Evidence has accumulated regarding health effects of environmental noise. The WHO European Centre for Environment and Health, Bonn, has organized several meetings of experts over recent years to examine the current state of knowledge, and to further develop approaches for quantifying the effect of noise on health. The outcomes of these meetings are now nearing finalization as a document providing initial guidance on risk assessment of environmental noise-quantitative risk assessments based on Environmental Burden of Disease (EBD) methodology and the metric Disability-Adjusted Life Years (DALY). The target audience for the document is primarily policy makers and their technical advisers who need to evaluate the issue of environmental noise in their jurisdictions. This document provides synthesized reviews of health effects of environmental noise (cardiovascular disease, cognitive impairment, sleep disturbance, annoyance, hearing impairment and tinnitus), and exemplary estimates, where possible, of the burden of the health outcomes of environmental noise based on exposure-response relationships, exposure prevalence, and disability weights. This paper describes the process by which the guidance has been prepared, and the structure of each chapter that deals with a particular health outcome: a summary of evidence linking noise with the outcome; sources and assumptions regarding the exposure-response relationship; suggested disability weights; example DALY calculations; and current uncertainties, limitations and challenges regarding risk assessment of that outcome.