The role of noise in clinical environments with particular reference to mental health care: A narrative review

Abstract

BackgroundThere is a large literature suggesting that noise can be detrimental to health and numerous policy documents have promoted noise abatement in clinical settings. ObjectivesThis paper documents the role of noise in clinical environments and its deleterious effects with a particular focus on mental health care. Our intention however, is to go beyond the notion that noise is simply undesirable and examine the extent to which researchers have explored the meaning of sound in hospital settings and identify new opportunities for research and practice. Data sources and review methodsThis is a narrative review which has grouped the literature and issues in the field into themes concerning the general issues of noise in health care; sleep noise and hospital environments; noise in intensive care units; implications for service users and staff; and suggestions for new ways of conceptualising and researching clinical soundscapes. Data sources comprised relevant UK policy documents and the results of a literature search of Pubmed, Scopus and Web of Knowledge using terms such as noise, health, hospital, soundscape and relevant additional terms derived from the papers retrieved. In addition the references of retrieved articles were scanned for additional relevant material and historical items significant in shaping the field. ResultsExcess unwanted noise can clearly be detrimental to health and impede recovery, and this is clearly recognised by policymakers especially in the UK context. We use the literature surveyed to argue that it is important also to see the noise in clinical environments in terms of the meaning it conveys and rather than merely containing unwanted sound, clinical environments have a 'soundscape'. This comprises noises which convey meaning, for example about the activities of other people, the rhythms of the day and the nature of the auditory community of the hospital. Unwanted sound may have unwanted effects, especially on those who are most vulnerable, yet this does not necessarily mean that silence is the better option.Page 2 Therefore it is our contention that it is important to begin thinking about the social functions of sound in the mental health environment. ConclusionsWhilst it can be stressful, sound can also be soothing, reassuring and a rich source of information about the environment as well. It may be used to secure a degree of privacy for oneself, to exclude others or as a source of solidarity among friends and colleagues. The challenge then is to understand the work that sound does in its ecological context in health care settings.

Noise Levels in a Medical Intensive Care Unit

“…In the past half century, the develop of science and technology have afforded medical countless new equipment and machines that have allowed patients to undergo medical procedures with improved outcomes [1,2]. However, these beneficial advances are were accompanied by the corresponding noises that result from their use [3,4]. In addition, poor design of hospital acoustic environment also contributes to increased noise [5,6].…”

Organizing the sensory: Ear-work, panauralism and sonic agency on a forensic psychiatric unit

“…These are sounds that are heavy with particular cultural and emotional significance, and can be powerful markers of institutional life for members. Brown et al (2015) also point to 'keynote sounds', such as machines, fans, computers, or clocks ticking, which make up the continuous background noise, and distinct 'sound signals' such as the rattle of a moving food trolley, panic alarms, telephones ringing or footsteps approaching. To the 'untrained ear' these sounds are unpredictable 'noise' that interrupt daily activities.…”

Implications and Prevention of Noise Hazards on Board Ships

“…Exposure to intense noise is known to cause damage to the hearing apparatus of man and it also implicates various non-auditory systems of the body through the secondary pathways [1][2][3][4][5][6][7][8][9][10][11] . In the defence and civil sectors, different types of machines, equipment, systems and processes, while in operation give rise to an environment full of noise.…”