Comparing light and noise levels before and after a NICU change of design

Aita, Marilyn; Robins, Stéphanie; Charbonneau, Lyne; Doray-Demers, Pascal; Feeley, Nancy

doi:10.1038/s41372-021-01007-8

Cited by 10 publications

(8 citation statements)

References 41 publications

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“…This is in line with previous studies that characterized light levels in different hospital settings, in which median daytime light levels ranged between 40-150 lux (Durrington et al, 2017;Fan et al, 2017;Greenfield et al, 2020;Lusczek and Knauert, 2021). In addition, in a study comparing two different NICU designs, it was found that daytime light levels were lower in an open ward design (comparable to the NICU in our study) compared to in pods and single-family rooms (69 vs. 368 lux) (Aita et al, 2021).…”

Section: Discussionsupporting

confidence: 92%

Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study

Van der Linden,

Hazelhoff,

De Groot

et al. 2023

Front. Physiol.

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Objectives: To characterize bedside 24-h patterns in light exposure in the Neonatal Intensive Care Unit (NICU) and to explore the environmental and individual patient characteristics that influence these patterns in this clinical setting.Methods: We conducted a retrospective cohort study that included 79 very preterm infants who stayed in an incubator with a built-in light sensor. Bedside light exposure was measured continuously (one value per minute). Based on these data, various metrics (including relative amplitude, intradaily variability, and interdaily stability) were calculated to characterize the 24-h patterns of light exposure. Next, we determined the association between these metrics and various environmental and individual patient characteristics.Results: A 24-h light-dark cycle was apparent in the NICU with significant differences in light exposure between the three nurse shifts (p < 0.001), with the highest values in the morning and the lowest values at night. Light exposure was generally low, with illuminances rarely surpassing 75 lux, and highly variable between patients and across days within a single patient. Furthermore, the season of birth and phototherapy had a significant effect on 24-h light-dark cycles, whereas no effect of bed location and illness severity were observed.Conclusion: Even without an official lighting regime set, a 24-h light-dark cycle was observed in the NICU. Various rhythmicity metrics can be used to characterize 24-h light-dark cycles in a clinical setting and to study the relationship between light patterns and health outcomes.

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Section: Discussionsupporting

confidence: 92%

Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study

Van der Linden,

Hazelhoff,

De Groot

et al. 2023

Front. Physiol.

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“…This study revealed elevated levels of noise in the investigated Brazilian NICU, consistent with findings from other published literature [19,[25][26][27][28][29][30][31][32][33].…”

Section: Discussionsupporting

confidence: 92%

Excessive Noise in Neonatal Units and the Occupational Stress Experienced by Healthcare Professionals: An Assessment of Burnout and Measurement of Cortisol Levels

et al. 2023

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Excessive noise in the work environment has been associated with extra-auditory symptoms, which can have harmful long-term effects on individuals. The purpose of this study was to identify noise levels in neonatal intensive care units and investigate their impact on the occurrence of stress among healthcare professionals, using cortisol levels as a biomarker for Burnout Syndrome. This descriptive, observational, and cross-sectional study was conducted in four public teaching hospitals in Fortaleza, Ceará, Brazil. Sound pressure levels in the environment were measured, and questionnaires were administered to collect sociodemographic data and assess perceptions of the work environment and Burnout symptoms. Saliva samples were collected at the beginning and end of work shifts for cortisol quantification. The average sound pressure ranged from 59.9 to 66.4 dB(A), exceeding the recommended levels set by Brazilian and international legislation. Among the 256 participants, the average age was 39.4 years, with 95% being female. The majority (70.9%) were nurses, and 22.7% were physicians. There was no significant association found between noise and Burnout Syndrome, nor with changes in cortisol levels. However, a significant association was observed between the perception of excessive noise and the sensation of a stressful work shift (p = 0.012). All evaluated professionals displayed symptoms of Burnout. The high sound pressure levels indicated that the assessed environments did not meet the recommended standards for acoustic comfort, and this was associated with the participants’ perception of stressful work shifts. While Burnout symptoms were evident in our participants, it was not possible to confirm a correlation with high noise levels.

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“…When compared to other NICUs, our open bay NICU with an average SPL of 53 dB(A) does not seem to be a loud one; the staff is trained to lower their voices, we offer music therapy, and we encourage parents to communicate with their newborns. Correspondingly, in a recent study in Montreal even after change of the whole NICU architecture, an average sound pressure level of 49 dB(A) (coming from 58 dB(A)) has been reported [76]. Similar ranges have been reported in South India [77].…”

Section: Conclusion For the Newborn Inside The Incubatorsupporting

confidence: 60%

Newborn Incubators Do Not Protect from High Noise Levels in the Neonatal Intensive Care Unit and Are Relevant Noise Sources by Themselves

et al. 2021

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Background: While meaningful sound exposure has been shown to be important for newborn development, an excess of noise can delay the proper development of the auditory cortex. Aim: The aim of this study was to assess the acoustic environment of a preterm baby in an incubator on a newborn intensive care unit (NICU). Methods: An empty but running incubator (Giraffe Omnibed, GE Healthcare) was used to evaluate the incubator frequency response with 60 measurements. In addition, a full day and night period outside and inside the incubator at the NICU of the University Hospital Zurich was acoustically analyzed. Results: The fan construction inside the incubator generates noise in the frequency range of 1.3–1.5 kHz with a weighted sound pressure level (SPL) of 40.5 dB(A). The construction of the incubator narrows the transmitted frequency spectrum of sound entering the incubator to lower frequencies, but it does not attenuate transient noises such as alarms or opening and closing of cabinet doors substantially. Alarms, as generated by the monitors, the incubator, and additional devices, still pass to the newborn. Conclusions: The incubator does protect only insufficiently from noise coming from the NICUThe transmitted frequency spectrum is changed, limiting the impact of NICU noise on the neonate, but also limiting the neonate’s perception of voices. The incubator, in particular its fan, as well as alarms from patient monitors are major sources of noise. Further optimizations with regard to the sound exposure in the NICU, as well as studies on the role of the incubator as a source and modulator, are needed to meet the preterm infants’ multi-sensory needs.

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Comparing light and noise levels before and after a NICU change of design

Cited by 10 publications

References 41 publications

Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study

Characterizing light-dark cycles in the Neonatal Intensive Care Unit: a retrospective observational study

Excessive Noise in Neonatal Units and the Occupational Stress Experienced by Healthcare Professionals: An Assessment of Burnout and Measurement of Cortisol Levels

Newborn Incubators Do Not Protect from High Noise Levels in the Neonatal Intensive Care Unit and Are Relevant Noise Sources by Themselves

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