The Environmental Noise Directive (END) is for local authorities the most important instrument to determine the levels of noise pollution. Also, the Directive is aimed at the evaluation of effect of measures and can make the effects of alternative measures visible. The Directive stimulates the Member States to take action to reduce the adverse effects of environmental noise . Annex III of the Directive is currently under revision and will include a method to calculate the effects of different noise sources, such as road- and rail traffic, according to the latest scientific evidence. In preparation of this update, RIVM in collaboration with international partners has prepared a guidance document. Not only annoyance and sleep disturbance are addressed as health effects, but also cardiovascular effects and cognitive impact in children (comprehensive reading impairment). The document is worded in such a way that it is easily used by local authorities. The guidance document was prepared on request of the EU commission. The document describes the steps of a health impact assessment one by one and explains the accompanying decisions and conditions. Next, the actual calculation methods are further explained for two indicators: the number of healthy life years adjusted for disease, disability and death (DALY) and the number of people that experiences adverse effects of noise ((NafP). Finally, as an example, the health impact of noise in Düsseldorf is described.