Nonauditory Effects of Infrasound and Low-Frequency Noise in Humans: A Systematic Literature Review

Objective: This systematic review aimed to assess the quality of evidence across studies on the nonauditory effects of infrasound (IS) and low-frequency noise (LFN) in adults, investigating physiological and psychological outcomes associated with such exposures. Materials and methods: Studies were searched in eight databases from their earliest records up to March 2026. Outcomes assessed included annoyance and noise sensitivity, sleep disturbances, cardiovascular diseases, cognitive and mental health impairments, and other health-related disturbances. The quality of evidence for each outcome was assessed using an adapted Grading of Recommendations Assessment, Development and Evaluation approach. Results: The review included 39 papers, predominantly cross-sectional designs (laboratory-based and real-life), with fewer cohort studies and only three randomized controlled trials. Exposure scenarios varied widely, encompassing wind turbine noise, traffic and community noise, occupational noise, and experimentally generated IS and/or LFN stimuli. The certainty of evidence ranged from moderate for annoyance/sensitivity to very low for sleep disturbance, cardiovascular outcomes, cognitive performance, mental health, and general health disturbances. These ratings were influenced by the predominance of cross-sectional studies, high overall risk of bias, methodological heterogeneity, inconsistent findings, and indirectness across outcomes. Conclusion: The findings showed that annoyance and sensitivity were the only outcomes associated with exposure to IS/LFN, supported by moderate-quality evidence, suggesting that these subjective responses should be included in health impact assessments. For all other outcomes, the certainty of the evidence remains very low, highlighting the urgent need for well-designed longitudinal and experimental studies.