Spatial Assessment of Environmental Noise Across Hospital Functional Zones: A Cross-Sectional Observational Study in...

Hospital environments comprise complex acoustic settings generated by routine clinical activities, medical equipment, staff communication, patient movement, and visitor traffic. Characterizing environmental noise across different hospital functional zones may help identify areas with consistently elevated acoustic exposure and inform targeted noise-management strategies. We hypothesized that environmental noise would differ among hospital functional zones and be associated with selected operational characteristics. A cross-sectional observational study was conducted across 15 inpatient departments of a tertiary teaching hospital using a standardized hierarchical sampling framework. Environmental noise was measured within four predefined functional zones (ward, corridor, nurses' station, and patient activity area) using a calibrated Class 1 integrating sound level meter. Equivalent continuous A-weighted sound pressure level (LAeq) measurements were obtained from repeated daytime recordings (09:00-19:00), together with maximum A-weighted sound pressure level (LAFmax) and peak C-weighted sound pressure level (LCpeak). Linear mixed-effects models were used to compare environmental noise among functional zones while accounting for repeated observations nested within hospital departments. Exploratory mixed-effects regression evaluated associations between environmental noise and selected operational characteristics. A total of 1,620 acoustic observations were analyzed. Nurses' stations demonstrated the highest adjusted environmental noise levels (estimated marginal mean, 66.90 dBA), followed by corridors (63.97 dBA), patient activity areas (61.38 dBA), and wards (60.38 dBA). All pairwise comparisons remained statistically significant following Tukey adjustment (all P < 0.001). Visitor count and departmental bed capacity were independently associated with higher LAeq in the parsimonious mixed-effects model. Environmental noise levels consistently exceeded commonly referenced World Health Organization, EN ISO 16032, and GB3096-2022 reference acoustic values during routine daytime operations. Environmental noise varied significantly across hospital functional zones, with nurses' stations representing the principal areas of elevated acoustic exposure. These findings support targeted acoustic monitoring and operational noise-management strategies while providing a reproducible framework for future hospital environmental acoustic research.