The study aimsed at surveying and analysing the prevailing risks for medical students due to so-called needlestick injuries, I. e., injuries to the skin by handling sharp objects by which blood of patients can be transmitted to the health professional. After introducing preventive measures in a typical German university hospital, a total of 1 903 students of human medicine in their clinical period from 2009 to 2012 (from a total of 2 024 subjects - a rate of 94.0%) were questioned in detail about potential needlestick or other injuries related to their work. The results show that such injuries happen particularly during the clinical period of the medical studies: While only 20.6% of the students indicated a needlestick injury at the beginning of this period, half of the students (50.9%) had experienced at least one injury at the end of the clinical period. The activities mentioned most frequently were taking of blood samples and injections. Needlestick injuries happened most frequently in surgical units, in internal medicine, and in gynaecology. Accidents happened mostly during secondary employment, medical traineeship, or in the context of practical nursing. In consequence, measures for improvement of the primary prevention should start with training on the one hand: Only briefing seems to be insufficient - intensive exercises in using stick-proof instruments seems to be more promising. On the other hand, the comprehensive introduction of stick-proof instruments has to be supported.

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The growing number of publications on noise in hospitals reflects not only a rising interest in this theme during the last decades, but also an increasing noise exposure of the patients: the average SPL reported in literature between 1960 and 2005 has risen from 57 to 72 dBA in daytime and from 42 to 60 dBA at night. The hospitals in question differ substantially with regard to type of construction, technical equipment, and organizational issues. But especially for intensive care units (ICUs), the main sources of noise described in international research are similar: sounds from technical appliance such as alarms, noise caused by the staff talking or handling material, and communication systems such as overhead paging. With regard to patients in ICUs, sleep disturbances in terms of falling asleep and sleeping through are the greatest problem as assessed by questionnaires or by physiological measurements. They might have harmful effects on the outcome of the medical treatment influencing the duration of recovery and the need for sedative medication. Several intervention programmes for noise reduction are reported in literature combining a variety of methods such as acoustical insulation, sound level reduction with regard to equipment, and especially behavior modification of the staff.

Noise research in hospitals focuses mainly on the harmful effects on patients. But at least in intensive care units and operation theaters, also the staff is exposed to high levels of noise during considerable portions of working time. Evidence from literature is summarized here. During operation sessions lasting from 30 min to several hours, reported average Leq values range from 58 to 72 dB(A) with maximum levels above 105 dB(A). Similar noise levels are reported from emergency departments. As concentration, precise communication, and fast decisions are necessary in these situations, the acoustical environment has to be considered an enormous strain for the staff and a potential risk with regard to faults at work. But also during normal day and night shifts in intensive care units, noise is mentioned as an important disturbance by the medical staff. Most disturbing are noises from telephones and other communication tools and the signals and sounds from medical devices. Questionnaire surveys result in 80 to 91% of the staff reporting negative effects of noise in their daily work. A variety of measures for noise reduction and prevention in hospitals is suggested in literature emphasizing that the staff plays a decisive role in such projects.

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