Personal stethoscope disinfection practices and bacterial contamination: A cross-sectional study at the University Hospital Emergency Department in Belgrade, Serbia.

BACKGROUND: A significant reduction in bacterial growth on stethoscope membranes has been noticed after performing daily disinfection. Nevertheless, disinfection is rarely performed. We aimed to assess self-reported stethoscope disinfection practices among medical doctors, detect bacterial contamination on personal stethoscopes, and estimate the effectiveness of 70% ethanol as a stethoscope disinfecting agent. METHODS: To determine stethoscope disinfection practices, participants filled out a questionnaire (N = 47), followed by providing stethoscopes for bacterial analysis. Differences in bacterial contamination were observed through the self-reported frequency and method of stethoscope disinfection. The effect of disinfecting with 70% ethanol was evaluated by comparing the presence of bacterial growth before and after disinfection. RESULTS: The presence of bacterial growth was found in 78.7% of the stethoscope samples, with the median (interquartile range) number of colony-forming units at 25 (10-105). The frequency of disinfection greatly impacted the number of colony-forming units, and the method affected the presence of bacterial growth. Disinfection of stethoscope membranes using 70% ethanol resulted in a compelling 97.3% reduction of bacterial growth. CONCLUSIONS: Adequate stethoscope disinfection is highly efficient in reducing bacterial contamination and as such should be considered a critical step in hygienic practices.

Energy Drinks and Sleep among Adolescents.

Many adolescents worldwide have the problem of meeting recommended nightly sleep hours. The causes of sleep disturbance are multifactorial, but interest in food's effect on sleep has dramatically increased lately. In this study, we investigated the association between regular energy drink (ED) intake (weekly or more frequent) and sufficient sleep (SS) (≥8 h) in adolescents. Additional objectives were to examine the relationship between health-related behaviors and SS, stratified by gender. A population-based cross-sectional study was conducted during the 2019/2020 school year from 12 schools in Belgrade. There were 1287 students aged 15 to 19 who participated (37.4% male). We used a modified version of the food frequency questionnaire adapted for Serbian adolescents. Logistic regression revealed that regular ED consumption was an independent risk factor negatively related to SS in both sexes. Additionally, daily vegetable and water intake (≥2 L) showed a positive correlation with SS in boys, while in girls, the odds of realizing SS decreased with statements of sedative use. In conclusion, we show that ED intake is negatively associated with SS in both sexes; daily vegetable and water intake (≥2 L) may raise the odds of SS in boys, while sedative use may decrease the chances of SS in girls.

Precautionary Allergen Labelling in Serbia: Market Audit and Consumers' Perception.

Background: Precautionary allergen labels (PAL) should be used to indicate the possibility of allergen presence in the food. This study aimed to determine the prevalence and types of precautionary labeling statements on different pre-packaged food products in retail stores in Belgrade, Serbia, as well as to assess consumers' attitudes and behavior towards PAL statements. Methods: This was a descriptive study. The following characteristics of 1404 pre-packaged foods were analyzed: prevalence of PAL, listed food allergens on PAL, and the types of the advisory terminology. In the group of 275 participants (94 with food allergies, and 181 persons who purchasing food for a household member with food allergy) reading practice of PAL, purchasing practice based on PAL, and the opinion about PAL statements credibility were evaluated. Results: Overall, 33.9% of products had precautionary statements for one or more allergens. "Tree nuts" were the most common allergens listed in the PAL. The most common type of PAL was "May contain traces of x [allergen]" (52.7%). The PAL was always read by half of the participants. Less than half (43.3%) of the participants incorrectly believed that PAL is regulated by national law. A quarter of participants thought that the PAL statements are trustworthy. Conclusion: PAL statements frequently are not user-friendly and are not providing sufficient protection for food allergic patients. To gain buyers' confidence, protect health and provide security, the necessity for the strategies that would regulate PAL by the law exists.

The proposed criteria for high perceived misophonia in young healthy adults and the association between Misophonia symptoms and noise sensitivity.

Context: The association between noise sensitivity and misophonia has not been explored in any population, according to the available literature. Aims: To assess the proportion of misophonia symptoms among young healthy adults, to propose the criteria for high perceived misophonia, and to explore the association between misophonia with noise sensitivity with adjustment for sex, age, perceived anxiety, and depression. Settings and Design: A cross-sectional study on 1132 medical students, aged 21.4 ± 2.1 years. Methods and Material: Misophonia symptoms were self-reported using the Amsterdam Misophonia Scale. Nine criteria for high perceived misophonia are proposed. Noise sensitivity was measured with Weinstein scale. Perceived anxiety and depression were measured using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale, respectively. Statistical Analysis Used: Multiple logistic regression. Results: Almost half of the students reported the feeling of irritation against people making provoking sounds. Only one in 10 claimed the feeling of loss of self-control when exposed to provoking sounds. High noise sensitivity and high depression were associated with higher odds of meeting the criteria for high perceived misophonia. Conclusion: Noise-sensitive students are at higher risk of reporting misophonia symptoms and of being classified with high perceived misophonia. The combination of at least four or more symptoms, which classifies every 10th student with high perceived misophonia, is proposed as a self-assessment tool for epidemiological studies among young healthy adults.

Water, sanitation, and hygiene services in health care facilities in the Autonomous Province of Vojvodina, Serbia.

Provision of safe water, sanitation, and hygiene (WASH) services in health care facilities is a priority at the global, national, and local levels. To inform improvements planning, conditions of WASH, waste management, and environmental cleaning were assessed in 81 facilities in the Autonomous Province of Vojvodina, Serbia, as part of a nationally representative survey in 2019. The survey included on-site checks, structured interviews, and drinking-water quality analysis. WHO/UNICEF indicators for WASH service levels and an advanced service level defined at the national level were applied. The results showed that all investigated facilities provided basic water services; 94% of facilities provided basic hygiene and waste management services; 58 and 2%, respectively, provided basic cleaning and sanitation services. Only 1% of investigated facilities met the basic level for all five WASH dimensions. Advanced service levels were only met for hygiene, waste management, and/or cleaning in 15-38% of facilities. In 33% of health care facilities, drinking-water quality was not in compliance with the national standards. The results revealed that there is a need for increased awareness and efforts to ensure basic provisions for sanitation, environmental cleaning, and drinking-water safety.

Dietary Habits of Older Adults in Serbia: Findings From the National Health Survey.

Objectives: Adults aged 65 years and older comprise one fifth of the Serbian population. Many of them have multiple, often diet-related comorbidities. We aimed to investigate their dietary habits by comparing them with younger adults' and to determine the relation of the differing ones to demographic, socioeconomic and health factors. Methods: We performed a secondary analysis of 2013 Serbian National Health Survey data on 14,082 adults. Binary logistic regression was used to determine dietary habits associated with older age (≥65 years) compared to younger age (18-64 years) and to assess their independent predictors in older adults. Results: Older adults more often reported everyday breakfast (OR = 2.085, 95%CI = 1.622-2.680) and brown/wholegrain bread consumption (OR = 1.681, 95% CI = 1.537-1.839), while using margarine (OR = 0.578, 95%CI = 0.397-0.839), discretionary salt (sometimes: OR = 0.648, 95%CI = 0.596-0.705, almost always: OR = 0.522, 95%CI = 0.445-0.614) and consuming fish (two or more times a week: OR = 0.465, 95%CI = 0.383-0.566) less frequently than younger adults. This was mainly positively related to urban environment, affluence, higher education and poor health. Conclusion: Using nationally representative data, we found that older adults reported healthier dietary habits compared to younger adults, which requires timely public health action.

Nutrition and Health Claims Spectra of Pre-Packaged Foods on Serbian Supermarket Shelves: A Repeated Cross-Sectional Study.

Nutrition and health claims (NHCs) are a powerful tool that influence consumers' final decision on the choice of food products. The purposes of this repeated cross-sectional study were to (i) assess the prevalence of pre-packaged food products containing nutrition and health claims among different food categories, (ii) to determine the type of NHCs labelled on the examined food products, and (iii) to evaluate the trend in the use of NHCs in comparison to the 2012 survey. The survey was conducted immediately before the full enforcement of the new national legislation on NHCs in 2020. It comprised 3141 pre-packaged food products from 10 product categories. In total, 21.2% of food products contained any claim (19.4% contained any nutrition claim; 8.2% contained any health claim). In comparison to the 2012 survey, we observed a rising trend in the presence of NHCs; the use of nutrition claims on food products increased three times and the use of health claims increased 1.3 times in the 2020 survey. Bearing in mind that NHCs are a powerful tool guiding consumers' food purchase decisions, NHCs should be supported by precise legislation and strict surveillance by the public health authorities.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Quality of Life, Wellbeing and Mental Health.

This systematic review assesses the quality of the evidence across studies on the effect of environmental noise (road traffic noise, aircraft noise, railway noise, wind-turbine noise) on quality of life, wellbeing and mental health. Quantitative studies of noise effects on children and adults published from January 2005 up to October 2015 were reviewed. A total of 29 papers were identified. 90% of the papers were of cross-sectional design, with fewer studies of longitudinal or intervention design. Outcomes included depression and anxiety, medication use and childhood emotional problems. The quality of the evidence across the studies for each individual noise source was assessed using an adaptation of the GRADE methodology. Overall, given the predominance of cross-sectional studies, most evidence was rated as very low quality, with evidence of effects only being observed for some noise sources and outcomes. These ratings reflect inconsistent findings across studies, the small number of studies and a lack of methodological robustness within some domains. Overall, there are few studies of clinically significant mental health outcomes; few studies of railway noise exposure; and studies of large samples are needed. The lack of evidence for noise effects across studies for many of the quality of life, wellbeing and mental health domains examined does not necessarily mean that there are no effects: rather, that they have not yet been studied robustly for different noise sources.

The timeline of blood pressure changes and hemodynamic responses during an experimental noise exposure.

BACKGROUND: Noise exposure increases blood pressure and peripheral vascular resistance in both genders in an experimental setting, as previously reported by the authors. OBJECTIVES: The aim of this re-analysis was to present the minute-by-minute timeline of blood pressure changes and hemodynamic events provoked by traffic noise in the young and healthy adults. METHODS: The experiment consisted of three 10-min phases: rest in quiet conditions before noise (Leq = 40 dBA), exposure to recorded road-traffic noise (Leq = 89 dBA), and rest in quiet conditions after noise (Leq = 40 dBA). Participants' blood pressure, heart rate, and hemodynamic parameters (cardiac index and total peripheral resistance index) were concurrently measured with a thoracic bioimpedance device. The raw beat-to-beat data were collected from 112 participants, i.e., 82 women and 30 men, aged 19-32 years. The timeline of events was created by splitting each experimental phase into ten one-minute intervals (30 intervals in total). Four statistical models were fitted to answer the six study questions what is happening from one minute to another during the experiment. RESULTS: Blood pressure decreased during quiet phase before noise, increased in the first minute of noise exposure and then decreased gradually toward the end of noise exposure, and continued to decline to baseline values after noise exposure. The cardiac index showed a gradual decrease throughout the experiment, whereas total vascular resistance increased steadily during and after noise exposure. CONCLUSIONS: The timeline of events in this 30-min experiment provides insight into the hemodynamic processes underlying the changes of blood pressure before, during and after noise exposure.

WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cognition.

This systematic review assesses the quality of the evidence across individual studies on the effect of environmental noise (road traffic, aircraft, and train and railway noise) on cognition. Quantitative non-experimental studies of the association between environmental noise exposure on child and adult cognitive performance published up to June 2015 were reviewed: no limit was placed on the start date for the search. A total of 34 papers were identified, all of which were of child populations. 82% of the papers were of cross-sectional design, with fewer studies of longitudinal or intervention design. A range of cognitive outcomes were examined. The quality of the evidence across the studies for each individual noise source and cognitive outcome was assessed using an adaptation of GRADE methodology. This review found, given the predominance of cross-sectional studies, that the quality of the evidence across studies ranged from being of moderate quality for an effect for some outcomes, e.g., aircraft noise effects on reading comprehension and on long-term memory, to no effect for other outcomes such as attention and executive function and for some noise sources such as road traffic noise and railway noise. The GRADE evaluation of low quality evidence across studies for some cognitive domains and for some noise sources does not necessarily mean that there are no effects: rather, that more robust and a greater number of studies are required.

Suitability of blood-pressure-to-height ratio as the criterion for high blood pressure in children in an environmental study.

BACKGROUND: Blood-pressure-to-height ratio is considered a simple, accurate, inexpensive and non-age-dependent index for screening high blood pressure in a clinical setting, but its suitability in epidemiological surveys was not taken into consideration. The aim of this study was to test the suitability of blood-pressure-to-height ratio against blood pressure for age percentiles for the identification of high blood pressure in an environmental study. METHODS: The sample consisted of 2195 children, aged 3 to 15 years, whose blood pressure was measured as part of an environmental study in Belgrade, Serbia. High blood pressure was estimated using percentiles (gold standard) and blood-pressure-to-height ratios for systolic and diastolic pressures separately (proposed criterion). The optimal cut-offs of the blood-pressure-to-height ratio (BPHR) were selected based on Youden's index (sensitivity + specificity - 1) calculated from the receiver operator characteristic curve analysis. RESULTS: The proposed criterion identified five times more cases of high blood pressure in the investigated children of all age groups in comparison to the gold standard. The optimal cut-off values were selected based on the sensitivity and specificity values by age groups and gender. CONCLUSION: Blood-pressure-to-height ratio can be a reliable criterion for the estimation of high blood pressure in epidemiological studies. This is the first study on the applicability of blood-pressure-to-height ratio in Serbian children, but it may not be easily generalized to other populations due to small sample size across the examined age groups and potential diversities in risk factors for high blood pressure. Applied in epidemiological studies, BPHR would help researchers estimate the role of certain environmental factors on blood pressure in children.

Recent advances in research on non-auditory effects of community noise.

Non-auditory effects of noise on humans have been intensively studied in the last four decades. The International Commission on Biological Effects of Noise has been following scientific advances in this field by organizing international congresses from the first one in 1968 in Washington, DC, to the 11th congress in Nara, Japan, in 2014. There is already a large scientific body of evidence on the effects of noise on annoyance, communication, performance and behavior, mental health, sleep, and cardiovascular functions including relationship with hypertension and ischemic heart disease. In the last five years new issues in this field have been tackled. Large epidemiological studies on community noise have reported its relationship with breast cancer, stroke, type 2 diabetes, and obesity. It seems that noise-induced sleep disturbance may be one of the mediating factors in these effects. Given a large public health importance of the above-mentioned diseases, future studies should more thoroughly address the mechanisms underlying the reported association with community noise exposure. Keywords: noise; cancer; stroke; diabetes mellitus type 2; obesity

Laterality in living beings, hand dominance, and cerebral lateralization.

To date, lateralization in living beings is a phenomenon almost mythologically unexplored. Scientists have proved that lateralization is not exclusively a human feature. Investigations in molecular biology, protein structure, mobility of bacteria, and intracellular lateralization in ciliates, shows important and universal nature of lateralization in living systems. Dominant lateralization implies the appearance of a dominant extremity, or a dominant sense during the performance of complex psychomotor activities. Hand dominance is usually defined as a tendency to use one hand rather than another to perform most activities and this is considered to be the most obvious example of cerebral lateralization and exclusive characteristic of humans. However, there are some exceptions in other species. The dominant hand is able to perform more complex and subtle manual tasks than the non-dominant hand, and this behavioral superiority is the absolute result of additional cerebral support. The asymmetry of brain organization was confirmed in rats, chimpanzees, dogs and birds, some fishes and lizards. The relationships between hand dominance with brain structure and function remain far from clear. For a long time, lateralization was considered unique to humans, but recently it has become clear that lateralization is a fundamental characteristic of the organization of brain and behavior in all vertebrates. It has been questioned to what extent lateralization in humans and other vertebrates may be comparable.

Nutrition labelling of pre-packaged foods in Belgrade, Serbia: current situation.

OBJECTIVE: To determine the presence of nutrition labels on pre-packaged food products, as well as to analyse the types of presentation. DESIGN: This was a descriptive study. The following characteristics were analysed: (i) presence and placement of the nutrition declaration (either as front-of-pack (FOP) or back-of-pack (BOP)); (ii) content of the presented information; (iii) presence of nutrition and health claims; and (iv) legibility of the written information. Settings Three different types of retailers in Belgrade, Serbia. SUBJECTS: A total of 2138 pre-packaged food products from ten categories. RESULTS: A nutrition declaration was found on 65.9% of all tested products. It was displayed on the back of the packaging of 62.7% of products and on the front of the packaging of 19.1% of products. BOP was the most commonly observed in breakfast cereals, soft drinks, milk and instant soups (in total over 90%), and the least common in meat products (21.5%). FOP was predominantly displayed on breakfast cereals (65.0%) and the least frequently on milk products (2.4%). The 'Big 4' (energy value, protein, carbohydrate and fat contents) and the 'Big 4 with additional information' figured on 40.9% of products. The 'Big 8' ('Big 4' plus sugar, saturated fat, fibre and sodium contents) and the 'Big 8 with additional information' were present less frequently (20.5%). Nutrition claims and health claims appeared on very few products (6.6% and 6.3%, respectively). The proportion of products with insufficient legibility was 31.5%. CONCLUSIONS: Nutrition labelling in Belgrade, Serbia is not satisfactory. Mandatory regulations may be the best way to improve the current situation.

Burden of myocardial infarction attributable to road-traffic noise: a pilot study in Belgrade.

The aim of this pilot study was to calculate the disability-adjusted life years (DALY) as a quantification of the burden of myocardial infarction (MI) attributable to road-traffic noise in Belgrade, Serbia. Exposure to road-traffic noise was estimated on a sample of almost 6000 adult inhabitants living in the central municipality Stari Grad in Belgrade, Serbia. Each participant was assigned to daytime noise levels for 16 h exposure measured on the street of current residence. Population-attributable fraction of MI due to road-traffic noise was calculated based on the distribution of the population in different noise exposure categories and the respective relative risk of MI compared to the reference level. DALYs due to noise-related MI were calculated as the sum of years of life lost and years with disability. The contribution of road traffic noise to the occurrence of MI for the population of the municipality Stari Grad in Belgrade equals 2.518%. Total DALY for MI due to road-traffic noise results in 176 years, that is, 115 years for men and 61 years for women. When adjusted for the present size of the population in Belgrade, total DALY due to road-traffic noise equals 107 years/million inhabitants that is, 70/million inhabitants for men and 37/million inhabitants for women. The burden of disease due to road-traffic noise in Belgrade is relatively small but noteworthy from the public health point of view.

Noise annoyance is related to the presence of urban public transport.

BACKGROUND: The association between noise annoyance and public transport as a source of noise has not been studied previously. The aim was to study noise annoyance in an urban population due to the presence, the type and the number of public transport vehicles, in relation to other acoustical and non-acoustical parameters. METHOD: The study sample comprised 5861 adults residing in 118 streets in the city center of Belgrade. The presence, the type and the number of public transport vehicles were assessed using official transport maps and matched with residential addresses. Noise annoyance was assessed by a questionnaire including a self-report five-graded scale. 'High noise annoyance' was defined by merging 'very' and 'extremely' annoyed answers. RESULTS: Significant predictors of high noise annoyance were the presence of public transport at daytime (yes vs. no) (odds ratio=1.47, 95% confidence interval=1.28-1.70), and at night (yes vs. no) (OR=1.39, 95% CI=1.20-1.61). Residing in the streets with more than 79 public transport vehicles per hour (3rd tercile vs. 1st tercile) predicted high noise annoyance at daytime (OR=1.64, 95% CI=1.18-2.27). Residing in the streets with buses and trams at night ('bus and tram' vs. no public transport) increased the risk of high noise annoyance (OR=2.67, 95% CI=1.78-4.09). These associations were independent from noise sensitivity, orientation of bedroom windows, floor level, and equivalent noise levels. Living in the apartment with bedroom windows facing the street was the strongest confounder for the association between noise annoyance, noise levels and public transport. CONCLUSION: The study has identified the presence of public transport at daytime and at night as a significant and independent predictor of high noise annoyance. Future intervention measures should concern the presence, the type and the number of public transport vehicles in order to reduce noise annoyance reactions in urban areas.

Thoracic bioelectrical impedance assessment of the hemodynamic reactions to recorded road-traffic noise in young adults.

Noise exposure increases blood pressure in both experimental and field studies. The underlying mechanisms may be evaluated by thoracic bioelectrical impedance. The aim of this experimental study was to assess changes in blood pressure, cardiac and hemodynamic parameters provoked by recorded traffic noise in young adults. The study included 130 participants (42 men and 88 women), aged 24.88±2.67 years. Thoracic electrical bioimpedance device was applied to monitor cardiac parameters, hemodynamic parameters, heart rate variability, blood pressure and heart rate. The testing procedure consisted of three phases. Participants were exposed to recorded road-traffic noise (Leq=89dBA) for 10min and relaxed in quiet conditions (Leq=40dBA) before and after noise exposure. Listening to recorded noise resulted in significant decrease of stroke volume and cardiac output, and an increase of vascular resistance. Heart rate variability and the overall sympathovagal balance remained similar through all experimental conditions. During noise exposure, systolic pressure increased by 2mmHg among women (95% confidence interval=0.97-2.73mmHg), and by 4mmHg among men (95% confidence interval=2.16-5.00mmHg). Similarly, diastolic pressure increased by 2mmHg among women (95% confidence interval=0.95-2.47mmHg), and by 4mmHg among men (95% confidence interval=2.46-5.28mmHg). Once noise ceased, both pressures returned to pre-exposure levels. Experimental exposure to recorded road-traffic noise of 89dBA for 10min provoked significant hemodynamic changes in young adults, including vasoconstriction (increase of vascular resistance), and hypodynamics (decrease of global heart flow). The interaction of these effects resulted in the elevation of blood pressure during noise exposure.

Prevalence of arterial hypertension in Serbia: PAHIS study.

BACKGROUND: Arterial hypertension (AH) is the most common cardiovascular disease risk factor, affecting between 30 and 50% of the adult population in developed countries. A steady increase of the prevalence of AH by about 60% is expected by year 2025. METHODS: Serbian Society of Hypertension conducted a prevalence study from February to May 2012 on a sample of 3878 adult respondents. The study included 2066 women (53.3%) and 1812 men (46.7%). Average age was 48.89 ±â€Š17.48 years. Most participants resided in urban areas (2956 people, 76.2%), whereas 922 resided in rural areas (23.8%). RESULTS: The prevalence of AH in Serbia is 42.7%. Hypertension is more frequently diagnosed among women (53.3%), than among men (46.7%). One thousand, four hundred and twelve respondents were previously diagnosed and treated for hypertension. The estimated awareness of the presence of AH was 42.99% (i.e. 40.00% among male and 45.41% among female participants). Out of all diagnosed cases of hypertension, 390 persons (27.7%) have well regulated blood pressure values, whereas 1022 persons (72.3%) do not have their blood pressure under control. CONCLUSION: Serbia belongs to countries with a high prevalence of AH. A poor control of AH may be explained in view of socioeconomic problems. High prevalence of AH may indicate a remarkably high cardiovascular disease mortality in Serbia.

Blood pressure of urban school children in relation to road-traffic noise, traffic density and presence of public transport.

The aim of the study was to investigate the relationship between noise levels, traffic density and the presence of public transport and children's blood pressure. Another aim was to assess the applicability of public transport as a proxy indicator of noise exposure. A cross-sectional study involved 1113 children aged 7-11 years from a central municipality in Belgrade. Equivalent noise levels were measured in front of all schools and in the middle of all streets. Traffic density was defined as number of light and heavy vehicles per hour. The number of public transport vehicles was calculated from official timetables. Children's addresses were matched with noise levels and transport maps. A physician measured blood pressure with the sphygmomanometer. Children attending schools with public transport running nearby had by 1.3 mmHg higher systolic pressure than did children from schools without public transport. This relationship was independent from children's age, gender, and body mass index, family history of hypertension, some dwelling characteristics, and lifestyle habits. The association between diastolic pressure and public transport was statistically insignificant. The study indicated a possible positive association between the presence of public transport in the vicinity of schools with systolic blood pressure in 7-11 year-old schoolchildren. The presence of public transport may serve as an auxiliary indicator of noise exposure in undeveloped countries with limited capacities for noise measurement or modeling.

Noise and children's health: research in Central, Eastern and South-Eastern Europe and Newly Independent States.

Many reviews have documented the adverse effects of noise on children's health, but the international scientific community was previously unfamiliar with noise research in Central and Eastern Europe (CEE), South-East Europe (SEE), and Newly Independent States (NIS). The aim of this review was to present studies on the effects of noise on children's health, conducted in aforementioned countries in the second half of the 20 th century, interpret their findings, and criticize their methodology and results wherever possible. This review focused on 30 papers published in national journals in the period from 1965 to 2000. By design, 22 studies were observational and cross-sectional, and eight studies were experimental. The outcomes under the study included auditory changes, stress reactions, sleep disturbances, school performance, upright posture, and vegetative functions. Researchers from CEE, SEE, and NIS were the pioneers in the assessment of noise-induced changes of vegetative functions and blood pressure of children in urban areas, as well as of infants exposed to noise in incubators. Future research should focus on intervention studies and follow-up of children's health in relation to noise exposure.