Noise-Induced Hearing Loss in Orthopedic Surgeons

OR saws, drills, and hammers—all can chip away at a surgeon’s hearing over the years…and yet, this issue is largely unexplored and underappreciated.

A new Rothman Orthopaedic Institute, Thomas Jefferson University in Philadelphia study has found that orthopedic surgeons are routinely exposed to “damaging noise levels.” Their work, “Risk of Noise-Induced Hearing Loss for Orthopaedic Surgeons,” was published in the December 7, 2022, edition of The Journal of Bone and Joint Surgery.

Joseph M. Daniel, D.O., co-author and associate professor at Thomas Jefferson, told OTW, “I have sustained a significant bilateral hearing loss secondary to a 20-year career on active duty with the U.S. Army. The hearing deficit led to studying the effects of noise exposure using power equipment in the operating room.”

For this prospective review, the team used intraoperative audio recordings across six orthopedic subspecialties. Baseline recordings were taken in the ORs prior to the surgical start time (controls); the investigators reported decibel levels as the maximum decibel level, which was defined as the highest sound pressure level during the measurement period, and as the time-weighted average, defined as the average decibel level projected over an 8-hour time period.

The team recorded noise doses as the percentage of maximum allowable daily noise (dose) and as the measured dose projected forward over eight hours (projected dose).

The team reviewed and collected data for 300 audio recordings.

They found that the average maximum sound level ranged from 96.9 to 102.0 decibels, with noise levels for all subspeciality procedures being significantly greater than the control recordings.

Overall, maximum decibel levels were >85 decibels in 84% of cases and >100 decibels in 35.0% of cases.

Interestingly enough, the procedure with the highest noise dose was a microdiscectomy, which reached 11.3% of the maximum allowable daily noise and a projected dose of 104.1%. Parsing things out by subspecialty, the team found that adult reconstruction had the highest noise dosage and projected dose per case among all subspecialties.

“All orthopedic surgeons are exposed to noise levels in the operating room that does have a cumulative effect and can lead to hearing loss,” said Dr. Daniel to OTW. “Going forward, more work is needed where we look at various ways to modify noise-induced hearing loss using noise cancelling equipment at critical stages of procedures.”