St George's University of London, London, SW17 0RE, UK.
St George's Hospital NHS Foundation Trust, London, UK.
Arch Orthop Trauma Surg. 2024 Aug;144(8):3343-3349. doi: 10.1007/s00402-024-05489-x. Epub 2024 Aug 6.
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.
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 (L). The daily noise exposure level for theatre staff for each procedure (L) and the L 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.
The L 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 L. 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).
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.
噪声性听力损失（NIHL）是由反复暴露于强噪声引起的一种病症，手术室人员可能存在风险。本研究旨在确定骨科手术室的典型噪声水平，并与 2005 年《工作场所噪声控制条例》进行比较。
我们在一个中心测量了 40 例创伤和骨科手术的平均噪声水平。我们使用 Decibel X 应用程序进行测量，然后进行校正以确定手术医生耳朵处的噪声水平（L）。计算了每种手术（L）的剧院工作人员每日噪声暴露水平，以及执行不同手术组时平均 8 小时工作日的 L 值。使用描述性统计、方差分析、t 检验和 Pearson 相关系数对数据进行分析。
执行单次全膝关节翻修或右踝关节清创术时，达到健康与安全执行局（HSE）设定的 L 较低动作值（80 dBA）。假设每个列表执行三个程序，包含关节置换术（82 dBA）或中等择期手术（81 dBA）的列表将超过此下限。此外，包含大中和小骨骨折的列表将接近限值（分别为 79 dBA 和 79 dBA）。软组织（74 dBA）、关节镜（73 dBA）和小骨骨折（71 dBA）手术的 L 值最低。对噪声水平贡献最大的是手术器械。房间内的人数对噪声水平有显著影响（p=0.032）。
我们已经确定了各种骨科手术的基线噪声水平。应采取措施以符合英国法规。进一步的研究应确定适合剧院工作人员听力保护的措施，并评估高噪声水平对患者的风险。
