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Noise exposure patterns and health risk assessment among nurses in a Chinese paediatric intensive care unit Cover

Noise exposure patterns and health risk assessment among nurses in a Chinese paediatric intensive care unit

By: Yan Liu and  Junlin Tan  
Open Access
|Mar 2026

Figures & Tables

Figure 1

Time-history plot of noise exposure (LAeq) for a representative 12-hour PICU nurse shift

Figure 2

Distribution of 8-hour TWA noise exposure (LAeq,8 h) by shift type (day vs night); TWA – time-weighted average

Figure 3

Acoustic characterisation of the PICU environment; A) 1/3 octave band frequency analysis at central nurse station; B) 1/3 octave band frequency analysis at patient bedside

Figure 4

Prevalence of hearing handicap (HHIA categories) by years of work at the PICU

Figure 5

Prevalence of poor sleep quality (PSQI>5) stratified by noise exposure groups

Figure 6

Scatter plots of 8-hour TWA (LAeq,8 h) vs Perceived Stress Scale (PSS-10) score(A), Pittsburgh Sleep Quality Index (PSQI) total score (B), and hearing handicap inventory (HHIA) total score (C)

Figure 7

Forest plot of adjusted odds ratios for poor sleep quality (PSQI>5); PICU – paediatric intensive care unit; PSQI – Pittsburgh Sleep Quality Index; PSS-10 – Perceived Stress Scale

Figure 8

Conceptual model of the hierarchy of noise control adapted for paediatric intensive care units

Pearson correlation matrix for LAeq,8 h, health outcome scores, and confounders

VariableLAeq,8 hPSS-10 scorePSQI scoreHHIA scoreAge
LAeq,8 h1
PSS-10 score0.450***1
PSQI score0.521***0.610**1
HHIA score0.279*0.1980.2451
Age0.0890.1520.1770.412**1
Years in PICU0.1030.1330.1600.445**0.891**

Descriptive statistics of full-shift noise-exposure measurements with personal dosimeters (N=60)

Noise exposureMean±SDMedianMinMaxDosimetry measurements > NIOSH REL (85 dBA/8 h)Dosimetry measurements > WHO (35 dBA)
LAeq (12-hr) (dBA)77.0±4.277.167.684.7N/A60
LAeq,8 h (dBA)78.5±4.278.669.186.2260
LCpeak (dBC)116.8±5.1115.9107.2130.10 (>140 dBC)60 (>40 dBA L_Amax)

Multivariate logistic regression analysis for predictors of poor sleep quality (PSQI>5)

VariableLog-odds ratio with PSQI > 5SEWaldp-valueAdjusted odds ratio (OR)95 % CI for OR
LAeq,8 h (per 1 dBA)0.2230.0886.390.012*1.251.05–1.48
PSS-10 score (per point)0.2700.0899.150.003**1.311.10–1.55
Age (per year)0.0410.0550.560.4541.040.93–1.16
Years in PICU (per year)−0.0290.0610.230.6330.970.86–1.09
Constant−18.757.116.970.008

Descriptive statistics for health outcome variables (N=60)

Health outcome variableScaleMean ± SDMedianMinMaxPrevalence of poor outcome
Perceived stress (PSS-10)0–4019.8±6.120.5832N/A
Sleep quality (PSQI)0–218.4±3.38.021739 of 60 (PSQI>5)
Hearing handicap (HHIA)0–10012.4±10.110.00447 of 60 (Score>16)

Primary identified noise sources and associated peak levels (LCpeak)

Noise sourceLocationMean LCpeak ± SD (dBC)
Mechanical ventilator alarm (high priority)Bedside112.4±3.1
IV pump alarmBedside105.8±4.5
Phone ringing (central station)Nurse station94.2±2.2
Staff conversation (group, 1 m)Nurse station85.0±5.7
Overhead paging systemUnit-wide88.6±3.9
Equipment Cleaning (metal-on-metal)Utility Room96.1±6.4

Sociodemographic and occupational characteristics of the PICU nurse cohort (N=60)

Demographic and job-related characteristics N (%) or Mean±SD
Age (years) 34.2±8.1
GenderFemale53 (88.3 %)
Male7 (11.7 %)
Marital statusMarried32 (53.3 %)
Single/other28 (46.7 %)
Highest nursing qualificationSecondary nursing school7 (11.7 %)
BScN/BN46 (76.7 %)
Master’s degree7 (11.7 %)
Years in nursing 10.1±7.3
Years in PICU 7.4±4.5
Monitored shiftDay shift (07:00–19:00)30 (50.0 %)
Night shift (19:00–07:00)30 (50.0 %)
DOI: https://doi.org/10.2478/aiht-2026-77-4077 | Journal eISSN: 1848-6312 | Journal ISSN: 0004-1254
Language: English, Croatian, Slovenian
Page range: 39 - 48
Submitted on: Nov 1, 2025
Accepted on: Dec 1, 2025
Published on: Mar 30, 2026
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2026 Yan Liu, Junlin Tan, published by Institute for Medical Research and Occupational Health
This work is licensed under the Creative Commons Attribution 4.0 License.