Noise pollution in the ICU

Measurements show a constant background noise of 60 dB(A) in the ICU during both day and night. Ventilators with their pneumatic and mechanical noise, ECG signals, drainage suction, special pneumatic beds, the balloon pump, etc. exert a constant cacophony that can mask speech and interfere with communication.

Sound level peaks of 70 to 80 dB(A), caused by the triggering of various alarms, occur at irregular intervals. Table 1 shows records of various alarms; L1 (sound pressure level for 1 per cent of time) indicates the short and very loud events that are the most disturbing ( Ba]ogh.ef a/ 1993). It is essential to remember that short-duration events of elevated intensity are both frightening and annoying for conscious patients, particularly because it is difficult to distinguish between the noise from their own bed and that from a neighboring bed. The reaction of sedated patients has never been systematically examined.

On average 2.1 alarms/patient/h have been recorded in our ICU, but up to 42 alarms/h may be present for patients in very unstable conditions ( Balogh et al: 1993).

Other studies have registered more than 100 alarms/h in an open ICU ward.

Thus noise caused by personnel and machines should be minimized in the design of an ICU to avoid physiological stress to patients and staff. Chapter References

Abel, S. (1990). The extra-auditory effects of noise and annoyance: an overview of research. Journal of Otolaryngology, 1 (Supplement), 1-13. Balogh, D., Kittinger, E., Benzer, A., and Hackl, J.M. (1993). Noise in the ICU. Intensive Care Medicine, 19, 343-6.

Kjellberg, A. (1990) Subjective, behavioral and psychological effect of noise. Scandinavian Journal of Work and Environmental Health, 16 (Supplement), 29-38.

Lercher, P., Hortnagl, J., and Kofler, W. (1993). Work noise annoyance and blood pressure: combined effects with stressful working conditions. International Archives of Occupational and Environmental Health, 65, 23-8.

van Dijk, F.J.H. (1986). Non-auditory effects of noise in industry. II. A review of the literature. International Archives of Occupational and Environmental Health, 58, 325-32.

D. Balogh and A. Benzer

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Noisedue to.building characteristics Noisecaused.during.dailv.. work Management.. ofnoïse.poHutio.n Chapter. References

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