CARDIOMETABOLIC RISK AMONG MONTENEGRIN URBAN CHILDREN IN RELATION TO OBESITY AND GENDER.

Considering previously reported discrepant results in the literature, we aimed to investigate the impact of gender and overweight/obesity on cardiometabolic risk (CMR) among Montenegrin urban children. The cross-sectional study included random sample of 201 schoolchildren aged 7-12 years (64% of boys) from Podgorica. Children's nutritional status was determined according to the International Obesity Task Force criteria. CMR was assessed using a sum of z values of the following five indicators: glucose, total cholesterol, inverted value of high-density lipoprotein cholesterol, triglycerides, and hypertension. Higher CMR was found among both overweight and obese boys compared to normal weight boys (p<0.001). The effect size of the difference in CMR between overweight and obese girls and normal weight counterparts was less prominent (p<0.05). Logistic regression analysis revealed that body mass index was independent predictor of high CMR [odds ratio (OR)=1.06; 95% confidence interval (CI)=1.02-1.10); p=0.002]. On the contrary, we found no impact of socioeconomic status, physical activity or sedentary time on CMR in the examined cohort of schoolchildren. In conclusion, both overweight and obesity even among young population are related to higher CMR and this effect is more prominent among boys as compared to girls.

Analysis of Escherichia Coli O104:H4 Outbreak in Germany in 2011 Using Differentiation Method for Unusual Epidemiological Events.

AIM: The aim of the study was to further clarify the origin of Escherichia coli O104:H4 outbreak in Germany in 2011 (German Ec) as the likelihood of a deliberate act has not been excluded in previous analyses. METHODS: We use an original and the most detailed scoring method so far, with 33 parameters pertaining to the source of infection/reservoir or possible perpetrator, pathogen or biological agent, transmission mechanism/factors or means/media of delivery, and population at risk or target. RESULTS: Total scores for a deliberate or accidental epidemic indicate that the outbreak was more probably caused unintentionally, presumably due to technical accidents or hygienic shortcomings in the food chain. CONCLUSIONS: The validity of the present assessment is limited by the lack of data on the reservoir of the pathogen, the source of infection, and the mode of food contamination. Conclusive evidences on these parameters are essential for the final clarification of the outbreak origin.

Escherichia coli O104:H4 outbreak in Germany--clarification of the origin of the epidemic.

BACKGROUND: In 2011, Germany was hit by one of its largest outbreaks of acute gastroenteritis and haemolytic uraemic syndrome caused by a new emerging enterohaemorrhagic Escherichia coli O104:H4 strain. The German Haemolytic Uraemic Syndrome/Enterohaemorrhagic E. coli (GHUSEC) outbreak had unusual microbiological, infectiological and epidemiological features and its origin is still only partially solved. The aim of this article is to contribute to the clarification of the origin of the epidemic. METHODS: To retrospectively assess whether the GHUSEC outbreak was natural, accidental or a deliberate one, we analysed it according to three published scoring and differentiation models. Data for application of these models were obtained by literature review in the database Medline for the period 2011-13. RESULTS: The analysis of the unusual GHUSEC outbreak shows that the present official assumption of its natural origin is questionable and pointed out to a probability that the pathogen could have also been introduced accidentally or intentionally in the food chain. CONCLUSION: The possibility of an accidental or deliberate epidemic should not be discarded. Further epidemiological, microbiological and forensic analyses are needed to clarify the GHUSEC outbreak.

Prevalence of and contributing factors for overweight and obesity among Montenegrin schoolchildren.

BACKGROUND: Newly emerging Western style economic systems provide new opportunities to study the prevalence and predictors of childhood obesity. We also provide for the first time a national study of childhood obesity using all three international anthropometric criteria. METHODS: The sample included 4097 Montenegrin children, 2076 boys (50.7%) and 2021 girls. Anthropometric measurements were performed in school. The questionnaire for parents included questions on 24 potential contributing factors for childhood obesity. Nutritional status was assessed according to World Health Organization, US Center for Disease Prevention and Control and International Obesity Task Force (IOTF) criteria. RESULTS: Overall percentage of Montenegrin children who are overweight or obese (IOTF) is 22.9% of which 5.3% are obese (7.0% boys vs. 3.5% girls). We found 10 factors to be independently associated with child obesity. Positive relations [odds ratio (95% confidence interval)] were found with maternal obesity [2.05 (1.68-2.51)], paternal obesity [1.67 (1.32-2.10)], paternal employment [1.40 (1.12-1.74)], maternal smoking [1.32 (1.08-1.61)], obesity at birth [1.33 (1.04-1.70)] and computer game playing [per hour--1.11 (1.00-1.24)]. Negative relations were found with female gender [0.64 (0.53-0.78)], the number of siblings [0.88 (0.78-0.98)], birth order [0.73 (0.64-0.83)] and age [0.92 (0.88-0.98)]. CONCLUSION: One out of four Montenegrin children is overweight, with two times more frequent obesity among boys compared with girls. Some previously salient predictors did not appear salient in this sample. To enable worldwide comparability, we propose the use of all three childhood obesity criteria in national studies.

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.

Blood pressure among rural Montenegrin children in relation to poverty and gender.

BACKGROUND: Health inequalities may begin during childhood. The aim of this study was to investigate the main effect of poverty and its interactive effect with gender on children's blood pressure. METHODS: The study was performed in two elementary schools from a rural region near Podgorica, the capital of Montenegro. A questionnaire including questions on family monthly income, children's physical activity and the consumption of junk food was self-administered by parents of 434 children (223 boys and 211 girls) aged 6-13 years. Children's poverty level was assessed using the recommendations from the National Study on Poverty in Montenegro. Children's body weight and height were measured and body mass index-for-gender-and-age percentile was calculated. An oscillometric monitor was used for measurement of children's resting blood pressure in school. RESULTS: A two-factorial analysis of variance with body mass index percentile, physical activity and junk food as covariates showed an interaction of gender and poverty on children's blood pressure, pointing to synergy between poverty and female gender, with statistical significance for raised diastolic pressure (F = 5.462; P = 0.021). Neither physical activity nor the consumption of junk food explained the interactive effect of poverty and gender on blood pressure. CONCLUSION: We show that poverty is linked to elevated blood pressure for girls but not boys, and this effect is statistically significant for diastolic pressure. The results are discussed in the light of gender differences in stress and coping that are endemic to poverty.

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.

Tinnitus among Serbian secondary school students in relation to their behavior and habits.

Although tinnitus is a very common symptom, risk factors related to behavior and habits have not been sufficiently investigated. As no investigation on this problem has been performed in Serbia, the aim of our study was to establish the prevalence of tinnitus among Serbian adolescents and to investigate the relationship between their behavior and habits and tinnitus. This investigation was designed as a cross-sectional interview study among secondary school students in Belgrade, Serbia (277 boys and 494 girls). An anonymous questionnaire was self-administered at classes. The investigated variables were: The presence of tinnitus, sources of noise, night outs at noisy places, use of personal music players, smoking, second hand smoke (SHS), substance abuse, coffee and alcohol consumption. Spearman's rank-order correlations and multiple logistic regressions were performed with variables related to behavior and habits as independent ones and tinnitus as a dichotomized dependent variable. Tinnitus was reported by 99 students (12.8%), more frequently among girls compared with boys (P = 0.009). Multivariate logistic regression analysis in boys revealed a significant independent effect of a regular drug abuse on the onset of tinnitus. The chances of tinnitus were 13 times higher among drug addicts compared with non-drug users (odds ratio [OR] and 95% confidence interval [CI] for tinnitus = 13.072; 1.335-127.946). In girls, the significant independent effect on tinnitus was found for daily duration of exposure to SHS (OR and 95% CI for tinnitus = 1.328; 1.073-1.644 /per 2 hours of exposure/).

Noise and performance: research in Central, Eastern and South-Eastern Europe and Newly Independent States.

Researches on noise and performance in central and Eastern Europe and South-East Europe countries and Newly Independent States have been performed in last 40 years in Bulgaria, Czechoslovakia, Former Yugoslav Republic of Macedonia, Hungary, Lithuania, Poland, Romania, Union of Soviet Socialistic Republics, Russia, Serbia and Yugoslavia, mainly at universities in the capitals. In laboratory studies the effects of noise have been studied on vigilance, visual performance, attention, information perception and processing, reaction time, short term memory and spatial reasoning. The field studies focused on the relation between chronic exposure to community noise and children's behavior and executive functioning (EF) and between industrial noise and occupational injuries. These studies were mainly complementary to the studies in Western Europe.

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.

Traffic noise and blood pressure in low-socioeconomic status, African-American urban schoolchildren.

The primary aim of this field study was to investigate the relationships among residential noise exposure at home and at school and blood pressure in low-socioeconomic status African-American children. Children were recruited from Boys and Girls Clubs in a mid-sized, Northeastern city. The sample consisted of 250 schoolchildren (128 boys and 122 girls) aged 6-14 years. Each child was interviewed prior to anthropometric and blood pressure measurement. An oscillometric monitor was used for measurement of resting blood pressure. Correlation analysis in the overall sample showed no significant relationship between noise exposure and children's blood pressure. No interactions were found between noise at home and at schools as well as orientation of bedroom and/or living room and noise at home with blood pressure. A sub-sample of children was also examined by adding the orientation of bedroom and living room as inclusion criteria (n = 128), and there was an interaction between noise exposure and age on systolic blood pressure. In younger children aged 6-10 years, a significant positive relation was found between noise levels at homes and systolic blood pressure, controlling for body mass index (B = 0.48, 95% C.I. = 0.07 -0.88, p = 0.02).

Cardiovascular effects of environmental noise: research in Serbia.

Research on the cardiovascular effects of noise in Serbia started in the year 2002, including experimental studies on humans and epidemiological studies on the adult and children population of Belgrade and Pancevo. Experimental exposure to noise [L eq = 89 dB (A)] had a hypodynamic effect, significantly lowering the cardiac index, cardiac work, and pump performance (P < 0.01). The vasoconstrictive effect of noise was shown through the significant elevation of after-load (P < 0.01). In a cross-sectional population study that was carried out on 2874 residents [1243 males and 1631 females] in Pancevo City, a significant odds ratio (adjusted for age, body mass index (BMI), and smoking habits) was found for self-reported hypertension (OR = 1.8, 95% CI = 1.0 - 2.4, P < 0.01) in men with a high level of noise annoyance compared to those with a low level of noise annoyance. In another study on 2503 residents (995 men and 1508 women) residents of Belgrade, the proportions of men with hypertension in the noisy [(L night , 8h > 45 dB (A)] and quiet areas [(L night , 8h ≤ 45 dB (A)] were 23.6% and 17.5%, respectively. The adjusted odds ratio (OR) for hypertension of the exposed group was 1.58 (95% CI = 1.03 - 2.42, P = 0.038), where men living in quiet streets were taken as a reference category. Associations between road traffic noise and blood pressure were also investigated in 328 preschool children in Belgrade. The systolic blood pressure was significantly higher among children from noisy residences and kindergartens, compared to children from both quiet environments (97.30 ± 8.15 and 92.33 ± 8.64 mmHg, respectively, P < 0.01). As a continuation of the study on preschool children, investigations were also carried out on 856 school children, aged between seven and eleven years, in Belgrade. It was found that systolic pressure was significantly higher among children from noisy schools and quiet residences, compared to children from both quiet environments (102.1 ± 9,3 and 100.4 ± 10.4 mmHg, respectively, P < 0.01).

Relationship of dietary magnesium intake and serum magnesium with hypertension: a review.

The relationship between magnesium and hypertension has been intensively investigated in the last few decades. Most of the so far reviews were focused on either dietary magnesium or serum magnesium or magnesium supplements. Our goal was to merge these findings with a more comprehensive approach. Internet search was performed in PubMed database without date limits, using the following search terms "dietary magnesium," "serum magnesium," "magnesium supplements," "hypertension," "drinking water," "food," "endothelial dysfunction," "arterial smooth muscle," and "arterial spasms." In general, there exists an inverse dose-dependent relationship between dietary magnesium intake and serum magnesium and the risk of hypertension. A negative correlation has been found between the serum magnesium concentration and Framingham risk score and intima-media carotid thickness and cardiovascular mortality. On the other hand, concentration of extracellular magnesium in the normal range acts as a natural calcium channel blocker, eliminates endothelial dysfunction, increases nitric oxide, and induces direct and indirect vasodilatation. In conclusion, an average magnesium dietary intake is below the recommended values and magnesium supplementation in the prevention and treatment of hypertension might be justified.

Dietary Factors and Tinnitus among Adolescents.

The number of people suffering from constant tinnitus is ever-increasing and has spread to all age groups, including adolescents. The etiology of tinnitus is multifactorial, but dietary factors have been rarely investigated. The purpose of this study is to examine the relationship between dietary factors and constant tinnitus among adolescents from an urban environment. A population-oriented cross-sectional study was carried out during the 2019/2020 school year in 12 Belgrade secondary schools. There were 1287 school children aged from 15 to 19 years who participated in the study. There were 1003 respondents who completed a questionnaire on tinnitus (response rate 77.9%; 31% male). We used the standardized Tinnitus Screener questionnaire and a food frequency questionnaire specially designed for this study and adapted to Serbian adolescents. A logistic regression analysis revealed a strong negative correlation between fresh vegetables and fruits and tinnitus presence. On the other hand, the risk of constant tinnitus increased with the increased intake of white bread, carbonated beverages, and fast food. In conclusion, we show that fresh fruit and vegetable intakes may be negatively related to tinnitus frequency, while sweetened sodas, fast food, and white bread may raise the odds for tinnitus.

Predictors of burnout among Belgrade veterinary students: A cross-sectional study.

BACKGROUND: To the best of our knowledge, studies are lacking on burnout among veterinary students in Serbia, and this is the first study trying to address such a problem. Therefore, the aim of this cross-sectional study was to investigate the predictors of burnout among Belgrade veterinary students. METHODS: Maslach Burnout Inventory (MBI) and anonymous structured questionnaire addressed to personal data, health habits and stressful influence of educational process were applied among 496 respondents from a total of 1113 students from all grades in spring semester 2014 (response rate 44.6%). RESULTS: The prevalence of burnout was 43.3%. High scores on depersonalization and emotional exhaustion scales of MBI were found among 79.4% and 45.0% students, respectively; low personal accomplishment was reported by 50.5% students. Female students reported higher levels of emotional exhaustion compared to males (p = 0.012). A low score on personal achievement scale of MBI was least frequent among the freshmen and most frequent among sophomores (41.1% and 65.3%, respectively; p = 0.986). There were more students with burnout who considered their health as a worsened vs. pre-study period compared to students with no burnout, both concerning mental (61.4% vs. 38.6%) and physical health (61.1% vs. 38.9%; both p<0.001). There were more smokers among students who suffered from burnout compared to students who did not (52.0% vs. 48.0%; p = 0.013). A multiple regression revealed an independent dose-response effect of perceived stress at exams on the onset of burnout (moderate stress OR = 2.164 and high stress OR = 3.878). Also, students with the moderate and high stressful effect of communication with teaching staff, as well as, those with worse self-perceived physical and mental health had more than two times higher presence of burnout. CONCLUSIONS: The prevalence of burnout among Belgrade veterinary students is relatively high. Primary prevention should be focused on the revealed predictors of burnout.

Maternal education, health profession and cigarette smoking are decisive factors for self-medication in children by parents.

Self-medication of children by their parents (SMCP) is an important public health issue as the effects and potential risks may be unpredictable. The objective of this first national Montenegrin study was to assess the prevalence of and factors influencing SMCP among schoolchildren. Data were obtained from a national representative sample of 4496 schoolchildren aged 7-13 years (50.4 % boys). Parents/caregivers completed a questionnaire concerning their demographic characteristics, socio-economic and cultural status, as well as the self-medication (SM) of their children. The association between SMCP and parents' socio-economic, demographic or cultural status was assessed by logistic regression analyses. The prevalence rate of SMCP was 24.6 %. Univariate logistic regression showed that maternal socio-demographic characteristics (educational level, employment status, health care profession and smoking habits) were relevant for SMCP. In a multiple logistic regression the independent effect /adjusted odds ratio (AOR) (95 % CI)/of maternal factors on SMCP remained for: education /2.23 (1.18-4.24)/, university-level vs. no education; profession /1.50 (1.07-3.00)/, health profession vs. non-health profession; and smoking habit /1.22 (1.04-1.42)/smokers vs. non-smokers. SMCP may be expected for every fourth child in Montenegro. Specific maternal factors that independently raise the probability of SMCP are higher education, health profession and smoking.

Predictors of noise annoyance in noisy and quiet urban streets.

OBJECTIVES: Although noise annoyance is a major public health problem in urban areas, there is a lack of published data on predictors for noise annoyance in acoustically different urban environments. The aim of the study was to assess the predictive value of various factors on noise annoyance in noisy and quiet urban streets. METHODS: Equivalent noise levels [Leq (dBA)] were measured during day, evening and night times in all of the streets of a central Belgrade municipality. Based on 24-hour noise levels, the streets were denoted as noisy (24-hour Leq over 65 dBA), or quiet (24-hour Leq under 55 dBA). A cross-sectional study was performed on 1954 adult residents (768 men and 1186 women), aged 18-80 years. Noise annoyance was estimated using a self-report five-graded scale. In both areas, two multivariate logistic regression models were fitted: the first one with nighttime noise indicators and the other one with parameters for 24-hour noise exposure. RESULTS: In noisy streets, the relevant predictors of high annoyance were: the orientation of living room/bedroom toward the street, noise annoyance at workplace, and noise sensitivity. Significant acoustical factors for high noise annoyance were: nighttime noise level [OR=1.02, 95%CI=1.00-1.04 (per decibel)], nighttime heavy traffic [OR=1.01, 95%CI=1.00-1.02 (per vehicle)]; or day-evening-night noise level (Lden) [OR=1.03, 95%CI=1.00-1.07 (per decibel)]. In quiet streets, the significant predictors were: noise sensitivity, the time spent at home daily, light vehicles at nighttime or heavy vehicles at daytime. CONCLUSIONS: Our study identified subjective noise sensitivity as a common annoyance predictor, regardless of noise exposure. Noise levels were important indicators of annoyance only in noisy streets, both for nighttime and 24-hour exposure. We propose that noise sensitivity is the most relevant personal trait for future studies and that nighttime noise levels might be as good as Lden in predicting annoyance in noisy urban areas.

Nighttime road-traffic noise and arterial hypertension in an urban population.

Commonly used daytime measurements in previous investigations on community noise and arterial hypertension (AH) may be a source of exposure bias, as urban residents spend most of their daytime hours out of the home on workdays. For this reason, we focused on the relation of nighttime noise and AH. A cross-sectional study was performed on a sample of 2,503 (995 men and 1,508 women) adult residents of a downtown Belgrade municipality. The inclusion criteria were a period of residence longer than 10 years and a bedroom oriented toward the street. The exclusion criteria were a high level of noise annoyance at work and diseases related to AH. Noise measurements were performed in all 70 streets of the municipality. The streets were grouped into noisy areas (equivalent noise level [Leq]>45 dB(A)) and quiet areas (Leq< or =45 dB(A)). The residents were interviewed in regard to antihypertensive therapy. Subjects who responded that they had not received such therapy were contacted for blood pressure measurements with mercury sphygmomanometer. Possible confounding factors: family history of AH, age, body mass index, smoking habits, physical activity and alcohol consumption were controlled for. The proportions of men with AH in the noisy and quiet areas were 23.6% and 17.5%, respectively. The adjusted odds ratio (OR) for AH was 1.58; the 95% confidence interval (CI) ranged from 1.03-2.42; and the probability value was 0.038, when men living in quiet streets were taken as a reference category. This relation was statistically insignificant for women: adjusted OR: 0.90; 95% CI: 0.59-1.38; p: 0.644. This cross-sectional study showed that nighttime urban road-traffic noise might be related to occurrence of AH in men.

Urban road-traffic noise and blood pressure and heart rate in preschool children.

Night time noise exposure has very rarely been used in previous studies on the relationship between community noise and children's blood pressure, although children spend a larger part of their night time sleeping at home than adults. For this reason, we focused on night time noise exposure at children's residences and daytime noise at kindergartens. The aim of this study was to investigate the effects of urban road-traffic noise on children's blood pressure and heart rate. A cross-sectional study was performed on 328 preschool children (174 boys and 154 girls) aged 3-7 years, who attended 10 public kindergartens in Belgrade. Equivalent noise levels (Leq) were measured during night in front of children's residences and during day in front of kindergartens. A residence was regarded noisy if Leq exceeded 45 dB (A) during night and quiet if the Leq was < or =45 dB (A). Noisy and quiet kindergartens were those with daily Leq>60 dB (A) and < or =60 dB (A), respectively. Children's blood pressure was measured with mercury sphygmomanometer. Heart rate was counted by radial artery palpitation for 1 min. The prevalence of children with hypertensive values of blood pressure was 3.96% (13 children, including 8 boys and 5 girls) with higher prevalence in children from noisy residences (5.70%), compared to children from quiet residences (1.48%). The difference was borderline significant (p=0.054). Systolic pressure was significantly higher (5 mm Hg on average) among children from noisy residences and kindergartens, compared to children from both quiet environments (p<0.01). Heart rate was significantly higher (2 beats/min on average) in children from noisy residences, compared to children from quiet residences (p<0.05). Multiple regression, after allowing for possible confounders, showed a significant correlation between noise exposure and children's systolic pressure (B=1.056; p=0.009).