Occupational Noise in Healthcare Settings: Health Effects on Healthcare Workers and Strategies for Prevention and Management

Sources and Levels of Occupational Noise Exposure in Healthcare Settings

Hospitals, particularly intensive care units (ICUs) and emergency departments, can expose nurses to elevated environmental noise. In the ICUs, reported sources include medical alarms, staff conversations, patient activity, visitors, and medical equipment (Dwairi et al., 2024; Konkani & Oakley, 2012). Multiple studies have reported sound levels in the ICUs that exceed recommended hospital environmental targets (Armbruster et al., 2023; Dwairi et al., 2024; Jeong & Kim, 2022; Terzi et al., 2019; Watson et al., 2015). Jeong and Kim (2022) also described frequent false alarms and associated alarm fatigue, while Dwairi et al. (2024) found that although ventilator alarms were the loudest measured source, nurses perceived noise from staff conversations as more irritating. In emergency settings, one trauma-hospital study reported sound levels of 56.6 to 68.8 dB, with peak values reaching 119 dB near helicopter landing zones (Filus et al., 2015). These findings suggest that nurses in emergency settings may experience intermittent exposure to high-intensity noise, although more setting-specific research is needed.

Negative Effects of Occupational Noise Exposure on Nurses

Occupational noise exposure poses several health risks to nurses, including hearing impairment, stress, and decreased job satisfaction (Dwairi et al., 2024; Terzi et al., 2019). Chronic exposure to high noise levels has been associated with NIHL, a progressive and irreversible condition (Sliwinska-Kowalska, 2020). Sliwinska-Kowalska (2020) emphasized that NIHL remains a significant occupational concern in healthcare settings where noise control measures are often inadequate.

Beyond hearing loss, excessive noise exposure contributes to stress, anxiety, and burnout among nurses. Terzi et al. (2019) found that nurses working in ICUs with noise levels exceeding 71 dB reported significantly higher levels of anxiety and emotional exhaustion. Noise exposure was also linked to lower job satisfaction, as nurses in high-noise environments reported reduced motivation and increased emotional fatigue. Similarly, Dwairi et al. (2024) reported that perceived noise irritation had a more substantial impact on nurses’ distress and fatigue than actual noise measurements, underscoring the role of subjective noise experiences in determining its psychological effects. McCullagh et al. (2021) found that nurses reporting occupational exposure to high noise levels self-reported higher rates of burnout, occupational stress, and lower quality of life scores, in comparison to nurses who did not report exposure to occupational noise. While McCullagh et al (2021) did not find an association with cardiometabolic health outcomes, associations between noise exposure and hypertension or heart disease have been reported in other studies (Bolm-Audorff et al., 2020; Skogstad et al., 2016; Teixeira et al., 2021).

Impact on Work Performance and Patient Care

In addition to psychological effects, noise exposure impairs concentration and increases the likelihood of medical errors. Jeong and Kim (2022) found that alarm fatigue delays nurses’ responses to critical alerts, potentially jeopardizing patient safety. Furthermore, environmental (non-occupational) noise has been shown to disrupt sleep patterns among nurses, leading to chronic fatigue and reduced cognitive function (Watson et al., 2015). These fatigue-related impairments may compound the effects of occupational noise exposure on performance and patient safety. Overall, these findings highlight the urgent need for effective noise management strategies.

High noise levels in hospitals affect nurses’ health and ability to perform essential tasks and ensure patient safety. Noise-related distractions interfere with communication among healthcare teams, leading to misinterpretations and care delays. Dwairi et al. (2024) found that noise-related disturbances reduced productivity and efficiency among nurses, ultimately affecting patient outcomes. In high-stakes environments such as emergency departments and ICUs, excessive noise can hinder collaboration and coordination, increasing the likelihood of errors.

Research also suggests that noise-related stress affects nurses’ ability to provide compassionate care. When exposed to persistent noise, nurses experience emotional exhaustion, leading to decreased patient engagement and reduced empathy (Terzi et al., 2019). These findings emphasize the importance of addressing noise exposure as both an occupational health concern and a factor influencing the quality of patient care.

Strategies for Prevention and Management of Occupational Noise Exposure

Efforts to mitigate occupational noise exposure in healthcare settings include engineering controls, administrative policies, and personal protective measures. Despite the OSHA noise standard, adherence to hospital noise-reduction guidelines may be inconsistent across units and institutions. Reducing unnecessary noise while maintaining patient safety, effective communication, and timely response to clinical alarms remains a key challenge (Lee et al., 2021; Lewandowska et al., 2020; Vreman et al., 2023).

Engineering solutions, such as sound-insulating hospital walls, using sound-absorbing materials, and optimizing medical equipment design, can help reduce noise pollution (Jeong & Kim, 2022). Administrative strategies, including implementing “quiet hours,” adjusting alarm volume settings, and scheduling noisy activities during less critical times, can also contribute to a more manageable noise environment (Dwairi et al., 2024). Konkani and Oakley (2012) suggested combining administrative and engineering controls to reduce noise levels while maintaining patient care and safety.

Education and training programs for nurses on noise management and alarm fatigue reduction may help improve staff awareness and support safer alarm practices (Jeong & Kim, 2022; Lewandowska et al., 2020). Jeong and Kim (2022) suggested that developing standardized alarm management protocols and providing ongoing training on noise mitigation strategies can help reduce alarm fatigue and improve patient safety. Personal protective equipment (PPE), such as noise-canceling headsets or earplugs, may temporarily relieve nurses working in high-noise areas (Sliwinska-Kowalska, 2020).

The literature suggests that occupational noise exposure may adversely affect nurses’ hearing health, psychological well-being, and job performance (Dwairi et al., 2024; McCullagh et al., 2021; Terzi et al., 2019). Despite existing guidelines and hospital policies, noise levels in many healthcare settings remain high, increasing the risk of hearing-related and stress-related adverse effects and potentially contributing to lower job satisfaction (Lewandowska et al., 2020; McCullagh et al., 2021; Padmakumar et al., 2013). Effective noise control strategies, regulatory compliance, and staff awareness are important for mitigating these risks (Armbruster et al., 2023; McCullagh et al., 2021). However, although many proposed noise-reduction strategies in healthcare are intuitively reasonable, their effectiveness has not been well tested in real-world clinical environments (Armbruster et al., 2023; Filus et al., 2015). Future research should focus on evaluating both the long-term effects of noise exposure on nurses and the feasibility and effectiveness of unit-specific noise-reduction interventions. By prioritizing noise management, healthcare institutions can create safer work environments that support nurse well-being and improve patient care outcomes.

Importance of Noise Level Monitoring and Measurement

The literature review reveals a noise monitoring and measurement deficit within hospital environments (Armbruster et al., 2023; Filus et al., 2015). Regular noise monitoring and measurement are vital in managing occupational noise, as they help pinpoint high-risk areas, assess the effectiveness of noise-reduction strategies, and ensure adherence to occupational safety regulations (Dwairi et al., 2024; Filus et al., 2015). Nevertheless, multiple studies indicate that noise levels in healthcare settings frequently surpass these limits, making continuous monitoring essential to avert negative health outcomes for nurses and healthcare workers (Konkani & Oakley, 2012; Terzi et al., 2019).

To ensure effective noise monitoring, OHNs can advocate for systematic noise level assessments using tools such as sound level meters, dosimeters, and continuous noise monitoring systems (Jeong & Kim, 2022; McCullagh et al., 2021). These instruments provide valuable data for assessing occupational noise exposure and guiding interventions to minimize excessive noise levels. Despite these costly instruments, OHNs may collaborate with industrial hygienists or external consultants to conduct exposure assessments and interpret measurement data. By routinely measuring noise levels, OHNs can identify high-risk hospital areas (e.g., ICUs and emergency departments) where noise exposure is most severe (Filus et al., 2015). Meanwhile, noise measurement should be conducted every time there is a change in the hospital and unit setting. OHNs can also evaluate noise-reduction interventions by tracking pre- and post-intervention noise data to determine their effectiveness (Dwairi et al., 2024). OHNs are well positioned to follow regulatory compliance with OSHA and WHO noise exposure standards, protecting healthcare workers from hazardous noise levels (Sliwinska-Kowalska, 2020). OHNs can enhance staff education and engagement by sharing noise level data and training healthcare workers on noise reduction strategies (Terzi et al., 2019).

Occupational Health Nursing Strategies for Noise Reduction

OHNs should incorporate noise monitoring into workplace safety programs and collaborate with hospital leadership to establish hospital-wide noise reduction policies. These policies should focus on engineering controls, such as sound-insulating walls, optimizing alarm settings, and modifying medical equipment to minimize noise (Jeong & Kim, 2022; Konkani & Oakley, 2012); administrative interventions, including “quiet zones,” scheduled quiet hours, and adjustments to alarm management systems to reduce unnecessary noise exposure (Dwairi et al., 2024); and education and training programs for nurses on the risks of noise exposure, alarm fatigue, communication and patient-safety considerations, and the selection, fitting, and appropriate use of approved hearing protection devices, as well as practical strategies for reducing unnecessary environmental noise and mitigating noise-related stress (McCullagh et al., 2021).

By integrating continuous noise monitoring with evidence-based noise reduction strategies, OHNs can proactively protect nurses and other healthcare workers from the long-term health effects of occupational noise exposure. Future research should focus on the long-term effects of noise exposure in hospital settings and identify the most effective interventions for reducing noise while maintaining optimal patient care (Armbruster et al., 2023).