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Audition Technology

Ototoxicity and your Hearing Health

What is ototoxicity

What are known ototoxins

Other risks worsening ototoxicity

How you can be affected

Health consequences of ototoxicity

DIY- Protection and Prevention

Prepared by:

Audition Technology

https://www.auditiontech.com/

In observance of OSHA Safe and Sound Week

August, 2021


What is ototoxicity

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.

What are known ototoxins

Drugs

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.

Acetazolamide 

Edema

Acetaminophen

Pain, fever

Alendronic acid

Osteoporosis

Amikacin

Bacterial infections

Amphotericin B

Fungal infections

Artemether

Malaria

Aspirin

Pain, fever

Avanafil

Erectile dysfunction

Azithromycin

Mycobacterial infections

Bismuth subsalicylate

Diarrhea

Boceprevir

Hepatitis C

Bortezomib

Cancer

Bromocriptine

Acromegaly,

Parkinson’s

Bumetanide

Edema

Carboplatin

Cancer

Celecoxib

Pain

Chlormethine

Cancer

Cisplatin

Cancer

Clonazepam

Seizure, panic

Cyclosporine

Organ transplantation

Docetaxel

Cancer

Deferasirox

Iron overload

Deferiprone

Iron overload

Deferoxamine

Iron overload

Ethacrynic acid

Edema

Enalapril

High blood pressure

Erythromycin

Bacterial infection

Febuxostat

Gout

Fenoprofen

Arthritis

Flumazenil

Drowsiness

Furosemide

Edema

Gabapentin

Neuralgia

Gentamicin

Bacterial infection

Hydroxychloroquine

Malaria

Ibuprofen

Pain

Interferon alpha

Hepatitis C

Isotretinoin

Acne

Itraconazole

Fungal infection

Kanamycin

Bacterial infection

Leuprolide

Cancer

Meropenem

Bacterial infection

Mefloquine

Malaria

Naproxen

Arthritis

Neomycin

Bacterial infection

Nicotine

Smoking cessation

Nilotinib

Cancer

Ofloxacin

Ear infection

Plazomicin

Urinary tract infection

Pramipexole

Parkinson’s disease

Quinine

Malaria

Ribavirin/Intron A

Hepatitis C

Rivastigmine

Dementia

Ropinirole

Parkinson’s disease

Ropivacaine

Anesthesia

Sildenafil

Erectile dysfunction

Sodium valproate

Epilepsy  

Streptomycin

Bacterial infection

Sumatriptan

Migraine

Tacrolimus

Transplant

Tadalafil

Erectile dysfunction

Teprotumumab

Thyroid eye disease

Terbinafine

Fungal infection

Thalidomide

Cancer

Tobramycin

Bacterial infection

Topiramate

Seizure

Vancomycin

Bacterial infection

Valproic acid

Seizure

Vardenafil

Erectile dysfunction

Verteporfin

Eye disorder

Vinblastine

Cancer

Vincristine

Cancer

Vinorelbine

Cancer

Viomycin

Tuberculosis

Zoledronic acid

Osteoporosis

Chemicals

Ototoxic chemicals listed in table below are used as part of occupational or personal activities.

Acrylonitrile

Arsenic

3-Butenenitrile

Carbon Disulfide

Carbon Monoxide

Chemical Warfare Agents

Cis-2-pentenenitrile

Cis-crotononitrile

Cyanide

Diesel fuel

Ethylbenzene

Fuels

Germanium dioxide

Heptane

Hydrogen cyanide

3,3’-iminodipropionitrile

Jet fuel

JP-8 fuel

Kerosene fuel

Manganese

Mercury

Methyl Ethyl Ketone

Methylstyrene

N-Hexane

N-propylbenzene

 Nitriles

Organic lead

Organic tin

Pesticides

P-xylene

Paraquat

Perchloroethylene

Polychlorinated biphenyls

Stoddard Solvent

Styrene

Tobacco smoke

Toluene

Trichloroethylene

Xylene         

These chemicals are used in construction, firefighting, manufacturing, mining, military, utilities related activities with sub sectors such as:

Appliance and Component

(including batteries)

Chemical (including glue,

paint, plastics)

Furniture

Electrical Equipment

Fabricated metal

Firefighting

Fueling vehicles an aircraft

Leather and Allied Product

Machinery

Pesticide spraying

Paper

Petroleum

Painting

Printing

Radiator Repair

Solar Cell

Textile and Apparel

Transportation Equipment (e.g.

ship and boat building)

Weapons firing

Other risks worsening ototoxicity

Combination with several other risk factors worsens the effect of ototoxicity.

How you can be affected

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.

Health consequences of ototoxicity

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.

DIY-Protection and Prevention

Protection

Prevention

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