Ototoxicity and your Hearing Health
In observance of OSHA Safe and Sound Week
Ototoxicity is hearing impairment caused by exposure to ototoxins - medications and chemicals that can be inhaled, absorbed through the skin, or consumed.
The condition is worsened when the exposure is combined with other risk factors for hearing impairment such as hazardous noise, certain underlying health conditions, certain lifestyle habits, genetic factors.
Several categories of drugs that are used commonly including some that have been recently approved by health authorities have varying levels of ototoxicity. The table below summarizes drugs (generic names) and the medical condition for which they are commonly prescribed or available over-the-counter. There are several hundred brand names associated with these drugs.
High blood pressure
Urinary tract infection
Thyroid eye disease
Ototoxic chemicals listed in table below are used as part of occupational or personal activities.
Chemical Warfare Agents
Methyl Ethyl Ketone
These chemicals are used in construction, firefighting, manufacturing, mining, military, utilities related activities with sub sectors such as:
Appliance and Component
Chemical (including glue,
Fueling vehicles an aircraft
Leather and Allied Product
Textile and Apparel
Transportation Equipment (e.g.
ship and boat building)
Combination with several other risk factors worsens the effect of ototoxicity.
Drug induced ototoxicity is dependent on factors such as dose, multiple dosing regimen, duration of therapy, concurrent renal failure (which could lead to drug accumulation), co-administration with other drugs with ototoxic potential.
Chemical induced ototoxicity is generally due to repeated inhalation and skin absorption at doses exceeding safe limits. The effects are amplified as several of these activities are accompanied by unprotected hazardous noise levels.
Common symptoms of hearing impact include tinnitus (ringing in the ears), ear ache, temporary hearing difficulties and in some cases sudden and permanent hearing loss.
In addition, you could experience temporary vertigo and difficulty maintaining balance and in some cases have severe loss of vestibular sensitivity which may persist permanently. Loss of vestibular sensitivity can cause walking difficulties and oscillopsia (affected eye movement or the eye’s ability to stabilize images).
Loss of hearing can impact social engagement, academic and job performances, pay and career advancements - overall affecting quality of life.
Loss of hearing is also associated with serious conditions such as depression, dementia, increased falls, hospitalizations.
Centers for Disease Control and Prevention (CDC). Too Loud! For Too Long! Loud noises damage hearing
Department of Defense (DoD), Hearing Center of Excellence
Food and Drug Administration (FDA): What are the signs and symptoms of hearing loss
National Institute for Occupational Safety and Health (NIOSH): Noise and hearing loss prevention
National Institute for Deafness and other Communication Disorders (NIDCD). Noise-induced hearing loss
Occupational Safety and Health Administration (OSHA): Preventing Hearing Loss Caused by Chemical (Ototoxicity) and Noise Exposure
World Health Organization (WHO): World Report on Hearing
This document will be updated as additional information becomes available