Floor vibrations on healthcare facilities: A case study on a surgical microscope

Omer F. Tigli, Senior Structural Engineer, McNamara/Salvia Inc. Consulting Engineers,

160 Federal Street, 5th Floor, Boston, MA, 02110, USA

ABSTRACT

Floor vibrations in modern healthcare facilities have become an important design consideration for structural engineers in
recent years. This paper describes a vibration issue experienced on a surgical microscope and presents the results of a series
of dynamic testing to resolve the issue. The microscope is located in an operating room (OR) on the fourth floor of a 10-
story, steel framed, inpatient hospital building constructed in 2011. The fifth floor of the building is a mechanical space. On
multiple occasions, neurosurgical cases have been disrupted due to the vibrations of the microscope. Floor and microscope
vibrations have been measured using accelerometers on multiple occasions, each time targeting a particular set of vibration
sources. Potential sources identified include human walking, internal electronics of the microscope itself, the intensity of the
air flow inside OR, other medical equipment used in the building, mechanical equipment located on the fifth floor including
four chillers, two air compressors and eighteen pumps. Microscope manufacturer did not provide any specific vibration
limits. Generic vibration criteria available in literature are provided for floors not necessarily for eye vibrations of the
microscope and they limit the vibrations at microsurgery floors to 1,000 micro-in/s (mips) in RMS. An independent vibration
criterion for the eye (3,500 mips) has been developed over the series of tests based on the subjective comments of the OR
personnel. Largest vibration levels measured at the eye reached to 10,000 mips at 21 Hz and that coincided with the motor of
a condenser water pump operating at 1260 RPM on the fifth floor.

Floor vibrations, healthcare facilities, vibration criteria, surgery microscopes

1. INTRODUCTION

Advances in building materials and technologies open the gate for more slender, lighter and economical structural systems
for buildings in recent decades. In a broad sense, buildings are designed, first, to safely carry the extreme loads that they may
be exposed to during their life-time (strength criteria) and, second, to be serviceable to its users in their daily activities
(serviceability criteria). Modern buildings with slender structural systems are easily shown to meet the strength criteria and
the traditional measure of serviceability checks: Deflection criteria. What they may fail to meet is the second aspect of the
serviceability checks: Vibration criteria.

Vibration criterion of a building floor is closely dependent on its users. Strength and deflection criteria of the same floor are
also dependent on its users, but in more general terms. For instance, strength/deflection criteria for a paper office or an
electronic office are exactly the same. However, their vibration performances are different to the point that they may warrant
different structural designs [1,2]. Similarly, the strength/deflection criteria for a hospital floor housing an electronic imaging
system or a hospital floor with inpatient rooms do not differ, but their vibration requirements will be totally different [3].

It does not take much to imagine what type of serviceability problems we may have, if the buildings are designed only for
traditional strength/deflection criteria. Unfortunately, if we go back and study the design documents of buildings with
vibration problems, we often encounter calculations with no reference to vibrations. Although it is beyond the scope of this
paper to study reasons behind this, in author’s humble opinion, one of the many contributing factors is the lack of a vibration
course/training in the engineering curriculum that the structural engineers are generally provided with.

This paper presents a case study involving vibration complaints on a surgical microscope used for neurosurgical cases on the
fourth floor of a 10-story, steel framed, inpatient hospital building. The fifth floor of the building is a mechanical space. On
multiple occasions, neurosurgical cases have been disrupted due to the vibrations of the microscope. About six vibration
complaints were reported within a year and each time disruptive vibrations lasted about couple hours after which the
vibrations were reduced to more tolerable levels.

From a source-path-receiver perspective, one can easily conclude that the receiver of the objectionable vibrations is the
microscope and/or the operating room (OR) personnel who are using the microscope, while the source and the path of the
vibrations are unknown and constitute the main objective of this study.

With the objective of finding the source of the vibrations, first, all nearby vibration sources that are likely to be responsible
for the objectionable vibrations have been considered, which included human walking, internal electronics of the microscope
itself, the intensity of the air flow inside OR, other medical equipment used in the building, mechanical equipment located on
the fifth floor including four chillers, two air compressors and eighteen pumps. The duration of the disruptive vibration event
quickly eliminated the sources that are transient in nature, such as human walking.

Next, a series of vibration tests were coordinated between OR scheduling and building engineering departments. Each test
consisted of taking acceleration measurements at the tip of the microscope eye and on the floor while a potential vibration
source was turned on and off. High number of potential vibration sources and inability of shutting off every source except the
one being tested constituted the main challenges in this approach. Ideally, the best approach would be to take vibration
measurements while a vibration event is actually happening. However, the infrequent nature of the reported vibration events
and pressing need to address this issue immediately by the hospital administrative diverted us from the ideal approach to
aforementioned brute force method. After performing four vibration tests as part of the brute force approach, a new vibration
event was reported and we were able to take measurements during this event. After this last test, the magnitudes of the
objectionable vibrations as well as corresponding frequencies have been determined. This information has been used to
narrow down potential vibration sources and a final comprehensive vibration testing has been conducted following the brute
force method with the reduced set of vibration sources. It was found that when one of the pumps operated at certain speed,
the vibration levels measured during the vibration event were replicated.

The rest of the paper is outlined as follows. Section 2 gives the description of the microscope and the structural floor. Section
3 summarizes the vibration criteria selected for the microscope. Section 4 describes the vibration tests performed and presents
the results. Section 5 provides a critical review of the findings.

2. DESCRIPTION OF THE MICROSCOPE AND THE STRUCTURAL FLOOR

The microscope is a Carl Zeiss OPMI Pentero surgical microscope (Figure 1). The microscope has a cantilevering arm of
about 170 cm (~5’-7”) long. As expected, largest accelerations are observed at the tip of the arm where the eye is located.
The microscope is assigned to the operating room located on the fourth floor of the hospital building. Figure 2 shows the plan
view of the operating room. In a regular day, the microscope is first located at the calibration location (CL), and then it is
moved next to the operation bed, operation location (OL), to be used during operations. For instance, the microscope is
located at CL in Figure 1.

The fourth floor structure is framed with structural steel supporting a composite 4 ¼” lightweight concrete slab on 3” metal
deck (7 ¼” total thickness). In general, the bay sizes are about 30’-0” x 41’-6” (9.1m x 12.6m), with columns occasionally
staggered in plan. The third floor and second floor are partially hung from the fourth floor framing via hanging columns at
mid-bay. This unique structural feature increases the mass of the fourth floor.
 Fig. 1 Photo of the surgical microscope during a vibration event

Fig. 2 Architectural plan view of the operating room

The fifth floor is the main mechanical room for the Building. Potential sources of vibrations identified on the fifth floor are
Chiller #3 located directly above the OR, Chillers #1 and #2 located to the west of Chiller #3, the Primary (PCHWP-1-4) and
Secondary Chilled Water Pumps (SCHWP-1-4) located to the North of Chiller #3, Condensing Water Pumps (CWP-1-4)
located to the south of the OR, the compressor pumps located in the northwest corner of the mechanical room.

3. VIBRATION CRITERIA

The microscope manufacturer did not provide any specific vibration criteria other than stating that the floor should meet the
“microsurgery” requirements. Design Guide 11 of American Institute for Steel Construction (AISC) [4] provides generic
vibration criteria for sensitive equipment. Here, the maximum allowable vibration velocity of microsurgery floors is limited
to 1,000 mips.

It is worth noting that recommended vibration levels are defined on the floor not on the tip of the microscope which might be
deemed a much more relevant location for the purpose of assessing vibration performance of microscopes. However, the
author could not find any published vibration criteria defined at the eye of the microscope eye.
In order to establish a vibration criteria for the eye, we resorted to subjective evaluations of OR personnel. Through the
vibration tests performed at six different occasions, we observed that OR personnel did not mind scope tip vibrations up to
the range of 3,000 – 4,000 mips level. Therefore, a scope tip vibration criterion of 3,500 mips has been proposed in this
paper.

4. DYNAMIC TESTING

Vertical accelerations on the floor and on the microscope tip were measured using PCB Piezotronics Model 393B05
accelerometers at a sampling rate of 2048 Hz. Digital data acquisition was performed using a National Instrument USB-9234
DAQ card. In the post-processing, measured accelerations were first segmented into 5-second long blocks with 50%
overlapping allowed. Then each data set was low-pass filtered with a cut-off frequency of 50 Hz, and then resampled at a
sampling rate of 100 Hz. Then, power spectrum of each data block was calculated with a peak conversion set to root-mean-
square (RMS). Then, the final power spectrum of each measurement was obtained by averaging the power spectra
corresponding to each data block.

4.1 Test #1

The main objective of the first test was to investigate whether Chiller #3 (Ch3) had anything to do with the objectionable
microscope vibrations, because it is located directly above the OR. It was found that the vibration levels on the floor and at
the scope tip did not change at any significant level when Ch3 was on or off (Figure 3). This observation lead us conclude
that Ch3 was not the source of the reported vibration issue.
2000 7000
1800 Floor Criteria Scope Criteria
6000
1600 Vert Floor (Ch3 ON) Vert Scope Tip (Ch3 ON)
Vert Floor (Ch3 OFF) Vert Scope Tip (Ch3 Off)
1400 5000
Velocity (mips)
Velocity (mips)

1200
4000
1000

800 3000

600
2000
400
1000
200

0 0
0 10 20 30 40 50 0 10 20 30 40 50
Frequency (Hz) Frequency (Hz)
(a) (b)
Fig. 3 Vertical floor (a), and scope tip (b) vibrations when Chiller #3 (Ch3) was on and off (Test #1)

4.2 Test #2

Our next objective was to investigate the following potential sources of vibrations: Chiller #1, (Chiller #2 was out of service),
Instrument compressor and Medical Vac. First, we took a baseline measurement when all the equipment mentioned above
was up and running. Then, we took successive measurements when only one of the equipment was turned off. We learned
that controlling the test conditions will be difficult as the building engineering department cannot control the independent
operation of each piece of fifth floor mechanical equipment due to a continuous demand on some by various hospital
services. Fig. 4 presents floor and scope tip vibrations for various combinations of mechanical equipment. None of the
selected mechanical equipment combinations induced significantly different floor or scope tip vibrations than the others.
Therefore, we conclude that none of the mechanical equipment tested is likely responsible for the vibration issue.
 2000 7000
Scope Criteria
1800 Floor Criteria
6000 Vert Scope (Ch1 & Inst. Comp. & Med. Vac ON)
Vert Floor (Ch1 & Inst. Comp. & Med. Vac ON)
1600 Vert Scope (Inst. Comp. OFF)
Vert Floor (Inst. Comp. OFF)
Vert Floor (Ch1 OFF) 5000 Vert Scope (Ch1 OFF)
1400
Vert Floor (Med. Vac OFF) Vert Scope (Med. Vac OFF)
Velocity (mips)

Velocity (mips)
1200
4000
1000
3000
800

600 2000
400
1000
200

0 0
0 10 20 30 40 50 0 10 20 30 40 50
Frequency (Hz) Frequency (Hz)
(a) (b)
Fig. 4 Vertical floor (a) and scope (b) vibrations when Chiller #1 (Ch1), Inst. Comp. and Med. Vac were on /off (Test #2)

4.3 Test #3

In this test, the microscope was turned on and off and the background vertical accelerations on the floor and on the
microscope were recorded. As Figure 5 indicates, no significant change in the vibration levels was observed, which
concluded that the scope itself (i.e., it’s CPU) was not the source for the scope vibrations.

2000 7000
1800 Floor Criteria
Scope Criteria
6000
1600 Floor (Scope ON) Scope Tip (Scope ON)
1400 Floor (Scope OFF) 5000 Scope Tip (Scope OFF)
Velocity (mips)

Velocity (mips)

1200
4000
1000

800 3000

600
2000
400

200 1000

0 0
0 10 20 30 40 50 0 10 20 30 40 50
Frequency (Hz) Frequency (Hz)
(a) (b)
Fig. 5 Vertical floor (a) and scope tip (b) vibrations when the scope was ON and OFF (Test #3)

4.4 Test #4

In our next visit, the effect of air pressure/flow within the OR was investigated for three conditions: When the air flow in the
OR was turned off completely, when it was maximized and when it was minimized. The data indicate that there were no
appreciable differences in the measurements for all three cases (Figure 6), which concludes that the air flow was not
responsible for the objectionable scope vibrations.
Surprisingly, the vibrations on the floor and at the scope tip exceeded their respective vibration criteria (1,000 mips and 3,500
mips) for the first time since our first testing (see the peak at ~21 Hz with a magnitude of ~2250 mips on the floor and ~8,500
mips at the scope tip). This was the case regardless of the air flow condition in the OR. This unexpected result could be
attributed to an unknown source that became active during test #4 but was inactive other times.

2500 9000

Floor Criteria 8000

Scope Criteria
2000 Floor Air Off Scope Air Off
Floor Min Air 7000
Scope Min Air
Floor Max Air Scope Max Air
6000
Velocity (mips)

Velocity (mips)
1500
5000

4000
1000
3000

2000
500

1000

0 0
0 10 20 30 40 50 0 10 20 30 40 50
Frequency (Hz) Frequency (Hz)
(a) (b)
Fig. 6 Vertical floor and scope vibrations when the air flow in the OR is Off, Maximized and Minimized (Test #4)

4.5 Test #5

This test was performed due to an urgent call informing us about an ongoing vibration event in the OR. The author
volunteered to go into the OR and took measurements on the floor and the scope tip, when the scope was located at CL (Fig
1). About a ten-minute long data were collected, which was broken into three pieces in the post-processing step for the
purposes that will be apparent soon. RMS averaged power spectra of these three data sets measured on the floor and at the
scope tip are presented in Figure 7. The largest scope vibrations were observed in Set 1 as 10,185 mips at 21 Hz, which then
reduced to 4,980 mips in Set 2 and then to 250 mips in Set 3. Similarly, the largest floor vibrations were observed in Set 1 as
3,030 mips at 21 Hz, which then reduced to 1,480 mips in Set 2 and to 75 mips in Set 3. This indicates that the vibration
source that was responsible for the reported complaint either stopped or changed its frequency after a few minutes we started
our recording. The fact measured vibrations both on the floor and at the scope exceeded their respective vibration criteria
confirmed the complaints as well as the selected vibration criteria. It is also interesting to note that excessive vibrations
measured during Tests #4 and #5 occurred at the same frequency of 21 Hz.

4.6 Test #6

The next task was to track the vibrations down to its source. The most valuable information identified about the source was
its frequency. Unknown vibration source must be operating and generating vibrations at 21 Hz. After studying datasheets for
various mechanical equipment located on the fifth floor, we found that all of the pumps and chillers were equipped with
variable frequency drives (VFDs) which are designed to change the pumps motor speed automatically in order to optimize
the efficiency of the whole system. We found that when operated at 100%, all pump motors generate vibrations at around 30
Hz. When VFD is set to 70%, however, motor speeds will be adjusted to around 1290 RPM, which in turn generate
vibrations at ~21 Hz. Table 1 lists all of the 18 pump motors located on the fifth floor and some of their engineering
parameters.
 3500 12000

3000 Floor Criteria Scope Criteria

10000
Ver Floor (Set 1) Ver Scope Tip (Set 1)
2500 Ver Floor (Set 2) Ver Scope Tip (Set 2)
Ver Floor (Set 3) 8000
Ver Scope Tip (Set 3)
Velocity (mips)

Velocity (mips)
2000
6000
1500

4000
1000

2000
500

0 0
0 10 20 30 40 50 0 10 20 30 40 50
Frequency (Hz) Frequency (Hz)
(a) (b)
Fig. 7 Vibration spectra on the floor and at the scope tip for three data sets (Test #5)

Test #6 is designed such that floor and scope vibrations were recorded continuously while each motor pump was set to
operate at 70% (21 Hz) and then at 90 % (27 Hz) in a predetermined order. The basic objective was to find the mechanical
equipment, which when operates at 21 Hz, would reproduce the scope vibrations that were measured during Test #5. It is
important to measure the scope vibrations when the scope is located at OL, since this is the location where it will always be
during operations. Therefore, the scope was located at OL during Test #6.

Table 1. Engineering properties of the pumps located at the 5th floor

Pump Tags Motor HP Motor RPM Weight (lbs)

CWP-1,2,3,4 150 1780 3611

PCHWP-1,2,3,4 100 1780 2241
SCHWP-1,2 100 1780 2965
SCHWP-3,4 50 1780 1567
HWP-1A,1B 30 1750 725
HWP-2A,2B 40 1750 1075
HRC-1,2 1.5 1750 175

Figure 8 presents the measured vertical vibration levels on the floor and at the tip of the microscope when condenser water
pump 4 (CWP4) operated at 70% (21 Hz) and then at 90% (27 Hz). Both floor and scope vibrations exceeded the vibration
criteria only when CWP4 operated at 21 Hz. Measured vibration levels never exceeded with any other pumps operating at the
mentioned speeds. For brevity reasons, vibration plots corresponding to the remaining pumps are skipped except the ones
associated with condenser water pump 3(CWP3) are presented in Figure 9 for comparison purposes. CWP3 is identical to
CWP4 and located next to CWP4. However, measured floor and scope vibrations in the OR during CWP3 operating at 21 Hz
and 27 Hz were all within the vibration criteria.

Since the main objective of Test #6 was to find the pump that would replicate the vibration levels measured during Test #5, it
is worth comparing Figures 5 and 8. Note that the magnitudes of the vibrations at 21 Hz measured on the scope tip (10,185
mips on Test #5 & 6,075 mips at Test #6) are quite different. The main reason behind this can be argued to be the fact that the
microscope was located at two different locations in the OR (at CL during Test #5, at OL during Test #6, see Figure 2).
 2000 7000

1800
6000 Scope Criteria
1600 Floor Criteria
Scope (CWP4, 70%)
Floor (CWP4, 70%) 5000
1400 Scope (CWP4, 90%)
Floor (CWP4, 90%)
1200
4000

Velocity (mips)
Velocity (mips)

1000
3000
800

600 2000
400
1000
200

0 0
0 10 20 30 40 50 0 10 20 30 40 50
Frequency (Hz) Frequency (Hz)
(a) (b)
Fig. 8 Vertical vibration spectra on the floor (a) and on the scope (b) when CWP-4 operates at 70% & 90% (Test #6)

2000 7000

1800 Floor Criteria Scope Criteria

6000
1600 Floor (CWP3, 70%) Scope (CWP3, 70%)

1400 Floor (CWP3, 90%) 5000 Scope (CWP3, 90%)

1200
4000
Velocity (mips)

Velocity (mips)

1000
3000
800

600 2000
400
1000
200

0 0
0 10 20 30 40 50 0 10 20 30 40 50
Frequency (Hz) Frequency (Hz)
(a) (b)
Fig. 9 Vertical vibration spectra on the floor (a) and on the scope (b) when CWP-3 operates at 70% & 90% (Test #6)

In order to verify the effect of location within OR, we placed an additional accelerometer on the floor at CL, during Test #6
while CWP4 was operating at 70%. Additionally, we calculated the transmissibility functions relating the response
measurements taken on the floor to that on the scope tip from the data collected during Test #5 (the scope located at CL).
Next, the scope tip vibrations were estimated from the transmissibility functions and the floor measurements taken from the
accelerometer located on the floor at CL during Test #6. Note that the estimated scope vibrations refer to the case as if the
scope was located at CL during Test#6. Figure 10 compares the estimated scope tip vibrations from Test #6 against the
measured scope tip vibrations from Test #5 (10,235 mips vs 10,185 mips at 21 Hz). This confirms the effect of location
within the OR and more importantly the fact that the source of objectionable vibrations reported during Test #5 was actually
CWP4 operating at 70% (21 Hz). Based on these findings and our recommendations, hospital engineering department
reprogrammed CWP4 to skip frequencies between 20 and 22 Hz. Since then, no other vibration complaints were reported by
the OR personnel.
 12000

10000 Est. Scope Vib., Test #6

Mea. Scope Vib., Test #5

8000 Scope Criteria

Velocity (mips) 6000

4000

2000

0
0 10 20 30 40 50
Frequency (Hz)

Fig. 10 Estimated and measured vertical vibration spectra on the scope when

5. CONCLUSIONS

A case study involving objectionable vibrations on a surgical microscope was presented. After extensive testing, it was found
that the source of the disruptive vibrations was a condenser water pump operating at a certain speed on the mechanical floor.
A simple solution, re-programing of the pump so that it never operates at the problematic speeds, was suggested and
successfully implemented.

A vibration criterion of 1,000 mips on the micro-surgery floors was acceptable for the case presented. However, because
different microscopes may amplify floor vibrations differently, a more direct vibration criterion may be established right on
the tip of the scope. Based on the subjective comments of the OR personnel and the limited data collected in this study, it is
suggested that a vibration level of 3500 mips at the scope tip may be an appropriate vibration criterion for surgical
microscopes.

ACKNOWLEDGMENTS

Mr. John Tracy, Associate at McNamara/Salvia Inc. is gratefully acknowledged for his assistance for the scheduling and
performing the dynamic tests.

REFERENCES

[1] Hanagan, Linda M. "Walking-induced floor vibration case studies." Journal of architectural engineering 11.1, 14-18, 2005

[2] Tigli, Omer F. "Human-induced Vibration Propagation on a Composite Floor System." Civil Engineering Topics, Volume
4, Springer New York, 99-108, 2011

[3] Ungar, Eric E. "Vibration criteria for healthcare facility floors." Sound and Vibration 41.9, 12-27, 2007

[4] Murray M.M, Allen D.E., Ungar E.E., “Floor Vibrations due to Human Activity AISC-Steel Design Guide Series – 11”,
AISC, Second Printing, October 2003