Noise Exposure and Cardiovascular Health in Children: A Review of Current Evidence.

Rapid global urbanisation has increased environmental noise from road traffic, aviation, industry, and community activities, posing a significant public health concern. Children aged 0-18 years are particularly vulnerable to noise exposure due to their immature auditory and cardiovascular systems, high sleep requirements, and limited self-protection capacity, with varying sensitivity across developmental stages (infant, preschool, school-age, and adolescent). Although the association between environmental noise and cardiovascular diseases in adults is well established, evidence in children remains fragmented. Some studies have linked noise exposure to elevated blood pressure, increased obesity risk, and reduced heart rate variability. Underlying pathophysiological mechanisms include activation of the hypothalamic-pituitary-adrenal axis and sympathetic nervous system, sleep disruption, and induction of vascular oxidative stress and chronic systemic inflammation. Noise and traffic-related air pollutants also have synergistic harmful effects. Current research lacks long-term longitudinal data and has insufficient precision in individualised exposure assessment. Multilevel interventions are needed-individual protection, school/community acoustic modifications, and noise-control policies. This review systematically summarises evidence on noise exposure and paediatric cardiovascular health, elucidates mechanisms, identifies research gaps, and provides a scientific basis for noise prevention strategies to protect this vulnerable population.