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Not Just Delay In Language Acquisition: Hospital Noise Poses Serious Risk To Premature Babies’ Health That Could Last A Lifetime

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Numerous studies suggest that premature babies may encounter learning difficulties later in life due to their exposure to noisy hospital wards and incubators, which function as “neurodevelopmental dungeons.”

A new study warns that intensive care incubators may also cause damage to premature babies’ hearing due to the resonation of sounds within them. Although the incubators can reduce some noises, they create a booming effect at low frequencies.

Premature babies rely on incubators in neonatal intensive care units (NICUs) to survive, but studies show that the noisy environment of the NICU can result in hearing impairment and language delays.

Researchers from Vienna, Hamburg, Munich, and Osnabruck sought to examine the impact of incubators, which they discovered were an overlooked component of the soundscape surrounding babies during their NICU stay.

“The motivation of our multidisciplinary research team concerns the question: why many more premature babies suffer hearing impairments,” adds corresponding author Dr. Christoph Reuter. “We believe that what we have measured in our studies could be a leading cause. However, to understand how to protect premature infants from such noise levels, precise environment information is needed.”

The noise experienced by premature babies in incubators is vastly different from the environment they would have experienced in the uterus. The amniotic fluid would have muffled outside sounds, with only low-frequency noises being heard. In contrast, incubators have many high-frequency noises and abrupt sounds, which can be harmful to babies. Despite recommended noise limits being in place, they are often exceeded, particularly when handling or opening incubators.

Dr. Matthias Bertsch from the University of Music and Performing Arts Vienna, a co-author of the study, explained: “Our study focused on various real-life noises and their levels as well as on their timbral characteristics, with two main purposes.

“Firstly, describing the NICU and incubator environment; secondly, providing awareness by presenting interactive material of real-life situations.”

The research team aimed to evaluate the impact of sound quality on newborns by placing a simulation manikin in an incubator equipped with measurement microphones at the Pediatric Simulation Center at the Medical University of Vienna. They recorded various sounds from inside and outside the incubator in the neonatal intensive care unit (NICU) and analyzed them to determine how they were affected by the incubator. The team assessed both weighted and unweighted decibel levels to measure the noise. Weighted decibel levels are often used in similar contexts as they account for the range of human hearing.

According to the team’s findings, the incubator generally reduced the volume of most sounds. However, some sounds resonated within the incubator, creating a booming effect and raising the noise level by up to 28 decibels. The sound that occurred inside the incubator or during handling was significantly louder than the sound outside the incubator. Interestingly, the noise wasn’t perceived as loud by individuals outside the incubator.

“As closed boxes, incubators usually have an inherent resonance at around 100 Hz, ie in this range sounds inside the incubator are exceptionally loud,” points out senior author Dr. Vito Giordano. “Noises from the outside sound more tonal inside the incubator, booming and muffled as well as less rough or noisy, because of this resonance.”

In addition, the researchers discovered that the unweighted decibel levels were significantly higher than the weighted decibel levels. They concluded that the weighted levels, which are commonly used for such studies, substantially underestimated the noise levels that premature babies were subjected to in the incubator. Weighting only provides an accurate reflection of sounds at lower levels and is designed for adult ears, which are sensitive to different frequency regions.

“Our results are not generalizable to all incubators available on the market,” warned Reuter. “Moreover, we measured in a simulation room under ideal conditions and not under everyday conditions, where the sound generated by the environment would be even louder.”

The researchers emphasized that the objective is not to completely eliminate all sound for babies in the incubator. It’s crucial for their development to hear the surrounding sounds. However, the team highlighted the need to consider the impact of sound when designing and using incubators, which has been underestimated in the past. The study authors argued that NICU noise should be viewed as a potential risk to the hearing of patients.

Source: 10.3389/fped.2023.1147226

Image Credit: Getty

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