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Improve Hearing Health 
Protect from ototoxins 

  • Chemicals 

  • Medicines

  • Prevent from making it worse  

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​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

  • Neurotoxicants - Damage nerve fibers that interfere with hearing and balance

  • Cochleotoxicants - Affect cochlear hair cells, which are the sensory receptors, and damage ability to hear.

  • Vestibulotoxicants - Affect hair cells on spatial orientation and balance organs

These chemicals can be used as part of work or personal activities

  • SOLVENTS: Carbon disulfide, n-hexane, toluene, p-xylene, ethylbenzene, n-propylbenzene, styrene and methylstyrene, trichloroethylene

  • ASPHYXIANTS: Carbon monoxide, hydrogen cyanide and its salts, tobacco smoke

  • NITRILES: 3-Butenenitrile, cis-2-pentenenitrile, acrylonitrile, cis-crotononitrile, 3,3’-iminodipropionitrile

  • METALS and COMPOUNDS: Mercury compounds, germanium dioxide, organic tin compounds, lead

  • MAY BE OTOTOXIC: Cadmium, arsenic, bromates, halogenated hydrocarbons, insecticides, alkylic compounds, and manganese

These chemicals can be used in

  • ​​​​​​​​​​​​​​​​​​​Appliance and Component (including batteries)

  • Chemical (including glue, paint, plastics)

  • Furniture

  • Electrical Equipment

  • Fabricated metal

  • Firefighting

  • Fueling vehicles an aircraft

  • Leather and Allied Product

  • Machinery

  • Pesticide spraying

  • Paper

  • Petroleum

  • Painting

  • Printing

  • Radiator Repair

  • Solar Cell

  • Textile and Apparel

  • Transportation Equipment (e.g. ship and boat building)

  • Weapons firing

What you can do

  • Review Safety Data Sheets (SDS)

  • See if the 'Toxicological Information' states that chemical is a neurotoxicant/ cochleotoxicant/ vestibulotoxicants

  • Check if you may be using any of these chemicals

  • Wear appropriate protection (masks, gloves) when using them

  • 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

  • Check your prescription and OTC medicines for this side effect

  • Check if there are alternatives, discuss with your doctor or your pharmacist

  • Check if you are exposed to ototoxicants and loud noise at the same time - lower sound volume, use hearing protection

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Prevent from making it worse

Lower these risks that can worsen the hearing damage by ototoxins

  • 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

  • Habits: Such as smoking (including second-hand smoke), vaping, recreational marijuana use, alcohol intake

  • Pre-existing ear conditions: Such as recurrent ear infections, ear damage due to impact, damaged tympanic membrane, pre-existing hearing loss

  • 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

  • How often you are exposed (exposure frequency)

  • How much you are exposed (chemical strength/potency)

  • How long you are exposed (duration)

Check ways that you can be exposed to ototoxic chemicals

  • Breathing them in

  • Through contaminated food or drinks

  • Through the skin by touching them

Ototoxic chemicals can also damage hearing aids

  • Outer casing

  • Drops can leak inside and damage electronics, other parts

Risks that worsen effect of ototoxins on hearing loss

At work

  • Combining with loud noise

    • Painting

    • Construction

    • Manufacturing jobs

    • Fueling vehicles and aircraft

    • Firefighting

    • Weapons firing

    • Pesticide spraying

Personal

  • Combining with smoking

  • Combining ototoxic chemicals and drugs

What you can do

  • Protect hearing aids from accidental sprays/splashes (for example waterproof hair nets)

  • Check if there is an option to replace ototoxic chemicals / medications with less toxic ones

  • Improve ventilation

  • Safely handle chemicals with proper PPE (gloves, respirators)​​

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© 2025 Audition Technology

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