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/treatment-approach-considerations-for-school-9472Treatment Approach Considerations for School-Aged Children with Speech Sound DisordersThis course will address the theoretical underpinnings and research base related to differential diagnosis and treatment of articulation and phonological deficits in children with speech sound disorders. Special considerations for how to tailor evaluation and intervention to meet the needs of school-age children will be discussed.auditory, textual, visual
This course will address the theoretical underpinnings and research base related to differential diagnosis and treatment of articulation and phonological deficits in children with speech sound disorders. Special considerations for how to tailor evaluation and intervention to meet the needs of school-age children will be discussed.
2https://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, visual
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)
3https://www.speechpathology.com/slp-ceus/course/behavioral-frameworks-for-dementia-management-9473Behavioral Frameworks for Dementia ManagementThis course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.auditory, textual, visual
This course will focus on cognitive-communication intervention strategies for various dementia presentations and will provide a review of evidence-based treatment. Behavioral frameworks along with their rationales will be introduced and applied across several dementia types and mild, moderate and severe levels of impairment.
4https://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, visual
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.
5https://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, visual
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.