1. Beal, Judy A. DNSc, PNP, RN
  2. Freda, Margaret Comerford EdD, RN, CHES, FAAN

Article Content

Bremmer, P., Byers, J., & Kiehl, E. (2003).Journal of Obstetric, Gynecologic, and Neonatal Nursing,32 (4), 447-454.


While NICU care providers may become immune to the noise levels in their work environment, it is well documented that in a typical unit the sound levels range from 50 to 90 dB with peaks as high as 120 dB. These sound levels exceed the 45 dB daytime and 35 dB evening levels recommended by the EPA (1994). This article reviewed recent research on the physiological effects of noise on premature infants and made recommendations for noise reduction in the NICU. Adverse effects of such loud noise on premature infants include: apnea, bradycardia, as well as abrupt fluctuations in heart rate, respiratory rate, blood pressure, and oxygen saturation (Philbin & Klass, 2000). Long-term sequelae include the potential for decreased calories available for growth (Catlett & Holditch-Davis, 1990), increased risk for hearing loss (Goldson, 1999), and attention-deficit hyperactivity disorder (Barkley, 1998). Decibel levels in the NICU can range from 50dB (from one nurse speaking to another at the bedside) to 70 to 95 dB (from closing an isolette cabinet) and between 130 to 140 dB (from banging an isolette to stimulate an apneic neonate) (Goldson, 1999). Practice implications suggested include major renovation as well as simple less costly strategies such as talking softly, implementing a quiet hour at the end of each shift, and responding quickly to alarms.


Comment by Judy A. Beal




Barkley, R. A. (1998). Attention-deficit hyperactivity disorder. Scientific American (Online). RetrievedAQ1 MONTH DAY YEAR from [Context Link]


Catlett, A., & Holditch-Davis, D. (1990). Environmental stimulation of the acutely ill premature infant: Physiological effects and nursing implications. Neonatal Network, 8 (6), 19-25. [Context Link]


Goldson, E. (1999). Nurturing the premature infant: Developmental interventions in the neonatal intensive care nursery. New York: Oxford Press. [Context Link]


Philbin, M., & Klass, P. (2000). The full-term and premature newborn: Hearing and behavioral responses to sound in full-term newborns. Journal of Perinatology, 20, S68-S76. [Context Link]