Orthopedic surgeons risk noise-induced hearing loss in the OR

Photo credit: Anna Shvets

by Daniel Fink, MD, Chair, The Quiet Coalition

I was surprised by this article on Healio reporting that orthopedic surgeons risk noise-induced hearing loss in the operating room, but then smiled to myself as I realized I shouldn’t have been surprised.

Orthopedic surgeons use sterilized versions of professional grade power tools as well as some manual tools that are similar to the ones I use in my various home repair and home improvement projects: power saws, power drills, sometimes hammers and chisels.

The research was done by Stephanie A. Kwan, DO and colleagues. The Healio article reports that the maximum sound pressure level produced by some equipment is 142 decibels. Whether that’s A-weighted* or not, it exceeds the Occupational Safety and Health Administration maximum permissible occupational noise exposure level of 140 dBA.*

Average sound exposures weren’t that high, but the mean maximum decibel level was 84.8 dB. Of greater concern were maximum decibel levels averaging 102 dB for adult reconstruction procedures, especially because some can be rather lengthy. The National Institute for Occupational Safety and Health recommends only 15 minutes at 100 A-weighted decibels to prevent noise-induced hearing loss, so it’s clear that the auditory health of orthopedic surgeons is at risk.

NIOSH also recommends using double hearing protection, i.e., both earplugs and earmuff hearing protection, for noise exposures above 100 dBA. That degree of hearing protection would make it difficult for surgeons to communicate with an assistant or other operating room staff.

A certain amount of sound is produced using any power tool, but perhaps this report will spur surgical equipment manufacturers to design quieter tools for orthopedic surgeons to use.

*Sound is measured on a logarithmic scale in units called decibels. A-weighting adjusts unweighted decibels for the sounds heard in human speech.

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