Objectives Sound environments in healthcare facilities are characterised and reported to be poor, and suggest adverse effects on patients and health care workers. This research aimed to examine the acoustical characteristics of long-term care facilities and evaluate the association between noise conditions and stress among residential care workers.

Method We recruited from long-term care facilities in Greater Vancouver, representing a range of building characteristics that influence background noise levels, reverberation time, and speech intelligibility index. Repeated measurements of noise (personal dosimeters and area assessments) and stress (heart rate variability (HRV) and salivary cortisol levels) were collected along with self-reported measures of stress for modelling.

Results Ninty-nine residential care workers participated, most of which were female (89%) and registered care aides (RCAs) (58.8%). Each participant contributed four days of measurements, on two consecutive days followed by another two consecutive days at least 2 weeks later, for a total of 392 person-days of measurements. Participants were exposed to mean A-weighted average sound pressure level of 74.8 dBA (range: 60.3–90.2 dBA) with RCAs and evening shift workers experiencing the highest mean personal exposure levels at 75.3 and 75.8 dBA, respectively.

Licensed practical nurses (LPNs) and those working the evening shift had the highest perceived stress scores, while RCAs were found to be the most stressed group of participants, with the lowest HRV and the lowest diurnal cortisol values.

Conclusions These results suggest that noise levels experienced by residential care workers induce an autonomic stress response capable of contributing to burnout, job dissatisfaction and increased absenteeism.