View
234
Download
2
Category
Tags:
Preview:
Citation preview
FGI/AIA Interim Sound & Vibration Guidelines for Hospitals & Healthcare Facilities
Copyright 2007 ANSI S12 WG44
Developed by the founders & co-chairmen of ANSI S12 WG44*:
David M. Sykes, ASA, INCEGregory C.Tocci, PE, FASA, INCE Bd Certwith William Cavanaugh, FASA, INCE Bd Cert, &
Wallace Clement Sabine Medalist (2006)
*These individuals led the development of the documents discussed in this seminar: the FGI/AIA Interim Guideline and the Green Guide for Health Care Acoustic Credits
A 1-hour seminar
Copyright 2007 ANSI S12 WG44
Thanks
The developers thank Doug Erickson, John Kouletsis, Kurt Rockstroh, Martin Cohen, Robert Loranger, Judene Bartley, Robin Guenther, Sholem Prasow, Debra Levin, Roger Leib, Roger Ulrich, Anjali Joseph, Bart Franey, Uriel Cohen, Orfeu Buxton as well as Harvard Medical School, the leaders and members of ASA, INCE & NCAC, and the members and sponsors of ANSI S12 WG44 for their commitment to & support of this work.
Copyright 2007 ANSI S12 WG44
3 goals of this seminar
Inform you about the new AIA Interim Guideline on acoustics (noise, privacy, sound & vibration) & the Green Guide’s two new acoustic credits
Learn from users about situations where acoustical issues arise in healthcare projects
Advise you where to turn for guidance when questions arise (we are your portal to the acoustics profession)
Copyright 2007 ANSI S12 WG44
Context
U.S. Noise Control Act (1972) de-funded in 1980 30 years of ‘benign neglect’ yielded 6% per year
growth in noise in healthcare facilities (>2X) Now urgent: we have “pandemonium” and “an
epidemic of noise” in healthcare & elsewhere Drive to fix acoustical problems began with HIPAA
& patient-centered care movement New recognition by LEED that “environmental
quality” should include noise, vibration & sound
Copyright 2007 ANSI S12 WG44
Authority
Commissioned in 2005 by AIA & the Facility Guidelines Institute (www.fgi-guidelines.org)
Published 11.1.06 Prepared by ANSI S12 Workgroup 44 – healthcare
acoustics, speech privacy & security, A joint technical committee of the three leading organizations in acoustics: ASA, INCE and NCAC
Copies & interpretation: www.healthcareacoustics.org
Read-only: www.fgi-guidelines.org
Copyright 2007 ANSI S12 WG44
The standard for GGHC’s new EQ acoustics credits
The LEED-based Green Guide for Healthcare V2.2 (1.31.07) now contains two credits for acoustics
The Interim Sound and Vibration Guideline is the sole reference standard for these credits
Download from: www.gghc.org See “Construction” section “Environmental Quality-Acoustics Credit 9.1-9.2”
Copyright 2007 ANSI S12 WG44
Objectives of the documents
Brief, comprehensive handbook Healthcare specific based on existing standards & best practices Objective & measurable criteria Practical guidance for designers
- Look-up tables- Code language linked to AIA Guidelines
- Design guidance
Copyright 2007 ANSI S12 WG44
International scope
The drafting committee included 480 authorities from 10 constituencies & several countries:
- Legislators - Planners, architects & designers- Regulatory agencies - Facility managers & engineers - Leaders of large HCOs - Acoustics researchers & - Clinical professionals practitioners - Healthcare lawyers - Acoustics professionals in large - Planners mfg. organizations
Copyright 2007 ANSI S12 WG44
Mission
The character and magnitude of all of the sounds in a building should be compatible with the intended use of the space. This rarely means silence, but it implies “quiet” which is the absence of distracting, annoying, interfering or unpleasant sounds.
William Cavanaugh
MIT, B. Arch ’51, FASA, INCE Bd. Cert.
Copyright 2007 ANSI S12 WG44
Medical perspective:Doctors know noise causes…
Sleep disruption (slows recovery) Stress response (compromises outcomes) Impaired communication (medical errors) Lost privacy (errors & misdiagnoses) Clinician “burnout” (accidents & staff turnover)
Copyright 2007 ANSI S12 WG44
Abundant medical evidence
Joseph & Ulrich: Sound Control for Improved Outcomes in Healthcare Settings (2007). Center for Health Design
Quieting Weinberg 5C: A case study in Hospital Noise Control (2006), Busch-Vishniac, et al. JASA
Ulrich & Quan, et al: The Role of the Physical Environment in the Hospital of the 21st Century… (2004). Center for Health Systems & Design/Texas A&M; with Zimring, Anjali, Choudery, Georgia Institute of Technology
Busch-Vishniac & West, et al: Noise Levels in Johns Hopkins Hospital (2005) with Barnhill, Hunter, Orellana, Chivakula. JASA
Rubin, Owens & Goldern: Status Report (1998): An investigation to determine whether the built environment affects patients’ medical outcomes. Center for Health Design at Johns Hopkins
Copyright 2007 ANSI S12 WG44
Example: sleep loss…
Risk of Injuries, Falls
Incidence of Pain
Weight Gain
Diabetes
Increased Consumption of
Healthcare Resources
Impaired Attention
and Reaction Time
Decreased Memory
and Concentration
Impaired Task Completion
Psychosocial difficulties
Insufficient or
Disordered Sleep
Worse Mood; depression
Cardiovascular Disease
Copyright 2007 ANSI S12 WG44
Significance of sleep for US obesity?
SOURCESObesity: CDC (NHES, NHANES)Sleep: Roffwarg Science 1966, NHIS (unpublisheddata), National Sleep Foundation polls, Hale J PublicHealth 2005
1960 1970 1980 1990 200040
50
60
70
Overweight and obesein the U.S. (%)
1960 1970 1980 1990 20006.5
7.0
7.5
8.0
8.5
9.0
year
mean sleep duration (hrs)
Copyright 2007 ANSI S12 WG44
Simple solutions
Solutions already exist Most architects have taken courses on acoustics 8,500 acoustics professionals are available What has held up implementation?- Assumptions about cost- Quality issues like noise & privacy are often
lost in value-engineering- Concerns about infection control
AIA & GGHC acceptance change this
Copyright 2007 ANSI S12 WG44
Core concept in architectural acoustics
Source > Path > Receiver
Copyright 2007 ANSI S12 WG44
Overview of the Guideline
1. Site exterior noise (5 pages)2. Acoustical finishes and details3. Room noise levels4. Sound isolation performance of constructions
including speech privacy5. Paging & call systems, clinical alarms, masking
systems & sound reinforcement6. Building vibration7. Glossary
Copyright 2007 ANSI S12 WG44
1. Site exterior noise
Copyright 2007 ANSI S12 WG44
Sec.1: Directive
Shall consider impact of exterior noise on hospital Shall consider impact of hospital noise on community Exterior noises which facility does not control:
- Highways, aircraft, trains, etc. - Helipads, ambulances Exterior noises which facility completely controls: - Cooling towers & other building MEP equipment - Delivery vehicles, refrigeration trucks, etc.
Copyright 2007 ANSI S12 WG44
Sec.1: Four new categories
…of exterior site environmental sound
A. Minimal—rural, quiet suburban
B. Moderate—busy suburbs, multifamily residential
C. Significant—commercial urban, busy streets
D. Extreme—near highway or airport flight path
Copyright 2007 ANSI S12 WG44
Exterior Site Noise Exposure Category A B C D
General description Minimal Moderate Significant Extreme
Day-night average sound level (Ldn) (dB) < 65 65-70 70-75 > 75
Ave. hourly nominal max. (L01) (dBA) < 75 75-80 80-85 > 85
Distance from nearest highway (ft) 1000 250-1000 60-250 < 60
Distance from aircraft flight track1 (ft) > 7000 3500-7000 1800-3500< 1800
Distance from nearest rail line (ft) 1500 500-1500 100-500 < 100
Exterior shell composite STC rating2 (STCc)
35 40 45 50
Exterior patient sitting areas OK OK NO NO
Design goal for hospital MEP noise on community
45 50 55 60
Sec. 1: Category levels
Copyright 2007 ANSI S12 WG44
Sec. 1: “Composite STC”
Copyright 2007 ANSI S12 WG44
Sec. 1: “Ceiling Attenuation Class”(CAC)
Copyright 2007 ANSI S12 WG44
Sec. 1: Action steps
Determine site type (A,B,C,D) Identify & characterize noise issues Consider solutions
Copyright 2007 ANSI S12 WG44
Sec. 2: Acoustical finishes
1. Site exterior noise2. Acoustical finishes and details (3 pages)3. Room noise levels4. Sound isolation performance of constructions
including speech privacy5. Paging & call systems, clinical alarms, masking
systems & sound reinforcement6. Building vibration7. Glossary
Copyright 2007 ANSI S12 WG44
Sec. 2: Indoor reverberation
Copyright 2007 ANSI S12 WG44
Sec. 2: Identify sound paths
Copyright 2007 ANSI S12 WG44
Sec. 2: Compare materials
Material NRC
Brick, unglazed 0.05
1/2" GWB on metal studs 0.05
Carpet on concrete 0.30
Wood floor 0.10
Glass, ¼” plate 0.05
3/4" fissured mineral tile 0.70
Carpet on pad 0.55
Vinyl tile floor 0.05
NRC – noise reduction coefficient (ave. abs. coef. () 250 to 2000 Hz
Copyright 2007 ANSI S12 WG44
2. Calculate absorption
Space design
Subjective description
Private room 0.15 “Average”
Corridor 0.15 “Average”
Waiting 0.25 “Medium-dry”
Atrium 0.10 “Medium-live”
Office 0.15 “Average”
Treatment 0.15 “Average”
New design tool: Average absorption coefficient ( )
Copyright 2007 ANSI S12 WG44
Sec. 2: Choose materials
Hospitals have a growing problems with nosocomial infections
“Devices that touch patients are the source” Important to use sound absorbing materials that
are cleanable Many products are well-suited:
Baffles, ceiling tiles, insulation, wall coverings, fabrics, furniture, flooring & carpet
No special requirements from EPA, CMS, CDC, JCAHO, FGI, ASTM or ASHRAE
Manufacturers cite ASTM C1338, & ASTM G21
Copyright 2007 ANSI S12 WG44
Sec. 2: Action steps
Analyze “source>path>receiver” issues Consider design choices Calculate absorption required Choose acoustical finishes
Copyright 2007 ANSI S12 WG44
Sec. 3: Room noise
1. Site exterior noise2. Acoustical finishes and details3. Room noise levels (2 pages)4. Sound isolation performance of constructions
including speech privacy5. Paging & call systems, clinical alarms,
masking systems & sound reinforcement6. Building vibration7. Glossary
Copyright 2007 ANSI S12 WG44
Sec. 3: Methods & criteria
Methods to quantify room noise: - dBA & NC are most common methods
Criteria for acceptable sound levels set by space use & special acoustical needs:
a. Anatomical sounds (heartbeats, etc.)?b. Hearing and voice testing?c. Distraction & annoyance?
d. Communication issues?e. Sleep interference?
Copyright 2007 ANSI S12 WG44
NC curves:
Copyright 2007 ANSI S12 WG44
NCcurve:
Copyright 2007 ANSI S12 WG44
Room Type NC dBA
Patient rooms 30-40 35-45
Multiple occupant patient care areas 35-45 40-50
NICU 25-35 30-40
Operating rooms 35-45 40-50
Corridors and public spaces 35-45 40-50
Testing/research lab, min. speech
45-55 50-60
Research lab, extensive speech 40-50 45-55
Group teaching lab 35-45 40-50
Doctor’s offices, exam rooms 30-40 35-45
Conference Rooms 25-35 30-40
Teleconferencing Rooms 25 (max) 30 (max)
Auditoria, large lecture rooms 25-30 30-35
Sec. 3: Level by room type
Copyright 2007 ANSI S12 WG44
Sec. 3: Action steps
Consider room types & uses Select appropriate noise level criteria (NC or
dBA) from table Review design options with ME to achieve
these criteria
Copyright 2007 ANSI S12 WG44
Sec. 4: Isolation & privacy
1. Site exterior noise2. Acoustical finishes and details3. Room noise levels4. Sound isolation performance of constructions
including speech privacy (4 pages)5. Paging & call systems, clinical alarms, masking
systems & sound reinforcement6. Building vibration7. Glossary
Copyright 2007 ANSI S12 WG44
Sec. 4: Methods & criteria
Sound isolation requirement depends on use of adjacent spaces
Sound Transmission Class rating (STC) for enclosed rooms (ASTM E90 & E413)
Articulation Index (AI) for open plan (ASTM E1130) Speech Privacy criteria:
- What level? (“normal,” “confidential,” “secure”)- Vocal effort? (normal, raised, loud)- Room absorption & isolation? (partitions, screens)- Background sound level? (ambient noise, masking)
Copyright 2007 ANSI S12 WG44
Sec. 4: Closed-plan privacy
Copyright 2007 ANSI S12 WG44
Sec. 4: Open plan privacy
Copyright 2007 ANSI S12 WG44
Adjacency combination STCc
Patient Room Patient Room (horizontal) 45
Patient Room Patient Room (vertical) 50
Patient Room Corridor (w/ entrance) 35
Patient Room Public Space 50
Patient Room Service Area 60
Exam Room Corridor (w/ entrance) 35
Exam Room Public Space 50
Toilet Room Public Space 45
Consultation Room Public Space 50
Consultation Room Patient Rooms 50
Consultation Room Corridor (w/ entrance) 35
Sec. 4: Consider adjacencies
STCc – Composite sound transmission class rating
Copyright 2007 ANSI S12 WG44
Sec. 4: Identify privacy goal
Privacy GoalAI
Articulation Index
PIPrivacy Index
STISound
Transmission Index
SIISpeech
Intelligibility Index
Closed Plan
NormalConfidential
Secure
<0.15<0.05
>85%>95%
<0.19<0.12
<0.20<0.10
Open Plan
Normal
Confidential
<0.20 >80% <0.23 <0.25
Special consideration required
Special consideration required
Copyright 2007 ANSI S12 WG44
Sec. 4: Action steps
Consider isolation/privacy requirement depending on adjacencies of “sources” & “receivers”
Select appropriate isolation/privacy criteria from tables (STC, AI etc.)
Evaluate adjacent spaces as possible “sources” or “receivers”
Evaluate performance of various constructions (doors, partitions, partial-height barriers, ceilings, etc.) including composite effects of multiple elements within partitions)
Detail & specify isolating elements to assure optimum field performance
Copyright 2007 ANSI S12 WG44
Sec. 5: Sound systems
1. Site exterior noise2. Acoustical finishes and details3. Room noise levels4. Sound isolation performance of constructions
including speech privacy5. Paging & call systems, clinical alarms,
masking & sound reinforcement (2 pages)6. Building vibration7. Glossary
Copyright 2007 ANSI S12 WG44
Sec. 5: Paging, call, alarm, masking & sound systems
Criteria: audibility, intelligibility, minimal annoyance You can limit annoyance, distraction, sleep loss by
reducing levels in limited areas or considering non-audible & wireless signals
HCO’s should consider “positive distractions” & Active-Noise-Cancelling systems for individual patients
Operational consideration: Should paging be routinely used in hospitals or used only for life/safety emergencies?
Copyright 2007 ANSI S12 WG44
Sec. 5: Problem may be code minimumsPage, call & sound reinforcement minimums:
a. 70 dBA minimum sound level; orb. 10 dBA above background noise levels
(whichever is higher); and c. Coverage within +/- 4 dB at 2000 Hz throughout areas served
These levels can represent serious intrusion! Consider limiting their use in patient- sensitive areas
Copyright 2007 ANSI S12 WG44
Sec. 5: Criteria
Alarms:NFPA 72 (ISO 7731)
Masking systems:a. Not higher than 48 dBAb. Uniform coverage +/-2dBAc. Suitable spectrum shape (innocuous)d. May be too high for many space uses
Copyright 2007 ANSI S12 WG44
Sec. 5: Action steps
Consider impact of criteria-determined minimum sound levels in relation to patient/staff needs
Evaluate communication system options for critical areas & set appropriate criteria, e.g.
- Wired traditional sound system?- Light/code systems?- Wireless pagers?
Copyright 2007 ANSI S12 WG44
Sec. 6: Vibration
1. Site exterior noise 2. Acoustical finishes and details3. Room noise levels4. Sound isolation performance of constructions
including speech privacy5. Paging & call systems, clinical alarms, masking
systems & sound reinforcement6. Building vibration (2 pages)7. Glossary
Copyright 2007 ANSI S12 WG44
Sec. 6: Means “minimal vibration” of building structure
Sources of vibration: footfall, MEP equipmentControls:
a. building stiffness, massb. vibration isolation of all MEP equipmentc. minimize proximity of vibration and impact sources from sensitive receivers & activities
Copyright 2007 ANSI S12 WG44
Sec. 6: Typical sources
Copyright 2007 ANSI S12 WG44
Sec. 6: Criteria
Space TypeFootfall Vibration
Peak Velocity (in/s)
Patient rooms & other patient areas 4000
Operating & other treatment rooms 4000
Administrative areas 8000
Public circulation 8000
Table 6.3.2-1: Recommended limits on footfall vibration in hospitals.
Copyright 2007 ANSI S12 WG44
Sec. 6: Action steps
Consider location of MEP equipment rooms, MRI, and foot traffic with respect to patient & research areas
Select appropriate criteria for building structure, mass, stiffness, etc.
Plan circulation pathways to minimize intrusions Evaluate mobile equipment (e.g. cart wheels) Detail & specify appropriate materials & finishes
Copyright 2007 ANSI S12 WG44
Bottom line for designers
You can’t see noise but it has profound effects on patients & staff
A row of trees will not protect a hospital from highway noise There are no paints that can absorb sound Curtains will not protect privacy in patient areas In quality surveys, doctors, nurses, administrators, patients
& families identify “noise & lack of privacy” as the top, most onerous issues
HCOs are learning how to deal with this—you can lead the dialogue as designers of the healthcare environment
90% of acoustical problems in HCFs can be solved in design at modest cost
“Fixing the problem later” is always more expensive
Copyright 2007 ANSI S12 WG44
Concluding comments
Basis for compliance A note about solutions Example of a “new product” Getting to code Discussion, Q&A Contact information Acknowledgements
Copyright 2007 ANSI S12 WG44
Basis for compliance
Documents are based on existing standards from recognized standards authorities & widely accepted professional best practices
Certification—standard analyses & tests can be performed in design & tested in-situ to show general conformance to the Guideline
For AHJ’s & HCO’s, this may be useful & desirable for inspections (e.g., JCAHO, etc.)
Copyright 2007 ANSI S12 WG44
Solutions: the revolution in building sciences
Many already available products are well suited for improving acoustics without compromising infection control
Fabrics (stain-proof, wrinkle-proof, color-fast) Insulation for ceilings, walls & floors Flooring & carpeting materials Filtration methods (e.g., for HVAC systems) Wireless communications
Sources: Cleantech, Greentech, MEMs & Nano-tech
Copyright 2007 ANSI S12 WG44
Example: aerogels are a “new & green” material
Thermo-acoustic insulation material that is: Hydrophobic Translucent Lightweight (97% air) & thin Available in multiple forms (insulation ‘blankets’
& rigid exterior glazing panels with R20) Widely available in volume
Copyright 2007 ANSI S12 WG44
Light 20% Light
Transmission
Noise 50% Sound
Reduction
Thermal Performance R-20 The insulating value
of a 6” stud wall
TestingPermanence ofperformance Non-combustible/
no smoke Mold/mildew resistance Condensation resistance UV Stable
Copyright 2007 ANSI S12 WG44
Questions?
Copyright 2007 ANSI S12 WG44
Frequently asked questions
When’s the best time to consider acoustics? How do we apply this to project work? Who pays for expertise when needed & how much? How do I find an acoustical consultant? What questions do healthcare people raise?*
*ex: “can absorptive materials compromise infection control?”
Copyright 2007 ANSI S12 WG44
Contact information
David Sykes: dsykes@healthcareacoustics.org
Gregory Tocci: gtocci@healthcareacoustics.org
Bill Cavanaugh: wcavanaugh@healthcareacoustics.org
Copyright 2007 ANSI S12 WG44
Committee sponsors
Armstrong
Cabot Corporation
CertainTeed
Dupont
Logison
Owens Corning
Quiet Solution
Sonare Technologies
Speech Privacy Systems
USG
Recommended