The Risk of Noise-Induced Hearing Loss Performing Knee Replacement Surgery

OBJECTIVE: Powered surgical instruments use to cut bones and fashion them for joint implant produce noise. Prior studies have not analyzed direct in vivo measurements of multiple procedures and exposure time. This study evaluates actual surgical noise levels exposure to the surgeon and this cumulative exposure that can result in noise-induced hearing loss (NIHL). WHAT IS KNOWN: Prior studies evaluated short duration noise exposure to surgical equipment in vitro, or in an operating room environment. WHAT THIS ADDS: This study evaluated in vivo cumulative measurements over an entire operating day and the associated risks. METHODS: Noise exposure to operating room personnel was measured during multiple knee replacement surgeries over three days. Measurements were compared to occupational exposure limits set by the National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA). RESULTS: Surgeons’ noise exposures exceed noise occupational exposure limits. Recorded levels of 104 dBA did occur with levels of 85dBA found from 10-18% of the time. CONCLUSIONS: Surgeons performing multiple total knee replacements per day are at risk of NIHL due to noise exposures that exceed National Institute for Occupational Safety and Health recommendations. Surgeons should be included in a hearing loss prevention program. LEVEL OF EVIDENCE: Therapeutic Level 1