Infant Sleep Machines and Hazardous Sound Pressure Levels WHAT’S KNOWN ON THIS SUBJECT: Many parenting Web sites encourage use of infant “sleep machines” to play ambient noise while infants sleep. Noise recommendations for hospital nurseries suggest a limit of 50 A-weighted dB, whereas occupational standards limit exposure times for noise .85 A- weighted dB. WHAT THIS STUDY ADDS: We measured the maximum sound level outputs of infant sleep machines and found that several devices are capable of producing levels that may be damaging to infant hearing and may be detrimental to auditory development. abstract BACKGROUND AND OBJECTIVE: Infant “sleep machines” (ISMs) pro- duce ambient noise or noise to mask other sounds in an infant ’ s room with the goal of increasing uninterrupted sleep. We suggest that the consistent use of these devices raises concerns for increasing an infant ’ s risk of noise-induced hearing loss. We therefore sought to determine the maximum output levels of these sleep machines. METHODS: Sound levels of 14 ISMs played at maximum volume were measured at 30, 100, and 200 cm from the machine using correction factors to account for a 6-month-old’ s ear canal. RESULTS: Maximum sound levels at 30 cm were .50 A-weighted dB for all devices, which is the current recommended noise limit for infants in hospital nurseries. Three machines produced output levels .85 A- weighted dB, which, if played at these levels for .8 hours, exceeds current occupational limits for accumulated noise exposure in adults and risks noise-induced hearing loss. CONCLUSIONS: ISMs are capable of producing output sound pressure levels that may be damaging to infant hearing and auditory develop- ment. We outline recommendations for safer operation of these machines. Pediatrics 2014;133:677–681 AUTHORS: Sarah C. Hugh, MD, a Nikolaus E. Wolter, MD, a Evan J. Propst, MD, MSc, a,b Karen A. Gordon, PhD, a,b Sharon L. Cushing, MD, MSc, a,b and Blake C. Papsin, MD, MSc a,b a Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Canada; and b Hospital for Sick Children, Toronto, Canada KEY WORDS hearing loss, noise induced, infant development, infant equipment, noise, sleep ABBREVIATIONS CCOHS—Canadian Centre for Occupational Health and Safety dBA—A-weighted dB ISM—infant sleep machine NIOSH—National Institute for Occupational Safety and Health Dr Hugh designed the study, acquired and analyzed data, and drafted the initial manuscript; Dr Wolter designed the study, acquired data, and reviewed and revised the manuscript; Drs Propst, Gordon, Cushing, and Papsin conceptualized and designed the study and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted. www.pediatrics.org/cgi/doi/10.1542/peds.2013-3617 doi:10.1542/peds.2013-3617 Accepted for publication Jan 21, 2014 Address correspondence to Blake C. Papsin, MD, MSc, Department of Otolaryngology, Head and Neck Surgery, 555 University Ave, Toronto, ON, Canada M5G 1X8. E-mail: blake. papsin@sickkids.ca PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2014 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING: No external funding. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose. PEDIATRICS Volume 133, Number 4, April 2014 677 ARTICLE by guest on April 21, 2016 Downloaded from