Approaches to managing ototoxicity in the workplace

  • 1Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, OH, USA.
  • 2Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada.
  • 3Auditory and Vestibular Clinical Research Section, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, MD, USA.
  • 4National Center for Rehabilitative Auditory Research VA Portland Health Care System, Portland, OR, USA.
  • 5Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA.
  • 6French Research and Safety Institute for the Prevention of Occupational Accidents and Diseases Toxicology and Biomonitoring Division (INRS), Vandœuvre les Nancy, France.
  • 7Department of Audiology and Phoniatrics, Nofer Institute of Occupational Medicine, Łódź, Poland.
  • 8School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA, USA.

Abstract

OBJECTIVE

Ototoxic chemicals in the workplace can pose a risk to hearing and balance functions. Our objective was to identify evidence-based practices for occupational health settings in managing ototoxicity. This resulted in the document, Health Management of Workers Exposed to Ototoxic Chemicals, created by the International Ototoxicity Management Group.

DESIGN

To develop a practical approach for any workplace, we reviewed a variety of sources and used an international panel of interdisciplinary experts. Evidence included data from experimental, observational, and review studies. Thirty-two subject matter experts were invited to review the document; twenty-two completed the review and unanimously endorsed the ototoxicity management system as proposed.

RESULTS

Six key action steps were proposed to: (1) identify workers exposed to ototoxic chemicals, (2) perform auditory and vestibular assessments, (3) follow-up after monitoring health, (4) document worker data, (5) maintain healthy safety culture, and (6) review ototoxicity management approach. These steps focus on the management of workers who are at-risk for workplace ototoxic chemical exposure at any level (with or without concurrent noise exposures).

CONCLUSIONS

Early identification strategies include self-report questionnaires; auditory testing; vestibular screening; referrals for diagnosis; management of cases; and monitoring of exposure scenarios to prevent further cases.

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