Excessive exposure of sick neonates to sound during transport

Objective: To determine the levels of sound to which infants are exposed during routine transport by ambulance, aircraft, and helicopter. Design: Sound levels during 38 consecutive journeys from a regional level III neonatal intensive care unit were recorded using a calibrated data logging sound meter (Quest 2900). The meter was set to record “A” weighted slow response integrated sound levels, which emulates the response of the human ear, and “C” weighted response sound levels as a measure of total sound level exposure for all frequencies. The information was downloaded to a computer using MS HyperTerminal. The resulting data were stored, and a graphical profile was generated for each journey using SigmaPlot software. Setting: Eight journeys involved ambulance transport on country roads, 24 involved fixed wing aircraft, and four were by helicopter. Main outcome measures: Relations between decibel levels and events or changes in transport mode were established by correlating the time logged on the sound meter with the standard transport documentation sheet. Results: The highest sound levels were recorded during air transport. However, mean sound levels for all modes of transport exceeded the recommended levels for neonatal intensive care. The maximum sound levels recorded were extremely high at greater than 80 dB in the “A” weighted hearing range and greater than 120 dB in the total frequency range. Conclusions: This study raises major concerns about the excessive exposure of the sick newborn to sound during transportation.

[1]  Ross L. Ewing Aviation medicine and other human factors for pilots : with accessment modules , 2003 .

[2]  S. Ciesielski,et al.  Incubator noise and vibration--possible iatrogenic influence on neonate. , 1980, International journal of pediatric otorhinolaryngology.

[3]  J. Lucey,et al.  Noise and hypoxemia in the intensive care nursery. , 1980, Pediatrics.

[4]  N. Todd At-risk populations for hearing impairment in infants and young children. , 1994, International journal of pediatric otorhinolaryngology.

[5]  Philbin Mk Some implications of early auditory development for the environment of hospitalized preterm infants. , 1996 .

[6]  S. Donn Neonatology: Pathophysiology and Management of the Newborn , 2000 .

[7]  The Influence of Auditory Experience on the Fetus, Newborn, and Preterm Infant: Report of the Sound Study Group of the National Resource Center: The Physical and Developmental Environment of the High-Risk Infant , 2000, Journal of Perinatology.

[8]  G. Avery Neonatology: Pathophysiology and management of the newborn , 1981 .

[9]  T. Buclin,et al.  Risk factors of sensorineural hearing loss in preterm infants. , 1997, Biology of the neonate.

[10]  Lawrence M. Schell,et al.  Noise: a hazard for the fetus and newborn. American Academy of Pediatrics. Committee on Environmental Health. , 1997, Pediatrics.

[11]  A. Macnab,et al.  Vibration and noise in pediatric emergency transport vehicles: a potential cause of morbidity? , 1995, Aviation, space, and environmental medicine.

[12]  L. Zahr,et al.  Premature infant responses to noise reduction by earmuffs: effects on behavioral and physiologic measures. , 1995, Journal of perinatology : official journal of the California Perinatal Association.

[13]  C. Miller The physiologic effects of air transport on the neonate. , 1994, Neonatal network : NN.