Whole-Body Vibration Exposure from Incubators in the Neonatal Care Setting: A Review

Abstract

Margaret McCallig*

The World Health Organisation (WHO) estimates that approximately 1 in 10, or 15 million babies are born prematurely worldwide each year. Neonatal intensive care forms a vital component of the survival chances of premature babies; whether from an inter orintra-hospitalsetting. Incubators by their design, emit vibration that potentially can have a negative impact on the neonate. ISO 2631-1:1997 details comprehensive methodologies for the measurement of whole body vibration and outlines a Comfort Scale Rating for determining severity of exposure. Whilst legislation exists from an occupational perspective, there are currently no legal limits with regards whole body vibration exposure to the neonate. The majority of the existing studies have limitations with regards sample sizes, use of neonates versus use of mannequins and transport modes. However, the vibration emission data collected and published to date is at the upper end or exceeds the Comfort Scale Rating as per ISO 2631-1:1997. There is limited data published on whole body vibration emissions from incubators in situ in the hospital setting. Recommendations to reduce exposure thus far are focused on improved design of incubator systems with a view to dampening vibration sources to reduce emissions. A better understanding of the lifespan of incubators, the preventative maintenance requirements, and ancillary equipment specifications of mattress and incubator frames is required in response to the ever-evolving design of neonatal incubators. What is already known about the subject?: Studies to date suggest that the whole body vibration emissions from neonatal incubators during intra and inter hospital exceed the exposure action and limit values, and present on the upper scales of the Comfort Scale Rating in the vast majority of cases. What are the new findings?: There exists a lack of whole body vibration emission data from incubators in situ in the hospital setting. How might this impact on policy or clinical practice in the foreseeable future?: Ancillary equipment such as mattresses and frames associated with incubators, as well as equipment lifespan and frequency of preventative maintenance are important determinants of vibration emission from incubators. A comprehensive policy on equipment lifespan and use of approved replacement ancillary equipment has the potential to reduce vibration emissions meeting and exceeding the existing legal limits. Search strategy and selection criteria: This Review was an analysis of the literature on vibration emissions from neonatal incubators, informed by expert opinion. We reviewed English language literature for studies on vibration exposure in the neonatal care setting. Our search termsincluded whole body vibration, incubator, neonatal and neonate. The search returned 68 results, of which 25 were eligible for inclusion in this Review. Data were extracted regarding reported vibration emissions asmeasured under ISO 2631:1997, the hospital setting and neonatal transfer via air and road. Further studies related to WBV were included for contextual purposes.