{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T12:46:57Z","timestamp":1790167617740,"version":"4.1.0"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"9-10","license":[{"start":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T00:00:00Z","timestamp":1591660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Noise exposure is an occupational health concern for certain professions, especially military servicemembers and those using power tools on a regular basis. The purpose of this study was to quantify noise exposure during total hip arthroplasty (THA) and total knee arthroplasty (TKA) cases compared to the recommended standard for occupational noise exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A sound level meter was used to record cumulative and peak noise exposure levels in 10 primary THA and 10 primary TKA surgeries, as well as 10 arthroscopy cases as controls. Measurements at the distance of the surgeon were taken in all cases. In TKA cases, measurements were taken at 3\u00a0feet and 8\u00a0feet from the surgeon, to simulate the position of the anesthetist and circulating nurse, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Time-weighted average was significantly higher in THA (64.7\u00a0\u00b1\u00a05.2\u00a0dB) and TKA (64.5\u00a0\u00b1\u00a06.8\u00a0dB) as compared to arthroscopic cases (51.1\u00a0\u00b1\u00a07.5\u00a0dB, P\u00a0&amp;lt;\u00a00.001) and higher at the distance of the surgeon (64.5\u00a0\u00b1\u00a06.8\u00a0dB) compared to the anesthetist (52.9\u00a0\u00b1\u00a03.8\u00a0dB) and the circulating nurse (54.8\u00a0\u00b1\u00a011.2\u00a0dB, P\u00a0=\u00a00.006). However, time-weighted average was below the recommended exposure level of 85\u00a0dB for all arthroplasty cases. Peak levels did not differ significantly between surgery type or staff role, and no values above the ceiling limit of 140\u00a0dB were recorded. Surgeon\u2019s daily noise dose percentage per case was 1.78% for THA and 2.04% for TKA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Noise exposure in THA and TKA was higher than arthroscopic cases but did not exceed occupational standards. A daily dose percentage of approximately 2% per case indicates that repeated noise exposure likely does not reach hazardous levels in modern arthroplasty practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/milmed\/usaa102","type":"journal-article","created":{"date-parts":[[2020,6,9]],"date-time":"2020-06-09T04:04:34Z","timestamp":1591675474000},"page":"e1551-e1555","source":"Crossref","is-referenced-by-count":10,"title":["Repeated Noise Exposure Does Not Reach Hazardous Levels During Total Joint Arthroplasty"],"prefix":"10.1093","volume":"185","author":[{"given":"Sean E","family":"Slaven","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin M","family":"Wheatley","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer K","family":"Saxena","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J","family":"McGill","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,6,9]]},"reference":[{"issue":"1","key":"2020092112343797400_ref1","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1302\/0301-620X.73B1.1991742","article-title":"Noise-induced hearing loss in orthopaedic staff","volume":"73","author":"Willett","year":"1991","journal-title":"J Bone Joint Surg"},{"issue":"11","key":"2020092112343797400_ref2","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1017\/S0022215100093403","article-title":"Orthopaedic theatres: a possible noise hazard?","volume":"96","author":"Kamal","year":"1982","journal-title":"J Laryngol Otol"},{"issue":"6","key":"2020092112343797400_ref3","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1258\/002221504323219509","article-title":"Noise exposure in orthopaedic practice: potential health risk","volume":"118","author":"Ullah","year":"2004","journal-title":"J Laryngol Otol"},{"issue":"8","key":"2020092112343797400_ref4","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1016\/j.arth.2007.05.048","article-title":"Noise exposure due to orthopedic saws in simulated total knee arthroplasty surgery","volume":"22","author":"Sydney","year":"2007","journal-title":"J Arthroplasty"},{"issue":"12","key":"2020092112343797400_ref5","doi-asserted-by":"crossref","first-page":"2773","DOI":"10.1016\/j.arth.2016.05.030","article-title":"Noise exposure in TKA surgery; oscillating tip saw systems vs oscillating blade saw systems","volume":"31","author":"Peters","year":"2016","journal-title":"J Arthroplasty"},{"key":"2020092112343797400_ref6","first-page":"98","volume-title":"Criteria for a Recommended Standard: Occupational Noise Exposure. U.S. Department of Health and Human Services, Public Health Service, Center for Disease Control, National Institute for Occupational Safety and Health, Cincinnati, OH. 1998; DHHS (NIOSH) Publication","author":"NIOSH","year":"2016"},{"issue":"3","key":"2020092112343797400_ref7","doi-asserted-by":"crossref","first-page":"660","DOI":"10.2106\/00004623-200603000-00027","article-title":"American Board of Orthopaedic Surgery Practice of the orthopaedic surgeon: part-II, certification examination case mix","volume":"88","author":"Garrett","year":"2006","journal-title":"J Bone Joint Surg"},{"key":"2020092112343797400_ref8","first-page":"1","volume-title":"ANSI S1.4: Specifications for Sound Level Meters, Acoustical Society of America, New York","author":"American National Standards Institute","year":"2012"},{"key":"2020092112343797400_ref9","first-page":"1","volume-title":"NIOSH Sound Level Meter Application (app) for iOS devices, National Institute for Occupational Safety and Health Digital Publication","author":"Kardous CACC","year":"2016"},{"issue":"2","key":"2020092112343797400_ref10","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1121\/1.418053","article-title":"A re-examination of risk estimates from the NIOSH Occupational Noise and Hearing Survey (ONHS)","volume":"101","author":"Prince","year":"1997","journal-title":"J Acoust Soc Am"},{"issue":"1","key":"2020092112343797400_ref11","doi-asserted-by":"crossref","first-page":"35","DOI":"10.3928\/0147-7447-19960101-06","article-title":"Noise levels of orthopedic instruments and their potential health risks","volume":"19","author":"Holmes","year":"1996","journal-title":"Orthopedics"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/9-10\/e1551\/33765649\/usaa102.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/185\/9-10\/e1551\/33765649\/usaa102.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T12:35:45Z","timestamp":1600691745000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/185\/9-10\/e1551\/5854780"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,9]]},"references-count":11,"journal-issue":{"issue":"9-10","published-online":{"date-parts":[[2020,6,9]]},"published-print":{"date-parts":[[2020,9,18]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usaa102","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,9]]},"published":{"date-parts":[[2020,6,9]]}}}