Approaches to managing ototoxicity in the workplace

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.

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.

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).

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.