We measured noise from around 20 inches from the chassis. For load, we set Crysis to maximum settings and recorded dB through a replayed run.
We recorded 63dBa with the GTX 480 making it the loudest single GPU card on test today and even managing to emit more noise than the last generation dual GPU HD4870 X2. How is it real world? Well if you have sensitive ears, it will not be the most ideal card for your next purchase, not until we see third party coolers emerging anyway.