Impacts of Extracorporeal Shockwave Therapy-Associated Noise: A Literature Review

Background: Extracorporeal Shockwave Therapy (ESWT) involves the application of impulse acoustic waves in a focused pattern to facilitate healing. While ESWT machines, classified as Class II medical devices, are widely used in urology and sometimes physical therapy, they produce impulse noise averaging 88 dB, raising concerns about potential auditory hazards for operators and clients. There is limited research and inconsistent recommendations regarding the need for hearing protection during ESWT. Aim: This literature review aims to investigate the available evidence on the auditory impacts of ESWT-associated noise for both operators and clients, assessing the necessity for hearing protection. Methods: A systematic search of studies on ESWT-associated noise was conducted, yielding 906 studies. After removing 131 duplicates and screening out 768 studies based on inclusion criteria, seven studies published in English were included in the review. The studies analyzed noise levels, hearing function outcomes, and recommendations for hearing protection. Results: The findings on ESWT-associated noise and its auditory impacts were mixed. Four studies reported no significant detrimental effects on hearing function, while three studies indicated hazardous sound levels with potential risks for hearing loss. Operating manuals for ESWT devices reviewed recommend hearing protection for both operators and clients, although reported sound levels were often within regulatory safety limits. Conclusions: There is inconsistent evidence regarding the auditory risks of ESWT-associated noise, with some studies identifying potential hazards, especially for operators exposed over extended periods. Operating manuals generally advise hearing protection, indicating a precautionary approach. Further research, such as randomized controlled trials, is needed to clarify the risks and develop evidence-based guidelines.