Noise Pollution: Neonatal Aspects

Abstract

The deafening effect of high intensity noise is well known—from rock music, aircraft, snowmobiles, motorcycles and the shooting of guns. The effects of hospital noise and its interaction with ototoxic drugs are less well known. The subject is of particular importance to pediatricians, because infants in incubators are exposed to substantial noise from the motor, airflow, respirators, slamming of incubator doors and the baby's own crying. Furthermore, animal experimentation1 shows that the ototoxic drug, kanamycin (often given to the premature infant to combat sepsis), can potentiate the effect of noise on hearing loss as much as 100-fold. Whether or not an interaction between noise and potentially ototoxic drugs occurs in man is as yet unknown. MEASUREMENT Noise has frequency and intensity. Frequency is measured in cycles per second, designated hertz (Hz). The young human ear is sensitive to a frequency range of 20 to 20,000 Hz. White noise, the auditory counterpart of white light, has equal energy in each frequency in the audible range. Intensity is measured in decibels on a scale which is linear with respect to audible frequencies. This measurement is designated dB (linear). Since the human ear is more sensitive to the damaging effects of high frequency sound than to low frequency, a better correlate with noise-induced hearing loss can be obtained when low frequencies are filtered out. Filtered sound level, measured on a so-called A-weighted scale, is designated dB(A). Room conversation produces 60 to 70 dB(A), rock music 100 to 120 dB(A) and snowmobiles 105 to 135 dB(A) for the driver.

Survey of Acoustic Output in Neonatal Brain Protocols

“…Neonatal hearing safety limits exist but are of limited use for neonatal MRI exposures. The American Academy of Pediatrics requests that manufacturers keep noise from incubator motors below 58 dBA 27 ; however, this was adapted from an observation of permanent threshold shift in adult guinea pigs under the influence of kanamycin, 28 which is not comparable to a human neonate in an MR scanner. A neonatal intensive care unit (NICU) Design Standard 29 limits continuous sound in any occupied bed space or patient care area to: a 1‐hour LAEQ of 50 dBA, a 1‐hour L10 (the sound level exceeded 10% of the time during the signal) of 55 dBA, and an LAS max of 70 dBA.…”