NeoSTRESS: Study of Transfer and Retrieval Environmental StressorS upon neonates via a smartphone application - Sound.

AIM: This study aimed to measure sound exposure during neonatal retrieval, determine whether this varied with mode of transport, and compare noise exposure to recommended levels in neonatal intensive care units. We also aimed to assess the acceptability of using a smartphone application to measure sound. SETTING: Neonatal retrieval service in Brisbane, Australia. METHODS: The Physics Toolbox Sensor Suite application was installed on a Samsung Galaxy S5 smartphone and calibrated for sound measurement. Data were collected during outbound, non-patient legs of 45 retrievals - 25 road, 11 fixed wing aircraft and 9 rotary aircraft journeys. Data were saved to cloud storage, then analysed using PostgreSQL database. RESULTS: The median sound level was 83 dB (interquartile range 66-91; range 27-≥97 dB). Continuous equivalent sound (Leq ) was 90 dB across all journeys. Rotary transport was loudest (Leq 94 dB). Fixed wing (Leq 89 dB) and road (Leq 87 dB) journeys also resulted in significant sound exposure. Sound exceeded recommended levels (45 dB) for 99% of all journey time, regardless of the mode of transport. CONCLUSIONS: Neonates encounter harmful sound levels during retrieval - louder than recommended levels for 99% of all retrieval time. Sounds levels were highest in rotary aircraft transport compared to fixed wing or road transport. It is feasible to use a calibrated smartphone application instead of a sound metre.

NeoSTRESS: Study of Transfer and Retrieval Environmental StressorS Upon Neonates via a Smartphone Application-Light.

OBJECTIVE: This study aimed to measure the light levels neonates would be exposed to during retrieval, determine whether this varied with transport mode, and compare them with recommended light exposure in neonatal intensive care units. We also aimed to determine the ease of use and acceptability of using the smartphone application. SETTING: A neonatal retrieval service in Brisbane, Australia. METHODS: This prospective study used the calibrated smartphone application Physics Toolbox Sensor Suite (Vieyra Software, Washington, DC). Data were collected during the outbound, nonpatient leg of 45 retrievals (25 road, 11 fixed wing aircraft, and 9 rotary aircraft journeys). Data were saved to Cloud storage and then analyzed using the PostgreSQL database. RESULTS: The median illuminance was 6 lux (interquartile range [IQR], 1-58). The maximum recorded was 93,842 lux. The median illuminance during daytime journeys was 15 lux (IQR, 2-77). The median light level for night journeys was 1 lux (IQR, 0.5-8). Illuminance exceeded the recommended level (600 lux) for 2.1% of all journey time. CONCLUSION: Retrieved neonates can be exposed to light in excess of recommended neonatal intensive care unit levels, including extremely bright light. It is feasible, with good staff acceptability, for a calibrated smartphone application to be used in place of a light meter.