Voice Pollution

Introduction

Noise pollution, like other types of pollution, can be detrimental to the people who have to deal with it. In hospitals, noise pollution can get to levels that are unsafe for not only the patients, but also the faculty. According to “Rise in Hospital Noise Poses Problems for?Patients and Staff” written by Phil Sneiderman and published through The Center for Quality Improvements and Patient Safety of Johns Hopkins Hospital, “Since 1960, average daytime hospital sound levels around the world have risen from 57 decibels to 72; nighttime levels have jumped from 42 decibels to 60.

All of these figures exceed the World Health Organization's 1995 hospital noise guidelines, which suggest that sound levels in patient rooms should not exceed 35 decibels.” (Sneiderman 2005). This noise is far above the recommended levels (there are no specific guidelines, only recommendations) which causes many problems in the different aspects of a hospital. Obviously, it affects the patients, which can be further broken down into newborns in the NICU, the Intensive Care Unit, and the emergency room. As far as the effects on staff and faculty, different noises in the operating room and in general workplaces can cause their work to be insufficient. The NASSMH (National Agency of Sanitary Surveillance of the Ministry of Health) conducted an experiment where they recorded levels of sound in a general trauma reference hospital in Curitiba, Parana State, Brazil, and Walderes Filus concluded results similar to Sneiderman, “Noise levels in sound pressure level ambiance [dBA] ranged from 56.6 to 68.8.” (Filus 2015). This concludes that in general, hospitals are too loud for things to go correctly.

Noise Pollution’s Effect on Patients

To begin, in general, noise pollution has a negative effect on patients in hospitals. According to a study done by Timothy Hsu at the University of Gothenburg Institute of Medicine Department of Public Health and Community Medicine, “it [noise pollution] relates to patient sleep disturbances, cardiovascular response, length of hospital stay, pain management, wound healing, and physiological reactions. Results generally show the potential for negative physiological effect when patients are exposed to noise…” (Hsu 2012). This study concluded that the effect of noise on patients is sometimes bad, but other times inconclusive. Phil Sneiderman says in his work, “During a two-year research project, acoustics experts Ilene Busch-Vishniac and James E. West learned that hospital noise is among the top complaints of both patients and hospital staff members, but that little is being done to address the problem.” (Sneiderman 2002). The authors of these works clearly agree on the fact that noise pollution is not good for patients for not only comfort, but also for their actual health.

Noise Pollution in the Intensive Care Unit

The ICU (Intensive Care Unit) alone is a hectic place with traumas coming in left and right, but when the factor of noise pollution is added to the mix, everyone starts to feel the effects. According to “An Investigation of Sound Levels on Intensive Care Units with Reference to the WHO Guidelines” written by JL Darbyshire and JD Young who have both done extensive research on patients in the ICU, “Patients in intensive care units (ICUs) suffer from sleep deprivation arising from nursing interventions and ambient noise. This may exacerbate confusion and ICU-related delirium… All ICUs had sound levels greater than WHO recommendations.” (Darbyshire, Young 2013). Similar to what Hsu said earlier, Darbyshire and Young touch on the subject of noise pollution causing sleep deprivation. In the work done by Sneiderman, he quotes a woman named Stephanie L. Reel, who is the vice president and chief officer for Johns Hopkins medicine, she says, “A noisy intensive care unit introduces patient, family and staff dissatisfaction. It has also been reported that noise can contribute to lapses in short-term memory, which could then introduce safety concerns.” (Reel, qtd. Sneiderman 2002). Not only is noise in the ICU uncomfortable for patients, it can also begin causing actual harm to them.

Noise Pollution in the Neonatal Intensive Care Unit

The Neonatal Intensive Care Unit, more commonly known as the NICU is where premature or ill infants stay to be cared for. The babies are already weak, so the added factor of noise pollution makes them very vulnerable and susceptible to defects and hearing loss. According to Abed Schokry who studies Ergonomics, Safety and Quality with the International Journal of Engineering and Innovative Technology, “…when fetuses are born too early they leave the silent atmosphere of the uterus and enter the noisy environment of the NICU. High sound levels have been shown to interfere with a newborn’s sleep and have a negative consequence on the infant’s critical signs, oxygen saturation, and auditory attention” (Schokry 2016). Similar to what Hsu and Sneiferman said, the loud and constant noise of the ICU and Nicu are detrimental to patient and especially infant health, comfort and well-being.

Noise Pollution and its Effects on Staff

Noise pollution in hospitals is not only bad for patients, it can also harm team members, staff, and faculty. According to Walderus Filus, author of “Ambient Noise in Emergency Rooms and its Health Hazards” published in the International Archives of Otorhinolaryngology (the study of the ear and diseases that affect hearing), “The author concluded that these levels [of ambient noise] are sufficient to cause deleterious psychological and secondary physical effects to the team members. Also, the author reported that reducing the level of ambient noise can improve patient care, reduce stress, and increase employee job satisfaction.” (Filus 2015). Not only are the staff at busy hospitals uncomfortable, they are beginning to see actual damage from the noise pollution in hospitals. For doctors working in operating rooms, these noises can really hurt them.

Noise Pollution in the Operating Room

When it come to the operating room or OR, noise comes right along with it. But when the noise is causing health problems to doctors often in these rooms, hospitals need to take action. According to Dr. Jonathan D. Katz, an Anesthesiologist, author of “Noise in the Operating Room”, “There is growing evidence that nurses and surgeons who consistently work in noisy operating rooms are susceptible to noise-induced hearing loss.  Substantial hearing loss has also been demonstrated among anesthesiologists.” (Katz 2014). Dr. Katz clearly agrees with Schokry who talks about newborns getting hearing loss from the constant noise. Both authors believe the ambient noise in the hospital is causing health issues to those working in the setting. Similarly, KM Willet, author of “Noise-Induced Hearing Loss in Orthopedic Staff” says, “The noise levels from a number of air-powered and electric tools were measured and analyzed and found to exceed the recommended levels. The predicted daily personal noise exposure was calculated and the potential for hearing damage confirmed.” (Willet 1991). Willet, Katz, and Schokry have all said that noise in a hospital setting can and will cause hearing loss, so they would all most likely agree there should be a solution.

Solution to the Noise in Hospitals

There are two solutions to the problem of ambient noise in hospitals, one, give patients ear plugs and eye masks so they are able to sleep in the crazy environment. According to Ahmad Reza Yazdannik, author of The Effect of Earplugs and Eyemasks on Patients’ Perceived Sleep Quality in Intensive Care Unit, “The results of the present study showed that usage of earplugs and an eye mask had a high effect on patients’ sleep supplementation, so that their level of sleep supplementation and daily nap decreased, possibly as a result of an increase in their night sleep.” (Yazdannik 2014). Also, Willet says, “The use of ear defenders should be promoted, and manufacturers should be encouraged to develop instruments with lower noise emission levels.” 8 (Willet 1991). These two authors agree on the solution of giving earplugs to patients and staff who work with loud instruments. The other solution is to make machines and other equipment quieter and maintain their volume. According to “Sound Practices: Noise Control in the Healthcare Environment”, a published piece in the Academy Journal, “considerable noise reduction can be achieved by simply fixing or replacing squeaky wheels and scheduling regular maintenance to keep mobile equipment in quiet working order. The noise level of heavy rolling equipment can be reduced by as much as 30 decibels just by lubricating the moving parts.” (Academy Journal 2007). If every hospital maintained their equipment the way the journal says to, patients would sleep better and staff would possibly work better.

Works Cited

1. Darbyshire, J L, and J D Young. “An Investigation of Sound Levels on Intensive Care Units with Reference to the WHO Guidelines.” Critical Care (London, England)., U.S. National Library of Medicine, 3 Sept. 2013, www.ncbi.nlm.nih.gov/pubmed/24005004.
2. Filus, Walderes, et al. “Ambient Noise in Emergency Rooms and Its Health Hazards.” International Archives of Otorhinolaryngology, Thieme Publicações Ltda, 25 Aug. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4490925/.
3. Hsu, Timothy, et al. “Noise Pollution in Hospitals: Impact on Patients.” University of Gothenburg, Institute of Medicine, Department of Public Health and Community Medicine, 2012, www.gu.se/english/research/publication/?publicationId=162394.
4. Katz, Jonathan D. “Noise in the Operating Room.” Anesthesiology: The Journal of the American Society of Anesthesiologists, The American Society of Anesthesiologists, Oct. 2014, anesthesiology.pubs.asahq.org/article.aspx?articleid=1921569
5. Schokry, Abed. “Study of Noise Levels in Neonatal Intensive Care Units (NICU) in Public Hospitals in Gaza City, Gaza Strip.” International Journal of Engineering and Innovative Technology, International Journal of Engineering and Innovative Technology, Sept. 2016, www.ijeit.com/Vol 6/Issue 3/IJEIT1412201609_01.pdf.
6. Sneiderman, Phil. “Rise in Hospital Noises Poses Problems for Patients and Staff.” Headlines@Hopkins: Johns Hopkins University News Releases, The Center for Quality Improvements and Patient Safety of Johns Hopkins Hospital, 21 Nov. 2005, pages.jh.edu/~news_info/news/home05/nov05/noise.html.
7. Willett, K M. “Noise-Induced Hearing Loss in Orthopaedic Staff.” The Journal of Bone and Joint Surgery. British Volume., U.S. National Library of Medicine, Jan. 1991, www.ncbi.nlm.nih.gov/pubmed/1991742.
8. Yazdannik, Ahmad Reza, et al. “The Effect of Earplugs and Eye Mask on Patients’ Perceived Sleep Quality in Intensive Care Unit.” Iranian Journal of Nursing and Midwifery Research, Medknow Publications & Media Pvt Ltd, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4280735/.
9. “Sound Practices: Noise Control in the Healthcare Environment.” Academy Journal, AIA Academy of Architecture for Healthcare, 1 Nov. 2007, www.brikbase.org/sites/default/files/aah_journal_v10_2007_nov_05_0.pdf. 

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