Auditory and non-auditory effects of noise on health

Noise is pervasive in everyday life and can cause both auditory and non-auditory health eff ects. Noise-induced hearing loss remains highly prevalent in occupational settings, and is increasingly caused by social noise exposure (eg, through personal music players). Our understanding of molecular mechanisms involved in noise-induced haircell and nerve damage has substantially increased, and preventive and therapeutic drugs will probably become available within 10 years. Evidence of the non-auditory eff ects of environmental noise exposure on public health is growing. Observational and experimental studies have shown that noise exposure leads to annoyance, disturbs sleep and causes daytime sleepiness, aff ects patient outcomes and staff performance in hospitals, increases the occurrence of hypertension and cardiovascular disease, and impairs cognitive performance in schoolchildren. In this Review, we stress the importance of adequate noise prevention and mitigation strategies for public health.

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Auditory and non-auditory eff ects of noise on health

Alarm fatigue is a national problem and the number one medical device technology hazard in 2012. The problem of alarm desensitization is multifaceted and related to a high false alarm rate, poor positive predictive value, lack of alarm standardization, and the number of alarming medical devices in hospitals today. This integrative review synthesizes research and non-research findings published between 1/1/2000 and 10/1/2011 using The Johns Hopkins Nursing Evidence-Based Practice model. Seventy-two articles were included. Research evidence was organized into five main themes: excessive alarms and effects on staff; nurse's response to alarms; alarm sounds and audibility; technology to reduce false alarms; and alarm notification systems. Non-research evidence was divided into two main themes: strategies to reduce alarm desensitization, and alarm priority and notification systems. Evidence-based practice recommendations and gaps in research are summarized.

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Monitor alarm fatigue: an integrative review.

There is increasing concern about the effects of pile driving and other anthropogenic (human-generated) sound on fishes. Although there is a growing body of reports examining this issue, little of the work is found in the peer-reviewed literature. This review critically examines both the peer-reviewed and 'grey' literature, with the goal of determining what is known and not known about effects on fish. A companion piece provides an analysis of the available data and applies it to estimate noise exposure criteria for pile driving and other impulsive sounds. The critical literature review concludes that very little is known about effects of pile driving and other anthropogenic sounds on fishes, and that it is not yet possible to extrapolate from one experiment to other signal parameters of the same sound, to other types of sounds, to other effects, or to other species.

The effects of anthropogenic sources of sound on fishes.

Introduction Human Factors and Ergonomics in Health Care and Patient Safety Human Factors and Patient Safety: Continuing Challenges Macroergonomics and Systems A Historical Perspective and Overview of Macroergonomics Work System Design in Health Care Sociotechnical System Design in Health Care Clinical Microsystems in Health Care: The Role of Human Factors in Shaping the Microsystem The Artichoke Systems Approach for Identifying the Why of Error Organizational Learning in Health Care The Relationship Between Physician Professionalism and Health Care Systems Change Collaborative Initiatives for Patient Safety Job and Organizational Design Job Stress in Health Care Workers Effect of Workplace Stress on Patient Outcomes Safety Culture in Health Care Burnout in Health Care Human Factors of Transition of Care Reliability Enhancement and Demise at Back Bay Medical Center's Children's Hospital The Relation Between Teamwork and Patient Safety Physical Ergonomics Human Factors in Hospital Safety Design Physical Environment in Health Care Physical Ergonomics in Health Care Evidence-Based Interventions for Patient Care Ergonomics Ergonomics: Noise and Alarms in Health Care An Ergonomic Dilemma Technology Human Factors Engineering and the Design of Medical Devices Patient Safety and Technology: A Two-Edged Sword New Technology Implementation in Health Care Robotics in Health Care: HF Issues in Surgery Human Computer Interaction in Health Care Re-Presenting Reality: The Human Factors of Health Care Information Human Error Behind Human Error: Taming Complexity to Improve Patient Safety Human Error Reduction Strategies in Health Care Medical Failure Taxonomies Human Factors of Health Care Reporting Systems Communicating About Unexpected Outcomes and Errors Human Factors and Ergonomics Methodologies Cognitive Work Analysis in Health Care Human Factors Risk Management in Medical Products Work Systems and Process Analysis in Health Care Video Analysis in Health Care Usability Evaluation in Health Care Assessing Safety Culture and Climate in Health Care Incident Analysis in Health Care Human Factors and Ergonomics Interventions Ergonomics Programs and Effective Interventions Quality Improvement in Health Care Work Organization Interventions in Health Care Teamwork Training for Patient Safety: Best Practices and Guiding Principles Tilting the Culture in Health Care: Using Cultural Strengths to Transform Organizations Specific Applications Human Factors and Ergonomics in Intensive Care A Process-Oriented Approach Human Factors and Ergonomics in the Emergency Department Human Factors and Ergonomics in Pediatrics Human Factors and Ergonomics in Home Care Human Factors and Ergonomics in Nursing Home Care Human Factors and Ergonomics in Primary Care

Handbook of Human Factors and Ergonomics in Health Care and Patient Safety (Human Factors and Ergonomics Series) (Human Factors and Ergonomics Series)

The hospital sound environment is complex. Alarms, medical equipment, activities, and ventilation generate noise that may present occupational problems as well as hinder recovery among patients. In this study, soundmeasurements and occupant evaluations were conducted in a neurological intensive care unit. Staff completed questionnaires regarding psychological and physiological reactions to the sound environment. A-weighted equivalent, minimum, and maximum ( L Aeq , L AFMin , L AFMax ) and C-weighted peak ( L CPeak ) sound pressure levels were measured over five days at patient and staff locations. Acoustical descriptors that may be explored further were investigated, including level distributions, restorative periods, and spectral content. Measurements near the patients showed average L Aeq values of 53 – 58 dB . The mean length of restorative periods ( L Aeq below 50 dB for more than 5 min ) was 9 and 13 min for day and night, respectively. Ninety percent of the time, the L AFMax levels exceeded 50 dB and L CPeak exceeded 70 dB . Dosimeters worn by the staff revealed higher noise levels. Personnel perceived the noise as contributing to stress symptoms. Compared to the majority of previous studies, this study provides a more thorough description of intensive care noise and aids in understanding how the sound environment may be disruptive to occupants.

Characterizing noise and perceived work environment in a neurological intensive care unit.

The sound environment in an ICU patient room--a content analysis of sound levels and patient experiences.

Objective:�Toreviewtheepidemiologyofnoisepollu- tioninhospitalsanditseffectsonpatients. •� Methods:�Reviewoftheliterature. •� Results:� Usingacademicsearchenginessuchas� PubMed,� JSTOR,� andJASA,� aswellascommon� internetsearchengines,� 36� paperswereselected� thatfocusonnoiseasitrelatestopatientsleepdistur- bances,�cardiovascularresponse,�lengthofhospital� stay,�painmanagement,�woundhealing,�andphysio- logicalreactions.�Resultsgenerallyshowthepotential� fornegativephysiologicaleffectwhenpatientsareex- posedtonoise;�however,�conflictingstudiesarealso� reported.�Thisreviewattemptstodefinetheresearch� chaininthecollectedarticlesbydeterminingwhich� acousticcharacteristicswereexamined,�whattypeof� acousticintervention�(ifany)�wasused,�andwhatthe� patientoutcomeswere.��

Noise pollution in hospitals: Impact on patients

Intensive care units (ICUs) have important but challenging sound environments. Alarms and equipment generate high levels of noise and ICUs are typically designed with hard surfaces. A poor sound environment can add to stress and make auditory tasks more difficult for clinicians. However few studies have linked more detailed analyses of the sound environment to nurse wellbeing and performance. This study is aimed at understanding the relationships between objective acoustic measures and self-reported nurse outcomes. Two 20-bed ICUs with similar patient acuity and treatment models were tested: A recently built neurological ICU and a 1980s-era medical-surgical ICU. The medical-surgical ICU was perceived as louder, more annoying, and having a greater negative impact of noise on work performance, health outcomes, and anxiety as compared to the neurological ICU. Surprisingly, there were little differences between two ICU sound environments based on traditional overall noise measures. The objective differences b...

Soundscape evaluations in two critical healthcare settings with different designs.

Patient's perception of care-referred to as patient satisfaction-is of great interest in the healthcare industry, as it becomes more directly tied to the revenue of the health system providers. The perception of care has now become important in addition to the actual health outcome of the patient. The known influencers for the patient perception of care are the patient's own characteristics as well as the quality of service received. In patient surveys, the physical environment is noted as important for being clean and quiet but is not considered a critical part of patient satisfaction or other health outcomes. Patient perception of care is currently measured as patient satisfaction, a systematic collection of perceptions of social interactions from an individual person as well as their interaction with the environment. This exploration of the literature intends to explore the rigorous, statistically tested research conducted that has a spatial predictor variable and a health or behavior outcome, with the intent to begin to further test the relationships of these variables in the future studies. This literature review uses the patient satisfaction framework of components of influence and identifies at least 10 known spatial environmental variables that have been shown to have a direct connection to the health and behavior outcome of a patient. The results show that there are certain features of the spatial layout and environmental design in hospital or work settings that influence outcomes and should be noted in the future research.

Erica E. Ryherd

Papers

Characterizing noise and perceived work environment in a neurological intensive care unit.

The sound environment in an ICU patient room--a content analysis of sound levels and patient experiences.

Noise pollution in hospitals: Impact on patients

Soundscape evaluations in two critical healthcare settings with different designs.

Environmental Variables That Influence Patient Satisfaction: A Review of the Literature