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Combined Exposure to Noise and Ototoxic Substances TE-80-09-996-EN-N Combined exposure to noise and ototoxic substances TE-80-09-996-EN-N TE-80-09-996-EN-N Combined exposure to Noise and Ototoxic Substances COMBINED EXPOSURE TO NOISE AND OTOTOXIC SUBSTANCES EU-OSHA – European Agency for Safety and Health at Work 1 Combined exposure to Noise and Ototoxic Substances Authors: Pierre Campo, Katy Maguin, Institut National de Recherche et de Sécurité pour la prévention des accidents du travail et des maladies professionnelles – INRS, France Stefan Gabriel, Angela Möller, Eberhard Nies, Institut für Arbeitsschutz der Deutschen Gesetzlichen Unfallversicherung – BGIA, (Institute for Occupational Safety and Health of the German Social Accident Insurance), Germany María Dolores Solé Gómez, Instituto Nacional de Seguridad e Higiene en el Trabajo – INSHT (Spanish National Institute for Safety and Hygiene at Work), Spain Esko Toppila, Työterveyslaitos Institutet for Arbetshygien (Finnish Institute of Occupational Health – FIOH), Finland Members of the Topic Centre Risk Observatory Edited by: Eusebio Rial González, European Agency for Safety and Health at Work (EU-OSHA) Joanna Kosk-Bienko, European Agency for Safety and Health at Work (EU-OSHA) This report was commissioned by the European Agency for Safety and Health at Work (EU-OSHA). Its contents, including any opinions and/or conclusions expressed, are those of the author(s) alone and do not necessarily reflect the views of EU-OSHA. Europe Direct is a service to help you find answers to your questions about the European Union Freephone number (*): 00 800 6 7 8 9 10 11 (*) Certain mobile telephone operators do not allow access to 00 800 numbers, or these calls may be billed. More information on the European Union is available on the Internet (http://europa.eu). Cataloguing data can be found on the cover of this publication. Luxembourg: Office for Official Publications of the European Communities, 2009 ISBN -13: 978-92-9191-276-6 DOI: 10.2802/16028 © European Agency for Safety and Health at Work, 2009. Reproduction is authorised provided the source is acknowledged. Acknowledgments The authors would like to thank Professor Ilmari Pyykkö (University of Tampere) for stimulating discussions, university lecturer Dr Jürgen Milde (SiGe, German Social Accident Insurance) and Dr Martin Liedtke (BGIA, German Social Accident Insurance) for critical reading of the manuscript, as well as Ulrike Koch, Rainer Van Gelder and Reimer Paulsen (BGIA) for their valuable help in providing MEGA and MELA datasets. EU-OSHA – European Agency for Safety and Health at Work 2 Combined exposure to Noise and Ototoxic Substances Table of Contents List of figures and tables:........................................................................................................................ 4 1. Introduction .................................................................................................................................. 5 1.1. Scope and objectives................................................................................................................... 5 1.2. Hearing mechanism: from sounds to nerve impulses ................................................................. 6 1.3. Hearing hazards: definitions ........................................................................................................ 7 1.4. Noise............................................................................................................................................ 7 1.5. Chemicals .................................................................................................................................... 9 1.5.1. Neurotoxicants ..................................................................................................................9 1.5.2. Ototoxicants ...................................................................................................................... 9 1.5.3. Cochleotoxicants............................................................................................................... 9 1.5.4. Vestibulotoxicants ............................................................................................................. 9 1.6. Age............................................................................................................................................... 9 2. Evaluation of hearing impairment .............................................................................................. 11 2.1. Pure tone audiometry ................................................................................................................ 11 2.2. High-frequency audiometry........................................................................................................ 11 2.3. Speech audiometry.................................................................................................................... 12 2.4. Otoacoustic emissions............................................................................................................... 12 2.5. Brainstem auditory evoked potentials........................................................................................ 13 3. Consequences of hearing impairment for humans.................................................................... 15 4. Ototoxic substances .................................................................................................................. 17 4.1. Rating the weight of evidence.................................................................................................... 17 4.2. Ototoxic compounds .................................................................................................................. 17 4.2.1. Compounds with “good evidence” of ototoxicity ............................................................. 17 4.2.2. Compounds with “fair evidence” of ototoxicity (suspected ototoxic substances) ........... 21 4.2.3. Compounds with “poor evidence” of ototoxicity (questionably ototoxic substances) ..... 23 4.3. Use of ototoxic chemicals in industry ........................................................................................ 24 5. Combined effects....................................................................................................................... 27 5.1. Effects of combined exposure to various (ototoxic) substances ............................................... 27 5.2. Combined effects with noise...................................................................................................... 28 5.2.1. Pharmaceuticals ............................................................................................................. 28 5.2.2. Solvents .......................................................................................................................... 28 5.2.3. Asphyxiants.....................................................................................................................29 5.2.4. Nitriles ............................................................................................................................. 29 5.2.5. Manganese ..................................................................................................................... 30 5.2.6. Tobacco smoke............................................................................................................... 30 6. Present policies.......................................................................................................................... 31 6.1. International Organisations........................................................................................................ 31 6.2. EU policy.................................................................................................................................... 31 EU-OSHA – European Agency for Safety and Health at Work 3 Combined exposure to Noise and Ototoxic Substances 6.3. Policies in EU Member States: some examples ........................................................................32 6.4. Policies in other countries ..........................................................................................................33 7. Conclusions................................................................................................................................35 8. References .................................................................................................................................39 9. GLOSSARY................................................................................................................................55 10. Annex 1 ......................................................................................................................................57 Evaluations of the BGIA – MELA noise exposure database.................................................................57 Evaluations of the BGIA – MEGA hazardous substances database ....................................................57 Evaluations of the BGIA – MELA noise exposure database.................................................................58 Evaluations of the BGIA – MEGA hazardous substances database ....................................................58 Evaluations of the BGIA – MELA noise exposure database.................................................................59 Evaluations of the BGIA – MEGA hazardous substances database ....................................................59 Evaluations of the BGIA – MELA noise exposure database.................................................................60
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