Skip to main content
SpringerLink
Log in

The Impact of Noise in the Intensive Care Unit

  • Conference paper
Intensive Care Medicine

Abstract

Noise may be defined simply as “unwanted sound” [1]. The World Health Organization (WHO) recommends that the average background noise in hospitals should not exceed 30 A weighted decibels (dB [A]), and that peaks during the night-time should be less than 40 dB(A) [1]. Noise in hospitals and particularly in intensive care units (ICUs), frequently exceeds these values [2]–[4]. The United States Environmental Protection Agency in fact defines noise as “any sound that may produce an undesired physiological or psychological effect in an individual or group”. Noise affects both staff and patients. It may impede concentration and cognitive function [5, 6]. It interferes with effective communication and may thus increase the risk of accidents [5, 7]. The critically ill are particularly sensitive to the disruption of sleep by noise [8]. In addition, and especially for the elderly and hard of hearing, noise may hinder communication and impair understanding of their environment. It may also potentially contribute to the abnormal thought processes and behavior associated with ICU delirium [9].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Berglund B, Lindvall T, Schwela DH (1999) Guidelines for Community Noise. World Health Organization, Geneva

    Google Scholar 

  2. Balogh D, Kittinger E, Benzer A, Hackl JM (1993) Noise in the ICU. Intensive Care Med 19:343–346

    Article  PubMed  CAS  Google Scholar 

  3. Meyer TJ, Eveloff SE, Bauer MS, Schwartz WA, Hill NS, Millman RP (1994) Adverse environ mental conditions in the respiratory and medical ICU settings. Chest 105:1211–1216

    PubMed  CAS  Google Scholar 

  4. Freedman NS, Gazendam J, Levan L, Pack AI, Schwab RJ (2001) Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med 163:451–457

    PubMed  CAS  Google Scholar 

  5. Office of the Scientific Assistant Office of Noise Abatement and Control, U.S. Environmental Protection Agency (1979) Noise Effects Handbook. National Association of Noise Control Officials, Florida, EPA 500-9-82-106

    Google Scholar 

  6. Murthy VS, Malhotra SK, Bala I, Raghunathan M (1995) Detrimental effects of noise on anaesthetists. Can J Anaesth 42:608–611

    Article  PubMed  CAS  Google Scholar 

  7. Blomkvist V, Eriksen CA, Theorell T, Ulrich R, Rasmanis G (2005) Acoustics and psychosocial environment in intensive coronary care. Occup Environ Med 62:e1–8

    Article  PubMed  CAS  Google Scholar 

  8. Gabor JY, Cooper AB, Crombach SA, et al (2003) Contribution of the intensive care unit environment to sleep disruption in mechanically ventilated patients and healthy subjects. Am J Respir Crit Care Med 167:708–715

    Article  PubMed  Google Scholar 

  9. Hansell HN (1984) The behavioural effects of noise on man: the patient with “intensive care unit psychosis”. Heart Lung 13:59–65

    PubMed  CAS  Google Scholar 

  10. The European Parliament and Council of the European Union (2003) Directive 2003/10/EC of the European Parliament and of the Council of 6 February 2003 On the Minimum Health and Safety Requirements Regarding the Exposure of Workers to the Risks Arising from Physical Agents (Noise). Official Journal of the European Union L042:38–44

    Google Scholar 

  11. Kahn DM, Cook TE, Carlisle CC, Nelson DL, Kramer NR, Millman RP (1998) Identification and modification of environmental noise in an ICU setting. Chest 114:535–540

    PubMed  CAS  Google Scholar 

  12. Morrison WE, Haas EC, Shaffner DH, Garrett ES, Fackler JC (2003) Noise, stress, and annoyance in a pediatric intensive care unit. Crit Care Med 31:113–119

    Article  PubMed  Google Scholar 

  13. Tsiou C, Eftymiatos D, Theodossopoulou, Notis P, Kiriakou (1998) Noise sources and levels in the Evgenidion Hospital intensive care unit. Intensive Care Med 24:845–847

    Article  PubMed  CAS  Google Scholar 

  14. Carvallho WB, Pedreira ML, de Aguiar MA (2005) Noise level in a pediatric intensive care unit. J Pediatr (Rio J) 81:495–498

    Article  Google Scholar 

  15. Al-Samsam RH, Cullen P (2005) Sleep and adverse environmental factors in sedated mechanically ventilated pediatric intensive care patients. Pediatr Crit Care Med 6:562–567

    Article  PubMed  Google Scholar 

  16. Berens RJ, Weigle CG (1995) Noise measurements during high-frequency oscillatory and conventional mechanical ventilation. Chest 108:1026–1029

    PubMed  CAS  Google Scholar 

  17. Moore MM, Nguyen D, Nolan SP, et al (1998) Interventions to reduce decibel levels on patient care units. Am Surg 64:894–899

    PubMed  CAS  Google Scholar 

  18. Cooper AB, Thornley KS, Young GB, Slutsky AS, Stewart TE, Hanly PJ (2000) Sleep in critically ill patients requiring mechanical ventilation. Chest 117:809–818

    Article  PubMed  CAS  Google Scholar 

  19. Freedman NS, Kotzer N, Schwab RI (1999) Patient perception of sleep quality and etiology of sleep disruption in the intensive care unit. Am J Respir Crit Care Med 159:1155–1162

    PubMed  CAS  Google Scholar 

  20. Parthasarathy S, Tobin MJ (2004) Sleep in the intensive care unit. Intensive Care Med 30:197–206

    Article  PubMed  Google Scholar 

  21. Bourne RS, Mills GH (2004) Sleep disruption in critically ill patients — pharmacological considerations. Anaesthesia 59:374–384

    Article  PubMed  CAS  Google Scholar 

  22. Krachman SL, D’Alonzo GE, Criner GJ (1995) Sleep in the intensive care unit. Chest 107:1713–1720

    PubMed  CAS  Google Scholar 

  23. Jones C, Griffiths RD, Humphris G (2000) Disturbed memory and amnesia related to intensive care. Memory 8:79–94

    Article  PubMed  CAS  Google Scholar 

  24. Topf M, Davis JE (1993) Critical care unit noise and rapid eye movement (REM) sleep. Heart Lung 22:252–258

    PubMed  CAS  Google Scholar 

  25. Aaron JN, Carlisle CC, Carskadon MA, Meyer TJ, Hill NS, Millman RP (1996) Environmental noise as a cause of sleep disruption in an intermediate respiratory care unit. Sleep 19:707–710

    PubMed  CAS  Google Scholar 

  26. Russell S (1999) An exploratory study of patients’ perceptions, memories and experiences of an intensive care unit. J Adv Nurs 29:783–791

    Article  PubMed  CAS  Google Scholar 

  27. Hagerman I, Rasmanis G, Blomkvist V, Ulrich R, Eriksen CA, Theorell T (2005) Influence of intensive coronary care acoustics on the quality of care and physiological state of patients. Int J Cardiol 98:267–270

    Article  PubMed  Google Scholar 

  28. Kim DW, Kil HY, White PF (2001) The effect of noise on the bispectral index during propofol sedation Anesth Analg 93:1170–1173

    Article  PubMed  CAS  Google Scholar 

  29. Halpern NA, Pastores SM, Price JB, Alicea M (1999) Hearing loss in critical care: an unappreciated phenomenon. Crit Care Med 27:211–219

    Article  PubMed  CAS  Google Scholar 

  30. Campbell VA, Crews JE, Moriarty DG, Zack MM, Blackman DK (1999) Surveillance for sensory impairment, activity limitation, and health-related quality of life among older adults-United States 1993–1997. MMWR CDC Surveill Summ 48:131–156

    PubMed  CAS  Google Scholar 

  31. McCoy SL, Tun PA, Cox LC, Colangelo M, Stewart RA, Wingfield A (2005) Hearing loss and perceptual effort: downstream effects on older adults’ memory for speech. Q J Exp Psychol A 58:22–33

    PubMed  Google Scholar 

  32. Larsby B, Hallgren M, Lyxell B, Arlinger S (2005) Cognitive performance and perceived effort in speech processing tasks: effects of different noise backgrounds in normal-hearing and hearing-impaired subjects. Int J Audiol 44:131–143

    Article  PubMed  Google Scholar 

  33. McGuire BE, Basten CJ, Ryan CJ, Gallagher J (2000) Intensive care unit syndrome. Arch Intern Med 160:906–909

    Article  PubMed  CAS  Google Scholar 

  34. Ely EW, Shintani A, Truman B, et al (2004) Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA 291:1753–1762

    Article  PubMed  CAS  Google Scholar 

  35. Innouye SK, Bogardus ST, Charpentier PA, et al (1999) A multicomponent intervention to prevent delirium in hospitalized older patients. N Engl J Med 340:669–676

    Article  Google Scholar 

  36. Innouye SK, Viscoli CM, Horwitz RI, Hurst LD, Tinetti ME (1993) A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics. Ann Intern Med 119:474–481

    Google Scholar 

  37. Bentall RP, Taylor JL (2006) Psychological processes and paranoia: implications for forensic behavioural science. Behav Sci Law 24:277–294

    Article  PubMed  Google Scholar 

  38. Stein LM, Theinhaus OJ (1993) Hearing impairment and psychosis. Int Psychogeriatr 5:49–56

    Article  PubMed  CAS  Google Scholar 

  39. Ballard C, Bannister C, Graham C, Oyebode F, Wilcock G (1995) Associations of psychotic symptoms in dementia sufferers. Br J Psychiatry 167:537–540

    PubMed  CAS  Google Scholar 

  40. Palmer KT, Griffin MJ, Syddall HE, Davis A, Pannett B, Coggon D (2002) Occupational exposure to noise and the attributable burden of hearing difficulties in Great Britain. Occup Environ Med 59:634–639

    Article  PubMed  CAS  Google Scholar 

  41. Topf M, Dillon E (1988) Noise-induced stress as a predictor of burnout in critical care nurses. Heart Lung 17:567–574

    PubMed  CAS  Google Scholar 

  42. Williams JM (1981) Noise at work. BMJ 283:731–732

    PubMed  CAS  Google Scholar 

  43. Walder B, Francioli D, Meyer JJ, Lançon M, Romand JA (2000) Effects of guidelines implementation in a surgical intensive care unit to control nighttime light and noise levels. Crit Care Med 28:2242–2247

    Article  PubMed  CAS  Google Scholar 

  44. Monsen MG, Edell-Gustafsson UM (2005) Noise and sleep disturbance factors before and after implementation of a behavioural modification programme. Intensive Crit Care Nurs 21:208–19

    Article  PubMed  Google Scholar 

  45. Interview 01 At: http://www.dipex.org/intensivecare/Exec Accessed Dec 2006

  46. Stanchina ML, Abu-Hijleh M, Chaudhry BK, Carlisle CC, Millman RP (2005) The influence of white noise on sleep in subjects exposed to ICU noise. Sleep Med 6:423–428

    Article  PubMed  Google Scholar 

  47. Wallace CJ, Robins J, Alvord LS, Walker JM (1999) The effects of earplugs on sleep measures during exposure to simulated intensive care unit noise. Am J Crit Care 8:210–219

    PubMed  CAS  Google Scholar 

  48. Byers JF, Smyth KA (1997) Effect of music intervention on noise annoyance, heart rate, and blood pressure in cardiac surgery patients. Am J Crit Care 6:183–191

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Intensive Care Unit, Whiston Hospital, Warrington Road, Prescot, L35 5DR, UK

    R. J. Pugh & C. Jones

  2. Division of Metabolic and Cellular Medicine School of Clinical Science Duncan Building, UCD, University of Liverpool, Liverpool, LK69 3GA, UK

    R. D. Griffiths

Authors
  1. R. J. Pugh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. D. Griffiths
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Intensive Care Erasme Hospital, Free University of Brussels, Route de Lennik 808, 1070, Brussels, Belgium

    Jean-Louis Vincent MD, PhD, FCCM, FCCP (Head) (Head)

Rights and permissions

Reprints and permissions

Copyright information

© 2007 Springer Science + Business Media Inc.

About this paper

Cite this paper

Pugh, R.J., Jones, C., Griffiths, R.D. (2007). The Impact of Noise in the Intensive Care Unit. In: Vincent, JL. (eds) Intensive Care Medicine. Springer, New York, NY. https://doi.org/10.1007/978-0-387-49518-7_85

Download citation

  • DOI: https://doi.org/10.1007/978-0-387-49518-7_85

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-49517-0

  • Online ISBN: 978-0-387-49518-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation