P0912 - Assessing Occupational Noise Generated from Surgical Suction Devices vs Traditional Wall Suction in Gastrointestinal Endoscopy: A Quality Improvement Project

Nicholas M. McDonald, MD¹, Raiya Sarwar, MD¹, Christina White, ², Mohammad Bilal, MD², Aasma Shaukat, MD², Brian Hanson, MD^2
1University of Minnesota Medical Center, Minneapolis, MN; ²Minneapolis VA Health Care System, Minneapolis, MN

Introduction: Occupational noise exposure can lead to noise-induced hearing loss (NHL) with serious health and economic consequences for workers. The Center for Disease Control and Prevention and the National Institute for Occupational Safety and Health (NIOSH) have published a recommended exposure limit of 85-decibels (dB) for workplace exposure to prevent NHL. Despite these recommendations for workplace noise exposure, little is known about the noise levels generated during gastrointestinal (GI) endoscopy. We aimed to investigate the noise generated by suction during GI endoscopy.

Methods: Sound levels were measured using the “NIOSH Sound Level Meter” smart phone application. The noise generated from an adult colonoscope (Olympus HQ190) at various levels of suction were measured using Neptune 3 (Stryker, Kalamazoo, MI) mobile surgical suction device (SSD) that allows a wide range of suction pressure levels versus “traditional” wall suction (WS). Measurements were obtained as average levels over a 30-second interval in a quiet, outpatient ambulatory endoscopy room. Noise measurements were obtained at various positions within the room (endoscopist, nurse/technician) as well as next to the endoscope suction button. The measurements were obtained with the endoscopist applying no suction, partial suction and complete suction.

Results: With the SSD, sound levels increased as suction pressure increased. The highest sound levels were generated when no endoscopic suction was applied. None of the measurements exceeded recommended exposure limits set by the NIOSH (Table 1). With pressure levels set at 200 mmHg (traditional wall suction maximums) sound levels at the endoscopist for SSD and WS were 54.3 dB and 47.1 dB, respectively, e.g. more than 7 times louder.

Discussion: Little is known about the occupational safety of noise levels in endoscopy nor the contribution suction contributes. In this study, noise levels did not exceed the recommended exposure limit set by the NIOSH. However, SSD generates significantly more noise than WS at the same pressure levels. While these levels may not constitute an occupational hazard, they make communication more difficult especially in the COVID era of enhanced PPE (e.g. face shield, N95). The techniques developed during the study offer a simple process that can be implemented in any GI endoscopy suite to assess the contributions of suction to workplace noise.

Suction Device and Pressure	Technician position (dB)	Nurse position (dB)	Endoscopist Position (dB)	Next to endoscope (dB)
Wall Suction Pressure 200 mmHg No suction Partial suction Complete suction	43.6 42.3 41.5	45.6 45.0 43.9	47.1 45.7 44.5	61.4 60.7 49.5
Surgical Suction Device Pressure 200 mmHg No suction Partial suction Complete suction	50.9 49.0 46.3	51.1 47.9 46.2	54.3 54.4 51.3	68.5 66.8 48.7
Surgical Suction Device Pressure 300 mmHg No suction Partial suction Complete suction	53.6 51.4 45.5	53.6 49.7 45.8	56.4 54.4 51.7	72.5 70.6 48.9
Surgical Suction Device Pressure 400 mmHg No suction Partial suction Complete suction	55.2 54.8 45.7	54.9 51.5 46.0	57.5 56.4 50.9	74.6 72.3 48.8
Surgical Suction Device Pressure 520 mmHg No suction Partial suction Complete suction	56.3 54.6 45.7	56.0 52.1 46.1	58.5 56.7 50.6	75.5 74.0 49.0
Baseline (quiet room)	43.3

Table: Table 1. Noise level based upon type of suction device and suction pressure


Disclosures:
Nicholas McDonald indicated no relevant financial relationships.
Raiya Sarwar indicated no relevant financial relationships.
Christina White indicated no relevant financial relationships.
Mohammad Bilal indicated no relevant financial relationships.
Aasma Shaukat indicated no relevant financial relationships.
Brian Hanson indicated no relevant financial relationships.


Nicholas M. McDonald, MD¹, Raiya Sarwar, MD¹, Christina White, ², Mohammad Bilal, MD², Aasma Shaukat, MD², Brian Hanson, MD². P0912 - Assessing Occupational Noise Generated from Surgical Suction Devices vs Traditional Wall Suction in Gastrointestinal Endoscopy: A Quality Improvement Project, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.