Noise Evaluation of Arthroplasty Theaters: Results From the NEAT Study

Palmer, Jonathan; Fraig, H; Wilson, Christopher J.; Garrett, Simon J.

doi:10.1016/j.arth.2020.11.026

Cited by 10 publications

(22 citation statements)

References 14 publications

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“…The average measured LAeq was 61.9 ± 1.0 dB(A) while the average LEPd was 53.2 ± 1.2 dB(A) during TKA performed within this study. Compared to other studies which also investigated noise levels during TKA, the noise exposure within this study was lower in comparison [ 1 , 38 ]. Especially when compared to robotic assisted TKA the noise exposure levels measured within this study were quite lower [ 39 ].…”

Section: Discussioncontrasting

confidence: 64%

“…Orthopedic operating theatres are known to be a working environment with considerable noise exposure—especially when joint replacements such as Total Knee Arthroplasty (TKA) or Total Hip Arthroplasty (THA) are performed [ 1 , 2 ]. In particular the use of instruments such as saws for bone preparation and hammers for chiseling of osteophytes or component placement is associated with substantial noise exposure.…”

Section: Introductionmentioning

confidence: 99%

“…Noise in general is not only compromising concentration and communication but is also possibly leading to hearing loss when exceeding a certain exposure level over a certain time, which represents a serious hazard in health care facilities and especially in operating theatres [ 1 , 9 , 10 , 11 , 12 , 13 , 14 ]. Health personnel and especially surgical orthopedic staff are at risk for suffering from Noise Induced Hearing Loss (NIHL), with evidence of NIHL found in up to 50% of orthopedic surgeons [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Failed Attempt to Recommend Noise Cancelling Headphones for Knee Arthroplasty Surgeons—Results of a Pilot Study

et al. 2023

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Background and Objectives: Noise exposure during total knee arthroplasty (TKA) has been demonstrated to exceed thresholds that are deemed as over-exposure by industry noise level standards. With orthopedic surgeons being at risk of suffering from Noise Induced Hearing Loss, the purpose of this pilot study was to evaluate the viability of the use of industry grade active noise cancelling headphones (ANCH) during TKA. Material and Methods: In this prospective pilot study, 10 TKA were performed. In five of these cases, surgeon, assistant, scrub nurse and anesthetist wore ANCH with automatic noise level dependent noise attenuation above 82 dB. A validated 14-item questionnaire was used after each case to evaluate the quality of communication, performance, teamwork and mental load. In seven cases a calibrated sound level meter was used to measure the operating theatre noise. Peak sound level (LApeak), A-weighted continuous sound level (LAeq) and A-weighted noise exposure averaged for an 8-h time-period (LEPd) were calculated. Results: There was no perceived benefit of ANCH for the surgeons (p = 0.648), assistants (p = 0.908) and scrub nurses (p = 0.251). There was an overall improvement observed by anesthetists (p = 0.001). A worse communication while wearing ANCH was reported by surgeons but not by the rest of the team. Average LApeak was 90.6 ± 3.2 dB(C), LAeq was 61.9 ± 1.0 dB(A) and LEPd was 53.2 ± 1.2 dB(A). Conclusions: Industry grade ANCH seem to provide no benefit for surgeons, assistants and scrub nurses during TKA, while anesthesiologists seem to benefit from the use of ANCH during TKA. Due to the limitations of this pilot study, further studies with larger study populations are necessary to adequately investigate the use of ANCH during TKA.

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Section: Discussioncontrasting

confidence: 64%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Failed Attempt to Recommend Noise Cancelling Headphones for Knee Arthroplasty Surgeons—Results of a Pilot Study

et al. 2023

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“…In total, 11 studies used sound level meters or a dosimeter, 10-18,20,22 the most popular of which were Bruel & Kjaer meters (Bruel & Kjaer, Denmark) or Quest dosimeters (TSI, USA). Three studies used sound level apps on a smartphone, 21,23,24 two of which were designed by the National Institute for Occupational Safety and Health, USA.…”

Section: Resultsmentioning

confidence: 99%

“…Of the 15 studies, 11 concluded that surgeons were at risk of noise induced hearing loss. 10,11,13,15-20,22,24 Butt et al 12 and Goffin et al 23 could not draw any conclusions, and stated that further evidence was required. In their study, Slaven et al 21 reported that surgeons were not at risk, despite showing evidence that the UK and European regulations were breached, the equivalent regulations in the USA, where the study was undertaken, were not breached.…”

Section: Discussionmentioning

confidence: 99%

The relationship between exposure to noise and hearing loss in orthopaedics

et al. 2023

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AimsIn the UK, the agricultural, military, and construction sectors have stringent rules about the use of hearing protection due to the risk of noise-induced hearing loss. Orthopaedic staff may also be at risk due to the use of power tools. The UK Health and Safety Executive (HSE) have clear standards as to what are deemed acceptable occupational levels of noise on A-weighted and C-weighted scales. The aims of this review were to assess the current evidence on the testing of exposure to noise in orthopaedic operating theatres to see if it exceeds these regulations.MethodsA search of PubMed and EMBASE databases was conducted using PRISMA guidelines. The review was registered prospectively in PROSPERO. Studies which assessed the exposure to noise for orthopaedic staff in operating theatres were included. Data about the exposure to noise were extracted from these studies and compared with the A-weighted and C-weighted acceptable levels described in the HSE regulations.ResultsA total of 15 studies were deemed eligible. These included a total of 386 orthopaedic operations and the use of 64 orthopaedic instruments. A total of 294 operations (76%) and 45 instruments (70%) exceeded the regulations on an A-weighted scale, and 22% (10 of 46) of operations exceeded the maximum C-weighted peak acceptable level of noise. Noise-induced hearing loss was reported in 28 of 55 orthopaedic staff members (50.9%).ConclusionSafe levels of noise can be exceeded in orthopaedic operations, and when using orthopaedic instruments. Employers have clear policies about exposure to noise in the workplace but have yet to identify orthopaedic theatres as a potential at-risk area. Orthopaedic staff need education, monitoring, and protection, while employers should consider regular assessments of staff in orthopaedic theatres and offer methods to prevent noise-induced hearing loss.Cite this article: Bone Joint J 2023;105-B(6):602–609.

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Noise exposure during robot-assisted total knee arthroplasty

Hönecke

Michael

Wangenheim

et al. 2022

Arch Orthop Trauma Surg

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The aim of the study was to examine the noise exposure for operating theater staff during total knee arthroplasty (TKA) with three different robot systems. There is already evidence that noise exposure during TKA performed manually exceeds recommended guidelines for occupational noise. Therefore, if surgical staff is exposed to it for several years, the development of noise-inducing hearing loss (NIHL) is significantly increased. To investigate the noise exposure during robot-assisted TKA, the study measured the average noise and the peak sound pressure during TKA with MAKO robot (Stryker, Kalamazoo, Michigan, United States), NAVIO robot (Smith and Nephew, London, Great Britain), and CORI robot (Smith and Nephew, London, Great Britain) using a class 1 sound level meter. Each robot system exceeds the recommended guidelines from the national institute for occupational safety and health. While the MAKO robot had the highest average sound level (93.18 dB(A)) of the three robot systems (NAVIO: 88.88 dB(A), CORI: 89.38 dB(A)), the peak sound level was the highest with the NAVIO Robot (134.48 dB(C)) compared to the MAKO Robot (128.98 dB(C)) and CORI robot (126.48 dB(C)). Robot-assisted TKA is a risk factor for NIHL, like manually performed TKA. Further research for decreasing the noise exposure during TKA is needed to minimize the hearing loss in operating theater staff.

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Noise Evaluation of Arthroplasty Theaters: Results From the NEAT Study

Cited by 10 publications

References 14 publications

Failed Attempt to Recommend Noise Cancelling Headphones for Knee Arthroplasty Surgeons—Results of a Pilot Study

Failed Attempt to Recommend Noise Cancelling Headphones for Knee Arthroplasty Surgeons—Results of a Pilot Study

The relationship between exposure to noise and hearing loss in orthopaedics

Noise exposure during robot-assisted total knee arthroplasty

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