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The effects of sound on man are reviewed with emphasis on the physiological reaction mechanisms and the ultimate stress reaction. It is seen that energy related noise levels are poor predictors for the reactions in man as noise is always interpreted in the central nervous system, generating secondary and tertiary reactions that are not controlled by the brain cortex. The stimulation of these reaction pathways in acute situations lead to involuntary reflexes and feelings of fright and despair. In chronic exposure situations a give-up stage may develop with reduced corporal and mental functions. In the acoustical panorama peak level noises usually cause the most pronounced effects as they stimulate reactions of fear and flight. The practical consequences of these reaction patterns in terms of prevention are discussed.

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