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行全髋关节置换术的外科医生有噪声性听力损失的风险,尤其是在使用自动扩孔时。

Surgeons Who Perform Total Hip Arthroplasty Are at Risk for Noise-Induced Hearing Loss, Especially When Using Automated Broaching.

出版信息

Orthopedics. 2024 Nov-Dec;47(6):349-354. doi: 10.3928/01477447-20240809-06. Epub 2024 Aug 19.

Abstract

BACKGROUND

Noise-induced hearing loss (NIHL) is a serious concern for orthopedic surgeons. The National Institute for Occupational Safety and Health (NIOSH) sets the safe exposure limit at 85 dB for 8 hours, yet operating rooms often surpass this limit. This study investigated if using an automated broaching system exposes orthopedic surgeons to dangerous decibel (dB) levels.

MATERIALS AND METHODS

A prospective study analyzed 138 intraoperative sound recordings from 92 total hip arthroplasty (THA) surgeries and 46 baseline measurements at an academic-affiliated private practice, using the NIOSH Sound Level Meter (SLM) application and a microphone. The surgeries were categorized into manual and automated broaching. Key metrics measured included maximal dB level (MDL), peak sound pressure (LC), average continuous sound (LA), and average weighted sound in an 8-hour period (TWA), along with dose representations, to identify hazardous noise levels.

RESULTS

Of the 92 THA sound recordings, 50 used manual broaching and 42 employed automated broaching. Automated broaching exhibited higher noise levels, with an average MDL of 109.92 dBA, a LA of 86.09 dBA, a TWA of 76.48 dBA, and a projected noise dose of 137.74%. In contrast, manual broaching exhibited an average MDL of 105.87 dBA, a LA of 83.06 dBA, a TWA of 72.82 dBA, and a projected noise dose of 82.02%.

CONCLUSION

This study highlights the auditory risks from automated broach and manual THA surgeries that orthopedic surgeons experience. Manufacturers should focus on reducing instrument noise when designing surgical tools and orthopedic surgeons and operating room staff should take measures to protect themselves from NIHL during surgery. [. 2024;47(6):349-354.].

摘要

背景

噪声性听力损失(NIHL)是骨科医生关注的一个严重问题。美国职业安全与健康研究所(NIOSH)将 8 小时内 85 分贝的安全暴露限值设定为安全值,但手术室的噪音经常超过这个限值。本研究旨在探讨使用自动扩孔系统是否会使骨科医生暴露在危险的分贝(dB)水平下。

材料与方法

一项前瞻性研究分析了一家学术型私人诊所的 92 例全髋关节置换术(THA)手术中的 138 个术中录音和 46 个基线测量值,使用 NIOSH 声级计(SLM)应用程序和麦克风。手术分为手动和自动扩孔。测量的关键指标包括最大 dB 级(MDL)、峰值声压(LC)、平均连续声(LA)和 8 小时内的平均加权声(TWA),以及剂量表示,以识别危险噪声水平。

结果

在 92 例 THA 录音中,50 例采用手动扩孔,42 例采用自动扩孔。自动扩孔的噪声水平较高,平均 MDL 为 109.92 dBA,LA 为 86.09 dBA,TWA 为 76.48 dBA,预测噪声剂量为 137.74%。相比之下,手动扩孔的平均 MDL 为 105.87 dBA,LA 为 83.06 dBA,TWA 为 72.82 dBA,预测噪声剂量为 82.02%。

结论

本研究强调了骨科医生在进行自动扩孔和手动 THA 手术时所面临的听觉风险。制造商在设计手术工具时应重点降低仪器噪声,而骨科医生和手术室工作人员在手术过程中应采取措施保护自己免受 NIHL。[2024;47(6):349-354.]。

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