title: Noise in the ED.
abstract: BACKGROUND
  The impact of noise pollution on both the patient and the care provider has been extensively studied in the neonatal intensive care unit and in other critical care units. Noise pollution makes errors more probable and is one of the risk factors for provider burnout and negative outcomes for patients. The Environmental Protection Agency (EPA) recommends that the acceptable noise level in a hospital should not exceed 40 dB.
  
  
  OBJECTIVE
  The purpose of this study was to record and analyze noise in a large urban level I emergency department (ED) and compare to the EPA guidelines.
  
  
  METHODS
  A 3-channel dosimeter Quest Q300 (Quest Technologies, Oconomowoc, WI) was placed as a stand-alone unit on the wall of the resuscitation booth in the ED. Sound was sampled 16 times per second for 12 hours and was recorded as peaks and averages for each minute. The dosimeter was then placed in the pocket of a medical student with a small 8-mm shoulder-mount type 2 microphone. The medical student followed an emergency medicine resident throughout an 8-hour shift in the main resuscitation area while monitoring and logging sound fluctuations in the environment. Sound pressure levels were logged in real time and subsequently correlated to the recorded peaks. Sound was sampled 16 times per second and recorded peaks and averages for each minute.
  
  
  RESULTS
  In the initial part of the study, the time-weighted average was 43 dB. The average sound levels peaked approximately 25 times over 12 hours. Individually measured peak levels of 94 to 117 dB occurred every minute. In the second part of the study, the time-weighted average was 52.9 dB.
  
  
  CONCLUSIONS
  When compared to EPA accepted noise levels for hospital (40 dB), the ED under study had excessive noise on a regular basis. There are easily identifiable sources of noise pollution in the ED. By identifying and modifying sources of noise, stress in the ED may be decreased.
authors.affiliation: Department of Emergency Medicine, Keck School of Medicine, LAC+USC Medical Center, Los Angeles, CA 90033, USA.
authors.forename: Marius A
authors.initials: MA
authors.lastname: Tijunelis
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fitzsullivan
authors.forename: Sean O
authors.initials: SO
authors.lastname: Henderson
mesh_terms: D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007396:Internship and Residency; D007588:Job Satisfaction; D015141:Los Angeles; D008297:Male; D009623:Noise, Occupational / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000209:etiology*