The relationship between exposure to noise and hearing loss in orthopaedics

Mistry, Dylan A.; Ahmed, Usman; Aujla, Randeep; Aslam, Nadim; D’Alessandro, Peter; Malik, Shahbaz S.

doi:10.1302/0301-620x.105b6.bjj-2022-0921.r1

Cited by 6 publications

(1 citation statement)

References 23 publications

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“…A systematic review by Mistry et al analysed the evidence on the noise generated from orthopaedic operations and instruments and compared this with the 2003 European Commission Directive and 2005 UK HSE National Occupational Health guidelines [ 19 ]. As identified in our study, they concluded that safe levels of noise can be exceeded during orthopaedic operations.…”

Section: Discussionmentioning

confidence: 99%

Study on impact of robotic-assisted orthopaedic industrial noise (SIREN)

Goffin,

MacRae,

Farrow

et al. 2024

Arch Orthop Trauma Surg

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Introduction The aim of this study was to evaluate noise exposure to the operating room staff consisting of the surgeon, assistant, anaesthetist and Mako Product Specialist (MPS) during Mako robotic-arm assisted total knee arthroplasty (TKA) and total hip arthroplasty (THA). We aimed to determine whether employees were exposed to noise at or above a lower exposure action value (LEAV) set out by the Noise at Work Regulations 2005, Health and Safety Executive (HSE), UK. Materials and methods We prospectively recorded intra-operative noise levels in Mako robotic-arm assisted TKA and THA over a period of two months using the MicW i436 connected to an iOS device (Apple), using the Sound Level Meter App (iOS) by the National Institute for Occupation Safety and Health (NIOSH). Data obtained was then used to calculate “worst case” daily exposure value to assess if sound levels were compliant with UK guidelines. Comparison between operating room staff groups was performed with ANOVA testing. Results A total of 19 TKA and 11 THA operations were recorded. During TKA, for the primary surgeon and the assistant, the equivalent continuous sound pressure level (LAeq) was over 80 dB, exceeding the LEAV set out by the Noise at Work Regulations by HSE. During THA, the average LAeq and peak sound pressure levels did not exceed the LEAV. The calculated daily exposure for the primary surgeon in TKA was 82 dB. A Tukey post hoc test revealed that LAeq was statistically significantly lower in the anaesthetist and MPS (p < .001) compared to the primary surgeon and assistant in both TKA and THA. Conclusions Operating room staff, particularly the primary surgeon and assistant are exposed to significant levels of noise during Mako robotic-arm assisted TKA and THA. Formal assessments should be performed to further assess the risk of noise induced hearing loss in robotic-arm assisted arthroplasty.

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Section: Discussionmentioning

confidence: 99%

Study on impact of robotic-assisted orthopaedic industrial noise (SIREN)

Goffin,

MacRae,

Farrow

et al. 2024

Arch Orthop Trauma Surg

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Evaluation of Noise Exposure Levels in Pediatric ENT Operating Rooms

Shakhtour,

Song,

Orobello

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveOperating room (OR) sounds may surpass noise exposure thresholds and induce hearing loss. Noise intensity emitted by various surgical instruments during common pediatric otolaryngologic procedures were compared at the ear‐level of the surgeon and patient to evaluate the need for quality improvement measures.Study DesignCross‐sectional study.SettingSingle tertiary care center.MethodsNoise levels were measured using the RISEPRO Sound Level Meter and SoundMeter X 10.0.4 at the ear level of surgeon and patient every 5 minutes. Operative procedure and instrument type were recorded. Measured noise levels were compared against ambient noise levels and the Apple Watch Noise application.ResultsTwo hundred forty‐two total occasions of noise were recorded across 62 surgical cases. Cochlear implantation surgery produces the loudest case at the ear‐level of the patient (91.8 Lq Peak dB; P < .001). The otologic drill was the loudest instrument for the patient (92.1 Lq Peak dB; P < .001), while the powered microdebrider was the loudest instrument for the surgeon (90.7 Lq Peak dB; P = .036). Noise measurements between surgeon and patient were similar (P < .05). Overall agreement between the Noise application and Sound Level Meter was excellent (intraclass correlation coefficient of 0.8, with a 95% confidence interval ranging from 0.32 to 0.92).ConclusionOtolaryngology OR noises can surpass normal safe thresholds. Failure to be aware of this may unwittingly expose providers to noise‐related hearing loss. Mitigation strategies should be employed. Quality improvement measures, including attention to surgical instrument volume settings and periodic decibel measurements with sound applications, can promote long‐term hearing conservation.DiscussionOtolaryngology OR noises can surpass normal safe thresholds. Failure to be aware of this may unwittingly expose providers to noise‐related hearing loss. The duration, frequency of exposure, and volume levels of noise should be studied further.Implications for PracticeMitigation strategies should be employed. Quality improvement measures, including attention to surgical instrument volume settings and periodic decibel measurements with sound applications, can promote long‐term hearing conservation.

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Noise in operating theatres, is it safe?

Ayoola,

Abelleyra Lastoria,

Casey

et al. 2024

Arch Orthop Trauma Surg

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Introduction Noise-Induced Hearing Loss (NIHL) is a condition caused by repeated exposure to loud noise, with operating theatre personnel potentially at risk. The aims of this study were to establish the typical noise levels in orthopaedic theatres and to compare these to The Control of Noise at Work Regulations 2005. Materials and methods We measured the average noise levels in 40 trauma and orthopaedic surgeries in a single centre. We used the Decibel X app to take measurements, then performed corrections to ascertain noise levels at the surgeon’s ear (Leq). The daily noise exposure level for theatre staff for each procedure (LEP, d) and the LEP, d over an average 8-hour working day when performing different groups of procedures were calculated. Data were analysed using descriptive statistics, ANOVA, t-test and the Pearson coefficient of correlation. Results The LEP, d lower action value (80 dBA) as set by the Health and Safety Executive (HSE) was met by performing a single revision total knee replacement or a right open ankle debridement. Assuming three procedures are conducted per list, lists consisting of joint replacements (82 dBA) or medium elective procedures (81 dBA) exceed this lower limit. Additionally, lists comprising large and medium bone fractures would be within 1 dB of the limit (79 dBA and 79 dBA, respectively). Soft tissue (74 dBA), arthroscopic (73 dBA), and small bone fracture (71 dBA) procedures had the lowest LEP, d. The greatest contributors to noise levels were surgical instruments. The number of people in the room made a significant difference to noise levels (p = 0.032). Conclusions We have established the baseline noise levels in various orthopaedic procedures. Measures should be taken to meet UK regulations. Further research should determine suitable measures for protection from hearing damage for theatre staff and evaluate the risks high noise levels pose to patients.

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The relationship between exposure to noise and hearing loss in orthopaedics

Cited by 6 publications

References 23 publications

Study on impact of robotic-assisted orthopaedic industrial noise (SIREN)

Study on impact of robotic-assisted orthopaedic industrial noise (SIREN)

Evaluation of Noise Exposure Levels in Pediatric ENT Operating Rooms

Noise in operating theatres, is it safe?

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