SOUND LEVELS

Safety Guideline for the Live Performance Industry in Ontario

Issued: August 2005

Revised: November 9, 2012

Content last reviewed: November 2012

See also: Performance Industry

Disclaimer: This resource has been prepared to help the workplace parties understand

some of their obligations under the Occupational Health and Safety Act (OHSA) and

regulations. It is not legal advice. It is not intended to replace the OHSA or the regulations.

FOR FURTHER INFORMATION PLEASE SEE FULL DISCLAIMER

It is a distinctive characteristic of the live performance industry that performers and support

staff are critically dependent on their hearing. The focus of this guideline is sound levels

encountered in rehearsals and performances, including music, sound effects, pyrotechnics,

gunshots etc.

Staff involved in the construction of sets and costumes may be exposed to dangerous sound

levels from power tools and other machinery. Carpenters, props builders, electricians,

welders, sewers and others exposed to noise produced by saws, nail guns, compressors,

sewing machines etc. should wear hearing protection. Refer to Section 139 of Regulation

851 (Industrial Establishments) under the Occupational Health and Safety Act (OHSA) for

the regulatory requirements regarding hearing protection. The Construction Projects

Regulations (O. Reg. 213/91) apply to load-ins, fit-ups, set-ups, lighting hangs, load-outs,

tear-downs and strikes; where multiple departments are working simultaneously in the same

area; where unique installation/removal techniques are in use; and where workers may be

exposed to hazards from a wide variety of sources. Once the workplace is no longer a

construction project, the Regulation for Industrial Establishments (Reg. 851) applies.

Hearing loss due to sound exposure is cumulative. Workers should be aware that activities

at a traditional worksite, including in performance, are only a part of ones daily work-related

exposure to sound. Additional sound exposures may include personal rehearsal time

practicing instruments, listening to students playing and listening to personal recording

devices with headphones or earbuds.

This guideline does not address exposure outside of live performance workplaces; however,

workers are encouraged to consider additional sound exposures as a contributing source of

hearing loss.

The following recommendations are intended to help prevent long-term auditory damage to

workers, while minimizing impact on artistic standards.

Definitions

Note: The definitions are provided for clarity and guidance only.

A-Weighting

see dBA

dB (Decibel)

A unit of measurement of sound pressure level. [Abbreviated definition. For the full

definition refer to section 139(1) of Regulation 851 (Industrial Establishments) under

the OHSA]

dBA

A measure of sound level in decibels when measured on the A-weighted network of

a sound level meter. A-weighting uses an electronic filter that approximates the

frequency response of the human ear. [Abbreviated definition. For the full definition

refer to section 139(1) of Regulation 851 (Industrial Establishments) under the

OHSA]

Equivalent sound exposure level (Lex,8)

The steady sound level in dBA which, if present in a workplace for eight hours in a

day, would contain the same total energy as that generated by the actual and

varying sound levels to which a worker is exposed in his or her total work day,

determined in accordance with a formula that takes into account the cumulative

effect of sound pressure level, duration of exposure, and the exchange rate.

[Abbreviated definition. For the full definition refer to section 139(1) of

Regulation 851 (Industrial Establishments) under the OHSA]

Equivalent sound level (Leq)

Equivalent sound level is a measurement of sound over a specified period of time.

Exchange rate

A rate, measured in decibels, indicating when the damage done by sound exposure

is doubled. A 3 dB exchange rate means that damage is doubled for every increase

of 3 dB.

Hearing conservation program

A program to prevent and control noise-induced hearing loss.

Impulse sound

A percussive sound such as a gunshot or a cymbal crash. The sound is often very

loud and may have peaks over 115 dB.

Loudness

Loudness is the subjective impression of the intensity that allows us to place it on a

scale going from very soft to very loud, without reference to any physical scale.

Within any one listening environment, there is a good correlation between the

physical measure of intensity and the subjective sense of loudness, yet there can be

some differences.

Personal Protective Equipment (PPE)

PPE is equipment worn to minimize exposure to a variety of hazards. (Example:

hearing protection such as ear plugs or ear muffs). Although an important part of

health and safety management, PPE is considered the last resort of hazard control,

used only after engineering controls and administrative controls (or work practices)

have been shown to be impractical, ineffective, or insufficient.

Steady state sound

Sound that does not involve a rapid rise and fall of levels, as compared to impulse

sound. The sound can be loud but has a more consistent level than impulse sound (a

non-varying sound, e.g. a held note on a trumpet, or the whine of a table saw).

Sound pressure level (SPL)

The intensity of sound measured in decibels.

General Guidelines

1. Employers are to take all measures reasonably necessary in the circumstances to

protect workers from exposure to hazardous sound levels.

2. Employers must ensure that workers are not exposed to a sound level greater than

an equivalent sound exposure level (Lex,8) of 85 dBA (see subsection 139(6) of the

Regulation for Industrial Establishments).

3. A risk assessment specific to sound level hazards should be conducted, and

appropriate engineering controls and work practice decisions incorporated in advance

of first need. In addition, sound level hazards should be reassessed and issues

resolved during the rehearsal period and before the first performance. In

determining sound level hazards, both sound pressure levels and sound exposure

duration will be factors.

4. Where a workers noise exposure is not consistent, the following table shows

maximum times for exposures. When this threshold is reached, the workers noise

exposure has reached 100% of the maximum daily noise exposure.

Table 1 Maximum Allowable Exposure (based on the equivalent sound

exposure level in section 139 of the Regulation for Industrial Establishments

(Reg. 851))

Duration Steady Sound Level (dBA)

8 hours 85

4 hours 88

2 hours 91

1 hour 94

30 minutes 97

15 minutes 100

5. NOTE: based on a 3 dBA exchange rate. The formula for determining the equivalent

sound exposure level referred to in Table 1 can be found in Appendix B of the

Amendments to Noise Requirements in the Regulations for Industrial Establishments

and Oil and Gas - Offshore.

6. The allowable exposure time to an equivalent sound level of 85 dBA is 8 hours (see

section 139 of the Regulation for Industrial Establishments). If the equivalent sound

level goes up by 3 dBA, the allowable exposure time is cut in half, to 4 hours. At 100

dBA the allowable exposure time is only 15 minutes per 8 hour workday, though we

recommend no exposure to those levels without protective measures (e.g. sound

baffles or hearing protection devices). Remember to include practice, teaching and

research in the 8 hours.

7. Workers should not be exposed to impulse sound pressure levels in excess of

100 dBA. Where impulse sound levels above 100 dBA cannot be avoided, exposure

control measures should be established to minimize the exposure. For example,

when rehearsing a scene that includes a gunshot or other impulse sound which

exceeds 100 dBA, all workers should be made aware of the hazard at each

repetition, so that appropriate measures may be taken.

8. Employers are required to protect workers from exposure to a sound level above 85

dBA Lex,8 by implementing 1) engineering controls and 2) work practices to reduce

sound levels.

9. Using personal protective equipment (PPE) to protect workers from exposure to a

sound level greater than the limit shall only occur when engineering controls:

o are non-existent or not obtainable;

o not reasonable or not practical to adopt, install or provide because of the

duration or frequency of exposures or because of the nature of the process,

operation or work;

o rendered ineffective because of a temporary breakdown of such controls; or

o ineffective to prevent, control or limit exposure because of an emergency.

10. A clearly visible warning sign shall be posted at every approach to an area in the

workplace where the sound level regularly exceeds 85 dBA (see subsection 139(10)

of the Regulation for Industrial Establishments).

Note: Refer to the Amendments to Noise requirements in the Regulations for

Industrial Establishments and Oil and Gas-Offshore Guideline which sets out some

examples of the content the signs may include.

Assessing Noise Exposures

1. It is important to assess noise exposures to help determine what measures are

necessary to ensure the health and safety of employees who are exposed to noise.

The following information is a summary from the Ministry of Labour guideline which

describes how to implement a noise exposure survey. Please refer to the

Amendments to Noise requirements in the Regulations for Industrial Establishments

and Oil and Gas-Offshore Guideline for more information.

2. A noise dosimeter, an integrating sound level meter, or in some circumstances, a

basic sound level meter can be used to measure sound levels. The Canadian

Standards Association provides guidance on equipment selection and specifications,

and on procedures for the measurement or calculation of sound levels.

3. Compliance with Ontarios regulatory requirements respecting noise exposure control

does not necessarily mean that a comprehensive noise survey needs to be done in

every workplace. Previous sound level or dosimetry data may be useful in assessing

worker exposures and the likelihood of them exceeding the occupational exposure

limit. Exposure data for a group of workers with the highest noise exposures may be

useful to infer compliance for less exposed groups.

4. Indicators that point towards the need for a noise exposure survey include the use of

equipment known to produce sound levels above 80 dBA in published data, worker

complaints regarding noise and symptoms, or audiometric test results showing early

signs of noise-induced hearing loss. It is appropriate for an employer to carry out a

noise exposure survey using approved measurement tools when noise levels

consistently exceed 85 dBA (e.g. orchestra pits).

5. Employers may contact their Safe Workplace Association or consultants specializing

in noise assessments to assist them with assessing sound levels in their workplace if

they do not possess the required instrumentation, resources, or knowledge to carry

these out. Also, the Occupational Health Clinics for Ontario Workers has published a

useful Noise Calculator spreadsheet on their website.

NOTE: Sound pressure levels should be measured at the ear of the worker most exposed to

the sound source. All measurements of sound levels in the workplace should be taken at

performance levels without adjusting the measurements to account for the use of PPE (e.g.

hearing protection devices).

Hearing Conservation Programs

Although not required by the regulations, it is considered good health and safety practice for

an employer, in consultation with the Joint Health and Safety Committee (JHSC), to

implement a Hearing Conservation Program that includes audiometric testing of workers

regularly working in areas with noise levels exceeding 80 dBA. This benefits both workers

and employers by identifying potential gaps in the noise exposure control program.

Reference for such programs can be found at some of the links listed in the Resources

section of this guideline.

1. Hearing conservation programs are the responsibility of the employer, in consultation

with workers. Every employer shall take all measures reasonably necessary in the

circumstances to protect workers from exposure to hazardous sound levels. (see

subsection 139(3) of Reg. 851). Program components may include sound monitoring,

feasible administrative and engineering controls, audiometric testing, hearing

protection, worker training and education, and record keeping.

2. In hearing conservation programs for long-running productions (in excess of six

months), periodic hearing assessments should be considered. The results of such

assessments are the sole property of the worker and his/her audiologist.

Sound Level Reduction in Performance

The best way to reduce sound impact is to put a distance between source and worker. Even

in a limited space, repositioning or re-angling the sound source can make a useful

difference.

1. Speakers: Speakers and monitors should have minimal floor contact since low

frequencies tend to travel through solid surfaces rather than through air. Reducing

the surface contact of speakers and monitors will increase the low end frequencies

received by audience and performers, so the overall sound level need not be as high.

Workers should not be exposed to the backs of open speaker enclosures. Baffles

between the worker and the speakers should also be used.

2. Risers: Raising the sound source 30-60 cm (1-2 ft.) above the ear of the affected

worker greatly reduces high frequency sound exposure. Because high frequency

sounds, typically those produced by a speaker horn or a belled musical instrument,

are directional, sound pressure levels above, below or to the side of the source are

significantly lower than those in front of it.

3. Spacing: Wherever possible, 2-3 m (6-8 ft.) of reflective floor surface should be left

unoccupied in front of a performance group. This generates additional reflections,

which raise the sound level in the audience but not on stage, so the overall level

need not be as high.

4. Isolation of impulse sound: Workers should not be within 2 m (6 ft.) of an

impulse sound. Wherever possible, shields and baffles should be used and reflective

surfaces around the sound source should be acoustically treated to reduce the

impulse effect. Where it is not possible to isolate the worker, additional measures

should be used.

Note: if the impulse sound is above the limit specified in the Regulation, the use of

hearing protection devices (i.e. PPE) is only allowed in certain circumstances.

5. Sound baffles and acoustical shields: Baffles and plexiglass shields may give

protection if used with other strategies to reduce the overall sound exposure.

However, acoustical baffles afford minimal effect unless they are within 18 cm (7 in.)

of the worker's head. In addition, the maximum high frequency attenuation is only

about 15-17 dB.

6. Hearing protection: Uniform attenuator ear plugs are available in custom and non-

custom forms. Other types of hearing protection are available for specific situations.

An audiologist or other hearing health care professional should be consulted before

choosing.

Conclusions

There are a number of strategies to reduce the potentially damaging effects of loud sound

on hearing. Environmental alterations or modifications to the room, location of the orchestra

or band, and alterations in the loudspeaker system, can all provide relief while maintaining

optimal sound quality and acceptance by both performer and audience. Hearing protection,

if properly specified and of uniform attenuation, can be a very useful strategy to minimize

the potentially damaging effects of loud sound, both on and off the stage.

Call toll-free

Call 1-877-202-0008 anytime to report critical injuries, fatalities or work refusals. For general

inquiries about workplace health and safety and to report potentially unsafe work conditions,

call 8:30 a.m. 5 p.m., Monday to Friday. In an emergency, always call 911 immediately.

More Information

Performance Industry

Ministry of Labour

Ontario.ca/labour

Health and Safety Ontario (health and safety association)

www.healthandsafetyontario.ca

Workplace Safety & Insurance Board

www.wsib.on.ca

Canadian Standards Association (CSA) standards referenced in occupational health and

safety legislation

ohsviewaccess.csa.ca

Resources

Hear The Music (Hearing Loss Prevention for Musicians)

by Marshall Chasin, AuD., M.Sc., Reg. CASLPO, Aud(C), Director of Audiology, Musicians

Clinic of Canada (ISBN 0-920445-74-8)

Hearing Loss in Musicians- Prevention and Management

by Marshall Chasin Plural Publishing Company, San Diego, CA, 2009 (ISBN 978-1-59756-

181-5).

Strategies to Minimize the Exposure to Loud Music

by Marshall Chasin

www.musiciansclinics.com

Tougher Legislation for Workplace Noise Exposure

Article written by Robert Stevens, P.Eng, MASc and Marshall Chasin

Engineering Dimensions May/June 2007

Canadian Hearing Society Position Paper on Noise Pollution

www.chs.ca

Canadian Centre for Occupational Health and Safety

www.ccohs.ca

Noise - Basic Information

Noise - Auditory Effects

Noise - Non-Auditory Effects

Hearing Protectors

Sound Advice

www.soundadvice.info

Webguide issued by the Health and Safety Executive in Britain, based on recommendations

produced by the Music and Entertainment Sector Working Group.

Music, Noise & Hearing How to Play Your Part A Guide for Musicians (BBC, August 2011)

www.bbc.co.uk

Summary (795 Kb)

Part I A Guide for Musicians (1.74 Mb)

Part II Toolkit for Managers (1 Mb)

Sample Hearing Conservation Program

www.ncbi.nlm.nih.gov

The social and emotional impact of hearing loss

www.hear-the-world.com

Decibel scale of common sounds

www.dangerousdecibels.org

Amendments to Noise Requirements in the Regulations for Industrial Establishments and Oil

and Gas - Offshore

Ministry of Labour

Ontario.ca/labour

Musicians Clinics of Canada

www.musiciansclinics.com

Canadian Hearing Society

www.chs.ca

Artists Health Centre Foundation

www.ahcf.ca

Royal National Institute for Deaf People (RNID UK)

www.actiononhearingloss.org.uk

Actsafe

www.actsafe.ca

Sound Advice: Hearing Conservation Programs

Actsafe Safety Guidelines

Subcommittee Members

Marshall Chasin Director of Audiology, Musicians Clinics of Canada

Christine Ardagh Executive Director, Artists Health Centre Foundation

Rex Banks Audiologist and Director of Hearing Healthcare, Canadian Hearing

Society

Janet Sellery Sellery Health and Safety

Steve Mosher Toronto Musicians Association Local 149 AFM

Hospitals & Health Care Noise Control

The High Cost of Noise in a Hospital on the Patients and Staff

When we think of where we would like to rest and recuperate from illness or medical

treatment, most of us visualize places that are quiet and peaceful. This is a stark contrast to

the typical hospital where sounds of beepers, alarms, machines, telephones and people's

voices are more of the "normal environment".

The epidemic of noise in hospitals, which is one of the biggest complaints of patients and

staff, is something that can no longer be ignored. Hospitals provide year round, round the

clock residential & sleeping accommodations for patients, but in today's high tech

environment of health care, there is noise everywhere and patients are paying a price.

Noise can come from nearby highways & roadways, airplanes & medical helicopters, building

cooling towers, emergency generators, even construction equipment used for hospital

additions or renovations. Regardless of where the patient is, equipment dominates the

hospital experience.

The environment of multiple monitors, beepers, buzzers, paging systems, telephones, carts,

wheel chairs & gurneys, hospital beds that are electric, pillow speakers and nurses call

systems, IV poles that role on tiled floors, doors that close abruptly, and carts that

squeak..all of this prior to one word being spoken or one person walking past the patient's

room.

All this noise needs to be managed.

The noise that the equipment makes, plus the noise of the hustle & bustle of a busy hospital

has a serious impact on patients & the staff alike. To name only a few problems that

patients in poorly acoustically designed healthcare facilities experience, are:

Elevated blood pressure levels

Sleep disruption

Decreased oxygen saturation

Decreased rates of wound healing

And higher incidences of re hospitalization

Neonatal intensive care patients have increased heart & respiration rates.

Remember, this is supposed to be a HEALING environment. It should be acoustically

designed to be healing environment. Loud noisy hospitals are contradictory to healing

environments.

However, noise not only affects the patients, it affects the staff as well!

Research is showing that a noisy environment causes emotional exhaustion & burnout

among critical care nurses and noise is strongly related to increased stress & annoyance

among nurses in general.

Healthcare providers polled also showed a lower job satisfaction rate in noisy environments

than in acoustically designed quieter ones.

Interesting enough, patients in noisy healthcare facilities were less satisfied with the level of

care they received than in quieter facilities.

It has been shown, that while noise may not necessarily affect the performance of the staff,

research does show that a healthcare worker who is working in a noisy situation will have to

concentrate harder & exert more effort to be able to perform their function properly, which

leads to them being more fatigued.

It is not hard for anyone of us to relate to the frustration that noise causes when we are

trying to concentrate at our jobs. Trying to work with so much noise going on around us

obviously opens the door to increased errors.

Why is noise so prevalent in healthcare facilities? It's a place of hard surfaces. In the world

of hard surfaces it takes much longer for the noise to stop bouncing around. Think of a

tennis ball. Throw it against a hard surface, and then throw it against a pillow. When the

ball hits a hard surface it keeps bouncing around. When it hits a pillow, it drops. That's what

happens to noise.

When the absorption of all that noise is not accounted for when the building is being

designed, then working in or being a patient in a healthcare facility can be very hard on the

body.

A study published in the American Journal of Nursing shows why the problem strikes such a

harsh note with patients....hospitals can sound as loud as jackhammers.

The researchers, who were a team of Mayo Clinic nurses, found that during the hustle and

bustle of a morning shift change... the blare reached 113 decibels.....that's about as loud as

a chain saw!

The nurses decided to conduct their investigation after hearing several patients complain

about the noise. As a part of their study, 2 of the Mayo clinic nurses slept overnight in a

room setup with equipment normally found in a thoracic unit, where patients recover from

chest operations....

They also put sound monitoring devices in 3 empty rooms. 1 of the nurses who spent the

night, wrote in the study that she was awakened by her roommates IV pump alarm at 1:15

am. She was awakened again at 3:15 am when the portable X ray machine was rolled into

the room, sounding like an oversized power tool as its motor whirred, and the cartridges of

X ray film bumped noisily together.

At 6:10 am the nurse was roused by the tapping of doctors dress shoes in the hallway.

One major university also did a study. They found that people in noisy areas were less likely

to aid someone in need, and they were more likely to miss auditory & visual cues, probably

because of the distractions of noise bouncing off hard surfaces.

Another major university did a very interesting study of the performance of complex tasks.

The experiment was conducted where people were given impossible puzzles to solve.

(Obviously they didn't know they were impossible)...Half of the group was put in quiet

spaces and the other half were put in noisy spaces. The result was that people in noisy

spaces gave up trying to solve the puzzle much sooner than the people who were in a

quieter space. Medical professionals are not trying to solve things as simple as puzzles!

The study also concluded that people who work in noisy environments are less creative &

make more errors.

In 5 published studies over the last 45 years, not 1 study reported noise levels that complied

with the World Health Organization guidelines for hospital noise levels.

However, hospital noise levels have been rising consistently since the 1960s. The

background noise levels rose from 57 decibels during daytime hours in 1960 to 72 decibels

today, and from 42 decibels during nighttime hours in 1960 to 60 decibels today. Many

studies indicate that peak hospital noise levels often exceed 85 to 90 decibels.

Noises from alarms from equipment such as portable X-Ray machines that exceed 90

decibels are comparable to walking next to a busy highway when a motorcycle or a large

truck passes.

Interestingly enough, federal safety standards list 85 decibels as the safe MAXIMUM level of

noise exposure for an 8 hour period without hearing protection!

Another way of characterizing the extraordinary loudness of common hospital sounds is to

consider that an 85 decibels noise is 100,000 times higher in sound pressure than the

recommended daytime level of 35dBA for patient spaces.

A decibel a unit for quantifying loudness levels based on a logarithmic scale. Think of the

Richter Scale. A few decibel difference can mean a lot!.The way the ear hears, something

that is 30 decibels is twice the sound as something that is 20 decibels.Something that is 40

decibels is twice as loud as something that is 30 decibels. For every 10 decibel increase, that

means twice the sound.

It is not surprising that high noise levels in hospitals have serious implications for staff &

patient health & well being.

Think of the surgery and testing sections of the hospital. Scanning & optical microscopes,

MRI machines, CAT scanners, laser devices, and other sensitive equipment can be badly

compromised by the low frequency rumble from HVAC systems & by vibration. Sensitive

equipment can be affected by vibrations that humans cannot feel. In fact, these are at levels

of vibration 1 to 3 orders of magnitude below what a human tactile sense can detect.

MRI equipment, for example....can give what are called "Ghost Images" if they are not

properly acoustically isolated from vibration.

And, not only does low frequency noise affect the equipment, it affects the people using

them as well.

Cornell University did a study on low frequency noise and they found that prolonged

exposure to low frequency noise, such as the low rumble of HVAC equipment could :

Raises a person's blood pressure level

Makes them feel more stressed

Causes headaches

And Respiratory ailments

This is already a stressful environment.

A hospital in India did a study of the effects of noise in the operating room. Not low

frequency noise, but the more typical high frequency noise. This is the only study of it's

kind. They wanted to test 2 cognitive functions: mental efficiency & short term memory.

In 5 separate operating suites, they made professional grade recordings of noise that was

generated during surgical procedures.

The noise levels were measured over 3 to 5 hours and it recorded the noise made by

surgical instruments, suction apparatus, monitors & alarms and the ambient noises of

doctors nurses & other operating room staff.

The microphones were placed 10 inches from the anesthesiologist's ears. The average noise

level turned out to be slightly over 77 decibels, which is considerably louder than an alarm

clock at 2 feet.

The results of the study showed that the anesthesiologists who were exposed to this level of

noise for prolonged periods of time were less efficient & had decreased short term memory.

Much of the anesthesiologist's job involves obtaining information from various sources.

Verifying the validity of the information, formulating priorities and taking prompt &

immediate action based on the information obtained.

The conclusion of the study was "the administration of anesthesia is a task where even

momentary inefficiency can result in serious consequences to the patient. Hence, operating

room noise should be reduced."

HIPAA

The Privacy Rule

The Health Insurance Portability and Accountability Act ("HIPAA") was enacted by the

federal government in 1996. Part of this act addressed confidentiality of patient insurance

and medical records. This "Privacy Rule," which went into effect on April 14, 2003,

addresses the use and dissemination of patient health information through electronic form

as well as in print or verbal communication. Organizations covered by the Privacy Rule

include doctor's offices, dental offices, hospitals, pharmacies, and other health care and

insurance providers. The Privacy Rule states that covered entities must adopt reasonable

safeguards to protect their patient's medical information.

Articulation Index

Although there are no specified speech privacy criteria currently defined in the HIPAA law,

the industry has adopted a standard referred to as the Articulation Index. Articulation Index

is a measure of the intelligibility of speech that takes into account the reduction in sound

pressure level afforded by a partition in question, the ambient noise level, and various

weighting factors. The Articulation Index of a space in question can be measured and

compared to industry standard values that define levels of acceptability. An Articulation

Index of .05 or less is typically used as an indication that a reasonable effort has been made

to protect patient information.

Impact of the Law

Since passage of the Privacy Rule, many health care providers are finding that their facility is

not living up to the speech privacy requirements. Other health care providers do not know if

their facility is in compliance or not. If a complaint is proven to be valid, the Department of

Health and Human Services may impose a civil penalty of $100 per failure to comply with

the Privacy Rule requirements (maximum of $25,000 per year).

What Can Be Done?

It is time to address your facility's speech privacy concerns. AcoustiControl can visit your

facility to conduct a noise survey and measure the Articulation Index to determine if your

facility exhibits a reasonable accommodation toward acoustical privacy. If not,

AcoustiControl can recommend ways to improve acoustical privacy. Please contact us for a

thorough site visit and a serious analysis of your situation.

If the project is still in the design phase, AcoustiControl can make recommendations to help

ensure a good acoustical design throughout the healthcare facility

There's good news.......

Those hospitals that have attacked the noise problem successfully by looking equipment and

making acoustical modifications to their facilities have improved patient satisfaction.

At Northside Hospital in Atlanta Georgia, a committee of employees from throughout the

hospital ( even accounting) studied ways to reduce noise. In 2 years, the committee was

able to drop the decibel level by as much as 40% in some hospital areas.

At other hospitals that took steps to reduce noise levels, patients were more satisfied with

their care, slept better, had lower blood pressure and were less likely to be re hospitalized.

Also, the staff felt better about their jobs and they also reported improved sleep quality.

Poor acoustics have dramatic consequences in healthcare environments, and using the

services of an acoustical consultant when designing hospital or healthcare environments will

help ensure that the facility will perform the purpose that it is designed to perform.

The 2014 FGI Guidelines Are Here

by Kristen Murphy on July 31, 2014

The new version of the FGI (Facility Guidelines Institutes) Guidelines is here! The FGI

Guidelines is an industry standard document focused on the design and construction of

healthcare facilities, covering topics from space planning and room design to equipment, to

(you guessed it) acoustics, which was introduced in the 2010 cycle.

The influence of the Guidelines is huge. Forty-two states use them in some form as part of

their building codes. They are cited in sixty countries. The acoustic design requirements are

the only comprehensive acoustical criteria for healthcare facilities written in code language,

and serve as the sole reference for acoustical criteria in ICC, LEED for Health Care, and

others.

The impact of the guidelines is no-less important. Hospitals can actually lose some of their

Medicare and Medicaid funding, based on their HCAHPS scores. The HCAHPS (Hospital

Consumer Assessment of Healthcare Providers and Systems) survey is a national,

standardized, publicly reported survey of patients perspectives of hospital care. The portion

of the survey covering quiet is typically the lowest scoring section. Improvements to a

hospitals acoustics score, can ensure their full incentive-based funding. The 2010 and now

2014 FGI Guidelines provide hospitals and other healthcare facilities the acoustical targets

necessary to help improve quiet, which in-turn promotes rest and healing, and in-turn can

improve the HCAHPS scores.

In order to stay current with the latest research and changes in healthcare laws, the

Guidelines are edited and re-issued every four years following an open, formal, Continual

Improvement Process. This work is done by the FGIs Health Guidelines Revision Committee

(HGRC), which is composed of a multi-disciplinary group of experts related to healthcare

facilities. The acoustical content is the responsibility of the FGI Acoustics Working Group

(AGW), a standing committee, formed in 2005. Kenric Van Wyk, serves as the Education

Chair of the group, which also includes members of the Acoustical Society, INCE-USA, and

other professional organizations. The AGW authors and edits the Sound & Vibration Design

Guidelines for Health Care Facilities (S&V-3.0-2014), which serves as the sole acoustical

reference for the FGI Guidelines.

The specific acoustical design criteria in both volumes of the Guidelines are presented in

terms of minimum standards, and cover the following categories:

Site exterior noise

Acoustic surfaces

Room noise levels

Performance of interior wall and floor/ceiling constructions

Speech privacy

Building vibration

Look for more details about all those criteria in an upcoming post. You might also invite

Acoustics By Design to visit your location as part of the Sound HealthCare 2014 tour.

One of the largest and most visible changes, from the 2010 cycle, is the split of the

Guidelines from a single document into two volumes:

Guidelines for the Design and Construction of Hospitals and Outpatient Facilities

Guidelines for the Design and Construction of Residential Health, Care, and Support

Facilities

Both volumes contain specific acoustical criteria for their respective facilities.

Also new to the 2014 cycle, is the safety risk assessment. The assessment works to evaluate

and mitigate potential causes of adverse safety events in healthcare facilities due to the built

environment. Notably, the 2014 Guidelines have formally identified acoustics as a life-safety

issue. Design guidelines have been set for these spaces to address evidence that sound and

noise affects the rate of medication errors. In addition, the Guidelines highlights alarm

fatigue. This desensitization to constant monitoring equipment alarms can lead to dangerous

behavior by staff, and can cause loss of sleep and an increase in anxiety in patients.

Working with an independent acoustical consulting firm, like Acoustics By Design, is the best

way to ensure new construction and remodeling of healthcare facilities take full advantage

of the standards found in the 2014 FGI Guidelines.

Kristen Murphy

Kristen Murphy, LEED AP BD+C, has worked in architecture and engineering since 2004. She

earned her BS in Architecture from the University of Michigan in 2008, and her Masters

Degree in Architectural Acoustics from Rensselaer Polytechnic Institute in 2011. Kristens

unique background has given her the perspective to serve as a liaison between the worlds of

architecture and acoustical consulting. Kristen is an Acoustical Consultant at Acoustics By

Design, in Grand Rapids, Michigan.

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