NICUs Exceed the American Academy of Pediatrics Recommended Decibel Level, Which Can be Measured by Smartphone App

The neonatology team at University of Maryland Children's Hospital has conducted the first-ever study examining the impact of neonatal intensive care unit (NICU) design and environmental factors on neonatal sound exposures.

Study Details

The team hypothesized that monitoring with a smartphone application would identify modifiable environmental factors in different NICU design formats. The study looked into the minimum, maximum, and peak decibel recordings, which were obtained using the Decibel X phone app. The study also examined the presence of noise sources recorded in each patient space at three NICUs over a 6-month period (December 2017 to May 2018).

Data were analyzed by Student's t-test and ANOVA with Bonferroni correction. Data were collected at the University of Maryland Children's Hospital single family room level IV NICU and St. Agnes Healthcare hybrid pod/single family room level III NICU, and at Prince George's Hospital Center open-pod design Level III NICU.


All recordings in the three NICUs exceeded the American Academy of Pediatrics (AAP) recommended <45 decibel level. The maximum and peak decibels were highest in the open pod format level III NICU. Conversations/music alone and combined with other factors contributed to increased sound exposure.

Sound exposure varied by day/night shift, with higher day exposures at the level III hybrid and open pod NICUs and higher night exposures at the level IV single family room NICU. Although sound exposure varied by NICU design, all recordings exceeded the AAP recommendation due, in part, to potentially modifiable environmental factors. A smartphone application may be useful for auditing NICU sound exposure in quality improvements efforts to minimize environmental sound exposure.

Read the entire white paper on this study.