Noise in Otolaryngology – Head and Neck Surgery operating rooms: a systematic review

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Abstract

Objective

Noise 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.

Methods

Ovid 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.

Results

This 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.

Conclusions

This 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.

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Supplementary Information

The online version contains supplementary material available at 10.1186/s40463-020-00487-6.

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Most cited references 51

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Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

David Moher, Larissa Shamseer, Mike Clarke … (2017)

Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.

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Noise pollution: non-auditory effects on health.

Stephen A Stansfeld, P Matheson (2002)

Noise is a prominent feature of the environment including noise from transport, industry and neighbours. Exposure to transport noise disturbs sleep in the laboratory, but not generally in field studies where adaptation occurs. Noise interferes in complex task performance, modifies social behaviour and causes annoyance. Studies of occupational and environmental noise exposure suggest an association with hypertension, whereas community studies show only weak relationships between noise and cardiovascular disease. Aircraft and road traffic noise exposure are associated with psychological symptoms but not with clinically defined psychiatric disorder. In both industrial studies and community studies, noise exposure is related to raised catecholamine secretion. In children, chronic aircraft noise exposure impairs reading comprehension and long-term memory and may be associated with raised blood pressure. Further research is needed examining coping strategies and the possible health consequences of adaptation to noise.

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Occupational noise exposure and hearing: a systematic review

Arve Lie, Marit Skogstad, Håkon Johannessen … (2015)

Purpose To give a systematic review of the development of noise-induced hearing loss (NIHL) in working life. Methods A literature search in MEDLINE, Embase, Web of Science, Scopus, and Health and Safety Abstracts, with appropriate keywords on noise in the workplace and health, revealed 22,413 articles which were screened by six researchers. A total of 698 articles were reviewed in full text and scored with a checklist, and 187 articles were found to be relevant and of sufficient quality for further analysis. Results Occupational noise exposure causes between 7 and 21 % of the hearing loss among workers, lowest in the industrialized countries, where the incidence is going down, and highest in the developing countries. It is difficult to distinguish between NIHL and age-related hearing loss at an individual level. Most of the hearing loss is age related. Men lose hearing more than women do. Heredity also plays a part. Socioeconomic position, ethnicity and other factors, such as smoking, high blood pressure, diabetes, vibration and chemical substances, may also affect hearing. The use of firearms may be harmful to hearing, whereas most other sources of leisure-time noise seem to be less important. Impulse noise seems to be more deleterious to hearing than continuous noise. Occupational groups at high risk of NIHL are the military, construction workers, agriculture and others with high noise exposure. Conclusion The prevalence of NIHL is declining in most industrialized countries, probably due to preventive measures. Hearing loss is mainly related to increasing age. Electronic supplementary material The online version of this article (doi:10.1007/s00420-015-1083-5) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

John Lee: John.Lee@unityhealth.to

Journal

Journal ID (nlm-ta): J Otolaryngol Head Neck Surg

Journal ID (iso-abbrev): J Otolaryngol Head Neck Surg

Title: Journal of Otolaryngology - Head & Neck Surgery

Publisher: BioMed Central (London )

ISSN (Print): 1916-0208

ISSN (Electronic): 1916-0216

Publication date (Electronic): 11 February 2021

Publication date PMC-release: 11 February 2021

Publication date Collection: 2021

Volume: 50

Electronic Location Identifier: 8

Affiliations

[1 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Faculty of Medicine, , University of Toronto, ; Toronto, ON Canada

[2 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Department of Otolaryngology Head and Neck Surgery, , University of Toronto, ; Toronto, ON Canada

[3 ]GRID grid.7737.4, ISNI 0000 0004 0410 2071, Department of Otorhinolaryngology, , University of Helsinki and Helsinki University Hospital, ; Helsinki, Finland

Author information

Justine Philteos http://orcid.org/0000-0002-3526-1345

Article

Publisher ID: 487

DOI: 10.1186/s40463-020-00487-6

PMC ID: 7879658

PubMed ID: 33573705

SO-VID: c04603ef-5ff2-4117-b9eb-4f251dafa465

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 8 August 2020

Date accepted : 21 December 2020

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Keywords: surgical safety,operating room communication,noise in the operating room

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Keywords: surgical safety, operating room communication, noise in the operating room

Noise in Otolaryngology – Head and Neck Surgery operating rooms: a systematic review

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Supplementary Information

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SICOT-J (Orthopedic surgery and traumatology)

Most cited references 51

Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

Noise pollution: non-auditory effects on health.

Occupational noise exposure and hearing: a systematic review

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