Noise in OR can compromise patient safety, study says

Ambient background noise — whether it is the sound of loud surgical equipment, talkative team members, or music — is a patient and surgical safety factor that can affect auditory processing among surgeons and the members of their team in the operating room (OR), according to a new study.1

The findings are the first to demonstrate that a surgeon’s ability to understand spoken words in the OR is directly affected by noise in the environment, says study coauthor Matthew Bush, MD, assistant professor of surgery at the University of Kentucky Medical Center, Lexington. “To minimize errors of communication, it is essential that we consider very carefully the listening environment we are promoting in the OR,” he says.

To assess the effects of ambient noise on communication in the OR, the researchers created a noise environment similar to that of an OR and tested 15 surgeons with one to 30 years of operating experience. The surgeons’ ability to understand and repeat words was tested using the Speech In Noise Test-Revised (SPIN-R) under four listening conditions typical of OR environments. These conditions included quiet, filtered noise through a surgical mask, and background noise both with and without music. Subjects were tested in two situations: engaged in a specific surgical task and task free.

The study showed a significant decrease in speech comprehension with the presence of background noise when the words were unpredictable. In addition, the surgeons demonstrated considerably poorer speech comprehension in the presence of music compared with a quiet environment or one with OR noise present. However, the addition of music became a significant barrier to speech comprehension only when the surgeon was engaged in a task.

The researchers concluded that OR noise can cause a decrease in auditory processing, particularly in the presence of music. Furthermore, the ability to understand what is being said becomes even more difficult when the conversations carry critical information that is unpredictable.


1. Way TJ, Long A, Weihing J, et al. Effect of noise on auditory processing in the operating Room. J Amer Coll Surg 2013; 216:933-938.