Decibel Levels Research Articles

An Evidence-Based Approach to Reducing Cardiac Telemetry Alarm Fatigue.

It is estimated that between 80% and 99% of alarms in the clinical areas are in actionable alarms (Gross, Dahl, & Nielson). Alarm management is one of the Joint Commission's National Patient Safety Goals (2014) because sentinel events have directly been linked to the devices generating these alarms. At an acute care facility in Boston, a multidisciplinary team consisting of Nursing, Biomedical Engineers, Patient Safety and Providers was formed to conduct a pilot study on the state of telemetry alarms on a surgical floor. An evidence-based approach was taken utilizing Philips Real-time data exporter alarms tracking software to capture all telemetry alarms during a 43-day time span. Likewise, noise meters were placed near telemetry alarm speakers to track decibel levels within the aforementioned timeframe for 21 days. Analysis of the data showed that clinically insignificant Premature Ventricular Contractions (PVC) alarms accounted for more than 40% of all alarms in the unit within the time span, while also contributing to an average noise level of 58.49 dB. In response to the data, the interdisciplinary team approved to permanently default the settings for PAIR PVC, MULTIFORM PVC, and RUN PVC alarms to off. The results showed a 54% decrease in the rate of alarms per bed per day, and an average noise reduction of 2.3 dB between the two selected noise measurement areas. Organizing a multidisciplinary team provides an effective framework toward analyzing and addressing cardiac telemetry alarm fatigue. Looking at quantitative datasets for clinical care areas through various lenses helps identify opportunities for improvement in regards to highlighting alarms that are not actionable. Pilot changes to alarm parameters can be tested for their environmental impact in the care area.

GIS-based modeling of tornado siren sound propagation: Refining spatial extent and coverage estimations

Urban areas located in Tornado Alley are consistently threatened by severe weather. Tornado sirens are commonly utilized by local governments to inform citizens of approaching danger. Geographic Information System (GIS)-based analyses have provided a practical means by which to assess the spatial extent and coverage of siren networks. Commonly, these studies apply arbitrary distance buffers to siren locations to determine areas where people can presumably hear them. This approach, however, does not account for the complexities of sound propagation (e.g., environmental factors such as weather conditions and topography). This study proposes the application of the SPreAD-GIS toolset to model the propagation of tornado siren sound. We model siren sound propagation in the city of Stillwater, Oklahoma (USA) for three scenarios, which align with the last three occasions when tornado warnings were issued in the city and the sirens were activated. We calculate mean siren decibel levels for all buildings in the city and relate this to population information to obtain a more comprehensive understanding of the performance of the siren network. Across all scenarios, findings indicate that the siren network performs well with less than 3% of the population residing in locations with a mean value of 80dB or less.

Comparison of noise effects to state anxiety levels of patients and nurses

IntroductionAn quiet environment is comfortable and peaceful. Also, healthy and safety environment is a human right. But, exposure to noise may cause negative effects on psychology and performance. Also, it is a problem in public hospitals, because, noise is an important issue for both nurses and patients.ObjectivesThe study was designed to determine decibel levels on the hospital's four unified clinics and compare noise effects to state anxiety levels of patients and nurses.MethodsInformation Form, Spielberger State-Trait Anxiety Inventory (STAI) were applied to participating 40 patients and 14 nurses. A measurement of the sound level of unified clinics was performed for two days in the morning and after lunch for two days.ResultsThe range of minimum to maximum decibel levels was significantly greater in nurses’ station (38.66 dB versus 82.48 dB) than patient rooms (24.61 dB versus 74.2 dB) (P < .05). 25 patients and 14 nurses stated that there was noise in the clinic. 19 patients and 10 nurses expressed that it caused a headache. The state anxiety levels were 39.29 ± 5.61 for nurses and 45.4 ± 4.86 for patients. The state anxiety level of patients were 44.83 ± 3.86 in 1. Clinic, 48.8 ± 4.37 in 2. Clinic, 43.82 ± 4.9 in 3. clinic, 44 ± 5.57 in 4. Clinic.ConclusionsWe should reduce the noise level to reduce the level of state anxiety. This study describes one reason to reduce peak noise levels on unified clinics. Standards applied across studies to measure and characterize acoustic environments are urgently needed.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Hearing Impairment

In a 2014 study of adults aged >18 years, the US Census Bureau and the Centers for Disease Control and Prevention found that 19% of 40- to 69-year-olds reported hearing trouble and 43% of 79-year-olds reported the same.1 Almost 50% of workers in the fields of carpentry, plumbing, and mining have hearing impairment.2 Hearing impairment rating determination, described in the AMA Guides, Sixth Edition, Section 11.2a, Criteria for Rating Impairment Due to Hearing Loss (6th ed, 247–260), remains quite simple.A hearing impairment evaluation is derived from a pure-tone audiogram, and it is always based on the functioning of both ears, even though the hearing loss may be present in only 1 ear. This method is used only in adults who have acquired language skills. If the patient uses a hearing aid or other prosthetic devise, the evaluator should remove it before testing, as explained in Section 2.4e, Using Assistive Devices in Evaluation (6th ed, 25).Impairment is intended to measure permanent loss. Examiners should be aware that hearing can be temporarily impaired by recent exposure to loud noise. Under these circumstances, an audiogram should be repeated after an extended period (eg, 12–14 hours) without exposure to loud noises.Audiometers should be properly calibrated, and technicians should be appropriately trained to obtain accurate measurements. In general, audiograms are obtained measuring the decibel loss at 500, 1000, 2000, 3000, 4000, 6000, and 8000 Hz.Present audiometric techniques for measuring speech are considered limited. The frequencies 500, 1000, 2000, and 3000 Hz are considered representations of everyday auditory stimuli in the speech ranges. Therefore, these 4 frequencies (test frequencies) are used to calculate impairment ratings.The evaluator tests the individual's right and left ears at 500, 1000, 2000, and 3000 Hz. The evaluator then adds the decibel levels for each of these frequencies for each ear separately. Following this, he or she locates the total worst ear decibel level on the vertical axis in Table 11-2, Computation of Binaural Hearing Impairment (6th ed, 252–253). The total better ear decibel level is located on the horizontal axis, and the intersection of these 2 points is the total hearing impairment. To convert hearing impairment to whole person impairment, the evaluator uses Table 11-3, Relationship of Binaural Hearing Impairment to Impairment of the Whole Person (6th ed, 254). If monoauricular impairments are required, the evaluator should use Table 11-1, Monaural Hearing Loss and Impairment (6th ed, 250), and apply the total decibel levels from each ear separately.Approximately 32% of all US adults report having tinnitus at sometime.3 The prevalence of tinnitus increases through age 70 years, and about 6.4% report that the tinnitus is severe or debilitating.4 Tinnitus can be rated if there is hearing loss in the ear that impacts speech discrimination. The hearing loss need not be from the injury in question since any hearing loss, rated according to the AMA Guides, affects speech discrimination. Tinnitus is only believed to be impairing when combined with such a hearing loss. The tinnitus rating is limited to up to 5% loss. The AMA Guides states that “tinnitus in the presence of unilateral or bilateral hearing impairment may impact speech discrimination. Therefore, add up to 5% for tinnitus in the presence of measurable hearing loss if the tinnitus impacts the ability to perform activities of daily living” (6th ed, 249).The only activity of daily living that tinnitus logically affects is speech discrimination, so tinnitus should be rated only if it impacts speech discrimination.There is no correction in the hearing section for age-related loss of hearing, although it is noted that this may be apportionable. Table 1 may be used to record hearing impairment.

Rating Cognitive Impairment, Part 2: Objective and Evidence-Based Integration of Neuropsychology Testing

Abstract Hearing impairment rating determination is described in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, Section 11.2a, Criteria for Rating Impairment Due to Hearing Loss. A hearing impairment evaluation for adults who have acquired language skills is derived from a pure-tone audiogram and always is based on the functioning of both ears even though hearing loss may be present in only one ear. Audiometers should be properly calibrated, and technicians should be appropriately trained to obtain accurate measurements. Audiograms typically are obtained at four frequencies (test frequencies): 500, 1000, 2000, and 3000 Hz, which are considered to be representative of everyday auditory speech ranges. The evaluator tests the individual's right and left ears at the test frequencies and adds the decibel levels for each of these frequencies for each ear separately; consults Table 11-2, Computation of Binaural Hearing Impairment; and finally consults Table 11-3, Relationship of Binaural Hearing Impairment to Impairment of the Whole Person. Tinnitus can be rated if the individual experiences hearing loss in the ear and this loss affects speech discrimination; loss is limited to a maximum of 5% loss. The AMA Guides provides no correction in the hearing section for age-related loss of hearing, although the latter may be apportionable. A table presents a model hearing impairment report.

Noise levels of amusement ride operators

ABSTRACTOne of the leading causes of noise-induced hearing loss is occupational noise exposure; however, little attention has been given to the exposure among amusement ride operators. According to the International Association of Amusement Parks and Attractions, 600,000 ride operators are employed in the U.S. The first objective of this descriptive study was to evaluate if ride operators were exposed to noise levels over 85 dB. The second objective was to classify the ride features that led to the highest noise levels. 136 rides were measured at 17 total amusement parks, county fairs, and festivals in southern Wisconsin and northern Illinois during summer 2015. A sound level meter recorded noise measurements as close in proximity to the ride operator as possible. Each ride was measured for two or three complete ride cycles, which included loading and operating the ride. The sound level meter was programmed to measure noise as recommended by the American Conference of Governmental Industrial Hygienists and with no threshold. 18% of rides measured had projected noise levels greater than American Conference of Governmental Industrial Hygienists recommendation of 85 dB. A repeated measures model was used to analyze the complete ride cycle decibel levels. The model found that traveling carnival rides had significantly higher levels compared to the stationary amusement park rides (p < 0.001), the rides operated near midway music had significantly higher levels than those without midway music (p < 0.001), and the type of ride was also significant. Tukey-Kramer multiple comparison test was used to determine differences in type of ride. According to the data, 18% of the amusement ride operators would be at risk for noise induced hearing loss and would require a hearing conservation program if the 8-hr time weighted averages were to follow the same trends as the complete ride cycle levels.

Student Zone

It was beautiful and sunny in Dallas, Texas, the morning of 15 October 2016. Students, with enthusiastic smiles and filled with curiosity, began to occupy a vast ballroom of a downtown hotel. As the number of students grew, the friendly chitchat among them reached a higher decibel level. A total of 51 students from 25 different countries filled the ballroom, and the stage was set for the SEG/Chevron Student Leadership Symposium (SLS), designed to prepare student leaders in the industry to tackle a variety of challenges and motivate their peers.

What Is a Safe Noise Level for the Public?

The author discusses what is considered to be a safe noise level for members of the public in the U.S., and it mentions the National Institute on Deafness and Other Communication Disorders' views about exposure to sound, decibel levels, and hearing loss. The U.S. Occupational Safety and Health Administration's adoption of a legal standard for workplace hearing protection is assessed, along with the American Environmental Protection Agency Office of Noise Abatement and Control.

Acoustic Design and Repetitive Speech and Motor Movement in Children with Autism

Emerging research in Evidence-Based Design for interiors such as classrooms has begun considering the unique sensory needs of users with autism spectrum disorders. The current study observes the impact of the acoustic environment on repetitive speech and motor movement in children with autism. An observational study was conducted in four school classrooms to observe changes in behavior associated with changes in the decibel levels in the room. Forty-two children diagnosed with high-functioning autism between the ages of six and nine years old were observed in classroom settings. Variant decibel levels in the classrooms and variance in the frequency of repetitive behaviors were measured to determine the strength and direction of the correlations between the two. Results were analyzed using Noldus Observer XT software, and confirmed the hypothesized relationship. The finding that repetitive behavior is correlated with the acoustical condition of the environment should be considered in the design of classrooms for children with autism, for the benefit of user comfort and educational performance.

Impact of Noise on Health: The Divide between Policy and Science

In her chapter “Sources of Noise” in Noise and Health, Annette Zaner [1] writes that sounds have been environmental pollutants for thousands of years, citing examples of stories of loud music in the Old Testament and noisy delivery wagons in ancient times. The Industrial Revolution and urbanization in more recent times raised the decibel levels in our communities, especially with the growth in transportation on the roads, on the rails and in the air, as well as the growth of noise polluting products. The proliferation of boom cars, cell phones and wind turbines during the past twenty years has made our world even noisier. Studies have been carried out that have demonstrated the potential impact of these noises on our mental and physical health, and there have been some efforts to lessen some of the intrusive sounds, e.g. aircraft and road traffic noise, but there is still too little attention paid to the deleterious effects of noise. While noise complaints top the list of complaints in major cities worldwide and noise even threatens the natural sound systems of our planet, there is no movement globally to address the noise pollutant. The following paper will examine the research linking noise to health effects, question why governments have not seriously attempted to lower noise levels and suggest ways to lessen the din. Doing so will not only be beneficial to our health and well-being but it would also be wise economically.

Spaces Matters: Classroom Acoustics and Repetitive Behaviors in Preschool Children with Autism

Autism has generally been ignored by the interior design community and excluded from building codes and guidelines, even those developed explicitly for special needs individuals. This research will look into how interior design factors affect individuals with autism; specifically with regards to acoustics. Today’s world has put much emphasis and consideration towards the diversity of individuals and their developmental and psycho-social disorders, yet research has not been thorough in this topic; thus, this article presents a further step when considering development. Therefore, one of the primary aims of this research is to correct this exclusion by developing a preliminary framework of interior design guidelines for autism. To reach this goal of developing a framework for architectural guidelines for autism, an extensive literature review was conducted and a behavioral observation took place. Four classrooms were identified in two schools (two rooms in each school) based on their noise levels and behaviors were recorded from 42 participants. Research results indicate that environment is important to the treatment of autism because it influences behavior. A significant positive correlation between noise levels and frequency of target behaviors was found; that is, as decibel levels increased, several of the observed behaviors occurred with greater frequency. This research gives practical solutions that architects and designers can use to modify the environment for children with autism. Developed and expounded by the author in two previous studies (Kanakri, et al. “An Observational Study of Classroom Acoustical Design and Repetitive Behaviors in Children With Autism,” Sage Publications, pp. 1-27, 2016) and (Kanakri, S. M., The Impact of Acoustical Environmental Design on Children with Autism. 2014), these analyses lay the groundwork for this article’s research which provides tangible modifications to help these children develop their skills, cope with auditory problems and improve their behaviors.

An Observational Study of Classroom Acoustical Design and Repetitive Behaviors in Children With Autism

The objective of the present study is to explore the impact of acoustical design on children with autism in school classrooms. Empirical research on this topic will provide information on how interior space features and spatial environment characteristics can be used to support the learning and developmental needs of children with autism. Specifically, the connection between repetitive behaviors and ambient noise levels in school classroom environments was observed in four classrooms. The occurrence of repetitive motor movements, repetitive speech, ear covering, hitting, loud vocalizations, blinking, and verbally complaining in relation to decibel levels were analyzed using Noldus Observer XT software. As hypothesized, a correlation between noise levels and frequency of target behaviors was found; that is, as decibel levels increased, several of the observed behaviors occurred with greater frequency. Further empirical testing is necessary to test a causal relationship between increased ambient noise levels and autism-related behaviors, and sensory discomfort as a mediator of that relationship. Findings are applied to the development of classroom design guidelines.

A Comparison of Sound Levels in Open Plan Versus Pods in a Neonatal Intensive Care Unit.

The objective of this study was to compare the noise levels recorded in two different neonatal intensive care unit (NICU) settings: a pod and an open plan NICU located in the same hospital. The NICU is a busy environment with ambient noise levels that often exceed established recommendations. This noise deleteriously affects the physiological stability and developmental outcomes of sick and preterm infants. Pods have reduced numbers of cots (in this case, 6) compared to open plan NICUs (in this case, 11), yet the noise levels in pods have not been reported. This study compared real-time decibel (dB) levels in an A-weighted scale, captured continuously by sound dosimeters mounted in both NICU settings for a period of 4 weeks: a pod setting and an open plan NICU. Researchers also collected observational data. The average noise level recorded in the pod was 3 dBs less than in the open plan NICU. This result was statistically significant. However, dB recordings in both areas were over the recommended limits by 4-6 dBs, with isolated peaks between 74.5 dBs (NICU) and 75.9 dBs (pod). Observational data confirmed this correlation. Further research to evaluate interventions to decrease the noise levels in both settings are needed, especially during times of peak activity. Staff working in these settings need to be more aware that control of acoustic levels is important in the neuroprotection of neonates. Coupling this with careful consideration to structural components and evidence-based design planning may contribute to lowering dB levels in the NICU environment.

Noise pollution levels in the pediatric intensive care unit

Patients and staff may experience adverse effects from exposure to noise. ObjectThis study assessed noise levels in the pediatric intensive care unit and evaluated family and staff opinion of noise. DesignNoise levels were recorded using a NoisePro DLX. The microphone was 1 m from the patient's head. The noise level was averaged each minute and levels above 70 and 80 dBA were recorded. The maximum, minimum, and average decibel levels were calculated and peak noise level great than 100 dBA was also recorded. A parent questionnaire concerning their evaluation of noisiness of the bedside was completed. The bedside nurse also completed a questionnaire. ResultsThe average maximum dB for all patients was 82.2. The average minimum dB was 50.9. The average daily bedside noise level was 62.9 dBA. The average % time where the noise level was higher than 70 dBA was 2.2%. The average percent of time that the noise level was higher than 80 dBA was 0.1%. Patients experienced an average of 115 min/d where peak noise was greater than 100 dBA. The parents and staff identified the monitors as the major contribution to noise. ConclusionPatients experienced levels of noise greater than 80 dBA. Patients experience peak noise levels in excess of 100 dB during their pediatric intensive care unit stay.

The implementation of low-cost urban acoustic monitoring devices

The urban sound environment of New York City (NYC) can be, amongst other things: loud, intrusive, exciting and dynamic. As indicated by the large majority of noise complaints registered with the NYC 311 information/complaints line, the urban sound environment has a profound effect on the quality of life of the city’s inhabitants. To monitor and ultimately understand these sonic environments, a process of long-term acoustic measurement and analysis is required. The traditional method of environmental acoustic monitoring utilizes short term measurement periods using expensive equipment, setup and operated by experienced and costly personnel. In this paper a different approach is proposed to this application which implements a smart, low-cost, static, acoustic sensing device based around consumer hardware. These devices can be deployed in numerous and varied urban locations for long periods of time, allowing for the collection of longitudinal urban acoustic data. The varied environmental conditions of urban settings make for a challenge in gathering calibrated sound pressure level data for prospective stakeholders. This paper details the sensors’ design, development and potential future applications, with a focus on the calibration of the devices’ Microelectromechanical systems (MEMS) microphone in order to generate reliable decibel levels at the type/class 2 level.

Effect two grades of octane numbers on the performance, exhaust and acoustic emissions of spark ignition engine

This study presents a comparative analysis of performance, exhaust and noise emissions for a one-cylinder, four-stroke, spark-ignition engine powered by gasoline fuels of two different grades of research octane numbers (RONs), namely octane 90, and octane 95. During the experimental works, each fuel test was performed by varying the engine speed within the range from 1000 to 3600rpm. The SI engine was connected to eddy current dynamometer with electronic control unit (ECU), an exhaust gas analyzer and the sound level meter (SLM) to determine engine performance, exhaust emissions, and measuring the sound pressure level (SPL) in decibels (dBA) and one octave frequency bands in the audible human range at different engine speeds, respectively. The experimental results showed that the using gasoline with octane grades higher than the requirement of an engine will decrease the engine performance. On average, the brake power and thermal efficiency for the SI engine fuelled with octane 90 is higher than that of gasoline octane 95 by 6% and 11% respectively, and improvement of BSFC by 14%, which is mainly due to higher heating value. Even though, the volumetric efficiency of octane 95 is more 5% than octane 90 due to higher latent heat and heat capacity. In general, the exhaust emission profiles for NOx and CO of the engine improved for octane 95 by 11% and 17% respectively. On the other side, the HC and CO2 emissions concentration of gasoline octane 90 is lower than that of gasoline octane 95 by 18% and 12% respectively. Finally, the noise levels showed a trend of the increase of disturbing for higher octane number and the increase of divergence between the two values of SPL at higher speed for both fuels.

The Quiet Classroom Game: A Class-Wide Intervention to Increase Academic Engagement and Reduce Disruptive Behavior

.The current study investigated the effectiveness of the Quiet Classroom Game, an interdependent group contingency using an iPad loaded with a decibel meter app, for increasing academically engaged behavior. Three first-grade classrooms in the southeastern United States, identified as displaying high levels of noise and disruptive behavior, were included in the study. A multiple-baseline design with an embedded ABAB condition sequence was used to evaluate the effect of implementation of the Quiet Classroom Game on academically engaged behavior, disruptive behavior, and classroom decibel level. Implementation of the intervention resulted in large increases in academically engaged behavior, moderate to large reductions in disruptive behavior, and large decreases in classroom noise. Results of social validity checklists administered to teachers and students indicated acceptability and utility of the intervention. Findings of the study suggest that the Quiet Classroom Game may be an effective method for increasing the academically engaged behavior and decreasing the noise and disruptive behavior of first-grade students in a general-education setting.

Permanent sensor-based hospital noise discovery

John Bialk, CEO of Quietyme, will discuss how using smart sensors and advanced analytics to measure sound levels in hospitals has revealed what really happens in healthcare settings. By measuring decibel levels once per second in every patient room, hallway, and nurse’s station, Quietyme is able to uncover the exact sources of patient noise disturbances and better understand solutions to reduce them. With nearly 100 million points of hospital sound data, John Bialk has a rare and purely objective perspective on hospital noise and will explain the difference between what the data has revealed and common misconceptions. In addition, Quietyme has helped with a variety of noise studies testing rooms and John will reveal findings that relate to hard surface vs. carpet, healthcare noise levels during construction and more.

Implementation of an augmented reality interface to reproduce and compare soundscapes

Soundscape design is a growing concern in architectural practice; yet, conveying soundscape properties is a challenge. Quantitative measures like decibel levels offer little utility; birdsong and squealing brakes may be at the same frequency and level, yet one is obviously preferable. Furthermore, visual qualities of the scene have a substantial effect on perception of the acoustic environment. To improve communication between acoustic designers, architects, and clients, an augmented reality interface has been designed to allow comparisons of soundscapes and their relationships to the built environment. The interface consists of a physical scale model, printed data, and a tablet application. The augmented reality application uses a machine vision algorithm to recognize the model and allow on-screen interaction. On the tablet, measurement points are displayed on a live image of the model at their respective locations, and the user may select a point by touch, which will begin sound playback and display an immersive image of the scene. The participant can then look around a spherical image of the scene using the tablet as a movable window, and thereby listen to the environment with appropriate accompanying visual cues. The interface has been a useful tool to communicate urban sound issues.

Uncertainty of decibel levels

The mean sound exposure level from a source is routinely estimated by the mean of the observed sound exposures from repeated measurements. A formula for the standard uncertainty based on the Guide to the expression of Uncertainty in Measurement (GUM) is derived. An alternative formula is derived for the case where the GUM method fails. The formulas are applied on several examples, and compared with a Monte Carlo calculation of the standard uncertainty. The recommended formula can be seen simply as a convenient translation of the uncertainty on an energy scale into the decibel level scale, but with a theoretical foundation.