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The Role of the Physical Environment in the Hospital of the 21 st Century: A Once-in-a-Lifetime Opportunity

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A Review of Published Research on Low Frequency Noise and its Effects

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.

Industrial wind turbines (IWTs) are a new source of noise in previously quiet rural environments. Environmental noise is a public health concern, of which sleep disruption is a major factor. To compare sleep and general health outcomes between participants living close to IWTs and those living further away from them, participants living between 375 and 1400 m (n = 38) and 3.3 and 6.6 km (n = 41) from IWTs were enrolled in a stratified cross-sectional study involving two rural sites. Validated questionnaires were used to collect information on sleep quality (Pittsburgh Sleep Quality Index — PSQI), daytime sleepiness (Epworth Sleepiness Score — ESS), and general health (SF36v2), together with psychiatric disorders, attitude, and demographics. Descriptive and multivariate analyses were performed to investigate the effect of the main exposure variable of interest (distance to the nearest IWT) on various health outcome measures. Participants living within 1.4 km of an IWT had worse sleep, were sleepier during the day, and had worse SF36 Mental Component Scores compared to those living further than 1.4 km away. Significant dose-response relationships between PSQI, ESS, SF36 Mental Component Score, and log-distance to the nearest IWT were identified after controlling for gender, age, and household clustering. The adverse event reports of sleep disturbance and ill health by those living close to IWTs are supported.

http://burenvanlageweide.nl/wp-content/uploads/2012/12/2012-11-Nissenbaum-Aramini-Hanning-Noise-and-Health.pdf

H.G. Leventhall

Papers

Effects on performance and work quality due to low frequency ventilation noise