As noise rises, so do the dangers

Even Florence Nightingale thought that all the noise in hospitals was harmful.

"Unnecessary noise is the most cruel abuse of care which can be inflicted on either the sick or the well," she wrote in her 1859 book, "Notes on Nursing."

Victorian hospitals are now museums, but a new study has found that Nightingale's observation is even more accurate for the high-tech hospitals of today. As the decibel levels in hospitals have steadily increased during the last five decades, so has the suffering of patients and staff.

Researchers from Johns Hopkins University took a look at the problem of noise in hospitals and found that the contemporary version of the "cruel abuse of care" translates into stressed workers, raises the risk of medical errors because instructions aren't properly heard, and can even interfere with healing and recovery.

Add to these problems the results of two other recent studies that link excessive noise to a higher risk of heart attacks and high blood pressure, and our cacophonous environment begins to look like a serious public health problem.

The study began when a vice president at the Johns Hopkins Hospital in Baltimore asked Eileen Busch-Vishniac and James West -- not medical doctors but acoustics experts -- to evaluate the noise levels in the pediatric intensive care unit and make recommendations to address the problem.

Their investigation then broadened to look at the levels throughout the hospital. The team made 24-hour sound measurements of every area, including operating rooms and patient waiting rooms, and developed a "sound picture" of the environment.

The picture was almost deafening. The Johns Hopkins researchers first performed an analysis of all the previous research on the subject and found that in 1995 the World Health Organization had issued noise guidelines for hospitals that put the preferable noise levels in patients' rooms at 35 decibels. They learned that few, if any, hospitals achieve that level of peace.

Johns Hopkins was consistent with the average noise levels in hospitals everywhere, which have risen dramatically since 1960, from 57 decibels to 72; evening levels have similarly soared from 42 decibels to 60.

Busch-Vishniac, a professor of mechanical engineering at Hopkins, points out that the problem is epidemic. "Whether you are in Islamabad, Athens, Nairobi or all over the U.S., we found the measurements were the same everywhere," she says.