
Improve Hearing Health
Protect from ototoxins
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Chemicals
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Medicines
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Prevent from making it worse

​Chemicals
Some chemicals cause ototoxicity (or harm to hearing) that is generally due to repeated inhalation and skin absorption of certain harmful chemicals at doses higher than safe limits
These chemicals can cause different types of harm
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Neurotoxicants - Damage nerve fibers that interfere with hearing and balance
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Cochleotoxicants - Affect cochlear hair cells, which are the sensory receptors, and damage ability to hear.
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Vestibulotoxicants - Affect hair cells on spatial orientation and balance organs
These chemicals can be used as part of work or personal activities
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SOLVENTS: Carbon disulfide, n-hexane, toluene, p-xylene, ethylbenzene, n-propylbenzene, styrene and methylstyrene, trichloroethylene
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ASPHYXIANTS: Carbon monoxide, hydrogen cyanide and its salts, tobacco smoke
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NITRILES: 3-Butenenitrile, cis-2-pentenenitrile, acrylonitrile, cis-crotononitrile, 3,3’-iminodipropionitrile
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METALS and COMPOUNDS: Mercury compounds, germanium dioxide, organic tin compounds, lead
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MAY BE OTOTOXIC: Cadmium, arsenic, bromates, halogenated hydrocarbons, insecticides, alkylic compounds, and manganese
These chemicals can be used in
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​​​​​​​​​​​​​​​​​​​Appliance and Component (including batteries)
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Chemical (including glue, paint, plastics)
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Furniture
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Electrical Equipment
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Fabricated metal
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Firefighting
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Fueling vehicles an aircraft
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Leather and Allied Product
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Machinery
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Pesticide spraying
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Paper
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Petroleum
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Painting
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Printing
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Radiator Repair
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Solar Cell
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Textile and Apparel
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Transportation Equipment (e.g. ship and boat building)
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Weapons firing
What you can do
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Review Safety Data Sheets (SDS)
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See if the 'Toxicological Information' states that chemical is a neurotoxicant/ cochleotoxicant/ vestibulotoxicants
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Check if you may be using any of these chemicals
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Wear appropriate protection (masks, gloves) when using them
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Check if a non-ototoxic chemical can be used

​Medicines
Some medicines, OTC and Prescription, can also harm hearing - as a side effect. The effect is made worse if combined with loud noise.
​Harm can be due to high dose, repeated dosing, over a long period of time and other complications such as kidney failure that causes drug buildup in body​
​The table below lists generic names and the medical conditions for these medications are commonly prescribed or available as OTC. 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, Pain
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
Self-checking is important for preventing and protecting from ototoxicants
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Check your prescription and OTC medicines for this side effect
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Check if there are alternatives, discuss with your doctor or your pharmacist
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Check if you are exposed to ototoxicants and loud noise at the same time - lower sound volume, use hearing protection

Prevent from making it worse
Lower these risks that can worsen the hearing damage by ototoxins
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Hazardous noise: The effect is synergistic (combined effect greater than individual sum). Several work and personal activities can combine ototoxicants (chemicals and medications) and unsafe noise exposures
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Habits: Such as smoking (including second-hand smoke), vaping, recreational marijuana use, alcohol intake
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Pre-existing ear conditions: Such as recurrent ear infections, ear damage due to impact, damaged tympanic membrane, pre-existing hearing loss
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Other: Such as increasing age, gender (males are more susceptible), genetic susceptibility, chronic diseases such as diabetes, hypertension
Manage ototoxins in the same way as noise
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How often you are exposed (exposure frequency)
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How much you are exposed (chemical strength/potency)
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How long you are exposed (duration)
Check ways that you can be exposed to ototoxic chemicals
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Breathing them in
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Through contaminated food or drinks
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Through the skin by touching them
Ototoxic chemicals can also damage hearing aids
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Outer casing
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Drops can leak inside and damage electronics, other parts
Risks that worsen effect of ototoxins on hearing loss
At work
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Combining with loud noise
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Painting
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Construction
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Manufacturing jobs
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Fueling vehicles and aircraft
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Firefighting
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Weapons firing
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Pesticide spraying
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Personal
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Combining with smoking
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Combining ototoxic chemicals and drugs
What you can do
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Protect hearing aids from accidental sprays/splashes (for example waterproof hair nets)
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Check if there is an option to replace ototoxic chemicals / medications with less toxic ones
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Improve ventilation
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Safely handle chemicals with proper PPE (gloves, respirators)​​

