Editorial
Noise Pollution

Editorial: The Importance of Decreasing Noise Pollution and the Possible Effects on Perceived Sleep Quality.

By: Brooke D. Quinn, BS, RPSGT & Jessica S. Ward, BS, RCP, RPSGT

Noise, or unwanted sound, is one of the most common environmental exposures in the United States (García 2001).  It is estimated that over 50% of the United States population alone have had yearly exposure to noise pollution of high enough levels to be considered harmful to human health. Examples of noises loud enough to be considered harmful to human health include firearms, firecrackers, and jet engines.

Numerous studies have been conducted revealing that chronic exposure to environmental noise pollution causes a wide variety of adverse effects on our health.  These include sleep disturbance, hearing loss, cardiovascular disease, annoyance; mood disorders, endocrine effects, as well as increases our chances of becoming diabetic (Hammer, Swinburn, and Neitzel, 2014). Despite the proven negative implications of long term exposure to noise pollution and the widespread prevalence of the population exposed to noise pollution annually, noise pollution is treated very differently than other forms of pollutants.

Other forms of environmental pollution, such as chemical pollution, have our society actively working to decrease their effects and limit the population’s exposure.  However, noise pollution is not treated in the same regard.  This is likely due to society’s belief that it is inevitable as our society grows and industrialism continues to flourish, likewise the noise levels continue to increase in level, frequency, and duration (Hammer, et.al, 2014).  Due to the lack of efforts being made to decrease the impact of noise pollution on a congressional level, it is becoming apparent that it will be left to individuals to be proactive in making their environment as free of harmful noise pollution as possible.  This is specifically important when it comes to our sleeping environment as noise pollution has been shown to not only decrease the quality and quantity of sleep, but has also been shown to cause increases in cardiovascular stress as well as other hormonal and chemical reactions within the body (Hume, 2011).

As is becoming more publically known, a good night's sleep is a key factor in achieving a happy and healthy lifestyle. Not only do we feel better throughout the day, healthy sleep is our body's time to repair itself. However, we cannot get an acceptable amount of quality sleep if we are constantly being aroused by the impact of noise around us (Hume, 2011).  Noise pollution has been a growing concern in hospitals as the effects of exposure to hospital noise can have vast implications.  In the 21st century hospital noise is considered a pandemic and noise also increases sleep deprivation and the perception of pain while heightening anxiety and stress levels (Mazer 2012). The added noise may interfere with patient’s rest, recovery and their perception of their stay while in the hospital.

In the hospital noise origins mainly from: (1) operational activities generated by the staff in their care giving activities and communication, (2) medical equipment and alarms and (3) structural sounds from the building such as ventilation and closing doors. While some sounds are unavoidable, many are totally or partially unnecessary (Ryherd, Waye 2013). Noise in hospitals has been suggested to increase the risk for cardiovascular response, pain, intensive care delirium, fragmented sleep and reduced recuperation (Ryherd, Waye 2013).

The World Health Organization states guideline values for continuous background noise in hospital patient rooms are 35 dB, with nighttime peaks in wards not to exceed 40 dB (Berglund, Lindvall, & Schwela, 1999). For comparison, consider that 35-40 dB is the equivalent of whispering in the library or the sound of a ceiling fan; 45-60 dB is the equivalent of normal conversation; and 85-90 dB is the equivalent of a running vacuum or a lawn mower. These guidelines notwithstanding, many studies have shown that hospital background noise levels fall in far higher ranges. Background noise levels typically are 45 dB to 68 dB, with peaks frequently exceeding 85 dB to 90 dB (Aaron et al., 1996; Allaouchiche, Duflo, Debon, Bergeret, & Chassard, 2002; Blomkvist et al., in press, 2004; Falk & Woods, 1973; Hilton, 1985; McLaughlin, McLaughlin, Elliott, & Campalani, 1996; Robertson, Cooper-Peel, & Vos, 1998).

Noisy environments can also negatively impact patient satisfaction Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. The Center for Medicare & Medicaid Services gives out the HCAHPS survey. Two questions on the HCAHPS survey deal with the environment from the patient’s perspective. One of the two questions is “ How often do you experience quiet around your room at night?” The HCAHPS scores noise as the number one complaint and consistently receives the lowest ratings. These scores are detrimental to hospitals because this is how their reimbursement rates are determined. Observing quiet time and making subtle changes can make a big difference and have a more positive outlook on the patient’s perception of the hospital noise.

The hospital environment will never be a completely quiet environment however with minor modifications such as: changing wheels, applying padding, repairing door bumpers, using thicker carpet, and installing effective acoustic ceiling tiles hospitals have the ability to reduce hospital noise by acknowledging quiet time (Mazer 2012). Acknowledging quiet time makes a difference in the patient’s perception of noise while also increasing HCAHPS scores. Other suggestions of ways to create a quiet sleeping environment include:

  • Noise barriers/earplugs
  • White noise
  • Noise reducing curtains

The inevitable truth is that noise pollution is here to stay, as our society continues to grow and inexorably become louder due to multiple factors including, increase in population, increases in traffic, and a shift towards a 24 hour society.  This places extra importance on finding ways to reduce the effects of environmental noise pollution both in the home and the hospital setting, for the sake of sleep health.

 
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