Fuente JOEM 09 - 1202 SIHL Fuente et al Peripheral and...

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Peripheral and Central Auditory Dysfunction Induced by Occupational Exposure to Organic Solvents Adrian Fuente, PhD Martin D. Slade, MPH Tanisha Taylor, MD, MPH Thais C. Morata, PhD Robert W. Keith, PhD Judy Sparer, MS, CIH Peter M. Rabinowitz, MD, MPH Objective: To examine the effects of solvent exposure on hearing function, through an audiological test battery, in a population not occupationally exposed to high levels of noise. Methods: One hundred ten workers from a coating factory were studied. Jobs at the factory were divided into three different levels of solvent exposure. Hearing status was assessed with a test battery including pure-tone hearing thresholds (0.5–8 kHz), high-frequency hearing thresholds (12 and 16 kHz), and dichotic listening measured through dichotic digits test. Multiple linear regression models were created to explore possible association between solvent exposure and each of the hearing outcomes. Results: Significant associations between solvent exposure and the three hearing outcomes were found. Covariates such as age, gender, race, and ethnicity were also significantly associated with the studied hearing outcomes. Con- clusions: Occupational exposure to solvents may induce both peripheral and central auditory dysfunction. The dichotic digits test seems as a sensible tool to detect central auditory dysfunction associated with solvent exposure. Hearing loss prevention programs may use this tool to monitor hearing in solvent-exposed workers. (J Occup Environ Med. 2009;51:1202–1211 ) W ork-related hearing loss (HL) due to noise exposure remains a prevalent occupational condition. 1 In addition to noise, other agents such as metals, asphyxiants, pesticides, and organic solvents may be hazardous to human hearing. 2–6 In the occupational health and safety arena, solvents have been associated with dermal effects, 7 neu- robehavioral changes, 8 and respiratory effects, 9 among other pathologies. Mil- lions of persons are currently exposed to solvents in their workplaces. 10 One of the first reports on the adverse effects of solvents on human hearing comes from Szulck-Kuberska et al, 11 who studied a group of workers ex- posed to trichloroethylene. Animal studies have found cochlear damage due to aromatic solvent exposure. 12,13 One of the most studied solvent in animals is toluene. Research has shown that toluene can reach cochlea and induce damage in the outer hair cells. 12,13 Recent studies have also demonstrated that toluene and other solvents may adversely affect the acoustic reflexes due to an anticho- linergic effect on the auditory effer- ent motoneurons. 14,15 Field studies conducted in populations of solvent- exposed workers have found an in- crement in the prevalence of HL among solvent-exposed workers in comparison with nonexposed control subjects.
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