P2519 - Assessing Noise Generated from Surgical Suction Devices While Using Upper Endoscope: A Quality Improvement Project

Mandip KC, MD¹, Nicholas M. McDonald, MD², Raiya Sarwar, MD², Mohammad Bilal, MD³, Aasma Shaukat, MD³, Anca Bejan, MS, COHC, CIH³, Brian Hanson, MD^3
1University of Minnesota, Minneapolis, MN; ²University of Minnesota Medical Center, Minneapolis, MN; ³Minneapolis VA Health Care System, Minneapolis, MN

Introduction: There is paucity of data regarding noise levels generated within endoscopy suite during endoscopic procedures. Occupational noise exposure can lead to noise-induced hearing loss with significant health and economic consequences for workers. The CDC and Prevention and National Institute for occupational safety and health (NIOSH) have published a recommended exposure limit of 85-decibels for workplace exposure. A recent study by our group measured sound levels using a colonoscope where the threshold was not exceeded. We aimed to replicate the study with an upper endoscope to evaluate variability due to difference in the scope.

Methods: The noise generated from an adult upper endoscope (Olympus HQ190) at various levels of suction were measured using the “NIOSH Sound Level Meter” smartphone application. Neptune 3 (Stryker, Kalamazoo, MI) surgical suction device (SSD) allows a wide range of suction pressure levels. Noise Measurements were obtained at various positions within the room as well as next to the endoscope suction button with the endoscopist applying no suction, partial suction and complete suction. To further validate the measurements from a phone based-app, sample measurements using an industrial grade sound level meter were also taken.

Results: With an upper endoscope, the highest sound levels were generated when partial suction was applied on the scope, compared to no suction or full suction. The sound levels increased proportionally to the level of the suction. None of the measurements exceeded recommended exposure limits (Table 1). The measurements using industrial grade sound level meter were within 5 dB range of the measurements obtained using a smartphone.

Discussion: There is variability in level of noise produced by an upper endoscope based on the pressure level of suction, as well as various modes of endoscope suction. In this study, the level of noise did not exceed the threshold limit set by NIOHS. However, high level of noise could impact communication between team members in the endoscopy suite and potentially impact patient care. Smartphone based apps are validated tools for sound measurement and are readily available for use, and if there are concerns for health safety due to noise, institutional industrial hygienist should be consulted for evaluation of the site and devices involved. Moreover, noise levels during equipment operation, and not at baseline alone, should be a consideration when acquiring new equipment for use in medical practice.

	Decibel (dB) Level
Position	Technician	Nurse	Endoscopist	Endoscope
Wall Suction (WS)
Suction Pressure 200 mmHg
No suction	52.1	51.7	52.2	59.6
Partial suction	56.1	54.6	60.9	74.2
Full suction	49.5	49	49.7	51.1
Surgical Suction Device (SSD)
Suction Pressure 200 mmHg
No suction	55.7	55	56.9	65.3
Partial suction	59.1	56.2	66	67.9
Full suction	52.1	52.2	54.7	55.2
300 mg
No suction	59.5	58.6	59.3	67.4
Partial suction	59.7	58.5	65.8	70.1
Full suction	57.1	51.7	54	56.7
400 mmHg
No suction	61.4	59.9	60.5	68.4
Partial suction	62.4	60.3	66.3	78
Full suction	56.9	51	52.1	55.3
520 mmHg (max)
No suction	63.1	61.7	62.1	70.2
Partial suction	64	62.3	67.8	80.5
Full suction	56.8	51.2	55.2	56.8
Baseline 49.1

Table: Noise levels in dB at various positions within the endoscopy suite, suction pressure level, and suction setting


Disclosures:
Mandip KC indicated no relevant financial relationships.
Nicholas McDonald indicated no relevant financial relationships.
Raiya Sarwar indicated no relevant financial relationships.
Mohammad Bilal indicated no relevant financial relationships.
Aasma Shaukat indicated no relevant financial relationships.
Anca Bejan indicated no relevant financial relationships.
Brian Hanson indicated no relevant financial relationships.


Mandip KC, MD¹, Nicholas M. McDonald, MD², Raiya Sarwar, MD², Mohammad Bilal, MD³, Aasma Shaukat, MD³, Anca Bejan, MS, COHC, CIH³, Brian Hanson, MD³. P2519 - Assessing Noise Generated from Surgical Suction Devices While Using Upper Endoscope: A Quality Improvement Project, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.