Joe Hurst, Key Account Manager – Social Care at Altro – sent us this great article about the impact of noise in care environments.
Control of noise is particularly important in care homes, to aid recovery from illness and to promote day-to-day wellbeing of residents. Poor acoustic performance of the care home can also have profound social, physical and psychological effects on residents with hearing impairment.
Action on Hearing Loss state that there are approximately 11 million people with hearing loss across the UK (one in six of the population) and 71% of people over the age of 70 suffer from age-related hearing impairment (presbycusis). This impacts on the resident’s ability to engage effectively with staff, visitors and others sharing their environment, and can lead to problems with communication, social isolation, confusion and the safeguarding of privacy. Saint-Gobain Ecophon estimate that age-related hearing loss leads to communication problems for approximately 37% of people between the ages of 61 and 70, and becomes an increasing problem as we age, with around 60% of people aged 71 to 80 experiencing difficulties with communication as a result of age-related hearing impairment.
Trying to understand in noisy situations, where background sound reduces intelligibility of speech, can leave a hearing-impaired person confused or frustrated. This is particularly the case for residents with dementia, who need additional support to help them interpret and navigate their surroundings. Those with hearing aids may find that background noise reduces the effectiveness of their devices, and Action for Hearing Loss stresses that speech intelligibility can be particularly challenging for those for whom English is not a first language. Inclusivity is, of course, crucial under the Equality Act 2010, which states that buildings should not disadvantage occupants irrespective of their age or abilities.
Achieving good acoustic performance
Saint-Gobain Ecophon explain that sound behaves in different ways according to the types of floor and wall surfaces in the room:
Transmission: Sound flows through and between materials.
Absorption: Sound energy is lost when sound waves come into contact with, for example, walls and floors, and is not reflected back into the space.
Reflection: Sound is reflected back into the space.
Diffusion: Rough surfaces reflect sound, scattering it in all directions.
Hard interior surfaces such as floors can reflect rather than absorb sound. This causes noise to bounce around, overlap, echo and reverberate. Reverberation causes noise to prolong and echo in the environment, meaning it takes longer before the sound stops. In addition to airborne noise, floors affect impact sound (such as footsteps transmitted to rooms below). So a quietly comfortable room should ideally have floor surfaces which mitigate the impact sound of traffic such as feet and the movement of equipment.
Surfaces of this type will also help to prevent escalating noise, described by the Lombard effect. This is the involuntary tendency of speakers to increase their vocal effort when speaking in noisy spaces to enhance the audibility of their voice. See Figure 1. Improving acoustic performance of an area, by fitting flooring with impact noise reduction capabilities, can prevent the tendency for those occupying the space to raise their voices, breaking the auditory ‘vicious circle’ of escalating noise.
Specifying acoustic and sound reduction flooring
Acoustics is, of course, a specialist field, and an acoustician will be able to consider these elements in the design of new buildings, and when tackling problems of noise through refurbishment. Under the Building Regulations: Part E – Resistance to the passage of sound, the organisations designing and constructing a new care home will have obligations relating to the acoustic performance of the floors. But what about the many care homes occupying older/heritage buildings?
In these applications, as well as in new care home premises, one of the solutions available to acousticians, and to teams involved in the day-to-day management of care home facilities, is the use of flooring to reduce impact sound transmission. A flooring specialist can provide the care home team with guidance on specifying and installing flooring materials that are capable of tackling problems with noise.
There are two key ways of driving enhanced acoustic performance via the choice of floor covering. Firstly, acoustic flooring products are available with different impact sound reduction characteristics. Altro Serenade vinyl acoustic flooring, for example, helps to tackle noise in buildings by reducing the impact sound transmission, increasing sound absorption and reducing sound reflection. It is 3.9mm thick and delivers an impact sound reduction of up to 19dB. In addition to contributing to a quieter atmosphere it provides comfort underfoot, making it an effective solution for staff who spend much of the time on their feet.
Alternatively, the Altro Wood Safety Comfort range provides a wide choice of wood look options in contemporary shades, with wide plank classic and rustic designs to create a welcoming, comfortable environment. But it also has the advantage of being a 2.85mm thick flooring product delivering a 14dB sound reduction, making it ideal for areas where noise can be a problem. As its name suggests, Altro Wood Safety Comfort is a safety floor (PTV >36), reducing the risk of slipping (which is, of course, a priority for the elderly, people with sensory impairment, those with dementia and people with physical disabilities). Another option to consider is Altro Orchestra – a 2.85 mm thick floor offering a level of impact sound reduction up to 15dB – which is available in 40 colours, offering extensive design opportunities.
The second way of driving enhanced acoustic performance is to fit an underlay beneath a traditional vinyl floor to enhance its impact sound reduction performance. In some parts of the care home a fully acoustic floor may not be needed. For example, ceilings commonly reduce impact sound from above, whilst furniture, wall coverings and curtains can also absorb sound, making a fully-acoustic floor unnecessary. Or in areas where wheeled traffic is common, a traditional floor covering could be preferable, as fully-acoustic or soft floor coverings can increase the resistance when pushing or pulling rolling loads.
An effective solution in these applications would be Altro Acoustic Underlay 110, suitable for use with Altro safety flooring, Altro Nuvola rubber flooring and Altro smooth flooring. Alternatively, Altro Everlay B underlays could be fitted, offering impact sound reduction of up to 20dB. These underlays enable a 2mm resilient sheet, such as Altro Aquarius, to perform an impact sound reduction role. When used in isolation Altro Aquarius has a dB rating of 5, for example, but by incorporating Altro 1101 underlay beneath it, this floor covering will have an overall impact sound reduction of up to 17dB. This option could be particularly helpful in areas requiring flooring with specific slip resistance properties, such as bathrooms or kitchens. As well as creating a more effective environment for residents, these impact sound reduction measures can also, of course, reduce common sources of noise-related stress for staff. The illustrations in Figure 2 demonstrate how much impact sound can be reduced by different Altro floors when installed on top of a range of substrates.
To conclude, good acoustic performance is at the heart of creating an inclusive and comfortable space, particularly for residents with hearing loss. Effective choice of flooring (via purpose-designed floors with impact sound reduction properties, or the installation of acoustic underlays) is a sound way to achieve a quieter life.
Please visit Altro’s website for further information.
 From Ecophon’s ‘Impact of noise in healthcare research summary’. Original source: Baur et al., Einfluss exogener Faktoren auf Altersschwerhörigkeit, HNO 2009, Springer Medizin Verlag 2009, pp. 1023–1028.