Workflow-dependent noise peaks and exposure assessment in operating rooms: implications for occupational risk

Abstract

Background Operating room noise is a recognized occupational exposure with potential implications for worker health and performance. Most workplace noise risk assessments rely on time-averaged levels, which may obscure short-duration, high-intensity exposure peaks occurring during specific workflow phases. Task-aligned exposure characterization may therefore provide additional value for occupational risk assessment.Methods A field measurement study was conducted in 26 operating rooms under routine clinical conditions. A total of 611 real-time sound level measurements were obtained across 13 predefined surgical workflow stages using a calibrated sound level meter. Stage-specific noise levels were recorded to characterize exposure variability and peak events. Surgical nurses completed the Perceived Stress Scale and the Attention Control Scale immediately before and after procedures. Descriptive statistics, paired comparisons, and correlation analyses were performed.Results The mean noise level across workflow stages was 66.57 dB, while short-term peak levels reached up to 87 dB. Peak exposures clustered in workflow stages involving equipment movement and patient transfer. Noise variability differed substantially between workflow stages. No statistically significant pre- to post-procedure differences were observed in perceived stress or attention control scores. Associations between stage-averaged noise levels and psychological measures were weak and not statistically significant.Conclusion Reliance on average noise levels alone may underestimate task-dependent peak exposures in operating rooms. Workflow-aligned measurement approaches improve exposure characterization and may strengthen occupational noise risk assessment. Integrating stage-specific monitoring into routine workplace exposure evaluation may support more precise hazard identification and targeted risk control strategies for operating room personnel.