Workload-moderated pathways from hospital acoustic environment to healthcare workers' health and burnout via noise stress

Workload-moderated pathways from hospital acoustic environment to healthcare workers' health and burnout via noise stress | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Workload-moderated pathways from hospital acoustic environment to healthcare workers' health and burnout via noise stress Wenyuan Wang, Rumei Han, Jiaxin Li, Yuxin Wang, Yuan Zhang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8233329/v2 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 29 Mar, 2026 Read the published version in Journal of Building Engineering → Version 2 posted You are reading this latest preprint version Show more versions Abstract The hospital acoustic environment significantly affects staff wellbeing, yet the mechanisms linking indoor sound sources to health outcomes, and how work context moderates these pathways, remain insufficiently understood for evidence-based building design. This study tested whether noise stress (NStr) mediates the effects of noise annoyance (NA) and noise sensitivity (NSen) on non-auditory health effects (NaHEs) and occupational burnout (BO), and whether workload moderates these pathways. A cross-sectional survey was conducted among 1,182 healthcare workers (HCWs) from twelve hospitals in China. NA was assessed for five main sound-source categories in hospitals: medical equipment, human speech, human activities, surrounding environment, and non-medical equipment. Structural equation modelling with multi-group analysis across workload clusters (high, medium, low) tested mediation and moderation. NStr significantly mediated the associations of NSen and NA with NaHEs and BO (β = 0.049–0.175, p < 0.001). NA also showed a direct effect on NaHEs (β = 0.262, p < 0.001), indicating partial mediation. Mediation pathways strengthened with increasing workload, supporting moderated mediation. These findings inform healthcare building design by supporting dual-pathway interventions that integrate acoustic treatment (sound source control, alarm management, sound-absorbing materials, spatial zoning) with operational provisions for high-workload units, and that prioritise noise-sensitive staff in environmental planning. Architecture, Design and Planning Hospital Noise stress Noise annoyance Evidence-based design Non-auditory health effect Full Text Additional Declarations The authors declare no competing interests. Supplementary Files Supplementarymaterial0221clean.docx Appendix Cite Share Download PDF Status: Published Journal Publication published 29 Mar, 2026 Read the published version in Journal of Building Engineering → Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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This study tested whether noise stress (NStr) mediates the effects of noise annoyance (NA) and noise sensitivity (NSen) on non-auditory health effects (NaHEs) and occupational burnout (BO), and whether workload moderates these pathways. A cross-sectional survey was conducted among 1,182 healthcare workers (HCWs) from twelve hospitals in China. NA was assessed for five main sound-source categories in hospitals: medical equipment, human speech, human activities, surrounding environment, and non-medical equipment. Structural equation modelling with multi-group analysis across workload clusters (high, medium, low) tested mediation and moderation. NStr significantly mediated the associations of NSen and NA with NaHEs and BO (β\u0026thinsp;=\u0026thinsp;0.049\u0026ndash;0.175, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). NA also showed a direct effect on NaHEs (β\u0026thinsp;=\u0026thinsp;0.262, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating partial mediation. 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These findings inform healthcare building design by supporting dual-pathway interventions that integrate acoustic treatment (sound source control, alarm management, sound-absorbing materials, spatial zoning) with operational provisions for high-workload units, and that prioritise noise-sensitive staff in environmental planning.\u003c/p\u003e","manuscriptTitle":"Workload-moderated pathways from hospital acoustic environment to healthcare workers' health and burnout via noise stress","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2026-03-06 21:49:10","doi":"10.21203/rs.3.rs-8233329/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2025-12-02 08:50:24","doi":"10.21203/rs.3.rs-8233329/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"0215b4b3-6dad-4ad1-a322-44f7fd67d92a","owner":[],"postedDate":"March 6th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":63317640,"name":"Architecture, Design and Planning"}],"tags":[],"updatedAt":"2026-03-30T14:27:05+00:00","versionOfRecord":{"articleIdentity":"rs-8233329","link":"https://doi.org/10.1016/j.jobe.2026.115931","journal":{"identity":"journal-of-building-engineering","isVorOnly":true,"title":"Journal of Building Engineering"},"publishedOn":"2026-03-30 00:00:00","publishedOnDateReadable":"March 30th, 2026"},"versionCreatedAt":"2026-03-06 21:49:10","video":"","vorDoi":"10.1016/j.jobe.2026.115931","vorDoiUrl":"https://doi.org/10.1016/j.jobe.2026.115931","workflowStages":[]},"version":"v2","identity":"rs-8233329","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8233329","identity":"rs-8233329","version":["v2"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}