Sensehacking by Charles Spence

Author:Charles Spence [Spence, Charles]
Language: eng
Format: epub
ISBN: 9780241361160
Publisher: Penguin Books Ltd
Published: 2019-07-04T00:00:00+00:00

Healthy hearing

Let us return to the auditory aspect of healthcare, as this is where most problems are currently found, and where some of the most intriguing solutions reside. Once again, Florence Nightingale was on the money more than 150 years ago when she wrote, ‘Unnecessary noise is the most cruel absence of care which can be inflicted either on sick or on well.’38 The sonic element of healthcare may become all the more salient in the patient’s experience precisely because the visual environment in many hospitals is typically so dull and boring.39 As anyone who has been in a hospital ward or intensive care unit knows only too well, they tend to be exceptionally noisy places, due, in large part, to the many alerts, alarms and other digital warning signals that can be heard on wards these days.40

While such high noise levels are bad enough during daylight hours, at night they can become especially disturbing. Noise levels have been increasing exponentially in hospitals in recent decades. According to guidelines from the World Health Organization, noise levels on hospital wards should not exceed 35dBA during the day and 30dBA at night.fn7, 41 For reference, 30dBA is about the same loudness as a whisper. It is shocking, therefore, to find peak levels in hospitals of more than 80dBA, equivalent to the noise made by a chainsaw.42 In an observational study in the UK, noise levels in five ICUs were 60dBA during the daytime, with peaks above 100dBA recorded every two to three minutes (equivalent to a noisy motorcycle or handheld drill). Although things quietened down at night, peak sounds above 85dBA were still identified up to sixteen times an hour.

No wonder so many patients complain that they simply cannot sleep in hospital. Being interrupted by noise every six minutes during the night while critically ill must surely be having a negative impact on healthcare outcomes.43 One poignant case involved a former chief scientific advisor to the UK government, Sir David MacKay. As a patient, he was driven to tears by the relentless noise on his hospital ward. As he put it in a blog posted the day before he died, ‘The ward is always full of lights going on and off, doors opening, special mechanical beds that make fizzing electrical noises and clunks for hours on end.’fn8, 44

The potentially damaging effects of excessive noise are not just problematic for patients. The operating staff themselves also suffer, with orthopaedic procedures known to be especially bad. Peak sound levels of 120dB or more are routinely recorded once the electric sawing, drilling and hammering begin, with knee replacement surgery and neurosurgery known to be particularly noisy. For comparison, military jet afterburners produce 130dB during take-off. Such noise levels are potentially damaging to the hearing of those working in the operating theatre, who are regularly exposed to them. They may, however, be even more damaging to the patients themselves, this despite the fact that they are hopefully oblivious of the loud noises around them. The anaesthetic

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