The Relationship Between Hospital Construction and High-Risk Infant Auditory Function at NICU Discharge: A Retrospective Descriptive Cohort Study

Abstract

Purpose:

To describe the difference in auditory function at neonatal intensive care unit (NICU) discharge between high-risk infant cases exposed to hospital construction during NICU stay and those not exposed.

Background:

Noise produced by routine NICU caregiving exceeds recommended intensity. As California hospitals undergo construction to meet seismic safety regulations, vulnerable neonates are potentially exposed to even higher levels of noise. Ramifications are unknown.

Methods:

Retrospective data-based descriptive cohort design was used to compare high-risk infant auditory function at NICU discharge between hospital construction exposed and unexposed groups. Sample size: N = 540 infant cases (243 construction exposed and 297 unexposed controls). Inclusion criteria: Infant cases born and discharged from the study site NICU in the year 2010 (unexposed) and year 2015 (exposed) and received a newborn hearing screening by automated auditory brainstem evoked response (ABER) prior to discharge with results reported. Infant cases excluded: hearing screen results by ABER unavailable, potentially confounding characteristics (congenital infection, major anomalies including cleft lip and/or palate), and transferred into or out of the study site. Instrumentation: ABER. Analysis: descriptive statistics (SPSS Version 24.0), hypothesis testing, correlation, and logistic regression.

Results:

The difference in auditory function at NICU discharge between high-risk infant cases exposed to hospital construction noise and those unexposed was statistically insignificant, χ² = 1.666, df = 4, p = .1968, 95% confidence interval [−0.635, 2.570].

Conclusions:

More research is needed to better understand whether hospital construction exposure during NICU admission negatively affects high-risk infant auditory function. Findings may catalyze theory development, future research, and child health policy.

Keywords

high-risk infant NICU hospital construction noise auditory function newborn hearing

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References

American Academy of Pediatrics. (1997). Noise: A hazard for the fetus, and newborn. AAP committee on environmental health policy statement. Pediatrics, 100, 1–10.

American Academy of Pediatrics. (2008). Hospital discharge of the high-risk neonate. AAP committee on fetus and newborn policy statement. Pediatrics, 122, 1119–1126.

American Speech Hearing Association. (2015). Newborn hearing screening. Retrieved from http://www.asha.org/Practice-Portal/Professional-Issues/Newborn-Hearing-Screening/

Balasundaram

Bhutani

V. K

. (2016). Severe hyperbilirubinemia prevention [SHP Toolkit]. Retrieved from https://www.cpqcc.org/qi-tool-kits/severe-hyperbilirubinemiaprevention-shp

Bleile

K. M.

(2015). The manual of speech sound disorders: A book for students and clinicians (3rd ed.). Stamford, CT: Cengage Learning.

Buck Louis

G. M.

Sundaram

(2012). Exposome: Time for transformative research. Statistics in Medicine, 31, 3–9.

California Department of Health Care Services. (2015). Newborn hearing screen program. Retrieved from www.dhcs.ca.gov/services/nhsp/Pages/default.aspx

California Health Care Foundation. (2015). California health care almanac quick reference guide. Retrieved from http://www.chcf.org/∼/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20C/PDF%20CaliforniaHospitalsQuickRefGuide2015.pdf

Centers for Disease Control and Prevention. (2015). Hearing loss in children. Retrieved from http://www.cdc.gov/ncbddd/hearingloss/research.html

10.

Cristobal

Oghalai

J. S.

(2008). Hearing loss in children with very low birth weight: Current review of epidemiology and pathophysiology. Archives of Disease in Childhood-Fetal and Neonatal Edition, 93, F462–F468.

11.

Dalebout

(2009). The Praeger guide to hearing and hearing loss: Assessment, treatment, and prevention. Westport, CT: Praeger.

12.

Darcy

Hancock

Ware

. (2008). A descriptive study of noise in the neonatal care unit: Ambient levels and perceptions of contributing factors. Advances in Neonatal Care, 8, S16–S26.

13.

Environmental Protection Agency. (2009). Noise and its effects on children (EPA-410-F-09-003). Retrieved from www.epa.gov/air/noise/ochp_noise_fs_rev1.pdf

14.

Environmental Protection Agency. (2013). EPA identifies noise levels affecting health and welfare. Retrieved from http:www.2.epa.gov/aboutepa/epa-identifies-noise-levels-affecting-health-and-welfare

15.

Environmental Protection Agency. (2015). Summary of the Noise Control Act. U.S. EPA laws and regulations. Retrieved from http://www.2.epa/laws-regulations/summary-noise-control-act

16.

Evans

J. B.

(2007). Noise control for neonatal ICU for demolition and construction within hospital facilities. Paper presented at the Institute of Noise Control Engineering Conference, NOISE-CON, Reno, NV.

17.

Evans

K. B.

Philbin

M. K.

(2000). The acoustic environment of hospital nurseries: Facility and operations planning for quiet hospital nurseries. Journal of Perinatology, 20, S105–S112.

18.

Foster

L. R.

Hynan

Anderson

J. M.

(2006). The interrater reliability of Apgar scores at 1 and 5 minutes. Journal of Investigative Medicine-British Medical Journal, 54, S292–S308.

19.

Frankenhaeuser

Lundberg

(1974). Immediate and delayed effects of noise on performance and arousal. Biological Psychology, 2, 127–133.

20.

Grahn

van der Berg

Persson Waye

Theorell

Thorgaard

Quinn

(2013). Care for sound: Sound environment, healing, and health-care. Ecophon, Sweden: Sound Environment Center, Lund University.

21.

Harlor

A. D.

Bower

(2009). Hearing assessment in infants and children: Recommendations beyond neonatal screening. Pediatrics, 124, 1252–1263.

22.

Harrison

Goodman

(2015). Epidemiologic trends in neonatal intensive care, 2007-2012. JAMA Pediatrics, 169, 855–862.

23.

Henkin

R. I.

Knigge

K. M.

(1963). Effect of sound on hypothalamic-pituitary-adrenal axis. American Journal of Physiology, 204, 701–704.

24.

Hulley

S. B.

Cummings

S. R.

Browner

W. S.

Grady

D. G.

Newman

T. B.

(2013). Designing clinical research (4th ed.). Philadelphia, PA: Wolters Kluwer/Lippincott, Williams, & Wilkins.

25.

IBM Corp. (2016). SPSS premium grad pack for Windows (Version 24). Armonk, NY: Author.

26.

Joint Committee on Infant Hearing. (2007). Position statement: Principles and guidelines for early hearing detection and intervention programs. Pediatrics, 120, 898–921.

27.

Juarez

Matthews-Juarez

Hood

D. S.

Levine

R. S.

Kilcourne

B. J.

… Lichtveld

M. Y

. (2014). The public health exposome: A population-based exposure science approach to health disparities research. International Journal of Environmental Research Public Health, 11, 12866–12895.

28.

Kuzniewicz

M. W.

Puopolo

K. M.

Fischer

Walsh

E. M.

Newman

T. B.

… Escobar

G. J

. (2017). A quantitative, risk-based approach to the management of neonatal early-onset sepsis. JAMA Pediatrics, 171, 365–371.

29.

Lahav

Skoe

(2014). An acoustic gap between the NICU and womb: A potential risk for compromised neuroplasticity of the auditory system in preterm infants. Frontiers in Neuroscience, 8, 1–8.

30.

Lechlitner Lusk

McCullagh

Vaughan Dickson

(2016). American academy of nursing on policy, position statement: Harmful effects of environmental noise exposures. Nursing Outlook, 64, 395–396.

31.

Levit

Himmelfarb

Dollberg

(2015). Sensitivity of the automated auditory brainstem response in neonatal hearing screening. Pediatrics, 136, e641–e647.

32.

Locher

Frijins

J. H.

van Iperen

de Groot

J. C.

Husiman

M. A.

Chuva de Sousa Lopes

S. M.

(2013). Neurosensory development and cell fate determination in the human cochlea. Neural Development, 8, 20.

33.

Maisels

M. J.

Watchko

J. F.

Bhutani

V. K.

Stevenson

D. K.

(2012). An approach to the management of hyperbilirubinemia in the preterm infant less than 35 weeks of gestation. Journal of Perinatology, 32, 660–664.

34.

Matook

S. A.

Sullivan

M. C.

Salisbury

Miller

R. T.

Lester

B. M.

(2010). Variations of NICU sound by location and time of day. Neonatal Network, 29, 87–95.

35.

McMahon

Wintermark

Lahav

(2012). Auditory brain development in premature infants: Importance of early experience. Annals NY Academy of Sciences, 1252, 17–24.

36.

Morton

C. C.

Nance

W. E.

(2006). Newborn hearing screening-A silent revolution. New England Journal of Medicine, 54, 2151–2164.

37.

National Center for Hearing Assessment and Management. (2015). Interactive web based newborn hearing screening training curriculum. NCHAM. Logan, UT: Utah State University. Retrieved from http://infanthearing.org/nhstc/index.html

38.

National Institute for Occupational Safety and Health. (1998). Occupational noise exposure: Criteria for a recommended standard. Atlanta, GA: CDC.

39.

National Institute for Occupational Safety & Health. (2013). Noise and hearing loss prevention: Noise meter. Atlanta, GA: CDC.

40.

Nightingale

(1860). Notes on nursing: What it is and what it is not. New York, NY: Appleton.

41.

Occupational Safety and Health Administration. (1998). Informational booklet on industrial hygiene. United States Department of Labor-OSHA 3134. Retrieved from https://www.osha.gov/Publications/OSHA3143/OSHA3143.htm

42.

Occupational Safety and Health Administration. (2016). OSHA strategic plan and FAQs. United States Department of Labor-OSHA. Retrieved from https://www.osha.gov/OSHA_FAQs.html

43.

Office of Statewide Health Planning and Development. (2015). Health information division. Retrieved from www.oshpd.ca.gov/HID/DataFlow/HospMain.html

44.

Office of Statewide Health Planning and Development. (2016). Overall mission and California seismic compliance. California OSHPD. Retrieved from www/pspd.ca.gov

45.

Oxford Dictionaries Online. (2015). Noise, vibration, and auditory function. Retrieved from https://en.oxforddictionaries.com/definition/us/noise

46.

Peng

Bachman

Jenkins

Chen

Chang

Wang

(2013). Relationships between environmental stressors and stress biobehavioral responses of preterm infants in NICU. Journal of Perinatal Neonatal Nursing, 23, 363–371.

47.

Persson Waye

Ryherd

(2013). Achieving a healthy sound environment in hospitals. Keynote paper presented at Inter Noise , Innsbruck, Austria.

48.

Pineda

Durant

Mathur

Inder

Wallendorf

Schlaggar

B. L.

(2017). Auditory exposure in the neonatal intensive care unit: Room type and other predictors. Journal of Pediatrics. Retrieved from www.jpeds.com

49.

Puopolo

K. M.

Draper

Newman

T. B.

Zupancic

Lieberman

… Escobar

G. J

. (2011). Estimating the probability of neonatal early-onset infection on the basis of maternal risk factors. Pediatrics, 128, e1155–e1163.

50.

Suppiej

Rizzardi

Zanardo

Franzoi

Ermani

Orzan

(2007). Reliability of hearing screening in high-risk neonates: Comparative study of otoacoustic emission, automated and conventional ABER. Clinical Neurophysiology, 118, 869–876.

51.

Trickey

A. W.

Arnold

C. C.

Parmar

Lasky

R. E.

(2012). Sound levels, staff perceptions, and patient outcomes during renovation near the NICU. Health Environments Research and Design Journal, 5, 76–87.

52.

Ulrich

Zimring

. (2004). The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime opportunity. Robert Wood Johnson Foundation. Concord, CA: Center for Health Design. Retrieved from https://www.healthdesign.org/system/files/Ulrich_RoleofPhysical_2004.pdf

53.

Viet

S. M.

Dellarco

Dearborn

D. G.

Neitzel

(2014). Assessment of noise exposure to children: Considerations for the national children’s study. Journal of Pregnancy and Child Health, 1, 105–125.

54.

Vrijheid

Slama

Robinson

Chatzi

Coen

van den Hazel

… Nieuwenhuijsen

M. J

. (2014). The human early-life exposome (HELIX): Project rationale and design. Environmental Health Perspectives, 122, 535–544.

55.

Wachman

Lahav

(2011). The effects of noise on preterm infants in the NICU. Archives of Disease in Childhood-Fetal and Neonatal Education, 96, F305–F309.

56.

Wild

C. P.

(2012). The exposome: From concept to utility. International Journal of Epidemiology, 4, 24–32.

57.

Zalk

D. M.

Spee

Gillen

Lentz

T. J.

Garrod

Evans

Swuste

(2011). Review of qualitative approaches for the construction industry: Designing a risk management toolbox. Safety and Health at Work, 2, 105–121.

58.

Zimmerman

Lahav

(2013). Ototoxicity in preterm infants: Effects of genetics, aminoglycosides, and loud environmental noise. Journal of Perinatology, 33, 3–8.

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