Noise quantification in the intensive care unit of a tertiary care hospital

doi:10.5492/wjccm.v15.i2.114240

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Publication Name

World Journal of Critical Care Medicine

ISSN

2220-3141

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Observational Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Crit Care Med. Jun 9, 2026; 15(2): 114240
Published online Jun 9, 2026. doi: 10.5492/wjccm.v15.i2.114240

Noise quantification in the intensive care unit of a tertiary care hospital

Ruchi Gupta, Arshdeep S Chadha, Himanshi Lakra, Rimsha Rehan, Raminder Kalra, Sumit Ray

Ruchi Gupta, Arshdeep S Chadha, Himanshi Lakra, Rimsha Rehan, Sumit Ray, Department of Critical Care Medicine, Holy Family Hospital, New Delhi 110025, India

Raminder Kalra, Holy Family College of Nursing, New Delhi 110025, India

Co-corresponding authors: Ruchi Gupta and Sumit Ray

Author contributions: Gupta R, Ray S and Chadha AS contributed to conceptualization and design; Gupta R, Kalra R, Lakra H and Rehan R contributed to material preparation, data acquisition, and analysis; Gupta R and Ray S contributed equally to the study and manuscript and are co-corresponding authors. All authors contributed to writing and revising the manuscript.

Institutional review board statement: This study was reviewed and approved by the Ethics Committee of Holy Family Hospital, No. EC/NEW/INST/2021/2040.

Informed consent statement: The study did not involve the collection, use, or recording of any patient data, including identifiable or de-identified health information. No interaction or intervention with patients occurred, and no protected health information was accessed or retained.

Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.

STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: There is no additional data available.

Corresponding author: Ruchi Gupta, MD, Consultant, Principal Investigator, Department of Critical Care Medicine, Holy Family Hospital, Okhla Road, New Delhi 110025, India. ruchigupta@holyfamilyhospitaldelhi.org

Received: September 16, 2025
Revised: November 28, 2025
Accepted: February 9, 2026
Published online: June 9, 2026
Processing time: 248 Days and 1.6 Hours

Abstract

BACKGROUND

Noise in intensive care units (ICUs) frequently exceeds recommended levels [the World Health Organization (WHO) recommends equivalent continuous noise level (Leq) < 35 dB], arising from alarms, equipment, and staff activity. Elevated sound can disrupt patients' sleep, increase stress, and impair recovery.

AIM

To identify the extent of noise exposure in the ICU.

METHODS

This observational study was conducted in the adult ICU of a tertiary care hospital. Noise was measured using the SERRAX SLM1090 sound level meter, which was placed in the center of the 10-bed ICU at a height of 6 feet above ground level. A 30-minute time window was set to obtain half-hourly Leq, L10, L50, L90 (representing sound levels exceeding 10%, 50%, and 90% of the time, respectively), and maximum sound level (Lmax).

RESULTS

Data were collected over 4 months (December 2024 to March 2025), yielding 5443 half-hourly recordings. The average Leq, Lmax, L10, L50, L90 and sound exposure level were 64.8 ± 2.8 dB, 82.5 ± 4.4 dB, 67.5 ± 2.9 dB, 61.4 ± 3.2 dB, 56.4 ± 2.8 dB and 97.7 ± 2.8 dB, respectively. Nurses’ handover, visitation and twilight hours were the noisiest. Nighttime (1:00 hours to 3:00 hours) was the quietest in the ICU. Lmax in the ICU exceeded the WHO cut-offs for industrial sounds and public addresses of 75 dB and 85 dB in 96.7% and 25.5% of readings, respectively. Twenty-four-hour cumulative sound exposure to the patient for night and evening-night penalties were 68 dB and 70 dB, respectively.

CONCLUSION

The noise exposure in the ICU persistently exceeded WHO-recommended thresholds. Maximum noise occurred during handovers, visitation and twilight activities, indicating that these times would be the most effective for intervention.

Keywords: Intensive care unit noise; Peak noise levels; Average noise equivalent continuous noise level; Peak noise maximum sound level; Day-night noise variation in intensive care unit

Core Tip: The purpose of the study was to quantify the noise pollution in intensive care units (ICUs). The average sound levels were consistently above the World Health Organization recommendations. Peak noise exceeded industrial noise cut-offs. Time periods with maximum noise in the ICU were identified during nursing handovers, visitations and twilight hours. The findings highlight the need to introduce measures for noise control in the ICU.