This article presents the results of a noise survey at Johns Hopkins Hospital in Baltimore, MD. Results include equivalent sound pressure levels (Leq) as a function of location, frequency, and time of day. At all locations and all times of day, the Leq indicate that a serious problem exists. No location is in compliance with current World Health Organization Guidelines, and a review of objective data indicates that this is true of hospitals throughout the world. Average equivalent sound levels are in the 5060dB(A) range for 1min, 12, and 24h averaging time periods. The spectra are generally flat over the 632000Hz octave bands, with higher sound levels at lower frequencies, and a gradual roll off above 2000Hz. Many units exhibit little if any reduction of sound levels in the nighttime. Data gathered at various hospitals over the last 45years indicate a trend of increasing noise levels during daytime and nighttime hours. The implications of these results are significant for patients, visitors, and hospital staff.

1.
F.
Biley
, “
Effects of noise in hospitals
,”
Br. J. Nurs.
3
,
110
113
(
1994
).
2.
F.
Nightingale
,
Notes on Nursing
(
Dover
, New York,
1969
).
3.
C.
Baker
, “
Sensory overload and noise in the ICU: Sources of environmental stress
,”
Crit. Care Nurs. Q.
6
,
66
79
(
1984
).
4.
A.
Turner
,
C.
King
, and
J.
Craddock
, “
Measuring and reducing noise
,”
Hospitals
49
,
85
90
(
1975
).
5.
R.
Aitken
, “
Quantitative noise analysis in a modern hospital
,”
Arch. Environ. Health
37
,
361
364
(
1982
).
6.
B.
Allaouchiche
,
F.
Duflo
,
R.
Debon
,
A.
Bergeret
, and
D.
Chassard
, “
Noise in the postanaesthesia care unit
,”
Br. J. Anaesth.
88
,
369
373
(
2002
).
7.
M.
Bayo
,
A.
Garcia
, and
G.
Amando
, “
Noise levels in an urban hospital and workers’ subjective responses
,”
Arch. Environ. Health
50
,
247
251
(
1995
).
8.
M.
Bovenzi
and
A.
Collareta
, “
Noise levels in a hospital
,”
Ind. Health
22
,
75
82
(
1984
).
9.
U.
de Camp
, “
The measurement of sound levels in hospitals
,”
Noise Control Eng.
13
,
24
27
(
1979
).
10.
S.
Falk
and
N.
Woods
, “
Hospital noise—Levels and potential health hazards
,”
N. Engl. J. Med.
289
,
774
780
(
1973
).
11.
L.
Goodfriend
and
R.
Cardinell
, “
Noise in hospitals
,” Technical Report No. 930-D-11, Public Health Service, Division of Hospital and Medical Facilities,
1963
.
12.
R.
Guerrero
, “
Intermittent noise sampling and control strategies in the hospital environment
,” Master’s thesis, NJIT,
2001
.
13.
P.
Haslam
, “
Noise in hospitals: Its effect on the patient
,”
Nurs. Clin. North Am.
5
,
715
724
(
1970
).
14.
B.
Hilton
, “
Noise in acute patient care areas
,”
Res. Nurs. Health
8
,
283
291
(
1985
).
15.
S.
Holmberg
and
S.
Coon
, “
Ambient sound levels in a state psychiatric hospital
,”
Arch. Psychiatr. Nurs.
XIII
,
117
126
(
1999
).
16.
D.
Kahn
,
T.
Cook
,
C.
Carlisle
,
D.
Nelson
,
N.
Kramer
, and
R.
Millman
, “
Identification and modification of environmental noise in an ICU setting
,”
Chest
114
,
535
540
(
1998
).
17.
A.
Ogilvie
, “
Sources and levels of noise on the ward at night
,”
Nurs. Times
76
,
1363
1366
(
1980
).
18.
F.
Omokhodian
and
M.
Sridhar
, “
Noise levels in the hospital environment in Ibadan
,”
Afr. J. Med. Med. Sci.
32
,
139
142
(
2003
).
19.
F.
Pimentel-Souza
,
J.
Carvalho
,
P.
Alvares
,
C.
Rodrigues
, and
A.
Siqueira
, “
Noise and sleep quality in two hospitals in the city of Belo Horizonte, Brazil
,”
2003
, http://www.icb.ufmg.br/lpf/2-19.html.
20.
N.
Shankar
,
K.
Malhotra
,
S.
Ahuja
, and
O.
Tandon
, “
Noise pollution: A study of noise levels in the operation theatres of a general hospital during various surgical procedures
,”
J. Indian Med. Assoc.
99
,
244
247
(
2001
).
21.
N.
Woods
and
S.
Falk
, “
Noise stimuli in the acute care area
,”
Nurs. Res.
23
,
144
150
(
1974
).
22.
D.
Anagnostakis
,
J.
Petmezakis
,
J.
Messaritakis
, and
N.
Matsaniotis
, “
Noise pollution in neonatal units: A potential health hazard
,”
Acta Paediatr. Scand.
69
,
771
773
(
1980
).
23.
D.
Balogh
,
E.
Kittinger
,
A.
Benzer
, and
J.
Hackl
, “
Noise in the ICU
,”
Intensive Care Med.
19
,
343
346
(
1993
).
24.
F.
Benini
,
V.
Magnavita
,
P.
Lago
,
E.
Arslan
, and
P.
Piaso
, “
Evaluation of noise in the neonatal intensive care unit
,”
Am. J. Perinatol
13
,
37
41
(
1996
).
25.
S.
Bentley
,
F.
Murphy
, and
H.
Dudley
, “
Perceived noise in surgical wards and an intensive care area: An objective analysis
,”
Br. Med. J.
2
,
1503
1506
(
1977
).
26.
G.
Blennow
,
N.
Svenningsen
, and
B.
Almquist
, “
Noise levels in incubators (Adverse effects?)
,”
Pediatrics
53
,
29
32
(
1974
).
27.
A.
Gottfried
,
J.
Hodgman
, and
K.
Brown
, “
How intensive is newborn intensive care? An environmental analysis
,”
Pediatrics
74
,
292
294
(
1984
).
28.
P.
Kam
,
A.
Kam
, and
J.
Thompson
, “
Noise pollution in the anaesthetic and intensive care environment
,”
Anaesthesia
49
,
982
986
(
1994
).
29.
J.
Long
,
J.
Lucey
, and
A.
Philip
, “
Noise and hypoxemia in the intensive care nursery
,”
Pediatrics
65
,
143
145
(
1980
).
30.
L.
Marshall
, “
Patient reaction to sound in an intensive coronary care unit
,”
Commun. Nurs. Res.
5
,
81
92
(
1972
).
31.
A.
McLaughlin
,
J.
Elliott
, and
G.
Campalani
, “
Noise levels in a cardiac surgical intensive care unit: A preliminary study conducted in secret
,”
Intensive Crit. Care Nurs.
12
,
226
230
(
1996
).
32.
T.
Meyer
,
S.
Eveloff
,
M.
Bauer
,
W.
Schwartz
,
N.
Hill
, and
R.
Millman
, “
Adverse environmental conditions in the respiratory and medical ICU settings
,”
Chest
105
,
1211
1216
(
1994
).
33.
J.
Redding
,
T.
Hargest
, and
S.
Minsky
, “
How noisy is intensive care
?,”
Crit. Care Med.
5
,
275
276
(
1977
).
34.
K.
Thomas
and
P.
Martin
, “
The acoustic environment of hospital nurseries: NICU sound environment and the potential problems for caregivers
,”
J. Perinatol
20
,
S94
S99
(
2000
).
35.
C.
Tsiou
,
D.
Eftymiatos
,
E.
Theodossopoulou
,
P.
Notis
, and
K.
Kiriakou
, “
Noise sources and levels in the Evgenidion Hospital intensive care unit
,”
Intensive Care Med.
24
,
845
847
(
1998
).
36.
B.
Hodge
and
J.
Thompson
, “
Noise pollution in the operating theatre
,”
Lancet
335
,
891
894
(
1990
).
37.
P.
Lewis
,
J.
Staniland
,
A.
Cuppage
, and
J.
Davies
, “
Operating room noise
,”
Can. J. Anaesth.
37
,
S79
(
1990
).
38.
H.
Love
, “
Noise exposure in the orthopaedic operating theatre: A significant health hazard
,”
ANZ J. Surg.
73
,
836
838
(
2003
).
39.
V.
Murthy
,
S.
Malhotra
,
I.
Bala
, and
M.
Raghunathan
, “
Detrimental effects of noise on anesthetists
,”
Can. J. Anaesth.
42
,
608
611
(
1995
).
40.
M.
Nott
and
P.
West
, “
Orthopaedic theatre noise: A potential hazard to patients
,”
Anaesthesia
58
,
784
787
(
2003
).
41.
C.
Ray
and
R.
Levinson
, “
Noise pollution in the operating room: A hazard to surgeons, personnel, and patients
,”
J. Spinal Disord.
5
,
485
488
(
1992
).
42.
R.
Shapiro
and
T.
Berland
, “
Noise in the operating room
,”
N. Engl. J. Med.
287
,
1236
1238
(
1972
).
43.
J.
Evans
and
M.
Philbin
, “
The acoustic environment of hospital nurseries: Facility and operations planning for quiet hospital nurseries
,”
J. Perinatol
20
,
S105
S112
(
2000
).
44.
R.
Gädeke
,
B.
Döring
,
F.
Keller
, and
A.
Vogel
, “
The noise level in a childrens hospital and the wake-up threshold in infants
,”
Acta Paediatr. Scand.
58
,
164
170
(
1969
).
45.
L.
Gray
and
M.
Philbin
, “
The acoustic environment of hospital nurseries: Measuring sound in hospital nurseries
,”
J. Perinatol
20
,
S100
S104
(
2000
).
46.
M.
Philbin
and
L.
Gray
, “
Changing levels of quiet in an intensive care nursery
,”
Acta Paediatr. Scand.
22
,
455
460
(
2002
).
47.
M.
Philbin
,
A.
Roberson
, and
J. W.
Hall
 III
, “
Recommended permissible noise criteria for occupied, newly constructed or renovated hospital nurseries
,”
J. Perinatol
19
,
559
563
(
1999
).
48.
M.
Philbin
, “
The full-term and premature newborn: The influence of auditory experience on the behavior of preterm newborns
,”
J. Perinatol
20
,
S77
S87
(
2000
).
49.
R.
Dodenhoff
, “
Noise in the orthopaedic operating theatre
,”
Ann. R. Coll. Surg. Engl.
77
,
8
9
(
1995
).
50.
G.
H.
 Jr
,
K.
Goodman
,
D.
Hang
, and
V.
McCorvey
, “
Noise levels of orthopedic instruments and their potential health risks
,”
Orthopedics
19
,
35
37
(
1996
).
51.
H.
Mullett
,
K.
Synnott
, and
W.
Quinlan
, “
Occupational noise levels in orthopaedic surgery
,”
Ir J. Med. Sci.
168
,
106
(
1999
).
52.
K.
Prasad
and
K.
Reddy
, “
Live recordings of sound levels during the use of powered instruments in ENT surgery
,”
J. Laryngol. Otol.
117
,
532
535
(
2003
).
53.
K.
Willett
, “
Noise-induced hearing loss in orthopaedic staff
,”
J. Bone Joint Surg. Br.
OL-73B
,
113
115
(
1991
).
54.
V.
Bredenberg
, “
Quiet, please!
,”
Hosp. Prog.
42
,
104
108
(
1961
).
55.
A.
Dellon
, “
To rid ORs of noise pollution
,” RN OR-6,
1975
.
56.
G.
Grumet
, “
Pandemonium in the modern hospital
,”
N. Engl. J. Med.
328
,
433
437
(
1993
).
57.
A.
Schneider
and
J.
Beibuyck
, “
Music in the operating-room
,”
Lancet
335
,
1407
(
1990
).
58.
D.
Scalise
, “
Shhh, Quiet please
!,”
Hosp. Health Netw.
78
,
16
17
(
2004
).
59.
C.
Cmiel
,
D.
Karr
,
D.
Gasser
,
L.
Oliphant
, and
A.
Neveau
, “
Noise control: A nursing team’s approach to sleep promotion
,”
Am. J. Nurs.
104
,
40
48
(
2004
).
60.
S.
Akhtar
,
C.
Weigle
,
E.
Cheng
,
R.
Toohill
, and
R.
Berens
, “
Use of active noise cancellation devices in caregivers in the intensive care unit
,”
Crit. Care Med.
28
,
1157
1160
(
2000
).
61.
W.
Morrison
,
E.
Haas
,
D.
Shaffner
,
E.
Garrett
, and
J.
Fackler
, “
Noise stress and annoyance in a pediatric intensive care unit
,”
Crit. Care Med.
31
,
113
119
(
2003
).
62.
M.
Topf
, “
Noise-induced occupational stress and health in critical care nurses
,”
Hosp. Top.
66
,
30
34
(
1988
).
63.
M.
Topf
and
E.
Dillon
, “
Noise-induced stress as a predictor of burnout in critical care nurses
,”
Heart Lung
17
,
567
574
(
1988
).
64.
D.
Fife
and
E.
Rappaport
, “
Noise and hospital stay
,”
Am. J. Public Health
66
,
680
681
(
1976
).
65.
B.
Minckley
, “
A study of noise and its relationship to patient discomfort in the recovery room
,”
Nurs. Res.
17
,
247
250
(
1968
).
66.
A.
Wysocki
, “
The effect of intermittent noise exposure on wound healing
,”
Adv. Wound Care
9
,
35
39
(
1996
).
67.
P.
Toivanen
,
S.
Hulkko
, and
E.
Naatanen
, “
Effect of psychic stress and certain hormone factors on the healing of wounds in rats
,”
Ann. Med. Exp. Biol. Fenn
38
,
343
349
(
1960
).
68.
I.
Cohen
, “
Stress and wound healing
,”
Acta Anat. (Basel)
103
,
134
141
(
1979
).
69.
C.
Hawksworth
,
P.
Sivalingam
, and
A.
Asbury
, “
The effect of music on anesthetists’ psychomotor performance
,”
Anaesthesia
53
,
195
197
(
1998
).
70.
K.
Moorthy
,
Y.
Munz
,
S.
Undre
, and
A.
Darzi
, “
Objective evaluation of the effect of noise on the performance of a complex laparoscopic task
,”
Surgery (St. Louis)
136
,
25
30
(
2004
).
71.
S.
Park
,
H.
Song
,
J.
Han
,
J.
Park
,
E.
Lee
,
S.
Park
,
K.
Kang
,
J.
Lee
,
S.
Hwang
,
S.
Rho
,
S.
Jeong
,
H.
Chung
, and
K.
Shinn
, “
Effect of noise on the detection of rib fractures by residents
,”
Invest. Radiol.
29
,
54
58
(
1994
).
72.
V.
Murthy
,
S.
Malhotra
,
I.
Bala
, and
M.
Raghunathan
, “
Auditory functions in anaesthesia residents during exposure to operating room noise
,”
Indian J. Med. Res.
101
,
213
216
(
1995
).
73.
Guidelines for community noise
,” edited by
B.
Berglund
,
T.
Lindvall
,
D. H.
Schwela
and
K. T.
Goh
, Technical Report,
World Health Organization
,
1999
.
74.
American National Standards Institute
, “
Criteria for evaluating room noise: S12.2
,”
1995
, reaffirmed on 24 May, 1999.
75.
Information on levels of environmental noise requisite to protect public health and welfare with an adequate margin of safety
,” EPA (
1974
).
76.
R.
Soutar
and
J.
Wilson
, “
Does hospital noise disturb patients?
,”
Br. Med. J.
292
,
305
(
1986
).
77.
M.
Wallace
,
M.
Ashman
, and
M.
Matjasko
, “
Hearing acuity of anesthesiologists and alarm detection
,”
Anesthesiology
81
,
13
28
(
1994
).
78.
E.
Liu
and
S.-M.
Tan
, “
Patients’ perception of sound levels in the surgical suite
,”
J. Clin. Anesth.
12
,
298
302
(
2000
).
79.
N.
Freedman
,
N.
Kotzer
, and
R.
Schwab
, “
Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit
,”
Am. J. Respir. Crit. Care Med.
159
,
1155
1162
(
1999
).
80.
L.
Stanford
,
J.
McIntyre
, and
J.
Hogan
, “
Audible alarm signals for anaesthesia monitoring equipment
,”
Int. J. Clin. Monit Comput.
1
,
251
256
(
1985
).
81.
A.
Cropp
,
L.
Woods
, and
D.
Raney
, “
Name that tone: The proliferation of alarms in the intensive care unit
,”
Chest
105
,
1217
1220
(
1994
).
82.
L.
Biot
,
P.
Carry
,
J.
Perdrix
,
A.
Eberhard
, and
P.
Baconnier
, “
Èvaluation clinique de la pertinence des alarmes en rèanimation (clinical evaluation of the importance of alarms in recovery)
,”
Ann. Fr. Anesth. Reanim
19
,
459
466
(
2000
).
You do not currently have access to this content.