Abstract
ObjectiveNoise in operating rooms (OR) can have negative effects on both patients and surgical care workers. Noise can also impact surgical performance, team communication, and patient outcomes. Such implications of noise have been studied in orthopedics, neurosurgery, and urology. High noise levels have also been demonstrated in Otolaryngology-Head and Neck Surgery (OHNS) procedures. Despite this, no previous study has amalgamated the data on noise across all OHNS ORs to determine how much noise is present during OHNS surgeries. This study aims to review all the literature on noise associated with OHNS ORs and procedures.MethodsOvid Medline, EMBASE Classic, Pubmed, SCOPUS and Cochrane databases were searched following PRISMA guidelines. Data was collected on noise measurement location and surgery type. Descriptive results and statistical analysis were completed using Stata.ResultsThis search identified 2914 articles. Final inclusion consisted of 22 studies. The majority of articles analyzed noise level exposures during mastoid surgery (18/22, 82%). The maximum noise level across all OHNS ORs and OHNS cadaver studies were 95.5 a-weighted decibels (dBA) and 106.6 c-weighted decibels (dBC), respectively (P = 0.2068). The mean noise level across all studies was significantly higher in OHNS cadaver labs (96.9 dBA) compared to OHNS ORs (70.1 dBA) (P = 0.0038). When analyzed together, the mean noise levels were 84.9 dBA.ConclusionsThis systematic review demonstrates that noise exposure in OHNS surgery exceeds safety thresholds. Further research is needed to understand how noise may affect team communication, surgical performance and patient outcomes in OHNS ORs.Graphical abstract
Highlights
The mean noise level across all studies was significantly higher in Otolaryngology-Head and Neck Surgery (OHNS) cadaver labs (96.9 Aweighted decibels (dBA)) compared to OHNS Operating rooms (OR) (70.1 dBA) (P = 0.0038)
This systematic review demonstrates that noise exposure in OHNS surgery exceeds safety thresholds
The maximum noise levels in OHNS ORs was 95.5 dBA across all studies, with the highest level recorded in a study being 125.5 C-weighted decibels (dBC)
Summary
Monitors, heating ventilation and air conditioning (HVAC) systems, music and team member communication all contribute to noise pollution in the OR [1–6]. OR noise pollution can negatively impact surgical technique and team communication [7, 8]. Such factors can lead to poor surgical outcomes [9, 10]. Increased noise during surgery can be deleterious for OR team members’ health. Noise-induced hearing loss (NIHL) and tinnitus are among adverse outcomes for staff with sustained exposure to loud ORs [11]. Recommendations by the World Health Organization (WHO) and Environmental Protection Agency (EPA) have established hospital and OR noise safety limits as 35 a-weighted decibels (dBA) and 45 dBA, respectively [12, 13]
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