Are orthopaedic trauma surgeons at risk of occupational noise-induced hearing loss?

Objectives: Orthopaedic surgeons are at risk of occupational, noise-induced hearing loss due to exposure to instruments in the operating room. The primary objective of this study was to determine whether orthopaedic trauma procedures exceed recommended decibel (dB) limits. The secondary objective was to demonstrate which actions during a case create the highest sound levels.

Methods: Intraoperative recordings were taken during orthopaedic trauma surgeries and classified into open reduction internal fixation (ORIF), intramedullary nailing, closed reduction percutaneous pinning, external fixation, soft tissue procedures, or a combination thereof. Recordings were taken of drilling, screw insertion, suctioning, saw use, and mallet striking. Decibel levels were reported as maximum dB level (MDL), LAeq, LCpeak, and time weighted average (TWA). Percentage of allowable daily noise was reported as dose, while the dose predicted for an 8-hour period was reported as projected dose.

Results: A total of 89 recordings were collected, comprising 46 baseline and 43 trauma case recordings. All procedures had significantly higher dB levels compared with controls for all variables (P < 0.001). In all cases, the MDL was greater than 85 dB. ORIF had the highest average MDL (108.4 dB) and TWA (70.3 dB). Overall, no procedures exceeded the maximum allowable daily noise dose. However, the soft tissue group had the highest projected dose (18.8%). Suctioning against soft tissue had the highest dose and projected dose.

Conclusion: Orthopaedic trauma procedures stayed within noise limits, but average MDL exceeded 85 dB. ORIF and suctioning produced some of the highest sound levels among procedures and recorded steps.