Question
A nurse at a local hospital has called our office seeking information about hearing conservation guidelines for neonatal babies being air transported. They use small sound meters in the incubators that are reading high levels of about 95-97dB. She has bee
Answer
There are actually two questions here. First, are the levels cited high enough to cause concern? Second, if noise protection is pursued, what is the best approach? The decibel levels cited were given without a weighting scale. When taking sound level measures, the A-weighting scale is typically used because it is the most similar to the response of the adult human ear. We do not have regulations or guidelines specific for neonates. Furthermore, we don't know if they are more susceptible to noise induced hearing loss than adults. If we use the adult regulations, the Occupational Safety and Health Administration specifies that measures be made with the A scale and a slow response time. For 95 dBA up to 4 hours of exposure would be permissible. For 96 dBA up to 3 hours would be permissible. Aside from noise exposure, high noise levels can be physiological stressors (e.g., increased heartrate) and this is another reason to try to provide noise protection.
If you decide to provide noise protection to decrease the likelihood of noise induced hearing loss or for promoting a good environment for physiologic reasons, I would suggest that you use over-the-ear coverage rather than inserting a plug into the ear. Neonates often have debris in the canal due to the birth process. This usually will naturally migrate out over a period of days or weeks. Without an otoscopic inspection, you do not know whether you are pushing debris and/or cerumen further into the canal. This could make the debris less likely to migrate out naturally. By using a muff that covers the pinnae, you avoid this problem. Although I do not endorse a specific manufacturer, Natus makes a product called Minimuffs that reduces sound levels by at least 7 dB. It fits over the outer ear and stays in place with a hydrogel adhesive.
Roanne Karzon received her Ph.D. from Washington University. Currently, she is a clinical assistant professor of Audiology at the Central Institute for the Deaf and a clinical assistant professor, Dept. of Otolaryngology, at Washington School of Medicine.
Roanne Karzon, Ph.D
Related Courses
1https://www.speechpathology.com/slp-ceus/course/ripple-effect-stuttering-community-based-9217The Ripple Effect of Stuttering: A Community-Based ApproachThis is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comThe Ripple Effect of Stuttering: A Community-Based ApproachThis is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)9217OnlinePT120M
This is Part 2 of a four-part series. The stuttering experience has a ripple effect that extends far beyond the child who stutters. Parents, teachers, peers, and others must possess both knowledge and skills to best support children who stutter. This course will highlight new clinical tools and resources to provide a community-based treatment approach for stuttering. (Part 1 - Course 9278, Part 3 - Course 9301, Part 4 - Course 9304)
2https://www.speechpathology.com/slp-ceus/course/20q-infection-control-strategies-for-972920Q: Infection Control Strategies for SLPsSpeech-language pathologists are expected by policy authorities to apply appropriate measures to protect patients, co-workers and themselves in clinical situations that may expose individuals to infectious microbes. This article provides practical guidelines for implementing infection control principles within the context of the COVID-19 pandemic, including discussion of personal protective equipment (PPE) and disinfecting and cleaning products.textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.com20Q: Infection Control Strategies for SLPsSpeech-language pathologists are expected by policy authorities to apply appropriate measures to protect patients, co-workers and themselves in clinical situations that may expose individuals to infectious microbes. This article provides practical guidelines for implementing infection control principles within the context of the COVID-19 pandemic, including discussion of personal protective equipment (PPE) and disinfecting and cleaning products.9729OnlinePT60M
Speech-language pathologists are expected by policy authorities to apply appropriate measures to protect patients, co-workers and themselves in clinical situations that may expose individuals to infectious microbes. This article provides practical guidelines for implementing infection control principles within the context of the COVID-19 pandemic, including discussion of personal protective equipment (PPE) and disinfecting and cleaning products.
3https://www.speechpathology.com/slp-ceus/course/thickened-liquids-in-clinical-practice-10497Thickened Liquids in Clinical Practice: The Plot “Thickens”Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comThickened Liquids in Clinical Practice: The Plot “Thickens”Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.10497OnlinePT60M
Clinicians who utilize thickened liquids in their clinical practice are aware of their benefits, but what about the risks and contraindications? Advantages and disadvantages of thickened liquids are reviewed in this course with a focus on clinical outcomes, including impacts on medication administration, lung health, and hydration. Product types are evaluated to facilitate appropriate choices for individual clients.
4https://www.speechpathology.com/slp-ceus/course/slp-in-nicu-overview-11267SLP in the NICU: An OverviewThis course provides an introductory overview of Speech-Language Pathology services in the Neonatal Intensive Care Unit (NICU), including the unique environment, the SLP’s role, and key components of neonatal care. Topics include cue-based and supportive feeding strategies, instrumental assessments, and approaches for empowering and supporting parents and caregivers.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comSLP in the NICU: An OverviewThis course provides an introductory overview of Speech-Language Pathology services in the Neonatal Intensive Care Unit (NICU), including the unique environment, the SLP’s role, and key components of neonatal care. Topics include cue-based and supportive feeding strategies, instrumental assessments, and approaches for empowering and supporting parents and caregivers.11267OnlinePT60M
This course provides an introductory overview of Speech-Language Pathology services in the Neonatal Intensive Care Unit (NICU), including the unique environment, the SLP’s role, and key components of neonatal care. Topics include cue-based and supportive feeding strategies, instrumental assessments, and approaches for empowering and supporting parents and caregivers.
5https://www.speechpathology.com/slp-ceus/course/dysphagia-in-neurodegenerative-disease-9732Dysphagia in Neurodegenerative DiseaseDysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.auditory, textual, visual129USDSubscriptionUnlimited COURSE Access for $129/yearOnlineOnlySpeechPathology.comwww.speechpathology.comDysphagia in Neurodegenerative DiseaseDysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.9732OnlinePT60M
Dysphagia is common in individuals with amyotrophic lateral sclerosis (ALS) and Parkinson’s disease. This course discusses the underlying pathophysiology and appropriate treatment programs for each disease, as well as use of alternate methods of nutrition/hydration.
