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Reference Ototoxin - FS - 51-002-0713
Reference Ototoxin - FS - 51-002-0713
The Problem
to any measurable level of a potential ototoxic
Exposure to certain chemicals, either alone or in chemical, yearly audiograms are highly
concert with noise, may result in hearing loss. recommended for workers whose airborne
exposures (without regard to respiratory protection
Inhalation exposure to some chemicals may cause worn) are at 50% or more of the Occupational
hearing loss, independent of noise exposure, while Exposure Limit (more stringent of the Occupational
some chemicals may not cause hearing loss, Safety and Health Administration Permissible
independently, but may potentiate noise-inducted Exposure Limit or American Conference of
hearing loss. Inhalation exposure to some Industrial Hygienist Threshold Limit Value) for the
chemicals may have additive or synergistic effects substance in question, regardless of the noise level.
with noise exposure. Certain chemical substances The 50%, while somewhat arbitrary, will ensure the
have shown ototoxic effects at high airborne collection of data from sub-Occupational Exposure
exposure levels but may not be ototoxic in the Limit exposures. If there are dermal exposures to
concentrations observed in typical occupational toluene, xylene, n-hexane, organic tin, carbon
settings. Some potential ototoxin chemicals (e.g., disulfide, mercury, organic lead, hydrogen cyanide,
toluene, xylene, n-hexane, organic tin, carbon diesel fuel, kerosene fuel, jet fuel, JP-8 fuel,
disulfide, mercury, organic lead, hydrogen cyanide, organophosphate pesticides, or chemical warfare
diesel fuel, kerosene fuel, jet fuel, JP-8 fuel, nerve agents, and such exposures may result in a
organophosphate pesticides, chemical warfare nerve systemic dose equivalent to 50% or more of the
agents) may be absorbed through the skin, and may Occupational Exposure Limit, yearly audiograms
significantly contribute to the systemic dose if are also recommended.
dermal exposures are not properly controlled.
If a worker is currently participating in a hearing
Since the exposure threshold for such ototoxic conservation program due to excessive noise, the
effects is generally not known, audiometric reviewers of the audiometric data should be alert to
monitoring is necessary to know if the substance is possible additive, potentiating, or synergistic effects
affecting the hearing of exposed workers. While between the exposure to noise and the chemical
audiometric data are useful for any worker exposed substance and, if necessary, suggest reducing the
exposure to one or both.
• Painting
• Printing
• Boat building
• Construction
• Furniture making
• Manufacturing of metal, leather and petroleum products
• Fueling vehicles and aircraft
• Firefighters
• Weapons firing
Documentation
Enter nature and level of the ototoxin in the comment sections of the DD 2215, Reference Audiogram and DD
2216, Hearing Conservation Data.
Further Reading
Morata T.C., Chemical Exposure as a Risk Factor for Hearing Loss, JOEM, Vol. 45, Number 7,
July 2003.
http://www.cdc.gov/niosh/topics/noise/whatsnew/noiseandchem/noiseandchem.html