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In the last decades exposure to noise has become one of the largest environmental burdens. Noise interferes not only at work, but with people’s daily activities at home, at school and during leisure time. According to experts of environmental medicine, the health impact of noise is probably underestimated. Recent research showed that a variety of health effects are linked to noise. There are two different types of health impacts: impairment of hearing and pysiological health effects. Many teenagers and young adults are exposed to excessive noise when listening to music during leisure activities or in discotheques. Permanent sound levels exceeding 85 db(A) can cause damages of the internal ear depending on the exposure time:
•    temporary threshold shift (hearing fatigue)
•    permanent threshold shift (probably inducing tinnitus or hearing impairment) 
ENT-doctors are increasingly faced with youths being hearing impaired by leisure noise. Adequate measures to reduce the exposure to high levels of noise are very important.
However, even noise below the threshold of 85 dB (A) can cause a variety of serious health effects, to some extent mediated by the autonomic nervous system:
•    cognitive impairments (working and communication is disturbed)
•    interferences with social behaviour (threshold for aggressiveness drops)
•    hormonal responses (stress hormones are released) and their impact on human metabolism and immune system
•    sleep disturbance and all its consequences on a long and short term basis for performance at school and work
•    Raising of blood pressure, cardiovascular diseases and increased risk for heart attack