Occupational Noise-induced Hearing Loss Research Articles

Research into occupational noise induced hearing loss in South African large-scale mines: Access denied?

Background: The South African mining industry is frequently criticized for its poor health and safety record and high numbers of fatalities, thereby prompting researchers to conduct research on challenges faced by this industry. Therefore, this study aimed to investigate the feasibility of conducting audiological research into occupational noise induced hearing loss (ONIHL) within the South African mining sector. Specific objectives involved determining ease of identifying focal persons in charge of hearing conservation programmes (HCP); establishing response time and rate of identified focal person for interviews; and exploring focal person’s willingness to share information regarding HCP. Methods: A qualitative research strategy comprising online desk research and interviews was undertaken through purposive sampling to recruit participants. Data were collected through checklists, logbooks and interviews. Deductive thematic analysis was used to analyse data. Results: Gaining access into the mining sector is negatively impacted by the following factors: firstly, contact details of focal person are not always listed on the websites. Secondly, prolonged response rate between initial contact and the time in which the participants respond. Lastly, unwillingness to share information regarding the management of ONIHL and progress made in HCP at various mines. Conclusions: Findings contribute evidence regarding possible barriers to effective and successful implementation of application of best practice in HCPs; guided by evidence that is contextually relevant. Challenges with accessing mines for research purposes by external and independent researchers arguably impacts on the available evidence produced by mines, due to a possible unavoidable conflict of interest. Success of HCPs depend on objective evidence regardless of whether it paints the mining industry in positive or negative light. It is only when this evidence is critically engaged with, that real and effective solutions can be deliberated and implemented. Clear, transparent, and open lines of communication between various stakeholders are key to achieving this.

Simulation of noise exposure level of fire-fighters in emergency response services in Malaysia

Excessive exposure to noise may lead to noise-induced hearing loss (NIHL). NIHL has emerged as the biggest cause of world occupational disease in recent years. Occupational hearing loss is among the common work related diseases in Malaysia. It has been proven that occupational NIHL shows the highest number of cases compared to other occupational diseases. Many occupational noise exposure studies have been conducted in various occupational sectors. However, no studies have been done on noise exposure of fire-fighters in Malaysia. This study aims to determine noise intensity and noise dose exposed to the fire-fighters during emergency response activity, to develop fire-fighter noise exposure indicator profile, and to propose solutions in order to reduce potential hearing loss among fire-fighters. Noise measurement from sirens emitted from truck and sirens at the station was carried out at Taman Universiti Fire Station using Sound Level Meter (SLM). Measurement was conducted on all pieces of equipment on truck including power saw, circular saw, hydraulic power unit, generator set, air compressor, and high and low pump. In order to assess the noise dose, a list of noise-producing equipment and the estimated total time of exposure is provided. Once the data had been analysed, an indicator system was constructed. As anticipated, all types of sirens and equipment produced noise greater than 85db except for noise emitted from AlarmCAD lite, emergency siren and generator set. Useful exposure indicator profile and solutions were proposed to reduce fire-fighters potential hearing loss.

Analysis of serum microRNA expression in male workers with occupational noise-induced hearing loss.

Occupational noise-induced hearing loss (ONIHL) is a prevalent occupational disorder that impairs auditory function in workers exposed to prolonged noise. However, serum microRNA expression in ONIHL subjects has not yet been studied. We aimed to compare the serum microRNA expression profiles in male workers of ONIHL subjects and controls. MicroRNA microarray analysis revealed that four serum microRNAs were differentially expressed between controls (n=3) and ONIHL subjects (n=3). Among these microRNAs, three were upregulated (hsa-miR-3162-5p, hsa-miR-4484, hsa-miR-1229-5p) and one was downregulated (hsa-miR-4652-3p) in the ONIHL group (fold change >1.5 and Pbon value <0.05). Real time quantitative PCR was conducted for validation of the microRNA expression. Significantly increased serum levels of miR-1229-5p were found in ONIHL subjects compared to controls (n=10 for each group; P<0.05). A total of 659 (27.0%) genes were predicted as the target genes of miR-1229-5p. These genes were involved in various pathways, such as mitogen-activated protein kinase (MAPK) signaling pathway. Overexpression of miR-1229-5p dramatically inhibited the luciferase activity of 3′ UTR segment of MAPK1 (P<0.01). Compared to the negative control, HEK293T cells expressing miR-1229-5p mimics showed a significant decline in mRNA levels of MAPK1 (P<0.05). This preliminary study indicated that serum miR-1229-5p was significantly elevated in ONIHL subjects. Increased miR-1229-5p may participate in the pathogenesis of ONIHL through repressing MAPK1 signaling.

Incidence of occupational diseases in a province of China during the period of "Twelfth Five-Year Plan" and its trend

Objective: To investigate the incidence of occupational diseases in a province of China during the period of "Twelfth Five-Year Plan" , and to analyze the features of disease spectrum, the characteristics of regional and industrial distribution, and incidence trend. Methods: Data (2011-2015) were collected from the Information System of Occupational Diseases and Occupational Health to analyze the reported cases of occupational diseases during the period of "Twelfth Five-Year Plan". A statistical analysis was performed to identify the characteristics of the disease distribution in terms of sex, age, working years, enterprise type, enterprise scale, and region, as well as the incidence trend. Results: The overall incidence of occupational diseases in this province fluctuated and decreased gradually. There were a total of 5036 new cases of occupational diseases during the period of "Twelfth Five-Year Plan" ; 89.45% of them were male, and 69.78% of them were aged 40-69 years; the most frequently seen occupational diseases were pneumoconiosis (72.48%) and ear, nose, throat, and oral diseases (7.23%). Most cases of pneumoconiosis occurred after 5-10 years of exposure, and other occupational diseases usually developed within 10 years of exposure. New cases of occupational diseases were often seen in small and micro enterprises, as well as Wuxi, Suzhou, and Yancheng. Conclusion: During the period of "Twelfth Five-Year Plan" , the incidence of occupational diseases in this province decreased gradually, indicating improved control of occupational diseases, but we still need to pay attention to the high-risk population (male, aged over 40 years) , as well as the prevention of occupational noise-induced hearing loss, and to strengthen the supervision of small and micro enterprises.

Analysis on occupational noise-induced hearing loss of different type workers in underground mining

Objective: To investigate hearing loss status of blasters, drillers mechanics and so on in underground mining, and put forward suggestion diagnosis of occupational explosive deafness and occupational deafness. Methods: Underground excavation workers in a metal mine were recruited in this study, those with a history of ear disease and non-occupational deafness were all excluded. Finally, the features of pure tone audiometry of 459 noise-exposed workers were analyzed. Results: High-frequency hearing loss occurred on 351workers and the positive detection rate was 74.29%, workers who had both high-frequency and linguistic frequency hearing loss were 51 and the positive detection rate was 11.11%. The positive detection of high-frequency hearing loss in right ear (χ(2)=9.427 and P= 0.024) and in left ear (χ(2)=14.375, P=0.002) was significantly different between different exposure age groups. The positive detection of high-frequency hearing loss of driving group was the highest, followed by blasting group, mining group and machine repair group. The characteristics of the hearing loss caused by drilling noise of the blasting workers with no accident occurred were in line with that of noise-induced hearing loss. Conclusion: The diagnosis grading should be carried out according to the diagnostic criteria of occupational noise-induced deafness for the employees who engaged in the blasting operation with no record of blast accident.

Interventions to prevent occupational noise-induced hearing loss.

Interventions to prevent occupational noise-induced hearing loss.

Occupational noise-induced hearing loss of workers in a bauxite mine in India

Noise exposure from workplace can cause occupational noise-induced hearing loss (ONIHL) which begins at higher frequencies and gradually extends to lower frequencies. The aim of this study was to investigate the ONIHL among a highly mechanized bauxite mine employees from Odisha, India and to identify the possible determinants of ONIHL. A total of 247 personnel were tested for hearing loss at various frequencies (500, 1000, 2000, 3000, 4000, 6000 and 8000 Hz) using PC-based digital audiometer between April 2014 and December 2015. Statistical analysis was conducted using SYSTAT 13.0. The study revealed that the industrial noise level exceeded the permissible limit during the operational hours and is likely to cause noise-induced hearing loss. Audiometric results reveal that a total of 85 out of 247 (34% )workers were found to have ONIHL in the age group of 28 to 63 years; from these, 43 of 57 (75%) work as operators followed by 27 of 58 (47%) charge-man, 12 of 92 (13%) technicians and 3 of 24 (12%) foreman. Study indicated a significant relation between occupation, industrial noise levels and duration of exposure in development of ONIHL among miners.

Historical review of efforts to reduce noise-induced hearing loss in the United States.

Noise-induced hearing loss is a centuries-old problem that is still prevalent in the United States and worldwide. To describe highlights in the development of hearing loss prevention in the U.S. from World War II to the present. Literature review. Approaches to occupational noise-induced hearing loss prevention in the United States over the past seven decades are described using a hierarchy of controls framework and an interdisciplinary perspective. Historical timelines and developmental milestones related to occupational noise-induced hearing loss prevention are summarized as a life course. Lessons are drawn for other countries in their hearing conservation efforts. Future developments building on the hearing loss prevention work of the past 70 years can prevent the problem of occupational NIHL in the 21st century. Am. J. Ind. Med. 60:569-577, 2017. © 2017 Wiley Periodicals, Inc.

Investigation of occupational noise exposure in a ship recycling yard

The ship recycling industry is often criticised for unacceptable occupational health and safety practices. In order to support the development of technical solutions and new regulatory norms, there is an urgent need for quantitative data explaining the impacts of ship recycling practices on health and safety. Therefore, this study investigated hazardous noise exposure in ship recycling yards by identifying the sources of noise, quantifying their potential impacts on workers and making recommendations for improvement. A noise exposure investigation in an operational ship recycling yard was conducted, which comprised a general noise survey, a personal noise exposure measurement for workers and comparison of the results with the exposure limits and action values defined by the European Union's Physical Agents (Noise) Directive (EC 2003b). The results of this study show that ship recycling workers are at risk of experiencing occupational noise induced hearing loss as a result of being exposed to hazardous noise levels for prolonged periods of time. This study explains that those working with torch cutting equipment, in particular, are most at risk. The study also shows that there is currently a lack of appropriate hearing protection being used in ship recycling yards.

Occupational noise-induced hearing loss in auto part factory workers in welding units in Thailand.

Most workers in auto part factories in Thailand are usually exposed to excessive noise in their workplace. This study aimed to assess the level of occupational noise-induced hearing loss and investigate risk factors causing hearing loss in auto part factory workers in the welding units in Thailand. This was a cross-sectional study. One hundred eighty subjects were recruited from 356 workers in the welding unit of three factories. Sixty eligible subjects in each factory were selected by systemic random sampling. The subjects were interviewed using a face-to-face questionnaire. Noise exposure levels and audiograms were measured by a noise dosimeter and an audiometer, respectively. The findings confirmed that noise exposure levels of 86-90 dB (A) and exceeding 90 dB (A) significantly increased the risk of hearing loss in either ear. A noise exposure level exceeding 90 dB (A) significantly increased the prevalence of hearing loss in both ears. Regarding, a 10-pack-year smoking history increased the prevalence of hearing loss in either ear or both ears. In addition, subjects with employment duration exceeding 10 years significantly developed hearing loss in either ear. The engineering control or personal control by wearing hearing protection device should be used to decrease noise exposure levels lower than 85 dB (A) for 8 h. Moreover, if the exposure level reaches 85 dB (A) for 8 h, the employer needs to implement a hearing conservation program in the workplace.

A cohort study on occupational noise induced hearing loss in workers at an iron and steel plant

Objective: To analyze the incidence rate of occupational noise-induced hearing loss in noise-exposed workers in an iron and steel plant from 2006 to 2015. Methods: Using a cohort study method, workers exposed to occupational noise from Jan 1, 2006 to Dec 12, 2015 were followed up and the pure tone hearing test was conducted. In total, 6 297 subjects completed two or more physical checks and the pure tone hearing test and were included in the analysis. The noise exposure level at the workplace and the equivalent continuous A-weighted sound pressure level for workers was monitored and the cumulative noise exposure dose was evaluated. The subjects were divided into low, middle and high exposure groups according to the noise exposure level, and the equivalent continuous A-weighted sound pressure level for 8 hours for each group was 80.6-85.0, 85.1-90.0 and 90.1-103.4 dB (A), respectively. While the RR and 95% CI were derived from unconditional logistic regression models. In logistic regression analysis, confounding factors such as age, gender, smoking habit, drinking habit, high temperature exposure and chemical hazards exposure level were controlled. Results: During the follow-up period, 392 cases of occupational noise-induced hearing loss were diagnosed among the 6 297 subjects, with an incidence rate of 6.23%; 318 cases of high-frequency hearing loss were diagnosed, with an incidence rate of 5.05%; and 74 cases of occupational noise-induced deafness were diagnosed, with an incidence rate of 1.18% . The incidence rates of hearing loss among the high, medium and low exposure groups were 9.22% (158/1 737), 6.49% (204/3 142) and 2.08% (30/1 442), respectively; the rates of high-frequency hearing loss were 7.41% (127/1 737), 5.25% (165/3 142) and 1.80% (26/1 442), respectively; and the rates of occupational noise-induced deafness were 1.81% (31/1 737), 1.24% (39/3 142) and 0.28% (4/1 442), respectively. For the groups corresponding to cumulative noise exposure doses of ≤84.99, 85.00- 87.99, 88.00- 90.99, 91.00- 93.99, 94.00- 96.99, 97.00- 100.99, 101.00- 102.99 and ≥103.00 dB (A) · year, the incidence rates of hearing loss were 0 (0/185), 1.22% (2/164), 2.52% (17/674), 3.83% (35/913), 5.80% (106/1 827), 6.02% (67/1 113), 9.20% (95/1 003) and 18.04% (70/388), respectively. Compared with the low exposure group, the RR of hearing loss, high-frequency hearing loss and occupational noise-induced deafness for the high exposure group were 4.78 (95% CI: 3.22- 7.11), 4.36 (95% CI: 2.84- 6.69) and 6.63 (95% CI: 2.33- 18.82), respectively; and for the medium exposure group were 3.27 (95% CI: 2.22-4.82), 3.02 (95% CI: 1.99-4.59) and 4.52 (95% CI: 1.61-12.67), respectively. Conclusion: The incidence rate of hearing loss for workers exposed to noise in an iron and steel plant was related to the cumulative noise exposure dose, gender, age, educational level, smoking habits, drinking habits and exposure to high temperature.

Association between eye absent homolog 4 gene polymorphisms and occupational noise-induced hearing loss

Objective: To identify the association between genetic polymorphisms in the eye absent homolog 4 (EYA4) gene and noise-induced hearing loss (NIHL). Method: A nested case control study was conducted based on a cohort of noise-exposed subjects. In total, 292 cases were selected from a steel factory from 6 297 subjects during Jan 1, 2006 to Dec 12, 2015,who had an average hearing threshold of more than 40 dB(A); 584 matched control subjects for each case were designated on the basis of matched criteria including same gender, age (±5 years) and duration of exposure to noise (±2 years). What's more, the control group had an average hearing threshold of less than 35 dB(A) in high frequency and less than 25 dB(A) in speech frequency. Four single nucleotide polymorphisms (SNPs) of the EYA4 gene were genotyped using a SNPscanTM multiplex SNP genotyping kit. Hardy-Weinberg equilibrium tests were performed using a χ2 test for goodness-of-fit for each SNP among the control group, and the effects of genotypes of the EYA4 gene on NIHL were analyzed by logistic regression. The haplotypes were established and their frequencies in the two groups were assessed using Haploview 4.2 and Phase 2.1 software, and interactive effects between haplotypes and cumulative noise exposure were analyzed. Results: The average age of the subjects was (40.1±8.4) years and the average number of noise-exposed working years was 20.3 (8.4, 27.3) years. The range of noise exposure levels and the cumulative noise exposure were 80.2- 98.8 dB (A) and 86.6- 111.2 dB(A) · year, respectively. After adjustment for covariates including height, blood pressure, drinking status and smoking status, in the noise intensity>85 dB (A) group, subjects carrying the rs3813346 TT genotype had a higher NIHL risk than those carrying the GG genotype, and the adjusted OR (95% CI) value was 2.12 (1.21- 3.69). In the cumulative noise exposure>98 dB (A) · year group, compared with haplotype TGC, haplotype CGT showed a protective effect in the development of NIHL, with an adjusted OR (95% CI) value of 0.60 (0.37-0.97), however, the significance of intercation between EY4 gene of noise was lost after Bonferroni correction. Conclusion: Genetic polymorphism in the EYA4 gene may be a genetic susceptibility factor for NIHL.

Association between variations in protocadherin 15 gene and occupational noise-induced hearing loss

Objective: The aim of this study was to investigate whether genetic variability in the protocadherin 15 (PCDH15) gene may correspond with increased susceptibility to noise-induced hearing loss (NIHL) in a Chinese population. Methods: A nested case-control study was performed that followed a cohort of 7 445 noise-exposed workers in a steel factory of Henan province in China from January 1, 2006 to December 31, 2015. In this study, 394 cases who had an average hearing threshold of more than 40 dB (A) in high frequency were defined as the case group, and 721 controls who had an average hearing threshold of less than 35 dB (A) in high frequency and less than 25 dB (A) in speech frequency were defined as the control group. A questionnaire was completed by participants and a physical test was also conducted. SNP genotyping was performed using the SNPscanTM Kit. Multivariate unconditional logistic regression additive models were used to analyze the genotypes in different groups, and the association with NIHL. Unconditional logistic regression models were used to assess the associations between the genotypes and NIHL. Results: The average age of study participants was (40.5±8.3) years and the median number of noise-exposed working years M (P25, P75) was 21.1 (9.1, 27.3). The range of noise exposed levels and the levels of cumulative noise exposure (CNE) were 80.1- 98.8 dB(A) and 86.6- 111.2 dB(A), respectively. Only the distribution of the genotypes (TT/CC/CT) of rs11004085 in the PCDH15 gene showed a significant difference between the case and control groups (P=0.049). In the case group, the distribution was 370 (93.9%), 24 (6.1%) and 0; in the control group, the distribution was 694 (96.3%), 23 (3.2%) and 1 (0.1% ). After smoking, drinking, hypertension, height and CNE adjustment, compared with the TT genotype individuals with the CC/CT genotype had a 1.90-fold increased risk of NIHL (95% CI: 1.06- 3.40). After stratified these data by the noise exposure level or CNE when the noise exposure level was>85 dB (A), compared with cases with the AA genotype of rs10825113, individuals with the GA/GG genotype had a 2.63-fold increased risk of NIHL (95% CI: 1.12- 6.14). When the CNE was ≤ 98 dB(A), compared with cases with the TT genotype of rs11004085, individuals with the CC/CT genotype had a 2.96-fold increased risk of NIHL (95% CI: 1.33- 6.56). However, these differences were not significant after Bonferroni correction had been applied. Conclusions: The results confirmed that genetic variation within the PCDH15 gene may affect the susceptibility to NIHL.

Safety Culture and Issue in the Malaysian Manufacturing Sector

. This paper highlights the Safety culture and issue in the Malaysian Manufacturing Sector and emphasis the high occupational accidents due to lack of safety culture and non-compliance of the requirements of Occupational Safety and Health Act 1994. The aim of this study is to review the occupational accidents occurrence in the Malaysia workplace since 2012-2016. Malaysia aimed to reduce the occupational accidents, the results show by DOSH increase that Occupational Noise Induced Hearing Loss 83.7%, occupational musculoskeletal diseases, 4.4% and occupational lung diseases 2.3%. But the as per the record from DOSH that in last 5-Years, the increment in the fatal accidents by Average 26%, Permanent Disability by Average 71% and Non-Permanent Disability by 64 % are investigated only in Manufacturing Industries. The government must show their high interest on such a vulnerable employees to accomplish the above aim. This step will be helpful for planning to reduce the accidents in workplaces and it will also detect the prevention for the future accidents.

COTTON GINNERS HANDBOOK: OSHA Noise Regulations and Agriculture, Including Cotton Gins

Since its formation in 1971, the Occupational Safety and Health Administration (OSHA) has recognized agriculture was not covered by their noise standards. However, in 2014, OSHA cited two gin companies under the OSHA general duty clause for an alleged failing to protect employees from exposure to hazardous noise levels by not requiring employees to wear hearing protection. In January 2016, OSHA withdrew both citations. The 2014 interpretations by OSHA were contrary to OSHA’s enforcement of the federal OSHA noise standards and guidance since 1971 when OSHA came into existence; 1981, when the hearing conservation amendment was promulgated and agriculture was specifically excluded; and 1983 when the OSHA 90 dBA level was reaffirmed. OSHA’s contention that their general duty clause requires these two gins to mandate hearing protection conflicts with OSHA guidance specifically related to this topic, as well as over 40 years of consistent enforcement of the Occupational Noise Exposure ("noise standard") standards relating to agriculture. OSHA has not presented any new health data indicating that working in a cotton gin over a working lifetime causes occupational noise-induced hearing loss, or issued any new guidance on enforcement of the OSHA noise standard as it applies to agriculture. The science and OSHA’s current guidance continue to support the conclusion that intermittent/interrupted exposure to noise in agriculture, including cotton gins, is not an occupational hazard, requiring mandatory hearing protection and a hearing conservation program. The OSHA noise regulations as they apply to agriculture, including cotton gins, are discussed.

Prevalence of Onihl in Manufacturing Industry

Objective: To find out the prevalence of occupational noise induced hearing loss (ONIHL) among the workers in a manufacturing engineering industry and to observe the effect of duration of noise exposure on hearing of workers. Study design:Observational case control study. Study sample: Of 236 subjects, 118 cases each in noise (>85dB) exposed (group A) and control (group B). All the subjects were subjected to audiometry and pure tone averages for frequencies 500Hz, 1kHz, 2kHz and 4kHz were calculated and compared. Results: Showed an overall prevalence of 41.5% hearing loss in the exposed study group A out of which 77.5% had mild while 22.5% had moderate hearing loss as compared to only 2.5% overall prevalence in unexposed group B, which was found to be statistically significant (p<0.005).The present study also compared the audiometry results with duration of exposure which revealed a hearing loss of 3.7% among workers exposed for duration of 5-9yrs, 51.6% for duration of 10- 14yrs and 100% for duration of ≥15yrs. Conclusion: ONIHL is prevalent in form of mild to moderate hearing loss within the manufacturing industry.

Strengthen the research for the prevention and control of occupational noise-induced hearing loss in our country

Strengthen the research for the prevention and control of occupational noise-induced hearing loss in our country

A qualitative study of factors affecting the compliance of hearing protective device usage among factory workers in Kuantan

Introduction: Occupational noise-induced hearing loss (NIHL) is an acquired cumulative and irreversible hearing impairment which is totally preventable. Literature review concluded that noise hazard control via administrative and engineering methods are difficult to implement for many reasons. Thus, hearing protection device (HPD) is the best compromise to protect workers from the excessive noise. The purpose of this study is to qualitatively explore the factors affecting the HPD compliance among factory workers in Kuantan. Methods: A purposive sampling of twenty four male workers exposed to occupational noise of 85 dB and more for 8 hour-period was recruited from 15th July to 31st August 2013 to participate in four focus group discussions. The open-ended guided questions were used during the discussions to explore the workers’ perspective, knowledge, attitude and behaviour regarding the use of HPD. The data were analyzed using the conventional content analysis and the key themes were elicited in relation to the study, either toward the positive hearing protective behaviours or the factors that act as the barriers against it. Results: From the findings, five themes have emerged with their respective subthemes including perception of noise in the workplace, use of HPD, barriers against the use of HPD, workplace influence and value of hearing. Our studies found that the three main reasons for workers not to wear HPD are discomfort, cumbersome and impediment of speech / other wanted sounds. Conclusions: Effective hearing conservation programme, particularly on the use of HPD should therefore address these factors to ensure good compliance among the workers.

Occupational noise induced hearing loss and hypertension: a cross-sectional study among dry food factory workers

Occupational noise induced hearing loss and hypertension: a cross-sectional study among dry food factory workers

Noise Exposure in TKA Surgery; Oscillating Tip Saw Systems vs Oscillating Blade Saw Systems

BackgroundHistorically it has been suggested that noise-induced hearing loss (NIHL) affects approximately 50% of the orthopedic surgery personnel. This noise may be partially caused by the use of powered saw systems that are used to make the bone cuts. The first goal was to quantify and compare the noise emission of these different saw systems during total knee arthroplasty (TKA) surgery. A second goal was to estimate the occupational NIHL risk for the orthopedic surgery personnel in TKA surgery by quantifying the total daily noise emission spectrum during TKA surgery and to compare this to the Dutch Occupational Health Organization guidelines. MethodsA conventional sagittal oscillating blade system with a full oscillating blade and 2 newer oscillating tip saw systems (handpiece and blade) were compared. Noise level measurements during TKA surgery were performed during cutting and hammering, additionally surgery noise profiles were made. ResultsThe noise level was significantly lower for the oscillating tip saw systems compared to the conventional saw system, but all were in a range that can cause NIHL. The conventional system handpiece produced a considerable higher noise level compared to oscillating tip handpiece. ConclusionNIHL is an underestimated problem in the orthopedic surgery. Solutions for decreasing the risk of hearing loss should be considered. The use of oscillating tip saw systems have a reduced noise emission in comparison with the conventional saw system. The use of these newer systems might be a first step in decreasing hearing loss among the orthopedic surgery personnel.