An Assessment of Sources of Noise and Their Effects on Healthcare Workers in Operation Theatre
Keywords:
Keywords: Healthcare workers, Noise, Occupational health, Operating theatre, Perception Work performance.Abstract
Background: Operating-theatre sound may interfere with communication, concentration, wellbeing, and task performance. Objective: To identify perceived sources of noise inside and outside operating theatres and examine their associations with self-reported health-effect domains among healthcare workers. Methods: This cross-sectional survey included 130 doctors, nurses, technicians, and technologists from Social Security Hospital Lahore and DHQ Hospital Gujranwala between December 2025 and March 2026. Participants completed a structured questionnaire covering perceived noise sources and subjective, emotional, physiological, and performance effects. Descriptive statistics and Spearman rank correlations were calculated in IBM SPSS Statistics version 27.0. Results: Participants most often rated conversations among visitors or family members inside the theatre as producing a lot of noise (30.0%), followed by patient moaning or crying (27.7%). Outside the theatre, staff conversation was most frequently rated as producing a lot of noise (30.0%). Emotion had the highest domain score (16.26 ± 3.72), followed by physiology (16.12 ± 3.66), performance (15.88 ± 3.74), and subjective perception (14.18 ± 4.01). The perceived noise score showed weak positive correlations with the overall health-effect score (r=0.189, p=0.031) and performance score (r=0.173, p=0.049); correlations with other domains were not statistically significant. Conclusion: Perceived operating-theatre noise was weakly associated with greater self-reported health effects, particularly performance-related disturbance. Human conversation and patient vocalization were prominent perceived sources, supporting locally tailored noise-awareness and communication practices.
References
1. Basner M, Babisch W, Davis A, Brink M, Clark C, Janssen S, et al. Auditory and non-auditory effects of noise on health. Lancet. 2014;383(9925):1325-1332. doi:10.1016/S0140-6736(13)61613-X.
2. World Health Organization Regional Office for Europe. Environmental Noise Guidelines for the European Region. Copenhagen: WHO Regional Office for Europe; 2018.
3. Mcleod RWJ, Myint-Wilks L, Davies SE, Elhassan HA. The impact of noise in the operating theatre: a review of the evidence. Ann R Coll Surg Engl. 2021;103(2):83-87. doi:10.1308/rcsann.2020.7001.
4. Katz JD. Noise in the operating room. Anesthesiology. 2014;121(4):894-898. doi:10.1097/ALN.0000000000000319.
5. Hasfeldt D, Laerkner E, Birkelund R. Noise in the operating room: what do we know? A review of the literature. J Perianesth Nurs. 2010;25(6):380-386. doi:10.1016/j.jopan.2010.10.001.
6. Hodge B, Thompson JF. Noise pollution in the operating theatre. Lancet. 1990;335(8694):891-894. doi:10.1016/0140-6736(90)90486-O.
7. Tsiou C, Efthymiatos G, Katostaras T. Noise in the operating rooms of Greek hospitals. J Acoust Soc Am. 2008;123(2):757-765. doi:10.1121/1.2821972.
8. Kracht JM, Busch-Vishniac IJ, West JE. Noise in the operating rooms of Johns Hopkins Hospital. J Acoust Soc Am. 2007;121(5):2673-2680. doi:10.1121/1.2714920.
9. Ginsberg SH, Pantin E, Kraidin J, Solina A, Panjwani S, Yang G. Noise levels in modern operating rooms during surgery. J Cardiothorac Vasc Anesth. 2013;27(3):528-530. doi:10.1053/j.jvca.2012.09.001.
10. Sampieri G, Namavarian A, Levin M, et al. Head and neck surgery operating rooms: a systematic review of noise levels and sources. J Otolaryngol Head Neck Surg. 2021;50:8. doi:10.1186/s40463-020-00487-6.
11. Kam PCA, Kam AC, Thompson JF. Noise pollution in the anaesthetic and intensive care environment. Anaesthesia. 1994;49(11):982-986. doi:10.1111/j.1365-2044.1994.tb04319.x.
12. Way TJ, Long A, Weihing J, Ritchie R, Jones R, Bush M, et al. Effect of noise on auditory processing in the operating room. J Am Coll Surg. 2013;216(5):933-938. doi:10.1016/j.jamcollsurg.2013.01.054.
13. Keller S, Tschan F, Semmer NK, Holzer E, Candinas D, Brink M, et al. Noise in the operating room distracts members of the surgical team: an observational study. World J Surg. 2018;42(12):3880-3887. doi:10.1007/s00268-018-4730-7.
14. Mentis HM, Chellali A, Manser K, Cao CGL, Schwaitzberg SD. A systematic review of the effect of distraction on surgeon performance: directions for operating room policy and surgical training. Surg Endosc. 2016;30(5):1713-1724. doi:10.1007/s00464-015-4443-z.
15. Moorthy K, Munz Y, Undre S, Darzi A. Objective evaluation of the effect of noise on the performance of a complex laparoscopic task. Surgery. 2004;136(1):25-30. doi:10.1016/j.surg.2003.12.011.
16. Siu KC, Suh IH, Mukherjee M, Oleynikov D, Stergiou N. The impact of environmental noise on robot-assisted laparoscopic surgical performance. Surgery. 2010;147(1):107-113. doi:10.1016/j.surg.2009.08.010.
17. Murthy VS, Stevenson J, Kim J, et al. Effects of varying noise levels on the performance of a mental task during monitoring of anaesthesia. Can J Anaesth. 1995;42(6):499-503. doi:10.1007/BF03011686.
18. Kurmann A, Peter M, Tschan F, Mühlemann K, Candinas D, Beldi G. Adverse effect of noise in the operating theatre on surgical-site infection. Br J Surg. 2011;98(7):1021-1025. doi:10.1002/bjs.7496.
19. Fu VX, Oomens P, Kleinrensink VEE, Sleurink KJ, Borst WM, Wessels PE, et al. The perception and attitude toward noise and music in the operation room: a systematic review. J Surg Res. 2021;263:193-206. doi:10.1016/j.jss.2021.01.038.
20. Wang X, Zeng L, Li G, et al. A cross-sectional study in a tertiary care hospital in China: noise or silence in the operating room. BMJ Open. 2017;7(9):e016316. doi:10.1136/bmjopen-2017-016316.
21. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296. doi:10.1371/journal.pmed.0040296.
22. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesth Analg. 2018;126(5):1763-1768. doi:10.1213/ANE.0000000000002864.
23. Peisl S, Sánchez-Taltavull D, Guillen-Ramirez H, Tschan F, Semmer NK, Hübner M, et al. Noise in the operating room coincides with surgical difficulty. BJS Open. 2024;8(5):zrae098. doi:10.1093/bjsopen/zrae098.
24. Lie A, Skogstad M, Johannessen HA, Tynes T, Mehlum IS, Nordby KC, et al. Occupational noise exposure and hearing: a systematic review. Int Arch Occup Environ Health. 2016;89(3):351-372. doi:10.1007/s00420-015-1083-5.
25. Szalma JL, Hancock PA. Noise effects on human performance: a meta-analytic synthesis. Psychol Bull. 2011;137(4):682-707. doi:10.1037/a0023987.
