Peak noise levels in a busy hospital ED can rival that of a construction site, according to Sydney researchers, who have warned the racket might have significant impacts on the safety and wellbeing of hospital staff and patients.

They used audio dosimeters to measure decibel levels over a 24-hour period in six distinct locations of the ED at a prominent public hospital in metropolitan Sydney, including the ambulance bay, waiting room and treatment areas.

Dosimeters were strategically positioned near the top of patient beds or installed on the wall in the waiting area at a height of a seated person’s head to estimate as closely as possible the level of noise a patient might encounter.

Audio data was collected during a typical weekday period in June 2022.

Published in Australasian Emergency Care [link here], findings showed that noise exceeded the WHO recommendation of below 35 decibels-A (dB-A) in all six areas of the ED for the entire 24 hours, with an average overall level of 56.53 dB.

Average noise levels were highest in the ED treatment areas one and two, with a mean of 59.40 dB and 60.01 dB respectively, and the ED waiting room with a mean of 59.96 dB. Whereas the overnight stay areas had the lowest average noise levels with means of 51.04 dB and 51.92 dB respectively.

Noise levels peaked at 102.8 dB in the ambulance bay and 99.68 dB in the waiting room, which was as loud as a construction site, noted the researchers from the Australian Institute of Health Innovation at Macquarie University.

However, despite having the highest peak levels, the mean peak levels recorded in the ambulance bay (70.92 dB) were lower than those in both ED treatment areas (72.21, 71.64) and the ED waiting room (73.45 dB).

The average noise levels were relatively lower between 12 am and 6 am in all six ED locations and the average noise levels were observed to be highest in the afternoon and early evening (between 2 pm and 7 pm) at most locations.

The researchers said their findings aligned with previous research, which suggested that ED noise levels had remained problematic for more than a decade and underscored the importance of introducing proactive measures.

“Our research highlighted the problematic nature of noise in the admission points of the ED, with peak noise levels comparable to those encountered at a construction site. Although the ambulance bay registered the highest peak noise levels, both the ED waiting room and treatment areas exhibited higher average noise levels,” they wrote.

“This suggests that, despite the sporadic instances of high noise levels in the ambulance bay (possibly caused by ambulance sirens), the sustained high average noise levels in the ED waiting room and treatment rooms may exert a more significant and enduring impact on both patients and staff.

“Given that a rise of 10 dB is often perceived as a doubling in the volume of sound, the detected noise levels within the ED surpass the recommended thresholds with a perceived loudness factor of more than four times.”

They concluded that it was “vital” for healthcare organisations to make concerted efforts to cultivate a therapeutic hospital setting, which would help reduce the negative consequences of excessive noise levels such as heightened stress levels, decreased patient satisfaction and impaired communication.

The researchers suggested this could be achieved by lowering noise levels via environmental enhancements, such as sound-absorbing walls and ceilings, introducing staff training about the impact of noise and providing patients with resources to minimise noise disturbances such as earplugs.