Sound Exposure in Total Joint Arthroplasty: Are All Operating Room Personnel at Risk?

A hearing conservation program is recommended by the Occupational Safety and Health Administration for prolonged exposure exceeding 85 dB. Arthroplasty surgeons often experience levels above this threshold. There is a paucity of literature regarding sound exposure for all arthroplasty operating room (OR) personnel. This study directly assesses and compares sound exposure levels for all OR personnel in total joint arthroplasty.

Sound data were recorded for 20 total hip arthroplasty (THA) and 20 total knee arthroplasty (TKA) cases. Recording devices collected sound data for the 5 primary OR roles-primary surgeon, first assistant, surgical technologist, anesthesia staff, and circulating nurse. T-test and analysis of variance were completed to compare between case type and OR personnel, respectively.

Average sound level exceeded 85 dB for the primary physician in hip and knee arthroplasty. Sound exposure in THA commonly exceeded that of TKA. The primary surgeon experienced significantly higher average sound level than all other OR personnel in TKA and THA (P < .01). The primary surgeon also experienced a significantly higher percentage of total time with sound exceeding 90 dB relative to other OR personnel (P < .0001).

All total joint arthroplasty OR personnel, including anesthesia and nursing, may be exposed to some degree of potentially dangerous sound. This risk is most notable for direct operative staff, and significantly higher for the primary surgeon. Our data suggests hearing protection is indicated by the Occupational Safety and Health Administration standards for the primary surgeon; however, all OR personnel would likely benefit based on our measured exposures.