arXiv:2502.00565eess.AScs.SD2025-02中稿 · manuscript submitt…被引 2

研究新生儿病房真实听觉环境,发现传统测音方式可能低估实际噪音暴露。

Do neonates hear what we measure? Assessing neonatal ward soundscapes at the neonates ears

  • 在新生儿床边直接测量声音,更贴近真实听力体验。
  • 不同麦克风位置导致噪声读数差异显著,床边噪声最高。
  • 建议采用双耳测量并加入音调、突发响声等新指标。

新生儿重症监护室(NICU)的声学指南旨在保护脆弱新生儿免受噪声引起的生理伤害。然而,缺乏国际统一的声音环境测量标准,导致现有研究中仪器使用和麦克风位置不一致,引发对指南相关性和有效性的担忧。本研究通过在运行中的NICU和高依赖病房进行长期声学监测,探究麦克风位置、床位布局和病房结构对声环境评估的影响。除了传统的A加权分贝指标外,还评估了C加权分贝(低频噪声)、音调声音(如报警声)出现频率以及可能干扰新生儿睡眠的瞬时强音事件。采用带秩转换的线性混合效应模型(LME-ART-ANOVA),结果表明麦克风位置对测得噪声水平有显著影响,强调需在新生儿耳旁直接采集声音数据。此外,床位位置和病房布局也显著影响噪声暴露,所有(心理)声学指标下,NICU床位始终呈现最高噪声水平。研究支持采用双耳测量,并整合音调特征与瞬时事件发生率等额外(心理)声学指标,以可靠表征新生儿的听觉体验。

原文摘要 · Abstract (English)

Acoustic guidelines for neonatal intensive care units (NICUs) aim to protect vulnerable neonates from noise-induced physiological harm. However, the lack of recognised international standards for measuring neonatal soundscapes has led to inconsistencies in instrumentation and microphone placement in existing literature, raising concerns about the relevance and effectiveness of these guidelines. This study addresses these gaps through long-term acoustic measurements in an operational NICU and a high-dependency ward. We investigate the influence of microphone positioning, bed placement, and ward layout on the assessment of NICU soundscapes. Beyond traditional A-weighted decibel metrics, this study evaluates C-weighted metrics for low-frequency noise, the occurrence of tonal sounds (e.g., alarms), and transient loud events known to disrupt neonates' sleep. Using linear mixed-effects models with aligned ranks transformation ANOVA (LME-ART-ANOVA), our results reveal significant differences in measured noise levels based on microphone placement, highlighting the importance of capturing sound as perceived directly at the neonate's ears. Additionally, bed position and ward layout significantly impact noise exposure, with a NICU bed position consistently exhibiting the highest sound levels across all (psycho)acoustic metrics. These findings support the adoption of binaural measurements along with the integration of additional (psycho)acoustic metrics, such as tonality and transient event occurrence rates, to reliably characterise the neonatal auditory experience.

新生儿声环境听力保护病房设计

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