4 minute read
Noise Pollution: The Hidden Threat
Tom Cropper, Editor
It’s not as commonly discussed as it could be, but noise pollution in the operating room (OR) can harm the wellbeing of staff, make it more difficult to do their job and put patients at risk.
THE OPERATING theatre is one of the most high-pressure working environments imaginable. The stakes are high, communication is vital and every task requires 100% concentration. Imagine, then, the impact that a sudden loud noise would have.
Unfortunately, this is the environment in which surgical staff regularly find themselves. However, although plenty of work has been done to adjust other environmental issues such as air quality, noise pollution has received relatively little attention, until now.
Impact of Noise Pollution Hospitals, and operating theatres in particular, have become extremely busy and noisy places. From the seventies onwards, the introduction of technology saw noise within the operating theatre rise considerably. Today it routinely exceeds levels which are considered hazardous to health 1 . A 2019 report into the impact of noise pollution in the operating theatre, found that it has a significant impact on medical staff. The study evaluated noise levels in the three areas of the operating theatre during all three shifts, before asking medical staff to complete a questionnaire.
59.2% of respondents described the workplace as noisy and 53.4% said it was disturbing. The report found that a relatively high level of professional burnout has been proven in medical staff (75.7% high depersonalisation and 48.6% emotional exhaustion).
Nursing staff said they found the environment noisy with 37.1% saying it made them more irritable. 48.2% said they felt stressed and 72.2% experienced fatigue. Professional burnout among nurses was also high (59.3% high depersonalisation and 61.1% emotional exhaustion).
In conclusion, the report found that noise affected different people in different ways depending on their role and where they worked. It had a negative impact on wellbeing and is one factor contributing to professional burnout among surgical staff 2 .
Communication Problems Background noise in the OR can also make it more difficult for surgical staff to do their jobs. A study published by the American College of Surgeons tested 15 surgeons with one to 30 years of operating experience in noise environments similar to the average OR. Their ability to understand speech was tested using the Speech in Noise Test Revised (SPIN-R) under four different conditions including quiet, filtered noise through surgical masks and background noise with and without music. They were tested while engaged in tasks and when task free.
The study identified a significant reduction in comprehension when questions were unpredictable with the presence of background noise. This, researchers said, was significant because unpredictable questions tend to be the ones which carry critical information.
Speaking at the time, the study’s co-author, Dr Matthew Bush said: “Our main goal is to increase awareness that operating room noise does affect communication and that we should foster the best environment in which we can communicate better 3 .” Miscommunication is one of the leading causes of error in the operating room 4 . The fact that noise levels make communication more difficult, said the report, meant that noise should be seen as a significant risk factor.
Another study backs this up. According to a questionnaire sent to 50 UK hospitals, 83% of respondents felt that noise contributed to human error and more than half thought the operating theatre was the noisiest area in the operating suite 5 .
Where the Noise Comes From Noise comes from a number of sources, including staff, equipment and, in many cases, music. The study by the American College of Surgeons said that the presence of music hindered communication. However, over 70% of respondents to the UK hospital survey said they
© MEDELA
felt music did not contribute to errors. Indeed, most studies suggest music can significantly improve surgical performance 6 . This leaves staff and equipment. As technology improved over the past few decades, the quantity of machines within the OR has also increased, with a subsequent impact on noise levels. According to the publication Anaesthesiology, equipment-related noise levels during peak operating times can be as high as 120 decibels. At peak times, surgical noise could be more than 130 decibels and, during noisy procedures, levels could be more than 100 decibels for 40% of the time 7 . Given that safe workplace noise levels are around 50 decibels and 140 decibels cause physical pain, noise should be seen as a significant health and wellbeing factor for both medical staff and patients.
Surgical teams can take measures to reduce noise levels, but the best way to have a major impact on noise pollution within the OR is to reduce the sound made by medical equipment. Slowly, but surely, attitudes are changing and this is beginning to happen.
Manufacturers are bringing to market new equipment which offers reduced sound footprints. For example, enhancements to the drive units can significantly reduce the noise made by devices. If each piece of equipment can eliminate 50% of noise pollution, it would have a profound effect on the environment within the operating theatre. The benefits could be felt by medical staff who could finally enjoy a more pleasant working environment, by patients who would be more comfortable and by surgeons who will have fewer distractions during extremely challenging and complicated procedures.
Given that safe workplace noise levels are around 50 decibels and 140 decibels cause physical pain, noise should be seen as a significant health and wellbeing factor for both medical staff and patients Miscommunication is one of the leading causes of error in the operating room
