Characterization of Vibration and Sound Exposure during Neonatal Transport: A Scoping Review of Methods and Findings.

Neonatal transport plays a vital role in ensuring that newborns who require specialized medical care can safely access appropriate services. Standard, regionalized transport protocols and equipment are required to improve access, timeliness, and consistency to the level of care provided. A key concern in neonatal transport is the potential exposure of newborns to elevated sound and whole-body vibration from the variety of transport incubators, medical equipment, and the vehicle platforms used in practice. Although international research groups are actively pursuing strategies to mitigate harmful sound and whole-body vibration, characterizing the transport environment remains a critical prerequisite for identifying resonance-driven amplification and informing targeted mitigation. This scoping review explores the methods and findings of vibration and sound characterization studies in neonatal transport. A total of 33 articles were included in this review, 28 of which evaluated vibration and 16 measured sound. The exposure levels of the different modes of transport and positions within the vehicles were compared. With the exception of a single study, sound measurements exceeded recommended limits for transport incubators, and vibration levels commonly surpassed "uncomfortable" thresholds for adults. Current whole-body vibration standards apply only to healthy adults, which results in ambiguity in their application to newborns and emphasizes a critical gap in defining safe exposure limits for neonates. Defining the risks, magnitude, and acceptable limits of these environmental stressors is essential to ensuring safer transport for vulnerable newborns.