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Hospital Noise: Risk to Health and Safety

Nursing Research Department, Portland VA Medical Center
Portland, OR

Human hearing is both sensitive and highly adaptive leading to culturally influenced and highly personal responses to sound. Unwanted sound is generally referred to as noise. Sound at intensities of approximately 85 decibels dBA time weighted average (TWA) is known to cause hearing loss and thus potential occupational exposure is federally regulated. However, sound levels well below those known to cause hearing loss can have negative consequences, particularly in the hospital setting. Numerous studies provide evidence that sound intensities typical of hospitals result in negative physiologic outcomes, reduced speech intelligibility, impaired cognition, and loss of privacy. The World Health Organization 1999 guidelines recommend hospital background levels average no higher than 40 dBA, guidelines that apply to an empty building. Hospitals in use are noisier than ever, averaging 72 dBA during the day.Although accrediting agencies and acoustical experts have begun to provide more specific guidelines related to controlling hospital noise, hospital noise below 85 dBA remains unregulated. Further research is required to provide evidence upon which these regulations would depend. This article will provide the reader with an increased awareness of the risks posed by hospital noise and existing barriers to controlling it.