Noise in the ICU

Objective The growing number of technical devices in ICUs makes noise exposure a major stressor. The purpose of this study was to assess noise levels during routine operation in our ICU.Design Our ICU is an open ward with four rooms, constructed in the 1960s. During the study period, 4 patients were in the controlled room and were treated by 4 nurses during the day and by 2 at night. A-weighted sound pressure levels (SPL) were measured continuously for 2 days and nights. Also measured were the alarms of various appliances. For gross overall evaluation it is customary to state the L_eq, i.e. the energy-averaged level during measurement. The annoyance caused by noise depends more on rare events of high intensity. Therefore, the distribution of SPL values (L_n) over time was also analysed.Results SPL was roughly the same during the day and at night, with L_eq between 60–65 dB(A) and peaks up to 96 dB(A). Most alarms reach an SPL of 60–70 dB(A), but some exceed 80 dB(A). During teaching rounds L_eq exceeds 65 dB(A).Conclusion During the day and at night SPL always surpasses the permissible noise exposure for 24 h of 45 db(A) recommended by the US Environmental Protection Agency. Alarms cause the most irritating noise. Hospital management should pay attention to internal noise, and SPL should be measured routinely.