Orthopaedic Department, Dorset County Hospital, Dorchester, UK.
J Arthroplasty. 2021 May;36(5):1819-1822. doi: 10.1016/j.arth.2020.11.026. Epub 2020 Nov 21.
The aim of this study was to define the levels of noise exposure for the surgeon, assistant, scrub nurse, and anesthetist during total hip and knee arthroplasty surgery. In addition, we sought to determine whether the noise exposure during these procedures reaches or exceeds the action values set out by the U.K. Noise at Work Regulations (2005).
Individual noise exposure during arthroplasty hip and knee surgery was recorded using a personal noise Dosemeter System model 22 (DM22) (Pulsar instruments, Filey, U.K.). Recordings were taken in real-time during five separate theater sessions. Each theater session included two arthroplasty procedures and lasted approximately 4 hrs. Personal noise exposure was expressed in terms of peak sound pressure and an average noise exposure over an 8-hour time-period to reflect the noise experienced by the ear over a working day.
In all three sessions involving total hip replacement surgery, the peak sound pressure, for the operating surgeon exceeded the exposure action values set out by the U.K. Noise at Work Regulations. Theater sessions involving total knee replacement surgery did not exceed any exposure action values for LCPeak or LEPd.
Arthroplasty surgery is a working environment with significant noise exposure. We recommend any surgeon or theater member who is concerned about the noise generated in their theater to have noise levels formally assessed using appropriately positioned recording devices.
本研究旨在确定全髋关节和膝关节置换手术中外科医生、助手、洗手护士和麻醉师的噪声暴露水平。此外,我们还试图确定这些手术过程中的噪声暴露是否达到或超过英国《工作场所噪声条例(2005 年)》规定的行动值。
使用个人噪声剂量计系统模型 22(DM22)(脉冲仪器,英国菲力)实时记录髋关节和膝关节置换手术中的个体噪声暴露情况。在五个单独的手术室时段进行了五次记录。每个手术室时段包括两个关节置换手术,持续约 4 小时。个人噪声暴露以峰值声压和 8 小时时间内的平均噪声暴露表示,以反映工作日耳朵所经历的噪声。
在所有涉及全髋关节置换手术的三个手术室时段中,手术外科医生的峰值声压超过了英国《工作场所噪声条例》规定的暴露行动值。涉及全膝关节置换手术的手术室时段,LCPeak 或 LEPd 均未超过任何暴露行动值。
关节置换手术是一个噪声暴露较大的工作环境。我们建议任何关心手术室产生噪声的外科医生或手术室成员使用适当位置的记录设备正式评估噪声水平。