HOSPITAL ACOUSTICS

PLANNING AGAINST NOISE

AR 310 Building Services – Acoustics

Faculty of Architecture &Planning
Integral University, Lucknow
INTRODUCTION OF ACOUSTICS

• Acoustics is the study of how sound and

buildings interact, including the behavior of
sound in concert halls and auditoriums but
also in office buildings, hospitals &
factories and homes.

• Problems of noise control vary from

hospital to hospital but the principles
outlined below apply to all types. A quiet
Environment in hospitals is desirable for
patients who are acutely ill.
IMPORTANCE OF ACOUSTICS IN HOSPITAL

• Noise in a hospital affects both doctors

and patients and raises the risk of medical
error.

• Hospitals should provide comfort to both

patients and medical staff , one of the
many factors to consider is acoustics.

• The acoustic environment is controlled by

the performance of elements such as room
or ward shape, size and the inter-
relationship between these areas.
Construction materials, surface finish and
furnishings need to be selected carefully to
minimize noise build-up.
• The sound transmission class-
specification of doors, walls and
ceiling constructions, is
necessary to block out
unwanted noise without
sacrificing other important
design aspects. Consideration
also needs to be given to the
impact of services such as
plumbing, electrical and
mechanical systems like air-
conditioning as well as external
noise intrusion, particularly from
traffic noise.
 SOURCES OF NOISE NUISANCE

• As staff require quiet conditions for consultations and

examinations and also in their living and sleeping quarters but
There have been rapid rises in noise levels in hospitals due to
the higher levels of outdoor noise, these are generally by
increased use of mechanical and mobile equipment ,some of,
which is now brought much nearer to the patient in order to
facilitate nursing procedure.
• The introduction of loudspeaker, radio, television and call
systems also increase the noise.
• Noise control in the hospital is made much more difficult by the
extensive use of hard washable surfaces which reflect and
intensify the noise.
• In most hospitals, windows to the open air and fanlights to the
corridors are usually open for the purpose of ventilation,
admitting noise from outside and allowing it to spread through
the building.
FACTORS GOVERNING NOISE:-

OUTDOOR NOISE - This may be, classified

into two main categories:

• Noise from sources outside the hospital

premises, for example, traffic and
Industrial noises; and

• Noise from sources outside the building

but usually within the control of the
hospital authority. for example.
Ambulances, motor-cars and service
vehicles, fuel and stores deliveries,
laundries, refuse collection, trucks and
trolleys.
INDOOR NOISE:-A hospital is a complex building with many services
and the numerous internal sources of structure-borne und air-borne noises
are grouped into three main categories:-

• Noises consequent upon hospital

routines. This category includes
sources which transmit noise through,
both structure-borne and air-borne
paths, many of which may be quite near
to, patients particularly those in wards,
such as the following:-

I) Wheeled trolleys of various kinds,

for food and medical supplies;

2) Sterilizing equipment:
3) Sluice room equipment including bedpan washers;,
4) Ward kitchen equipment;
5) Noises caused during maintenance and overhaul of engineering
services;
6) Doors banging;
7) The handling of metal or glass equipment;
8) Vacuum cleaners, mechanical polishers, etc.
9) Footsteps;

• Loudspeaker, radio or television, audible call system, telephone bells

and buzzers, and other ,air-borne noises, such as loud
conversation are basic roots of indoor noise.
• Noises from fixed or mobile equipment and services
not directly concerned, with hospital routines. These
include all the fixed services as given below:
I) Plumbing and sanitary fittings;
2) Steam, hot and cold water and central heating pipes;
3) Ventilation shafts and ducts;
4) Fans;
5) Boilers;
6) Pumps;
7) Air compressors:
8) Pneumatic tubes;
9) Electrical and mechanical motors and equipment:
10) Lifts;
II) Laundry equipment; and
12) Main kitchen equipment (refrigerators. mixers.
steam boilers. etc).
• Overhearing by flanking transmission of sound over partitions is a
frequent complaint, for example between waiting areas and
consultants' offices.
• The transmission of sound energy via paths which bypass the
partition is known as, flanking transmission.

It can occur because the sealing of the panel

around its perimeter is inadequate or small gaps have been left where
services pass through the partition or because energy which has got
into the main structure travels through the structure to he reradiated on
the other side of the partition. Flanking transmission means that the
partition fails to give the performance that laboratory measurements
would indicate it is capable of. In practice flanking transmission is
always a possibility and every effort should be made to guard against
the most obvious means by which energy can bypass the partition.
RECOMMENDATIONS

• SITE PLANNING:-

Hospital sites with, their high degree of sensitivity to

outside noise should be as far away from outside sources as may be
compatible with other considerations, such as accessibility and
availability of services.
The building should be so arranged on the site that
sensitive areas like wards, consulting and treatment rooms, operating
theatres and staff bedrooms are placed away from outdoor sources of
noise, if possible, with their windows overlooking areas of acoustic
shadow.
• DETAILED PLANNING:-

There is a very large number of unit and room

classification in hospital design and in planning the units in
relation to each other and to the common services, (such as X-
ray departments, operating theatre suits and main kitchens),
noise reduction in the sensitive areas should be weighed
carefully against other design factors.

Special care in overall planning and internal

planning against noise is required in the planning within the
building of units which are themselves potential noise sources,
for example, children's wards and outpatients' departments,
parts of which require protection against noise.
• Unloading bays, refuse disposal areas, boiler houses, workshops
and laundries are examples of service units which should be as far
from sensitive areas as possible.

• The kitchen is a constant source of both air-borne and structure-

borne noise and should preferably be in a separate building away
from or screened from the sensitive areas. If this is not possible and
the main kitchens must form part of a multi-storey building, noise
control is easier if they are placed below and not above the wards
and other sensitive rooms so as to facilitate the insulation of the
equipment and machinery in order to reduce the transmission of
structure borne noise to a minimum.
• In ward units, the kitchens, sluice rooms, utility rooms, sterilizing
rooms and other ancillary rooms, need to be placed quite near to the
beds if they are to fulfill their purposes, which are all sources of
noise. Some form of noise burning between open wards and rooms
of this kind will be needed.

REDUCTION OF NOISE AT SOURCE

• In view of the difficulty of

suppressing noise in hospital
buildings. it is important to eliminate
noise at its source wherever possible.
• USE OF RESILIENT MATERIAL:-

• Mats of rubber or other resilient material on draining

boards and rubber-shod equipment will greatly reduce
noise from utility rooms, sluice rooms and ward kitchens.
• The use of plastics or other resilient materials for sinks,
draining boards. utensils and bowls would also reduce
the noise.
• Many items of equipment especially mobile equipment,
such as trolleys and beds, may be silenced by means of
rubber- tyred wheels and rubber bumper and the
provision of resilient floor finishes. The latter also
reduces footstep noise.
• Silent type curtain rails, rings and runners should be
used.
• Lift gates and doors should be fitted with buffers and
silent closing gear. Fans and other machinery should be
mounted on suitable resilient mountings to prevent the
spread of noise through the structure.
OTHER MEASURES :-

• Noise from water or heating pipes may be reduced by installing

systems which operate at comparatively low pressures and
velocities.

• Silencing pipes and specially designed flushing action reduce

water closet noise at source and make structural measures easier
to apply.

• The ventilation system should be designed so as not to create a

noise problem. Silent closers should be fitted to doors.
REDUCTION OF NOISE BY STRUCTURAL MEANS
INSULATION:-
Since the various departments or units may be planned
in many ways, only general guidance on the insulation values for walls
and partitions are
given as below:-
a) It is recommended that walls or partitions between rooms should
normally have an insulation value of at least 40 dB. Higher values of
insulation of at least 45 dB are necessary where a noisy room is adjacent
to one requiring quiet. Doors should be solid with close fitting in the
frames.
b) There is little insulation value in double swing doors and where these
are fitted to a noisy room the opening should be planned so that it is
screened from areas requiring quiet by a baffle lobby lined with
absorbent material. Very high insulation values may be necessary in
special cases and exceptional measures may be required.
c) Solid floors with floating finishes and resilient surfaces are necessary
particularly between wards and other parts of the building. Ordinary timber
board on joist floors should never be used.

d) Conduits, ventilation ducts, chases, etc, should be constructed so as not

to form easy by-pass for disseminating noise about the building, and
should be provided with sufficient sound insulation. Pipe ducts should be
completely scaled around the pipes where they pass through walls or
floors. Ducts carrying waste or water pipes should be lined with sound
insulating material to prevent noise from the pipes passing through duct
walls into the rooms through which they pass.
ABSORPTION:-
Most surfaces in hospitals should be easily
cleanable, so as to prevent the build-up of bacteria which may cause
cross-infection. Many sound absorbent materials of a soft nature and
difficult to clean are unsuitable for use in some hospital areas and lose
much of their effectiveness, if painted for hygienic reasons.

Some porous materials with very thin non­porous

coverings (like mineral wool covered with thin plastic sheets) have
good sound absorption and when covered with a perforated sheet
metal facing can be used in most areas requiring a washable acoustical
treatment. In noisy areas, such as corridors and waiting rooms,
however, a wider choice of absorbents is available.
In the ward, bed curtains, window curtains, etc. add to the absorbent
properties of the room and help reduce reverberation in otherwise
hard surfaced surroundings. .
SPECIAL ROOMS
Sensitive areas such as operation theatres, Doctors' consultation rooms,
intensive care units (ICU) require special consideration against noise
control. Apart from outdoor noise, a common problem is the
transmission of sound between the consulting room and the waiting
room. To ensure silence, a sound reduction of 45dB(A) between the
rooms shall be provided. If the doors are directly connected by a single
communicating door it will not be possible to achieve these values of
insulation. To obtain 40-45dB(A) insulation between communicating
rooms is necessary to provide two doors separated by an air gap, such
as a lobby or corridor .
Checklist of acoustical materials while
planning a hospital.
 Discussion of materials and finishes

 Tremendous number of finishes and products available

 Advertising claims vs. actual use
 Finish and material comparison
a. Finish and material durability
1) What is the performance required of the material or finish?
2) Surface finish vs. homogeneous finish
3) Expansion, contraction, and flexibility
4) Underlayement (surface over which a finish material is applied)
5) Maintenance required and maintenance cost
6) Product life expectancy and warranty
b. Finish and material appearance
1) What appearance is desired?
2) Colors available
3) Textures or patterns available
4) Sizes available
5) Maintenance required and maintenance cost

c. Finish and material cost

1) Initial material cost
2) Installation or application cost

 See the material or finish in use (preferably after years of service)

 Ensure that the product is installed properly and according to

manufacturer's recommendations (very important for warranty)

 Establish a maintenance schedule and maintain the product or finish

properly
MATERIALS USED FOR ACOUSTICS

Some companies offers consulting services in the fields of

building acoustic design, noise and vibration control as well as sound
system design and audio-visual systems. Acoustical consulting
services are used to enhance sound within a space, to improve speech
intelligibility, to ensure privacy, or to reduce noise intrusion.

They provide a total acoustic design solution,

incorporating the critical elements of room size, shape, finish,
materials, furnishings as well as quieting of mechanical noise from
exterior and interior noise intrusion.
ROOM-BY-ROOM LISTING OF MATERIALS AND FINISHES

The selection of materials and finishes is one of the most important aspects
of the design of medical facilities.

EXTERIOR FINISHES
Wall materials
Brick masonry
Stone masonry
Wood siding
Vinyl siding
Metal siding
Dryvit (exterior insulation and finishsystem)
Pre-engineered metal building panels
Combination of above materials
SOFFIT, FASCIA, AND TRIM
Wood
Vinyl
Dryvit
Metal
Pre-engineered metal building systems
WALKS
Concrete with light broom finish
ROOFING
Fiberglass composition shingles
Metal standing seam
Ethylene propylene diene monomer (EPDM) single-ply roof system
Pre-engineered metal roof panels, Clay tile, Fire-retardant wood
shingles
DRIVES
Concrete paving
Asphalt paving
Polyurethane Wedge
Cutting Wedge
Hanging Baffles

Bermuda triangle
Wall Panels

Max Wedge
 Ceiling banners & baffles
Broad Band Absorber

Sound channels

Wall Panels  & Ceiling Treatments

RECEPTIONIST FLOOR
Sheet vinyl (minimum .080
gauge)
Carpet

RECEPTIONIST BASE
Rubber base

RECEPTIONIST WALLS
Gypsum board with painted
surface
Gypsum board with Type II vinyl
wall covering

RECEPTIONIST CEILINGS
Lay-in type acoustical ceiling
system (5/8'' acoustical panels
and steel grid)
EXAMPLE FOR HOSPITAL ACOUSTIC
SYSTEM
INTERIOR FINISHES
ENTRY FLOORS
Quarry tile (traction surface) with epoxy grout
Sheet vinyl (minimum .080 gauge)
Ceramic tile (traction surface) with epoxy grout

ENTRY BASE
Quarry tile (traction surface) with epoxy grout
Rubber base
Ceramic tile (traction surface) with epoxy grout
Cove sheet vinyl base

ENTRY WALLS
Gypsum board with painted surface
Gypsum board with Type II vinyl wall covering

ENTRY CEILING
Lay-in type acoustical ceiling system (5/8'' acoustical panels and steel grid)
WAITING FLOOR
Quarry tile (traction surface) with epoxy grout
Sheet vinyl (minimum .080 gauge)
Ceramic tile (traction surface) with epoxy grout

WAITING BASE
Quarry tile
Rubber base
Ceramic tile
Cove sheet vinyl base

WAITING WALLS
Gypsum board with painted surface
Gypsum board with Type II vinyl wall covering

WAITING CEILING
Lay-in type acoustical ceiling system (5/8'' acoustical panels and steel
grid)
EXAM ROOM FLOOR
Quarry tile (traction surface) with epoxy grout
Sheet vinyl (minimum .080 gauge)
Ceramic tile (traction surface) with epoxy grout

EXAM ROOM BASE

Quarry tile
Rubber base
Ceramic tile
Cove sheet vinyl base

EXAM ROOM WALLS

Gypsum board with painted surface
Gypsum board with Type II vinyl wall covering

EXAM ROOM CEILING

Lay-in type acoustical ceiling system (5/8'' acoustical
panels and steel grid)
PHARMACY AND LAB FLOOR
Sheet vinyl (minimum .080 gauge)
Carpet

PHARMACY AND LAB BASE

Rubber base

PHARMACY AND LAB WALLS

Gypsum board with painted surface

PHARMACY AND LAB CEILING

Lay-in type acoustical ceiling system (5/8'' acoustical panels
and steel grid)
TREATMENT ROOM FLOOR
Sheet vinyl (minimum .080 gauge)
TREATMENT ROOM BASE
Rubber base
TREATMENT ROOM WALLS
Gypsum board with painted surface

TREATMENT ROOM CEILING

Lay-in type acoustical ceiling system
(5/8'' acoustical panels and steel grid)

PACK/SCRUB FLOOR
Sheet vinyl (minimum .080 gauge)

PACK/SCRUB BASE
Rubber base
SURGERY FLOOR
Sheet vinyl (minimum .080 gauge)

SURGERY BASE
Rubber base, Cove sheet vinyl base

SURGERY WALLS
Gypsum board with epoxy painted surface

SURGERY CEILING
Gypsum board with epoxy painted surface
Lay-in type acoustical ceiling system (5/8'‘
acoustical panels and steel grid)

RADIOLOGY FLOOR
Sheet vinyl (minimum .080 gauge)
RADIOLOGY WALLS
Gypsum board with painted surface , Radiology ceiling Lay-in type
acoustical ceiling system (5/8'' acoustical panels and steel grid)
WARD/BATHING FLOOR
Sheet vinyl (minimum .080 gauge) with central floor
drain

WARD/BATHING BASE
Rubber base

WARD/BATHING WALLS
Concrete block with epoxy
painted surface

WARD/BATHING CEILING
Lay-in type acoustical ceiling
system (3/4'' acoustical panels
and aluminum grid) with 6''
sound attenuation batts plus
thermal insulation batts.
STORAGE FLOOR
Sheet vinyl (minimum .080 gauge)

STORAGE BASE STORAGE WALLS

Rubber base Gypsum board with painted surface

STORAGE CEILING
Lay-in type acoustical ceiling system (5/8'' acoustical panels and steel grid)

STAFF/LOUNGE FLOOR STAFF/LOUNGE BASE

Sheet vinyl (minimum .080 gauge) Rubber base

STAFF/LOUNGE CEILING
Lay-in type acoustical ceiling system (5/8'' acoustical panels and steel grid)

STAFF/LOUNGE WALLS
Gypsum board with painted surface
Gypsum board with Type I vinyl wall covering
DOCTOR'S/BUSINESS OFFICE FLOOR
Sheet vinyl (minimum .080 gauge)
Carpet

DOCTOR'S/BUSINESS OFFICE BASE

Rubber base
Wood base

DOCTOR'S/BUSINESS OFFICE WALLS

Gypsum board with painted surface
Gypsum board with Type I vinyl wall covering

DOCTOR'S/BUSINESS OFFICE CEILING

Lay-in type acoustical ceiling system
(5/8'' acoustical panels and steel
grid)