdam Metropolitan Region is working on an extension of the number of P+R parking places. In 2020, the region must have 23,000 places, compared to almost 6,000 at the end of 2007. In combination with the use of public transport, this can lead to a reduction in the traffic flow.

Chapter 7: Framework of measures

33

Enforcing limitations on the type of vehicle allowed on municipal roads has practical objections and has, up to now, often only been linked to vehicle emissions. If limitations are introduced and if they are linked to noise production, the complexity will increase strongly, meaning that this measure will not contribute to solving the problem in the short term. The reason for the complexity is twofold. On the one hand it is difficult to enforce environmental zoning and on the other hand the annoyance caused is also strongly determined by behaviour. A quiet car can still cause a lot of annoyance if the driver drives in an undesired way. Measures focused on the source of noise A measure that the municipalities can take to prevent problems in the future is to retain a building-free zone along the traffic infrastructure, so that the negative effects (in addition to noise, air quality and external safety) due to an increase in traffic will remain limited and standards will not be exceeded. This must be worked out in more detail in spatial plans. This is only an option where the room is actually available. For inner city situations this is normally not the case. Quiet road surfaces also limit the noise at source, which limits the volume and range of the noise. Quiet road surfaces are quieter than regular road surfaces. With quiet road surface a noise reduction of at the maximum 6 dB is possible. The locations exposed to high noise levels along the municipal roads where the most people and the most people who are severely annoyed by noise live cannot, apart from a few exceptions, be the target for noise screens and barriers.

MSR Theme report - Noise, Health and Money

Granting concessions to operate public transport in the Rotterdam Metropolitan Region and the city of Rotterdam is an excellent way of introducing requirements related to both air pollution and noise production.

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When compared to quiet asphalt and noise screens or barriers, the cost of house insulation is relatively high, with the exception of low density housing. Moreover, it only offers protection from the noise when the residents are in the house and keep the windows closed. This measure does not contribute to stopping the negative effects on pleasurable living outside of the dwelling. As the Noise Abatement Act describes that the noise levels must be limited at the facade, this solution is only relevant for remediating old cases, that is to say the houses that are listed in the ‘A- and Rail list’. Municipalities can (jointly) encourage private individuals to voluntarily insulate their houses by providing information and communicating. Here the use of sound proof ventilators and sealing of gaps can be considered. However, it is currently very difficult for private individuals to get the right information and materials that they can then install themselves. It is possible for the municipality to try and prevent as much annoyance as possible by planning the living areas of dwellings (living room and bedrooms) as far away as possible from any noise source, and to promote this when plans are being

developed. This is possible by linking such requirements to granting an exemption from the higher limit value in the framework of the Noise Abatement Act. Companies In 2007, the DCMR intended to formulate environmental objectives for companies in Rijnmond in the Environmental objectives for companies project. The project mapped out the main environmental problems in the region and their sources. This is also worked out for each sector, which makes it possible to indicate the main environmental problems for each sector. For a further explanation, you are referred to the relevant subsection in the Province section. The table below shows the degree to which noise is important for a sector. Table 16 Environmental objectives of companies with municipal authority

Sources Small and medium-sized companies - arable farming - cultivation under glass - livestock farms - meat/fish processing companies - food companies - textile companies - wood / furniture industry - graphical industry - rubber and plastics industry - glass companies - metal/electric companies - shipyards - building contractors - garages - car respraying businesses - petrol stations - wholesale and retail trade - fireworks - catering industry - railway yards - other storage and transhipment - storage and transhipment of hazardous substances

Noise



- dry cleaners - water treatment plants - other service provision - education and healthcare - sports and recreation

0 1 2 1 2

0 1 0 1 1 1 0 1 1 1 2 2 2 1 1 0 3 0 3 1 2 1

Colour code legend: Negligible: Contribution of the sector to the problem <0.1% 0

1 2 3

Limited contribution: Contribution of the sector to the problem 0.1-0.5% Important contribution: Contribution of the sector to the problem 0.5-2.5% High priority: Contribution of the sector to the problem > 2.5%

7.5 District water boards District water boards sometimes manage ‘polder roads’. The category ‘polder roads’ means those roads that are situated outside of the built-up area. Such roads are managed not only by the district water boards, but also by municipalities. Because of their special character when compared to inner city roads, it has been decided to address them separately. As for the province, the possible measures can be divided into traffic measures, source measures for vehicles or road surfaces, and screening measures in the form of barriers or noise insulation for dwellings. Except for a few special cases, nowhere do noise levels reach or exceed 65 dB. For reasons of completeness, the decision has been made to also discuss a number of options to reduce the noise levels of these roads. Traffic measures Reducing motorised road traffic is not an option as good accessibility by road is an important factor for the location of companies and their employees. It is therefore undesirable to jeopardise this and violate the policy to improve accessibility. Lowering the maximum speed on (sections of the) ‘polder roads’ is an option, but because almost all of the applicable roads have become 60-km/h zones, little benefit can be gained. The actual noise levels here depend on the enforcement of the maximum speed limits. Moreover, the roads where it is possible to lower speed limits often carry little traffic and therefore also generate limited noise. Another point is that only a few houses are found along such roads.

At a short distance from the road, noise screens or barriers offer the most noise reduction for people living in the immediate vicinity (immediately behind a 2-metre high barrier approximately 10 dB). Other advantages of barriers are that they can be used at any moment as long as there is room for them or is created for them and that the noise reduction does not decline over the course of time. The disadvantage that the noise reduction declines markedly with the distance to these roads is less of a disadvantage than for provincial roads due to the low density nature of the houses near these roads. The costs of barriers are very high, in particular due to the high costs for the foundations needed to be able to resist high wind loads. In particular on old roads on dikes it is physically very difficult to install a barrier and therefore this option is dropped. For the locations along the polder roads that are exposed to high levels of noise, with the exception of some special cases, use can be made of noise screens or barriers. House insulation is an option for houses that are situated very close to the roads. The insulation must be tailored to the situation. It can be concluded that individual solutions must be sought for those few exceptional cases where the noise levels are too high. Noise barriers and house insulation are the first options. n

Rerouting the traffic leads in general to additional mobility, but it can contribute to tackling persistent problem areas. Here roads (on dikes) can first be considered, where the houses are built close to the road. For such roads it is sometimes an option to close the road to traffic, with the exception of local traffic. Enforcing limits on the type of vehicle on polder roads is not an option for the same reason as it is not an option for provincial roads.

Quiet road surfaces also limit the noise at source, which limits the volume and range of the noise. Quiet road surfaces are quieter than regular road surfaces. With a quiet road surface a noise reduction of at the maximum 6 dB is possible. A disadvantage is the high costs in relation to the number of dwellings that experience a reduction in noise levels.

Chapter 7: Framework of measures

Measures focused on the source of noise A measure that the district water boards and municipalities can take to prevent problems in the future is to retain a building-free zone along the traffic infrastructure, so that the negative effects (in addition to noise, air quality and external safety) due to an increase in traffic will remain limited and standards will not be exceeded. This must be worked out in more detail in spatial plans.

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 8

Recommendations The previous chapters have sketched out a picture of the legal and policy frameworks related to noise, the effects of noise on health and the economic effects. Furthermore, the set of available measures has been addressed. In this last chapter, the emphasis is on the question of what opportunities are there for the organisations in the region.

Indicators have been formulated, based on the opportunities. However, indicators are also required that give a picture of the existing or future situation. The indicators do not give a complete picture, but give the initial impetus for those aspects that must be monitored in the coming years. Unless stated otherwise and if possible, the indicators will be included in the Noise chapter of the main report.

Via the implementation of the action plans, the coming years will see a lot of work being done to make Rijnmond quieter. It is possible that this report can play a role in detailing or implementing the plans. If this is too late for this year’s action plan, in 2013, the public authorities must draw up a new action plan. Around this time, repeating this research on the basis of new insights into the health effects resulting from noise could be very useful. In this report we recommend that the possibilities available at the supralocal level should also be used. It is for instance possible to jointly, in collaboration with other stakeholders such as the Ministry of Housing, Spatial Planning and the Environment and EUROCITIES, request that Brussels pays more attention to accelerating the (obligatory) replacement of the existing tyres by quieter tyres and to requirements related to the noise production of cars, trucks and aircraft. The Central Government can be encouraged to accelerate the payment and execution of ISV2 projects and to introduce a system to check the permanent noise requirements of the road traffic (periodic motor vehicle test for noise).

Indicators that are already monitored and that are in line with the content of this report are: n Noise levels in Rijnmond (see chapter Space); n Quiet environmental protection area; n Reports concerning noise; n Annoyance due to noise (environmental perception survey); n Higher limit value exemptions; n Progress of remediation of the houses on the A-list and the rail list. These indicators must continue to be monitored.

A second important aspect is harmonisation with other policy domains such as air and spatial planning. When determining the priorities of the activities, the preference should be for those measures that have a positive effect on multiple policy domains. With respect to air, various regional agreements have been made in the Rijnmond Regional Action Programme for Air Quality. A large number of action points also have an effect in the area of noise, which makes regional harmonisation with respect to noise also desirable and which offers additional opportunities. Possibly this can result in an integrated Rijnmond Regional Action Programme Air and Noise. At a later stage, the climate can also become part of this programme, in particular for traffic. In any event (as the first step) there must be a programme for Rijnmond that focuses on cost-effective measures such as quiet road surfaces in areas where noise is a problem in terms of health.

Proper monitoring provides insight into the noise situation and can also provide insight into the effects of the measures (from the action plans) that are taken to combat noise pollution. It is therefore important to link the measures from the action plans to MSR. In the coming years, MSR will work on the development and further substantiation of these and other (improved) indicators. In this way, MSR can serve as a good basis for drawing up the 2013 action plan, as there will then be insight into the effectiveness of the measures that have already been taken. n

Chapter 8: Recommendations

The effects of the measures taken must be monitored. A number of possible indicators that can be used here have been mentioned in the theme report, such as the (geographic) calculation of the noise levels in Rijnmond, the health damage and the economic effects. To allow the economic effects and the related cost-benefit analysis of measures to be correctly calculated, it is necessary for a study to be made in collaboration with the Tilburg University. In addition to these and other indicators, it is necessary to keep up to date with more general developments, such as the use of quieter tyres and the European obligations with respect to making passenger cars and commercial vehicles quieter.

New indicators can be: n Health effects of noise; n Economic effects of noise levels; n Noise barriers along national trunk roads and provincial roads n Quiet asphalt on national trunk roads (ZOAB - very porous asphalt); n Quiet asphalt on provincial and municipal roads (DGD - thin noisereducing top layers); n Clean and quiet vehicles for various government organisations (see also the trend analysis in the chapter concerned with social context); n Clean and quiet vehicles for companies and private individuals; n Indicators that are in line with the implementation of the various (municipal) action plans; n Indicators that are in line with the noise aspect of the environmental objectives for companies.

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 9

Literature list Babisch 2006

Kempen 2005a

Babisch W Transportation noise and cardiovascular risk. Review and synthesis of epidemiological studies. Dose-effect curve and risk estimation. WaBoLu 01-06. Dessau Umweltbundesamt, 2006

Kempen EEMM van, Kamp I van, Stellato RK, Houthuijs DJM, Fischer PH Het effect van geluid van vlieg- en wegverkeer op cognitie, hinderbeleving en de bloeddruk van basisschoolkinderen Rijksinstituut voor Volksgezondheid en Milieu Bilthoven: RIVM rapport 441520021

Berglund 1999 Berglund B, Lindvall T, Schwela DH (eds) Guidelines for community noise Geneva: World Health Organization, 1999

Kempen 2008 Kempen EEMM van Transportation noise exposure and children’s health and cognition Proefschrift Universiteit Utrecht, January 2008

GR 2004 Over de invloed van geluid op de slaap en gezondheid Den Haag: Gezondheidsraad, publicatienummer 2004/14, 2004

Knol 2005

Stille gebieden en gezondheid Den Haag: Gezondheidsraad, publicatienummer 2006/12

Knol AB, Staatsen BAM Trends in the environmental burden of disease in the Netherlands 1980-2020 Rijksinstituut voor Volksgezondheid en Milieu Bilthoven: RIVM rapport 500029001/2005

Fast 2004

MBO 2005

Fast T, Bruggen M van Beoordelingskader Gezondheid en Milieu: GSM-basisstations, Legionella, radon en geluid door wegverkeer Rijksinstituut voor Volksgezondheid en Milieu Bilthoven: RIVM rapport 609031001/2004

Onderzoek Milieubeleving Zuid-Holland 2005. Onderzoek naar de milieubeoordeling door de bevolking. Provincie Zuid-Holland, Directie Groen, Water en Milieu

GR 2006

Franssen 2004 Franssen EAM, Dongen JEF van, Ruysbroek JHM, Vos F, Stellato R Hinder door milieufactoren en de beoordeling van de leefomgeving in Nederland. Inventarisatie Verstoringen 2003 Rijksinstituut voor Volksgezondheid en Milieu Bilthoven: RIVM rapport 815120001, 2004

Hoeymans 2006 Hoeymans N, Poos MJJC Wat is de ziektelast en hoe wordt deze berekend? In: Volksgezondheid Toekomst Verkenning, Nationaal Kompas Volksgezondheid http://www.nationaalkompas.nl > Gezondheid en ziekte\ Sterfte, levensverwachting en DALY’s\ Ziektelast in DALY’s, 19 June 2006 Bilthoven: RIVM

Meijers Research 2008 Onderzoek luchtvaarthinder Rotterdam Airport Meijers Research Rotterdam: 2008

Miedema 2001 Miedema HME, Oudshoorn CGM Annoyance from transportation noise: relationships with exposure metrics DNL and DENL and their confidence intervals Environmental Health Perspectives 2001; 109: 409-16.

Miedema 2002 Miedema H.M.E., Jong de R.G., Cleij J, et al Relaties tussen geluidbelasting en hinder voor industrie- en rangeerterreinen Delft: TNO Inro rapport 2002-53, 2002

MSR 2004 Kempen 2005

Monitoring Milieu en Gezondheid Fase 2: Pilot Regio Rijnmond - Geluid Samenwerkingsverband Milieumonitoring Stadsregio Rotterdam (MSR) Rotterdam: 2004 Chapter 9: Literature list

Kempen EEMM van, Staatsen BAM, Kamp I van Selection and evaluation of exposure-effectrelationships for health impact assessment in the field of noise and health Rijksinstituut voor Volksgezondheid en Milieu Bilthoven: RIVM rapport 630400001/2005

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Peeters 2007 Peeters E (red) Handboek binnenmilieu 2007 GGD Nederland Rotterdam, October 2007

RIVM 2008 Text website RIVM n Nationaal Kompas Volksgezondheid > Gezondheidsdeterninanten > Omgeving > Milieu > Geluid (via http://www.rivm.nl/vtv/object_class/kom_determinant.html) n Gezondheid en milieu http://www.rivm.nl/gezondheidenmilieu/ themas/geluid/geluidgezondheid April 2008

Staatsen 2004 Staatsen BAM, Nijland HA, Kempen EMM van, Hollander AEM de, Franssen AEM, Kamp I van Assessment of health impacts and policy options in relation to transport-related noise exposures. Topic paper noise Rijksinstituut voor Volksgezondheid en Milieu Bilthoven: RIVM rapport 815120002/2004

WHO 2001 Factsheet no 258. Occupational and community noise World Health Organization, 2001

WHO 2006 Constitution of the World Health Organization Basic Documents, Forty-fifth edition, Supplement, October 2006 World Health Organization, 2006 http://www.who.int/governance/eb/who_constitution_en.pdf

Woudenberg 2006

MSR Theme report - Noise, Health and Money

Woudenberg F, Perenboom RJM, Hofman WF, Kamp I van (2006) Geluid en gezondheid Praktijkreeks geluid en omgeving SDU Uitgevers, Den Haag: 2006 n

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  10

Glossary Action plan for noise

The set of measures to ensure that the noise levels are reduced to or remain below the plan threshold value and to ensure that quiet areas are protected.

DALY

Disability Adjusted Life Years or the number of healthy life years that a population group looses due to disease.

dB(A)

Unit for sound pressure weighted to human hearing. The strength of noise or the noise level is expressed in decibel (dB). The human ear is not equally sensitive to all frequencies (pitches). To measure the strength of sound as experienced by a human being the measured sound level is corrected for the difference in sensitivity. By adding up all of the corrected frequencies, a single numeric value for the sound level is arrived at, expressed in decibel(A) or dB(A).

Noise map

Geographic map showing the noise levels at a certain location. The map must show per source (road traffic noise, rail noise, aircraft noise and industrial noise) and subdivided into noise classes, the number of dwellings exposed to noise within that class. This map is used in spatial processes to substantiate the noise policy.

Hedonic Price Method

The Hedonic Price Method is based on observing (for instance) real estate price differences that can be attributed to certain characteristics of the environment, such as air or noise quality and risks. Using statistical techniques, the method tries to establish the degree to which the price difference can be attributed to a specific difference in environmental quality. In particular regression analysis is applied to the prices of the properties and a number of explanatory variables.

Lden

Annual average level of noise throughout the entire 24-hour period, with a weighting to day, evening and night

Lnight

Annual average level of noise in the night

MBO

Milieubelevingsonderzoek [Environmental perception survey]

MNP

Milieu- en Natuurplanbureau [environmental and nature planning office]

MSR

Milieumonitoring Stadsregio Rotterdam [environmental monitoring in the Rotterdam Metropolitan Region]

Plan threshold value

Noise level above which noise-reducing measures must be taken. The plan threshold value can apply to both the entire area and to specific areas.

RIVM

Rijksinstituut voor Volksgezondheid en Milieu [National Institute of Public Health and Environmental Protection]

TNO

Nederlandse Organisatie voor Toegepast Natuurwetenschappelijk Onderzoek [Netherlands Organisation for Applied Scientific Research]

WHO

World Health Organization n

Chapter 10: Glossary

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  A1

Data processing

Various methods have been used for Rotterdam and for the other Rijnmond municipalities to process the noise maps. Various methods have been used for Rotterdam and for the other Rijnmond municipalities to process the noise maps.

Method 1 The figures for the municipality of Rotterdam were calculated using the URBIS method. Berekeningspunt Calculation point Postcode huisnummer Postcode and house Woning of woonblok (Block of) dwellings

For each dwelling or block of dwellings and for each facade a calculation point has been generated at a height of 4 metres above ground level. The noise level is calculated from a source or from all sources together at all of these calculation points. The highest noise level determines the noise level for the dwelling or the entire block of dwellings. Using a GIS tool, postcodes and house numbers, including the registered number of inhabitants are assigned per dwelling or block of dwellings. Example Postcode and

Numbers of Lden

house number inhabitants Total

2642 KE 15

3.2

54

Lden

Lden

Lden

Lnight

Lnight

Lnight

Lnight

road

rail

industry

Total

road

rail

industry

50

48

48

50

47

46

43

Method 2 Calculations have been made for the municipalities of The Hague, Barendrecht, Maassluis, Vlaardingen, Schiedam, Capelle aan den IJssel, Ridderkerk, Albrandswaard, Rozenburg and Spijkenisse using the Geonoise SKM II method.

A fixed grid of calculation points has been calculated at a height of 4 metres above ground level. Based on the results of the calculations 1 dB contours have been generated. The highest noise level determines the noise level for the dwelling or the entire block of dwellings. Using a GIS tool, postcodes and house numbers are assigned per dwelling or block of dwellings. The number of inhabitants per postcode + house number is determined using the number of inhabitants per 6PPC (6 Position Postcode Centroíd). Postcodes with house numbers that are outside of a building have been assigned the value of the 1 dB contour. n Appendix 1: Data processing

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  A2

Questionnaire surveys

The survey method used for the MBO Zuid-Holland (MBO 2005) differs from the method used for the annoyance survey of TNO-RIVM (Franssen 2004). Therefore, the results from the surveys cannot simply be compared. This is, among other things, because of the following differences: n In the TNO-RIVM survey, questions are asked about annoyance caused by separate road traffic sources (such as mopeds/scooters, motorbikes, passenger cars, trucks and buses). In the MBO Zuid-Holland, questions were asked about the annoyance caused by road traffic, without making a distinction between different road traffic sources. It is conceivable that asking about the annoyance caused by different sources gives a higher annoyance score than when only asking about the annoyance caused by “road traffic”. n The two surveys use a different way of phrasing the questions and different scales to score the annoyance. The MBO Zuid-Holland for instance uses a 5-point scale for the degree of annoyance; TNO-RIVM uses an 11-point scale. n In the TNO-RIVM survey, participants are 16 years of age and older, in the MBO the participants are 18 years of age and older. n

Appendix 2: Questionnaire surveys

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  A3

Annoyance Caused by Noise Method

Transport traffic Based on the data from a large number of national and international questionnaire surveys, correlations have been derived between the noise level and the degree of annoyance experienced due to the noise from aircraft, road traffic and rail traffic. These surveys established the annoyance using questionnaires for adults. The noise level was calculated outside at the facade exposed to the highest level of noise. The correlations therefore only apply in residential circumstances (Miedema 2001). No correlation can as yet be derived for the noise levels (Fast 2004) for the annoyance that is experienced in for instance (green) recreational areas. Correlations have been derived for the percentage slightly annoyed (LA), annoyed (A) and severely annoyed (HA):

Aircraft: %LA %A %HA

= -6,158*10-4(Lden-32)3+3,410*10-2(Lden-32)2+1.738(Lden-32) = 8,588*10-6(Lden-37)3+1,777*10-2(Lden-37)2+1.221(Lden-37) = -9,199*10-5(Lden-42)3+3,932*10-2(Lden-42)2+0.2939(Lden-42)

Road traffic: %LA = -6,235*10-4(Lden-32)3+5,509*10-2(Lden-32)2+0.6693(Lden-32) %A = 1,795*10-4(Lden-37)3+2,110*10-2(Lden-37)2+0.5353(Lden-37) %HA = 9,868*10-4(Lden-42)3-1,436*10-2(Lden-42)2+0.5118(Lden-42) Rail traffic: %LA = -3,229*10-4(Lden-32)3+4,871*10-2(Lden-32)2+0.1673(Lden-32) %A = 4,538*10-4(Lden-37)3+9,482*10-3(Lden-37)2+0.2129(Lden-37) %HA = 7,239*10-4(Lden-42)3-7,851*10-3(Lden-42)2+0.1695(Lden-42) Comment: The calculated annoyance (A) includes severe annoyance (HA). The calculated percentage of annoyed people, therefore also includes people who experience severe annoyance. Industry In 2002, TNO established correlations between the noise levels generated by industry and annoyance. Here questionnaires have also been used and the noise levels are determined at the facades of the dwellings (Miedema 2002). A distinction has been made between shunting yards, season-bound companies and other companies. For the calculations in Rotterdam-Rijnmond, the results for ‘other companies’ have been used: %LA = 11,477 - 1,130Lden + 0.02815Lden2 %A = 36,854 - 2,121Lden + 0.03270Lden2 %HA = 36,307 - 1,886Lden + 0.02523Lden2

Limitations The exposure-response relationships have a number of limitations: n The relationships can only be used in long term “steady state” situations. n The relationships are only suitable for use at a large geographic level. When used for local situations the differences can be substantial. Therefore in this report the relationships have been used for Rijnmond and the three major cities, but not for the smaller municipalities. n The relationships have been developed for adults (MSR 2004). Research shows that it is possible to derive exposure-response relationships for children (aircraft and road traffic). Although children are less annoyed by levels above 55 dB, the relationships are approximately comparable to those of their parents (Kempen 2008). In this report, the exposure-response relationships for adults have been used and only the annoyance to inhabitants of 20 years of age and older has been calculated. n

Appendix 3: Annoyance Caused by Noise Method

The noise levels caused by industry that are used in the calculations in this report are possibly overestimated. This is because the pictured noise levels are the accumulated noise levels of all companies together on a zoned industrial estate. These accumulated noise levels are based on the permitted levels per company. For companies that do not operate continually, it can be the case that the maximum permitted noise levels are only generated a few times a year, for instance once or twice a week. Because companies that do not operate continually will not produce the maximum noise at the same time, the actual noise levels will often be lower than the calculated noise levels. The experienced annoyance will therefore probably also be lower than the calculated annoyance.

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  A4

Sleep Disturbance Method

The sleep disturbance has been calculated for road and rail traffic based on preliminary relationships between noise levels and sleep disturbance for adults (Miedema 2003). The relationships give the percentage light sleep disturbance (LSD), sleep disturbance (SD) and severe sleep disturbance (HSD) as a function of the noise levels at night (Lnight) at the facade exposed to the highest level of noise. Road traffic: % LSD = -8.4 + 0.16Lnight + 0.01081Lnight2 % SD = 13.8 - 0.85Lnight + 0.01670Lnight2 % HSD = 20.8 - 1.05Lnight + 0.01486Lnight2 Rail traffic: % LSD = 4.7 - 0.31Lnight + 0.01125Lnight2 % SD = 12.5 - 0.66Lnight + 0.01121Lnight2 % HSD = 11.3 - 0.55Lnight + 0.00759Lnight2 Comment: The calculated sleep disturbance (SD) includes the severe sleep disturbance (HSD). The calculated percentage of people who experience sleep disturbance therefore also includes people who experience severe sleep disturbance. n

Appendix 4: Sleep Disturbance Method

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  A5

High Blood Pressure and Heart Attacks

The influence of road traffic noise on the occurrence of heart attacks and of aircraft noise on the occurrence of high blood pressure has now been sufficiently scientifically established. The degree to which road traffic noise influences high blood pressure is still being discussed in scientific circles. High blood pressure As the discussion regarding the influence of transport noise on cardiovascular disease is still ongoing, for this report the decision has been made to take the RIVM 2005 approach. In this approach, no distinction is made between aircraft, road or rail traffic for the doseeffect relationship between noise and high blood pressure and a relative risk of 1.26 per 5 dB is used, based on the effects of aircraft noise. This relative risk applies for between 55 to 72 dB(A). The number of fatalities can be indirectly determined by establishing how many people die as a result of high blood pressure and by multiplying this number by the percentage of people who have raised blood pressure due to noise (Kempen 2005, Knol 2005). Heart attack The influence of road traffic noise on the rate of heart attacks has been established sufficiently scientifically. For this report, the calculations are based on the relative risks as established in a Babisch review (see table). The chance of a heart attack increases at noise levels above 60 dB(A) and increases even more at higher noise levels. Noise levels above 75 dB(A) increase the chance of a heart attack by approximately 40% (Babisch 2006). Table: risk of heart attack due to road traffic noise (Babisch 2006)

Average Sound Pressure Level during the day (6-22 h) [dB(A)]

Relative risk OR

<=60 >60 - 65 >66 - 70 >70 - 75 >75 - 80

1 1.05 1.09 1.19 1.47

Calculations The effects of noise on high blood pressure and heart attacks have been calculated for Rijnmond. The method used is based on the calculation method used by the RIVM (Kempen 2005). This method calculates the Population Attributive Risk (PAR). The PAR is a unit for the percentage of patients that can be attributed to a certain risk factor - in this case noise. Using the PAR, for each exposure category it has been calculated how many people in Rijnmond have been affected by high blood pressure or a heart attack due to noise. The number of fatalities is indirectly determined by establishing how many people die as a result of high blood pressure and by multiplying this number by the percentage of people who have raised blood pressure due to noise. n

Appendix 5: High Blood Pressure and Heart Attacks

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  A6

DALYs

In this report, two effects of noise are expressed in DALYs: severe sleep disturbance and severe annoyance. Until recently, mortality resulting from high blood pressure due to noise was also calculated in DALYs (RIVM 2005, Woudenberg 2006). However, there is scientific discussion concerning the influence of road traffic noise on high blood pressure and with it the calculation of DALYs from this effect. Therefore mortality resulting from high blood pressure is not calculated in DALYs in this report. To calculate the DALYs due to noise levels in Rijnmond and in Rotterdam, Amsterdam and Utrecht, the following data are used: n The number of people who suffer from severe sleep disturbance and the number of people who suffer from severe annoyance due to noise: For this report the calculated number of inhabitants who suffer from severe annoyance and severe sleep disturbance are assumed on the basis of exposure-response relationships. n The weighting factors for severe sleep disturbance and severe annoyance: In this report the weighting factor of 0.02 is taken over from the RIVM. This weighting factor has a relatively large uncertainty (0.01-0.12 for annoyance and 0.01-0.1 for sleep disturbance) (Knol 2005). In this report, this spread is not shown. n

Appendix 6: DALYs

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Colophon The following organisations work together in the ‘Environmental Monitoring Rotterdam Metropolitan Region’ project: DCMR Rijnmond Environmental Agency Rotterdam Municipality The Rotterdam-Rijnmond Public Health Service The higher water board of Delfland The higher water board of Schieland and the Krimpenerwaard Rotterdam-Rijnmond Police Province of Zuid-Holland Directorate General of Public Works and Water Management, Directorate Zuid-Holland Rotterdam Metropolitan Region District water board Hollandse Delta

Theme group members: Floor Baan Niels Cools Carola Hegger Frans van Kampen Roel Kerkhoff Rita Slob Astrid van Wijk Henk Wolfert Fred Woudenberg

DCMR DCMR Rotterdam-Rijnmond Public Health Service Province of Zuid-Holland Rotterdam-Rijnmond Public Health Service Rotterdam-Rijnmond Public Health Service DCMR DCMR Amsterdam Public Health Service

Number of certificate SCGM-2005.04.01

Colophon

Paper: Paper: This theme report is printed on 9lives FSC certified paper. Printer: Henskes Grafisch Totaal (environmental certified producer according to ISO 14001).

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