1
|
Ahluwalia J, Drury E, Haupert M. Removal of Cyanoacrylate Glue From the External Auditory Canal With Hydrogen Peroxide and Acetic Acid: A Case Report. Cureus 2024; 16:e57213. [PMID: 38681471 PMCID: PMC11056237 DOI: 10.7759/cureus.57213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/01/2024] Open
Abstract
Ear canal foreign bodies are commonly encountered in the field of otolaryngology. This is especially common in the pediatric otolaryngology discipline. As a foreign body, cyanoacrylate glue (also called "super glue") can be difficult to remove and cause significant patient distress. Multiple solvents can be described as aiding in removing such foreign bodies. Here, a case is described in which hydrogen peroxide and acetic acid were used sequentially to remove cyanoacrylate glue from the external auditory canal. We describe a technique allowing en bloc removal of the cyanoacrylate glue. Thankfully, the patient's hearing returned to baseline post-operatively with minimal complications. Overall, cyanoacrylate glue can be a very difficult foreign body to remove from the ear canal. In this case, the sequential use of hydrogen peroxide and acetic acid to soak the glue was a safe and successful method to facilitate glue removal from the ear canal.
Collapse
Affiliation(s)
| | - Emily Drury
- Otolaryngology, Ascension St. John Hospital, Detroit, USA
| | - Michael Haupert
- Pediatric Otolaryngology, Ascension St. John Hospital, Detroit, USA
| |
Collapse
|
2
|
Hemmativaghef E. Exposure to lead, mercury, styrene, and toluene and hearing impairment: evaluation of dose-response relationships, regulations, and controls. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2020; 17:574-597. [PMID: 33275083 DOI: 10.1080/15459624.2020.1842428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The risk of hearing loss from exposure to ototoxic chemicals is not reflected in occupational exposure limits and most jurisdictions. The aims of this research were to investigate dose-response relationships between exposure to lead, mercury, toluene, and styrene and hearing impairment based on current epidemiological evidence, conduct cross-jurisdictional comparisons, and investigate control measures for exposure to ototoxic chemicals. Ovid Medline and Ovid Embase databases were used to find relevant publications. A total of 86 epidemiological studies met the eligibility criteria for final evaluation. When significant associations between exposure and outcome were identified, exposure levels were evaluated to determine whether No Observed Adverse Effect Level (NOAEL) and Lowest Observed Adverse Effect Level (LOAEL) could be identified. Cross-jurisdictional comparisons included the U.K., U.S., Canada, and Australia occupational health and safety legislations. The majority of lead (75%), styrene (74%), and toluene (77%) studies showed significantly increased risks of hearing loss from exposure to these substances, although numerous studies on toluene (70%) and styrene (16%) compared auditory function between "solvent mixture" or "noise and solvent mixture" exposed groups and controls and not necessarily on groups exposed to a single agent. Based on five studies, blood lead ranges of 1-1.99 μg/dL to 2.148-2.822 μg/dL were identified as NOAELs while blood lead levels of 2 μg/dL up to 2.823-26.507 μg/dL were identified as LOAELs for hearing loss. Except for general duty clauses, the U.S., Canadian, and Australian jurisdictions have set no enforceable regulations specific to ototoxic chemical exposures. A biological exposure index of 2 μg/dL is recommended for prevention of hearing impairment from lead exposure. Based on Safe Work Australia, noise exposure limits may be reduced to 80 dB(A) for 8 hr. Other recommendations include performing audiometric testing and controlling exposure through all routes of entry.
Collapse
Affiliation(s)
- Ehsan Hemmativaghef
- Faculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
3
|
Sliwinska-Kowalska M, Fuente A, Zamyslowska-Szmytke E. Cochlear dysfunction is associated with styrene exposure in humans. PLoS One 2020; 15:e0227978. [PMID: 31961907 PMCID: PMC6974250 DOI: 10.1371/journal.pone.0227978] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 01/03/2020] [Indexed: 11/30/2022] Open
Abstract
AIM Occupational exposure to styrene has been shown to be associated with an increased probability of developing hearing loss. However, the sites of lesions in the auditory system in humans remain unknown. The aim of this study was to investigate the possible adverse effects of styrene exposure on the cochlea of human subjects. DESIGN The hearing function of 98 styrene-exposed male workers from the glass fibre-reinforced plastics industry (mean concentration of 55 mg/m3) was evaluated bilaterally using pure-tone audiometry (1000-16000 Hz), distortion product otoacoustic emissions (DPOAEs), and auditory brainstem response (ABR). The results were compared to a group of 111 male workers exposed to noise (above 85 dBA) and 70 male white-collar workers exposed to neither noise nor solvents. Age and noise exposure levels were accounted for as confounding variables in all statistical models. RESULTS Styrene exposure was significantly associated with poorer pure-tone thresholds (1-8 kHz), lower DPOAE amplitudes (5-6 kHz), and shorter wave V latencies in both ears compared to control-group subjects. Similar results were found among noise-exposed subjects. A further analysis with wave V latency showed that styrene-exposed subjects showed significantly shorter latencies than expected according to normative data. These results suggest that occupational exposure to styrene at moderate concentrations is associated with cochlear dysfunction, at least at high frequencies. DPOAEs may be considered a valuable diagnostic tool in hearing conservation programs in workers exposed to styrene.
Collapse
Affiliation(s)
| | - Adrian Fuente
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal, Québec, Canada
- École d’orthophonie et d’audiologie, Faculté de médecine, Université de Montréal, Québec, Canada
| | - Ewa Zamyslowska-Szmytke
- Department of Audiology and Phoniatrics, Nofer Institute of Occupational Medicine, Lodz, Poland
| |
Collapse
|
4
|
Pudrith C, Dudley WN. Sensorineural hearing loss and volatile organic compound metabolites in urine. Am J Otolaryngol 2019; 40:409-412. [PMID: 30871731 DOI: 10.1016/j.amjoto.2019.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/04/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE Oxidative stress in the auditory system contributes to acquired sensorineural hearing loss. Systemic oxidative stress, which may predict auditory oxidative stress, can be assessed by measuring volatile organic compound metabolite concentrations in urine. The purpose of this retrospective study was to determine if hearing decreased in those with higher concentrations of urinary volatile organic compound metabolites. MATERIALS AND METHODS Audiometric, demographic, and metabolite concentration data were downloaded from the 2011-2012 cycle of the U.S. National Health and Nutritional Examination Survey. Participants were first grouped by reported noise exposure. For each metabolite, an analysis of covariance was used to look for differences in age-adjusted hearing loss among urinary volatile organic compound metabolite concentration groups. Participants were grouped into quartiles based on concentration for each metabolite separately because many individuals were at the lower limit of concentration detection for several metabolites, leading to a non-normal distribution. RESULTS Age-adjusted high-frequency pure-tone thresholds were significantly (FDR < 0.05) increased by about 3 to 4 dB in high concentration quartile groups for five metabolites. All five metabolites were glutathione-dependent mercapturic acids. The parent compounds of these metabolites included acrylonitrile, 1,3 butadiene, styrene, acrylamide, and N,N-dimethylformamide. Significant associations were only found in those with no reported noise exposure. CONCLUSIONS Urinary metabolites may help to explain susceptibility to oxidative stress-induced hearing loss.
Collapse
Affiliation(s)
- Charles Pudrith
- Department of Allied Health and Communicative Disorders, Northern Illinois University, IL, United States of America.
| | - William N Dudley
- Department of Public Health Education, University of North Carolina at Greensboro, NC, United States of America.
| |
Collapse
|
5
|
Pleban FT, Oketope O, Shrestha L. Occupational Styrene Exposure on Auditory Function Among Adults: A Systematic Review of Selected Workers. Saf Health Work 2017; 8:329-336. [PMID: 29276630 PMCID: PMC5715476 DOI: 10.1016/j.shaw.2017.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 12/30/2016] [Accepted: 01/11/2017] [Indexed: 11/17/2022] Open
Abstract
A review study was conducted to examine the adverse effects of styrene, styrene mixtures, or styrene and/or styrene mixtures and noise on the auditory system in humans employed in occupational settings. The search included peer-reviewed articles published in English language involving human volunteers spanning a 25-year period (1990–2015). Studies included peer review journals, case–control studies, and case reports. Animal studies were excluded. An initial search identified 40 studies. After screening for inclusion, 13 studies were retrieved for full journal detail examination and review. As a whole, the results range from no to mild associations between styrene exposure and auditory dysfunction, noting relatively small sample sizes. However, four studies investigating styrene with other organic solvent mixtures and noise suggested combined exposures to both styrene organic solvent mixtures may be more ototoxic than exposure to noise alone. There is little literature examining the effect of styrene on auditory functioning in humans. Nonetheless, findings suggest public health professionals and policy makers should be made aware of the future research needs pertaining to hearing impairment and ototoxicity from styrene. It is recommended that chronic styrene-exposed individuals be routinely evaluated with a comprehensive audiological test battery to detect early signs of auditory dysfunction.
Collapse
Affiliation(s)
- Francis T Pleban
- Department of Public Health, Health Administration, and Health Sciences, Tennessee State University, Avon Williams Campus, Nashville, TN, USA
| | - Olutosin Oketope
- Department of Public Health, Health Administration, and Health Sciences, Tennessee State University, Avon Williams Campus, Nashville, TN, USA
| | - Laxmi Shrestha
- Department of Public Health, Health Administration, and Health Sciences, Tennessee State University, Avon Williams Campus, Nashville, TN, USA
| |
Collapse
|
6
|
|
7
|
Vyskocil A, Truchon G, Leroux T, Lemay F, Gendron M, Gagnon F, Majidi NE, Boudjerida A, Lim S, Emond C, Viau C. A weight of evidence approach for the assessment of the ototoxic potential of industrial chemicals. Toxicol Ind Health 2011; 28:796-819. [PMID: 22064681 DOI: 10.1177/0748233711425067] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There is accumulating epidemiological evidence that exposure to some solvents, metals, asphyxiants and other substances in humans is associated with an increased risk of acquiring hearing loss. Furthermore, simultaneous and successive exposure to certain chemicals along with noise can increase the susceptibility to noise-induced hearing loss. There are no regulations that require hearing monitoring of workers who are employed at locations in which occupational exposure to potentially ototoxic chemicals occurs in the absence of noise exposure. This project was undertaken to develop a toxicological database allowing the identification of possible ototoxic substances present in the work environment alone or in combination with noise exposure. Critical toxicological data were compiled for chemical substances included in the Quebec occupational health regulation. The data were evaluated only for noise exposure levels that can be encountered in the workplace and for realistic exposure concentrations up to the short-term exposure limit or ceiling value (CV) or 5 times the 8-h time-weighted average occupational exposure limit (TWA OEL) for human data and up to 100 times the 8-h TWA OEL or CV for animal studies. In total, 224 studies (in 150 articles of which 44 evaluated the combined exposure to noise and a chemical) covering 29 substances were evaluated using a weight of evidence approach. For the majority of cases where potential ototoxicity was previously proposed, there is a paucity of toxicological data in the primary literature. Human and animal studies indicate that lead, styrene, toluene and trichloroethylene are ototoxic and ethyl benzene, n-hexane and p-xylene are possibly ototoxic at concentrations that are relevant to the occupational setting. Carbon monoxide appears to exacerbate noise-induced hearing dysfunction. Toluene interacts with noise to induce more severe hearing losses than the noise alone.
Collapse
Affiliation(s)
- A Vyskocil
- Institut de recherche en santé publique de l'Université de Montréal, Département de santé environnementale et santé au travail, Université de Montréal, Canada.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
|
9
|
Gopal KV, Wu C, Moore EJ, Gross GW. Assessment of styrene oxide neurotoxicity using in vitro auditory cortex networks. ISRN OTOLARYNGOLOGY 2011; 2011:204804. [PMID: 23724250 PMCID: PMC3658808 DOI: 10.5402/2011/204804] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2011] [Accepted: 07/06/2011] [Indexed: 11/23/2022]
Abstract
Styrene oxide (SO) (C8H8O), the major metabolite of styrene (C6H5CH=CH2), is widely used in industrial applications. Styrene and SO are neurotoxic and cause damaging effects on the auditory system. However, little is known about their concentration-dependent electrophysiological and morphological effects. We used spontaneously active auditory cortex networks (ACNs) growing on microelectrode arrays (MEA) to characterize neurotoxic effects of SO. Acute application of 0.1 to 3.0 mM SO showed concentration-dependent inhibition of spike activity with no noticeable morphological changes. The spike rate IC50 (concentration inducing 50% inhibition) was 511 ± 60 μM (n = 10). Subchronic (5 hr) single applications of 0.5 mM SO also showed 50% activity reduction with no overt changes in morphology. The results imply that electrophysiological toxicity precedes cytotoxicity. Five-hour exposures to 2 mM SO revealed neuronal death, irreversible activity loss, and pronounced glial swelling. Paradoxical "protection" by 40 μM bicuculline suggests binding of SO to GABA receptors.
Collapse
Affiliation(s)
- Kamakshi V Gopal
- Department of Speech and Hearing Sciences, University of North Texas, P.O. Box 305010, Denton, TX 76203-5010, USA ; Center for Network Neuroscience, University of North Texas, P.O. Box 305010, Denton, TX 76203-5010, USA
| | | | | | | |
Collapse
|
10
|
Morata TC, Sliwinska-Kowalska M, Johnson AC, Starck J, Pawlas K, Zamyslowska-Szmytke E, Nylen P, Toppila E, Krieg E, Pawlas N, Prasher D. A multicenter study on the audiometric findings of styrene-exposed workers. Int J Audiol 2011; 50:652-60. [DOI: 10.3109/14992027.2011.588965] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
11
|
Chen GD, Henderson D. Cochlear injuries induced by the combined exposure to noise and styrene. Hear Res 2009; 254:25-33. [DOI: 10.1016/j.heares.2009.04.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2009] [Revised: 03/15/2009] [Accepted: 04/09/2009] [Indexed: 10/20/2022]
|
12
|
Abstract
Organic solvents have been reported to adversely affect human health, including hearing health. Animal models have demonstrated that solvents may induce auditory damage, especially to the outer hair cells. Research on workers exposed to solvents has suggested that these chemicals may also induce auditory damage through effects on the central auditory pathways. Studies conducted with both animals and humans demonstrate that the hearing frequencies affected by solvent exposure are different to those affected by noise, and that solvents may interact synergistically with noise. The present article aims to review the contemporary literature of solvent-induced hearing loss, and consider the implications of solvent-induced auditory damage for clinical audiologists. Possible audiological tests that may be used when auditory damage due to solvent exposure is suspected are discussed.
Collapse
Affiliation(s)
- Adrian Fuente
- Centre for Communication Disorders, The University of Hong Kong, Hong Kong, China.
| | | |
Collapse
|
13
|
Hoet P, Lison D. Ototoxicity of Toluene and Styrene: State of Current Knowledge. Crit Rev Toxicol 2008; 38:127-70. [DOI: 10.1080/10408440701845443] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
|
14
|
Occupational styrene exposure and hearing loss: a cohort study with repeated measurements. Int Arch Occup Environ Health 2008; 82:463-80. [PMID: 18762967 DOI: 10.1007/s00420-008-0355-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Accepted: 08/11/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Associations between occupational styrene exposure and impairment of hearing function were investigated, guided by three questions: are there hearing losses concerning high frequency and standard audiometric test? Are there dose-response relationships and measurable thresholds of effects? Are there signs of reversibility of possible effects if the workers are examined during times of improvement from their work? METHODS A group of workers from a boat building plant, some of whom were laminators, were examined in subgroups of current low (n = 99, mean mandelic acid MA + phenylglyoxylic acid PGA = 51 mg/g creatinine), medium (n = 118, mean 229 mg/g creat.) and high (n = 31, mean 970 mg/g creat.) exposure to styrene. In addition, subgroups chronically exposed to high-long (n = 17) and low-short (n = 34) styrene levels were analysed. The examinations were carried out during normal work days and during the company holidays. Hearing thresholds and transient evoked otoacoustic emissions (TEOAE) were measured. Statistics included multiple co-variance analyses with repeated measures, linear regressions, and logistic regressions. RESULTS The analyses of all participants demonstrated no clear exposure effects. Particularly no sufficient proof of dose-response relationship measured against parameters of current exposure (MA + PGA, styrene/blood) and of chronic exposure (cumulative and average life time exposure resp.) was found. The analyses of groups exposed to high levels show elevated thresholds at frequencies up to 1,500 Hz among the subgroup exposed to high styrene levels (e.g. 40-50 ppm as average) for a longer period of time (e.g. more than 10 years). These participants also demonstrated signs of "improvement" at frequencies above 2,000 Hz during work holidays, when they were not exposed to styrene. A significantly elevated odds ratio for cases of hearing loss (more than 25 dB (A) in one ear, 3,000-6,000 Hz) was found among the group exposed to high levels (above 30 ppm as average) for a longer period of time (more than 10-26 years). The measurements of TEOAE did not exhibit significant results related to exposure. CONCLUSION This study found, that chronic and intensive styrene exposure increases the hearing thresholds. At levels of about 30-50 ppm as an average inhaled styrene per work day over a period of about 15 years with higher exposure levels above 50 ppm in the past, an elevated risk for impaired hearing thresholds can be expected. The formerly published results on ototoxic effects below 20 ppm could not be confirmed. With few exceptions (at frequencies of 1,000 and 1,500 Hz) no dose-response relationship between threshold and exposure data was found. Improvements of hearing thresholds during work- and exposure-free period are possible.
Collapse
|
15
|
Relationship Between Styrene Exposure and Hearing Loss: Review of Human Studies. Int J Occup Med Environ Health 2007; 20:315-25. [DOI: 10.2478/v10001-007-0040-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
16
|
Gagnaire F, Langlais C, Grossmann S, Wild P. Ototoxicity in rats exposed to ethylbenzene and to two technical xylene vapours for 13 weeks. Arch Toxicol 2006; 81:127-43. [PMID: 16786347 DOI: 10.1007/s00204-006-0124-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Accepted: 05/30/2006] [Indexed: 10/24/2022]
Abstract
Male Sprague-Dawley rats were exposed to ethylbenzene (200, 400, 600 and 800 ppm) and to two mixed xylenes (250, 500, 1,000 and 2,000 ppm total compounds) by inhalation, 6 h/day, 6 days/week for 13 weeks and sacrificed for morphological investigation 8 weeks after the end of exposure. Brainstem auditory-evoked responses were used to determine auditory thresholds at different frequencies. Ethylbenzene produced moderate to severe ototoxicity in rats exposed to the four concentrations studied. Increased thresholds were observed at 2, 4, 8 and 16 kHz in rats exposed to 400, 600 and 800 ppm ethylbenzene. Moderate to severe losses of outer hair cells of the organ of Corti occurred in animals exposed to the four concentrations studied. Exposure to both mixed xylenes produced ototoxicity characterized by increased auditory thresholds and losses of outer hair cells. Ototoxicity potentiation caused by ethylbenzene was observed. Depending on the mixed xylene studied and the area of the concentration-response curves taken into account, the concentrations of ethylbenzene in mixed xylenes necessary to cause a given ototoxicity were 1.7-2.8 times less than those of pure ethylbenzene. Given the high ototoxicity of ethylbenzene, the safety margin of less or equal to two (LOAEL/TWA) might be too small to protect workers from the potential risk of ototoxicity. Moreover, the enhanced ototoxicity of ethylbenzene and para-xylene observed in mixed xylenes should encourage the production of mixed xylenes with the lowest possible concentrations of ethylbenzene and para-xylene.
Collapse
Affiliation(s)
- François Gagnaire
- Département Polluants et Santé, Institut National de Recherche et de Sécurité, Avenue de Bourgogne, BP 27, 54501 Vandoeuvre Cedex, France.
| | | | | | | |
Collapse
|
17
|
Hoffmann J, Ihrig A, Hoth S, Triebig G. Field study to explore possible effects of styrene on auditory function in exposed workers. INDUSTRIAL HEALTH 2006; 44:283-6. [PMID: 16716004 DOI: 10.2486/indhealth.44.283] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
OBJECTIVES We conducted this study to examine, whether occupational styrene exposures are associated with reduced hearing ability. METHODS The auditory function was investigated by pure tone audiometry and registration of transitory evoked otoacoustic emissions (TEOAE) in 32 workers of a fibre-reinforced plastic boat building factory. Sixteen subjects were laminators (mean age: 41 yr (SD: 8)) and therefore regularly exposed to styrene with mean duration of exposure to styrene of 7.5 yr (SD 5.0). The tests were applied to a reference group of 16 workers (mean age: 39 yr (SD: 8)) who were not directly exposed to styrene but had a similar noise exposure. RESULTS A few and isolated correlations between the parameters of hearing acuity and exposure indices, such as current internal styrene exposures (sum of MA and PGA) and duration of styrene exposure, were statistically significant, but no consistent association was found. CONCLUSION The results of this study do not support the assumption of an ototoxic effect of chronic styrene exposure in workers.
Collapse
Affiliation(s)
- Jörg Hoffmann
- Institute and Outpatient Clinic for Occupational and Social Medicine, University Hospital Heidelberg, Vosstrasse 2, 69115 Heidelberg, Germany
| | | | | | | |
Collapse
|
18
|
Lawton BW, Hoffmann J, Triebig G. The ototoxicity of styrene: a review of occupational investigations. Int Arch Occup Environ Health 2005; 79:93-102. [PMID: 16151828 DOI: 10.1007/s00420-005-0030-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Accepted: 07/11/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The objective of this study was to review critically a number of occupational investigations of the exposure and effect relation between inhaled styrene vapour and hearing loss. There is concern that workers' hearing may be impaired by exposure to styrene, as used in industries making plastics and fibreglass-reinforced products. METHODS Seven occupational studies, each dealing with the ototoxicity of styrene, were examined. Factors assessed included the experimental design and number of subjects within exposure groups, measurement of the styrene-in-air concentration, confirmation of the styrene exposure by blood or urine analysis, determination of the hearing threshold levels for the exposure and control groups, and measurement of any occupational noise in the subjects' workplaces. Consideration was also given to statistical relations between high-frequency hearing loss and lifetime exposure indices for styrene and noise. RESULTS The results are equivocal. Four investigations failed to find any effect of styrene on hearing thresholds. In contrast, other investigations claimed to have demonstrated styrene-induced hearing loss in industrial populations, with synergism between styrene and noise. However, these reports exhibited shortcomings of experimental design and data analysis. CONCLUSIONS Considering the body of evidence as a whole, hearing deficits due to occupational exposure to styrene at low concentrations have not been demonstrated by scientifically reliable argument. There is some suggestion of an association between styrene exposure, occupational noise, and hearing dysfunction. Further studies in humans are necessary to clarify this question.
Collapse
Affiliation(s)
- B W Lawton
- Institute of Sound and Vibration Research, University of Southampton, University Road, Highfield, SO17 1BJ, Southampton, United Kingdom.
| | | | | |
Collapse
|
19
|
Abstract
The effect of industrial chemicals on the sensory perception of exposed workers has received scant attention from the medical community to date, and the scientific literature is mainly limited to some case-reports or isolated studies. Possible explanations for this include the complexity of sensory perception, and the lack of agreement among researchers on methods for testing large groups of subjects. Nevertheless, some published studies showed that vision, hearing and olfactory function can be affected by various industrial metals and solvents, and some data exist also for touch and taste. This review discusses the main industrial chemicals involved. The pathogenesis of the toxicity of chemicals to sensory perception may be related to an action on receptors, nerve fibers, and/or the brain; probably, different pathogenetic mechanisms are involved. One of the main problems in this research field is that most of the studies to date evaluated the effect of a single industrial chemical on a single sense: as an example, we know that styrene exposure can impair smell and also hearing and vision but we have little idea whether different senses are impaired in the same worker, or whether each impairment is independent. In addition, workers are frequently exposed to different chemicals: co-exposure may have no effect, or result in both an increase or a decrease of the effect, as was observed for hearing loss, but studies on this aspect are largely insufficient. Research shows that both occupational and environmental exposure to industrial chemicals can affect sense organs, and suggests that the decline of perception with age may be, at least partly, related to this exposure. Nevertheless, available evidence is incomplete, and is largely inadequate for an estimation of a "safe" threshold of exposure. Good quality further research in this field is needed. This is certainly complex and demands adequate resources, but is justified by the ultimate result: the possibility to prevent an avoidable part of the decline in sensory function with age.
Collapse
Affiliation(s)
- Fabriziomaria Gobba
- Cattedra di Medicina del Lavoro, Dipartimento di Scienze Igienistiche, Università di Modena e Reggio Emilia, 41100 (MO) Modena, Italy.
| |
Collapse
|
20
|
Morata TC, Johnson AC, Nylen P, Svensson EB, Cheng J, Krieg EF, Lindblad AC, Ernstgård L, Franks J. Audiometric findings in workers exposed to low levels of styrene and noise. J Occup Environ Med 2002; 44:806-14. [PMID: 12227672 DOI: 10.1097/00043764-200209000-00002] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Audiometry and exposure measurements were conducted on workers from fiberglass and metal products manufacturing plants and a mail distribution terminal (N = 313). Workers exposed to noise and styrene had significantly worse pure-tone thresholds at 2, 3, 4, and 6 kHz when compared with noise-exposed or nonexposed workers. Age, noise exposure, and urinary mandelic acid (a biologic marker for styrene) were the variables that met the significance level criterion in the multiple logistic regression. The odds ratios for hearing loss were 1.19 for each increment of 1 year of age (95% confidence interval [CI], 1.11-1.28), 1.18 for every decibel >85 dB(A) of noise exposure (95% CI, 1.01-1.34), and 2.44 for each millimole of mandelic acid per gram of creatinine in urine (95% CI, 1.01-5.89). Our findings suggest that exposure to styrene even below recommended values had a toxic effect on the auditory system.
Collapse
Affiliation(s)
- Thais C Morata
- National Institute for Occupational Safety and Health, Division of Applied Research and Technology, Cincinnati, Ohio 45226, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Cohen JT, Carlson G, Charnley G, Coggon D, Delzell E, Graham JD, Greim H, Krewski D, Medinsky M, Monson R, Paustenbach D, Petersen B, Rappaport S, Rhomberg L, Ryan PB, Thompson K. A comprehensive evaluation of the potential health risks associated with occupational and environmental exposure to styrene. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2002; 5:1-265. [PMID: 12012775 DOI: 10.1080/10937400252972162] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Affiliation(s)
- Joshua T Cohen
- Harvard Center for Risk Analysis, Harvard School of Public Health, Boston, Massachusetts, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
22
|
|