Environmental Noise around Hospital Areas: A Case Study

Urban noise assessment in hospitals: measurements and mapping in the context of the city of Sorocaba, Brazil

Noise pollution has become a public health problem in several countries worldwide. Noise maps are tools used in many cities, mainly on the European continent. In other regions, they are used in smaller areas, and few studies focus on hospital areas, considered noise-sensitive zones. In this context, this study aimed to perform sound measurements and noise maps for the day and night periods in the surroundings of three hospitals in Sorocaba, Brazil. Sound measurements occurred around the three hospitals based on NBR 10151 and ISO 1996 standards. The noise maps were drawn up using a calculation model based on ISO 9613-2. Results showed that the sound measurement points around the hospitals had levels above those recommended by the Brazilian standard for sensitive areas (LAeq 50 and 45 dB for day and night, respectively). The acoustic maps showed high sound levels on all faces of the hospital buildings, both during the day and at night. The worst scenario concerned the vicinity of the roads with the highest flow and speed of vehicles. We concluded that three different hospitals in the city have high sound levels in their surroundings above the recommended for sensitive areas.

Noise levels and annoyance among staff in a tertiary care hospital in North India: A cross-sectional study

Hospital noise has remained a low priority problem in India. An area of not less than 100 meters around a hospital is considered a silence zone, with guidelines restricting noise levels at 50dBA during daytime and 40dBA during the night. World Health Organization (WHO) guidelines also stipulate an average of 30dBA and a maximum of 40dbA. Annoyance is a known effect of noise exposure. However, very few studies have attempted to explore the hospital soundscape and the annoyance among staff related to it. Noise data was collected from 30 sites, using a Digital Integrating Sound Level Meter, LutronSL-4035SD (ISO-9001,CE,IEC1010) meeting IEC61672 standards. Stratified random sampling of staff was done on basis of noise exposure. A pre-designed, semi-structured questionnaire collected information on sociodemographic and work profile. Annoyance was defined as a stress reaction to environmental noise and was measured using standardized general purpose noise reaction questionnaire (ISO-TS/15666). Data was analyzed in SPSS. The mean LAeq 24 h across all the sites was 69.5dBA (SD ±5.8dBA) for the weekdays and 66.2dBA (SD ±4.6dBA) for the weekends. Noise levels were higher during the day than during the night, and higher during the weekdays as compared to the weekends. 332(73.8%) study participants were found to be annoyed due to hospital noise. Annoyance among study participants was significantly associated with LAeq 24 h > 80 dBA during the weekdays [aOR = 5.08 (1.17-22.06)] and LAeq 24 h of 65-80 dBA during the weekends [aOR = 2.71 (1.46-5.01)]. Noise levels in the hospital far exceeded WHO and Central Pollution Control Board (CPCB) guidelines recommended for indoor hospital noise, as well as the national guidelines for sensitive zones. Almost three-fourth of the study participants were annoyed due to hospital noise. Significant association was found between annoyance among staff and higher noise levels of their workplace. Similar studies need to be conducted in hospitals across India to generate evidence on the current situtation and identify solutions.

Smartphone applications for measuring noise in the intensive care unit: A feasibility study

PURPOSE

This study aims to explore the suitability of using smartphone applications with low-cost external microphones in measuring noise levels in intensive care units.

METHODS

Four apps and two external microphones were tested in a laboratory by generating test signals at five noise levels. The average noise levels were measured using the apps and a professional device (i.e. a sound level meter). A field test was performed in an intensive care unit with two apps and one microphone. Noise levels were measured in terms of average and maximum noise levels according to the World Health Organisation's guidance. All the measurements in both tests were conducted after acoustic calibration using a sound calibrator.

RESULTS

Overall, apps with low-cost external microphones produced reliable results of averaged noise levels in both the laboratory and field settings. The differences between the apps and the sound level meter were within ±2 dB. In the field test, the best combination of app and microphone showed negligible difference (< 2 dB) compared to the sound level meter in terms of the average noise level. However, the maximum noise level measured by the apps exhibited significant differences from those measured by the sound level meter, ranging from -0.9 dB to -4.7 dB.

CONCLUSION

Smartphone apps and low-cost external microphones can be used reliably to measure the average noise level in the intensive care unit after acoustic calibration. However, professional equipment is still necessary for accurate measurement of the maximum noise level.

Acoustic environments of intensive care units during the COVID-19 pandemic

This study aims to investigate the typical noise levels and noise sources in an intensive care unit (ICU) during the COVID-19 pandemic. Acoustic experiments were conducted over 24 hrs in patient wards and at nurse stations in four Chinese hospitals. From the measurements, noise levels and sources were analysed in terms of the A-weighted equivalent sound pressure levels (L _Aeq) and A-weighted maximum Fast time-weighted sound pressure levels (L _AFmax) over three different time periods during the day (i.e. day, evening and night). Overall, noise levels (L _Aeq) for 24 hrs in all hospitals exceeded the World Health Organisation's (WHO) guide levels, varying from 51.1 to 60.3 dBA. The highest maximum noise level reached 104.2 dBA. The single-bedded wards (side rooms) were quieter than multi-bedded wards, and night time noise levels were quieter than daytime and evening across all hospitals. It was observed that the most dominant noise sources were talking/voices, door-closing, footsteps, and general activities (e.g. noise from cleaning equipment and cutlery sound). Footsteps became an unexpected dominant noise source during the pandemic because of the staff's disposable shoe covers which made footsteps noisier. Patient alarms and coughing varied significantly between patients. Talking/voices produced the highest maximum median values of the sound exposure level (SEL) and the maximum noise level at all sites. Noise levels in all the patient rooms were more than the WHO guidelines. The pandemic control guidelines had little impact on the noise levels in the ICUs.

Analysis of the Acoustic Comfort in Hospital: The Case of Maternity Rooms

Hospitals include a variety of different spaces with different requirements and levels of sensitivity to noise but also different activities and equipment that can cause high noise levels. In this article, noise disturbance in hospitals is studied with reference to a case study in a maternity ward. The analysis is carried out by means of sound insulation measurements between bedrooms and between bedroom and corridor. Equivalent sound pressure level measurements were carried out continuously for two days and nights. The number of awakening events is examined for each hour of the two nights. In addition, the results of a questionnaire conducted on more than 100 patients are reported. The results of the study show that the main cause of noise disturbance is activity in the corridors and that this kind of disturbance is usually repeated throughout the night. This is made more critical by the poor acoustic performance of the doors, but also by the habit of keeping doors open or half-open to allow doctors to always control patients. The article proposes some possible solutions to reduce noise intrusion from the corridor to the rooms.

Effect of ambient noise on indoor environments in a health care facility in Oman

Hospital-noise levels can induce physiological responses and affect sleep quality, which could contribute to cardiovascular-related health problems. Till date, high-resolution hospital noise exposure assessment studies have not received much attention in Oman. This study aims at assessing sound pressure levels across hospital wards and intensive care unit (ICU) rooms to determine annoyance and potential health effects based on perception and risk estimates. An indoor exposure assessment using high precision noise sensors was conducted in a female medical ward (FMW), isolated ward (SLW), emergency ward (EMW), and intensive care unit (ICU) in a public hospital in Muscat city, Oman. Self-administered questionnaire was randomly distributed among respondents using both online and field survey approach to ascertain annoyance, health effects, and potential risks associated with exposure. The study found that 24-h noise levels (L_Aeq) ranged from 55.2 to 61.7 dB(A) in the hospital wards and ICU rooms, which exceeded WHO's hospital indoor rooms critical limit of 35 dB(A) by 58-76%. A total of 150 participants took part in the survey. Among the respondents, 53% reported moderate annoyance at the hospital wards, while 56% felt sensitivity to the noise levels. Noise annoyance was reported by the majority of the patients across the various wards and emergency rooms as causing slight annoyance (50%) and intermittent sleep disturbances (49%). The majority (73%) of the medical staff have complained that the current noise levels affect overall work performance (p = 0.004), while 70% of them have further complained of it as a cause of workplace distraction (p = 0.011). Logistic binary regression analysis has revealed that the complaint of noise sensitivity has a positive association with noise levels in VCW (OR: 1.54; 95% CI: 0.92-2.58), and reported loss of concentration by the medical staff also associated with noise levels at the EMW (OR: 1.61; 95% CI: 0.65-4.01). Quantitative risk estimates showed that both the percentages of highly annoyed (HA) persons (16%), and highly sleep-disturbed (HSD) persons (9%) were very high in FMW, while ICU was found to have the lowest risk. However, the greater number of the respondents (87%) believed that there are possibilities of mitigating (p < 0.001) the current noise levels.

Environmental noise in hospitals: a systematic review

Environmental noise has been growing in recent years, causing numerous health problems. Highly sensitive environments such as hospitals deserve special attention, since noise can aggravate patients' health issues and impair the performance of healthcare professionals. This work consists of a systematic review of scientific articles describing environmental noise measurements taken in hospitals between the years 2015 and 2020. The researchers started with a consultation of three databases, namely, Scopus, Web of Science, and ScienceDirect. The results indicate that for the most part, these studies are published in journals in the fields of medicine, engineering, environmental sciences, acoustics, and nursing and that most of their authors work in the fields of architecture, engineering, medicine, and nursing. These studies, which are concentrated in Europe, the Americas, and Asia, use as reference values sound levels recommended by the World Health Organization. L_eq measured in hospital environments showed daytime values ranging from 37 to 88.6 dB (A) and nighttime values of 38.7 to 68.8 dB (A). L_eq values for outdoor noise were 74.3 and 56.6 dB (A) for daytime and nighttime, respectively. The measurements were taken mainly inside hospitals, prioritizing more sensitive departments such as intensive care units. There is a potential for growth in work carried out in this area, but research should also include discussions about guidelines for improvement measures aimed at reducing noise in hospitals.

Effect of parking lanes on assessing the impact of road traffic noise on building façades

The use of strategic noise maps as a means for estimating population exposure to environmental noise and defining action plans to mitigate its effects on human health has become a reality since the publication of the European Noise Directive. In this context, it is known that some differences can be found between the values obtained for sound indicators through simulation and measurements due to different causes. One of these factors is the presence of elements in urban environments not currently considered in calculation methods but certainly present in validation measurements. This paper presents an assessment of the acoustic shielding effect due to parked vehicles on urban streets using computational methods. First of all, a process of validation of the software model by means of different simulation methods and in situ measurements was carried out. Then, a study was developed varying different variables related to urban planning and noise modelling, as well as considering different typologies of real streets according to a categorisation method. Broadband results show that this shielding effect can be significant in common configurations in urban environments, even to receiver heights of 4 m considered as a reference in strategic noise maps. The magnitude of this effect varied depending on the distances between the building façade, parked vehicles and sound sources, as well as the receiver height. Differences up to 4 dBA in sound levels were found in several configurations between situations without and with cars parked at 4 m, although in some specific cases it reached up to 8 dBA. Therefore, results of this study indicated that parking lane shielding effect should be considered in calculations and validation measurements for strategic noise maps in order to obtain an adequate estimation of population exposure to road traffic noise.

Preface: New Solutions Mitigating Environmental Noise Pollution

The increasing attention of the public towards the effects of noise pollution on health pushed the EU to issue the Environmental Noise 49/2002/CE Directive [...]