Promotion of noise-induced hearing loss by chemical contaminants

Risk analysis of noise-induced hearing loss of workers in the automobile manufacturing industries based on back-propagation neural network model: a cross-sectional study in Han Chinese population

OBJECTIVES

This study aims to predict the risk of noise-induced hearing loss (NIHL) through a back-propagation neural network (BPNN) model. It provides an early, simple and accurate prediction method for NIHL.

DESIGN

Population based, a cross sectional study.

SETTING

Han, China.

PARTICIPANTS

This study selected 3266 Han male workers from three automobile manufacturing industries.

PRIMARY OUTCOME MEASURES

Information including personal life habits, occupational health test information and occupational exposure history were collected and predictive factors of NIHL were screened from these workers. BPNN and logistic regression models were constructed using these predictors.

RESULTS

The input variables of BPNN model were 20, 16 and 21 important factors screened by univariate, stepwise and lasso-logistic regression. When the BPNN model was applied to the test set, it was found to have a sensitivity (TPR) of 83.33%, a specificity (TNR) of 85.92%, an accuracy (ACC) of 85.51%, a positive predictive value (PPV) of 52.85%, a negative predictive value of 96.46% and area under the receiver operating curve (AUC) is: 0.926 (95% CI: 0.891 to 0.961), which demonstrated the better overall properties than univariate-logistic regression modelling (AUC: 0.715) (95% CI: 0.652 to 0.777). The BPNN model has better predictive performance against NIHL than the stepwise-logistic and lasso-logistic regression model in terms of TPR, TNR, ACC, PPV and NPV (p<0.05); the area under the receiver operating characteristics curve of NIHL is also higher than that of the stepwise and lasso-logistic regression model (p<0.05). It was a relatively important factor in NIHL to find cumulative noise exposure, auditory system symptoms, age, listening to music or watching video with headphones, exposure to high temperature and noise exposure time in the trained BPNN model.

CONCLUSIONS

The BPNN model was a valuable tool in dealing with the occupational risk prediction problem of NIHL. It can be used to predict the risk of an individual NIHL.

Coexposure to Solvents and Noise as a Risk Factor for Hearing Loss in Agricultural Workers

OBJECTIVE

This study addressed the relationship of hearing loss and coexposure to solvents and noise among farmers and ranchers in central United States.

METHODS

The surveillance study included surveys to stratified random samples of operations in 2018 and 2020 (n = 34,146), requesting information on injuries, illnesses, exposures, and preventive measures. Responses (n = 7495) were analyzed using hierarchical multinomial logistic regression, adjusting for personal and work characteristics.

RESULTS

Nearly 60% of respondents exposed to both solvents and noise reported hearing loss. The exposures increased the adjusted odds of moderate/severe hearing loss as follows: solvents alone, (odds ratio [OR], 1.49; 95% confidence interval [CI], 0.93-2.38), noise alone (OR, 4.42; 95% CI, 3.39-5.76), and coexposure to both noise and solvents (OR, 6.03; 95% CI, 4.67-7.78).

CONCLUSIONS

Solvent exposure, along with noise, should be considered in hearing conservation programs among farmers and ranchers.

Assessing ototoxicity due to chronic lead and cadmium intake with and without noise exposure in the mature mouse

Exposure to heavy metals may lead to hearing impairment. However, experimental studies have not explored this issue with and without noise exposure in mature animals with environmentally relevant doses. The aim of this study was to investigate ototoxicity produced by lead (Pb) and cadmium (Cd) and noise, singly and in combination, in the adult CBA/CaJ mouse. Metals were delivered via drinking water (0.03 mM, 1 mM, and 3 mM Pb; or 30, 100, and 300 μM Cd) for 12 weeks, resulting in environmentally- and occupationally relevant mean (± standard deviations) blood levels of Pb (2.89 ± 0.44, 38.5 ± 4.9, and 60.1 ± 6.6 μg/dl, respectively) and Cd (1.3 ± 0.23, 6.37 ± 0.87, 27.2 ± 4.1 μg/L, respectively). Metal treatment was also combined with a noise exposure consisting of a 105 dB broadband (2-20 kHz) stimulus for 2 hr or a sham exposure. Auditory performance was determined by comparing auditory brainstem responses (ABR) and distortion product otoacoustic emissions (DPOAE) at baseline and after 11 weeks of metal treatment. Metal-exposed animals did not develop significant auditory deficits and did not exhibit morphological damage to cochlear hair cells. In contrast, noise-exposed animals, including those exposed to combinations of metals and noise, demonstrated significant hair cell loss, reduced DPOAE amplitudes, and ABR threshold shifts of 42.2 ± 13 dB at 32 kHz (105 dB noise alone). No significant potentiation or synergistic effects were found in groups exposed to multiple agents. This study establishes a highly reproducible adult mouse model that may be used to evaluate a variety of environmental exposure mixtures.

Exposure assessment of non-electric ice resurfacer operators in indoor ice rinks: a pilot study

Exposure of ice resurfacer operators to indoor air contaminants was measured in six indoor ice arenas. A standardized questionnaire on technical and operational features was employed and indoor airborne concentrations of carbon monoxide (CO), carbon dioxide (CO₂), nitric oxide (NO), nitrogen dioxide (NO₂), sulfur dioxide (SO₂), and total volatile organic compounds (VOCs) were measured. Air samples were collected using a range of direct reading instruments attached to the driver's seat of the resurfacer. The range of mean exposure concentrations via positional sampling (i.e. as close as able to the operator's breathing zone) were 5.7-7.4 ppm, 694-2171 ppm, <0.5 to 0.5 ppm, and < 0.1 to 0.2 ppm, for CO, CO₂, NO, and NO₂, respectively. Exposure levels for SO₂ and VOC were below detection. Overall, each of the measured indoor air contaminants was found to be below its respective occupational exposure limits (OEL), suggesting that the risk of hazardous exposure is low. The use of natural gas as a fuel source is believed to contribute to low contaminant concentrations.

Associations of genetic variation in CASP3 gene with noise-induced hearing loss in a Chinese population: a case-control study

BACKGROUND

Noise-induced hearing loss (NIHL) is a complex disease caused by environmental and genetic risk factors. This study explored the relationship between the genetic variations in the CASP gene and the risk of developing NIHL among Chinese workers exposed to occupational noise.

METHODS

A case-control study of 272 NIHL workers and 272 normal-hearing workers matched for age, sex and years of noise exposure was conducted. Fifteen single-nucleotide polymorphisms (SNP) in the CASP1, CASP3, CASP4, CASP5, CASP6, CASP8, CASP9, CASP10 and CASP14 genes were genotyped using the polymerase chain reaction-ligase detection reaction method. Using conditional logistic regression models, the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of genetic variations associated with NIHL risk were calculated.

RESULTS

Two SNPs in the CASP3 gene were associated with NIHL risk. For rs1049216, TT genotype was associated with a decreased risk of NIHL (OR = 0.246, 95% CI = 0.069-0.886) when compared with the CC genotype. For rs6948, the AC and CC genotype were associated with a decreased NIHL risk (OR = 0.568, 95% CI = 0.352-0.916) compared with AA genotype. There were joint effects of working time and CASP3 polymorphisms on NIHL risk (P < 0.05).

CONCLUSIONS

Genetic variations in the CASP3 gene and the joint effects of working time and CASP3 polymorphisms may modify the risk of developing NIHL.

PON2 and ATP2B2 gene polymorphisms with noise-induced hearing loss

BACKGROUND

Noise-induced hearing loss (NIHL) is a complex disease induced by a combination of genetic and environmental factors. Paraoxonase2 (PON2) gene involved in the regulation of reactive oxygen species, and affecting the vulnerability of cochlea to NIHL, and ATPase, calcium-transporting, plasma membrane 2 (ATP2B2) gene which encodes plasma membrane calcium-transporting ATPase isoform 2 (PMCA2) are the candidate genes relating to the attack of NIHL. In this study, we investigated whether ATP2B2 and PON2 polymorphisms were associated with NIHL in Chinese of Han nationality population.

METHODS

We performed a case-control study between six single nucleotide polymorphisms (SNPs) (rs1719571, rs3209637 and rs4327369 within ATP2B2, rs12026, rs7785846 and rs12704796 within PON2) and NIHL in 454 subjects. All the SNPs were genotypes, using the TaqMan MGB probe assay. Odds ratios (ORs) were calculated with 95% confidence intervals (95% CIs) with logistic regression analysis to test the level of association for SNPs.

RESULTS

In our study, 221 subjects with hearing loss and 233 subjects without hearing loss were recruited. The frequencies of the CG and CG + GG genotype of rs12026 (PON2) conferred risk factors for NIHL with adjusted OR values of 2.62 (95% CI, 1.69-4.06) and 2.48 (95% CI, 1.63-3.78), respectively. This kind of significance was also found at locus rs7785846, where genotypes CT and CT + TT were the risk types, with adjusted ORs of 2.52 (95% CI, 1.62-3.93) and 2.35 (95% CI, 1.54-3.58), respectively. We performed stratified analysis per noise exposure level, when it came to rs7785846 and rs12026 in the >92 dB(A) noise exposure group, the subjects who carried heterozygote were of significantly (P<0.01) higher susceptibility to NIHL than homozygote carriers. By contrast, no significantly higher risk was found for any rs12704796 genotypes or any genotypes in ATP2B2 (P>0.05), which may suggest that these SNPs did not have significant effects on noise susceptibility across noise exposure.

CONCLUSIONS

Our research suggested that PON2 might play a role in the etiology of NIHL in Chinese of Han nationality population.

Is There Sufficient Training of Health Care Staff on Noise Reduction in Neonatal Intensive Care Units? a Pilot Study From Neonoise Project

Evidence indicates that exposure to high levels of noise adversely affects human health, and these effects are dependent upon various factors. In hospitals, there are many sources of noise, and high levels exert an impact on patients and staff, increasing both recovery time and stress, respectively. The goal of this pilot study was to develop, implement, and evaluate the effectiveness of a training program (TP) on noise reduction in a neonatal intensive care unit (NICU) by comparing the noise levels before and after the implementation of the program. In total, 79 health professionals participated in the study. The measurements of sound pressure levels took into account the layout of the unit and locations of the main sources of noise. General results indicated that LAeq levels before implementation of the training program were often excessive, ranging from 48.7 ± 2.94 dBA to 71.7 ± 4.74 dBA, exceeding international guidelines. Similarly, following implementation of the training program, noise levels remained unchanged (54.5 ± 0.49 dBA to 63.9 ± 4.37 dBA), despite a decrease in some locations. There was no significant difference before and after the implementation of TP. However, a significant difference was found for Lp,Cpeak, before and after training staff, suggesting greater care by health care professionals performing their tasks. Even recognizing that a TP is quite important to change behaviors, this needs to be considered in a broader context to effectively control noise in the NICU.

Sound Levels and Risk Perceptions of Music Students During Classes

It is well recognized that professional musicians are at risk of hearing damage due to the exposure to high sound pressure levels during music playing. However, it is important to recognize that the musicians' exposure may start early in the course of their training as students in the classroom and at home. Studies regarding sound exposure of music students and their hearing disorders are scarce and do not take into account important influencing variables. Therefore, this study aimed to describe sound level exposures of music students at different music styles, classes, and according to the instrument played. Further, this investigation attempted to analyze the perceptions of students in relation to exposure to loud music and consequent health risks, as well as to characterize preventive behaviors. The results showed that music students are exposed to high sound levels in the course of their academic activity. This exposure is potentiated by practice outside the school and other external activities. Differences were found between music style, instruments, and classes. Tinnitus, hyperacusis, diplacusis, and sound distortion were reported by the students. However, students were not entirely aware of the health risks related to exposure to high sound pressure levels. These findings reflect the importance of starting intervention in relation to noise risk reduction at an early stage, when musicians are commencing their activity as students.

Mitochondrial DNA common deletion increases susceptibility to noise-induced hearing loss in a mimetic aging rat model

Noise-induced hearing loss (NIHL) is an important occupational health hazard. However, susceptibility to NIHL remains poorly understood. The present study was designed to investigate whether mitochondrial DNA common deletion (CD) increases the susceptibility of individuals to NIHL. A mimetic aging rat model harboring increased CD in the inner ear was established by chronic d-galactose administration, and the synergic effect of CD and noise on hearing sensitivity was assessed. We determined that although developed the same magnitude of temporary threshold shifts and hair cell loss, the d-galactose treated rats with increased CD in the inner ear exhibited a longer hearing recovery process and experienced higher permanent hearing threshold shifts at high frequencies than the saline-treated control rats. Greater supporting cell damage and stria vascularis ultrastructural changes were observed in d-galactose treated rats three weeks after recovery. The results suggested that the elevated CD in the inner ear could increase an individual's susceptibility to NIHL, which likely through a reduction in the self-repairing capability within the cochlea after acoustic injury.

Noise-induced hearing loss in workers exposed to urban stressors

The technological and industrial progress together with the intensification of vehicular traffic and the adoption of new social habits are the cause of an increasing noise pollution with possible negative effects on the auditory system. This study aims to assess the noise exposure levels and the effects on the hearing threshold in outdoor and indoor male workers of a big Italian city. The study was carried out on 357 outdoor male workers, exposed to urban noise and on a control group of 357 unexposed indoor workers. Noise levels were measured in 30 outdoor and indoor areas. The subjects underwent tonal liminal audiometry in order to determine the value of their hearing threshold. During their working activity, outdoor and indoor workers are exposed to different noise levels LEX<80 dB(A). At mid-low frequencies (250-2000 Hz), the results show significant differences in the average values of hearing threshold between the two groups in both ears and for all age classes; there are no significant differences between the two groups at higher frequencies. The outdoor noise levels measured are not usually ototoxic and the hearing loss at mid-low frequencies is not characteristic of the exposure to industrial noise. For these reasons the Authors hypothesize that the results may be due to the combined effect of the exposure to noise and to ototoxic air pollutants. The impairment of speech frequencies is disabling and involves the risk of missed forensic recognition.

Determinants of bilateral audiometric notches in noise-induced hearing loss

OBJECTIVES/HYPOTHESIS

To explore the possible determinants of bilateral audiometric notches in noise-induced hearing loss (NIHL).

STUDY DESIGN

Prospectively enrolled cohort with cross-sectional analysis.

METHODS

Male workers (n = 412) with exposure to continuous loud noise (noise exposure level normalized to a nominal 8-hour working day >75 dBA) during work were included in this cohort study. The relationship between the presence of bilateral audiometric notches and age, noise exposure duration, noise exposure level, and shift from the predicted thresholds over different frequencies were determined by regression model analysis, receiver operating characteristic analysis, and area under the curve analysis.

RESULTS

The presence of bilateral audiometric notches was closely associated with the shifts from the predicted thresholds over 1, 2, 3, 4, and 6 kHz. The shift pattern was somewhat different between those who used hearing protection devices and those who did not. The shifts from the predicted thresholds demonstrated a stronger association with bilateral audiometric notches than did age, gender, noise exposure level, or noise exposure duration.

CONCLUSIONS

The bilateral audiometric notches in NIHL could not be determined only on the basis of age, gender, noise exposure level, or noise exposure duration. The importance of other factors associated with bilateral audiometric notches should be recognized. Elucidation of the factors of formation of bilateral audiometric notches would help us to develop a more comprehensive protection strategy to prevent further NIHL.

Association between paraoxonase 2 gene polymorphisms and noise-induced hearing loss in the Chinese population

OBJECTIVES

The aim of the present study was to investigate whether PON2 gene polymorphisms (rs7493, rs12026, rs12704796, rs7785846 and rs7786401) are associated with susceptibility to noise-induced hearing loss (NIHL) in the Chinese population.

METHODS

A case-control study was conducted using 615 cases selected without any restriction in age or sex and 644 controls who were matched with the cases in terms of age, gender and the intensity and duration of exposure to noise. Information on these subjects was gathered by questionnaires that were administered through face-to-face interviews by trained interviewers.

RESULTS

We found that the rs7493 CG + GG genotype (OR=1.36, 95% CI, 1.08-1.72), rs12026 CG + GG genotype (OR=1.34, 95% CI, 1.06-1.70), rs7785846 CT + TT genotype (OR=1.36, 95% CI, 1.07-1.71) and rs7786401 GT + TT genotype (OR=1.33, 95% CI, 1.05-1.68) were risk factors for NIHL.

CONCLUSIONS

PON2 gene polymorphisms may be associated with susceptibility to NIHL in the Chinese population

Subchronic JP-8 jet fuel exposure enhances vulnerability to noise-induced hearing loss in rats

Both laboratory and epidemiological studies published over the past two decades have identified the risk of excess hearing loss when specific chemical contaminants are present along with noise. The objective of this study was to evaluate the potency of JP-8 jet fuel to enhance noise-induced hearing loss (NIHL) using inhalation exposure to fuel and simultaneous exposure to either continuous or intermittent noise exposure over a 4-wk exposure period using both male and female Fischer 344 rats. In the initial study, male (n = 5) and female (n = 5) rats received inhalation exposure to JP-8 fuel for 6 h/d, 5 d/wk for 4 wk at concentrations of 200, 750, or 1500 mg/m³. Parallel groups of rats also received nondamaging noise (constant octave band noise at 85 dB(lin)) in combination with the fuel, noise alone (75, 85, or 95 dB), or no exposure to fuel or noise. Significant concentration-related impairment of auditory function measured by distortion product otoacoustic emissions (DPOAE) and compound action potential (CAP) threshold was seen in rats exposed to combined JP-8 plus noise exposure when JP-8 levels of 1500 mg/m³ were presented with trends toward impairment seen with 750 mg/m³ JP-8 + noise. JP-8 alone exerted no significant effect on auditory function. In addition, noise was able to disrupt the DPOAE and increase auditory thresholds only when noise exposure was at 95 dB. In a subsequent study, male (n = 5 per group) and female (n = 5 per group) rats received 1000 mg/m³ JP-8 for 6 h/d, 5 d/wk for 4 wk with and without exposure to 102 dB octave band noise that was present for 15 min out of each hour (total noise duration 90 min). Comparisons were made to rats receiving only noise, and thosereceiving no experimental treatment. Significant impairment of auditory thresholds especially for high-frequency tones was identified in the male rats receiving combined treatment. This study provides a basis for estimating excessive hearing loss under conditions of subchronic JP-8 jet fuel exposure.

A weight of evidence approach for the assessment of the ototoxic potential of industrial chemicals

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.

Role of CYP2E1-mediated metabolism in the acute and vestibular toxicities of nineteen nitriles in the mouse

Allylnitrile, cis-crotononitrile, and 3,3'-iminodipropionitrile are known to cause vestibular toxicity in rodents, and evidence is available indicating that cis-2-pentenenitrile shares this effect. We evaluated nineteen nitriles for vestibular toxicity in wild type (129S1) and CYP2E1-null mice, including all the above, several neurotoxic nitriles, and structurally similar nitriles. A new acute toxicity test protocol was developed to facilitate evaluation of the vestibular toxicity by a specific behavioral test battery at doses up to sub-lethal levels while using a limited number of animals. A mean number of 8.5±0.3 animals per nitrile, strain and sex was necessary to obtain evidence of vestibular toxicity and optionally an estimation of the lethal dose. For several but not all nitriles, lethal doses significantly increased in CYP2E1-null mice. The protocol revealed the vestibular toxicity of five nitriles, including previously identified ototoxic compounds and one nitrile (trans-crotononitrile) known to have a different profile of neurotoxic effects in the rat. In all five cases, both sexes were affected and no decrease in susceptibility was apparent in CYP2E1-null mice respect to 129S1 mice. Fourteen nitriles caused no vestibular toxicity, including six nitriles tested in CYP2E1-null mice at doses significantly larger than the maximal doses that can be tested in wild type animals. We conclude that only a subset of low molecular weight nitriles is toxic to the vestibular system, that species-dependent differences exist in this vestibular toxicity, and that CYP2E1-mediated metabolism is not involved in this effect of nitriles although it has a role in the acute lethality of some of these compounds.

Effects of gene-environmental interaction on noise-induced hearing threshold levels for high frequencies (HTLHF)

In this study we assessed the interaction between glutathione S-transferase (GST) genetic polymorphisms and noise exposures, with regard to their effect on the hearing threshold levels for high frequencies (HTLHF). Research participants comprised 347 male workers, and each participant's cumulative noise exposure was determined using a job-exposure matrix. Approximately 64.6% of the participants' exposure in L(eq-8 h) was above 90 dBA. The mean HTLHF was 32.1 dB. A significant dose-response relationship was found between noise exposure and HTLHF. We further converted the estimated total noise exposure level over each participant's job history to a noise exposure level that corresponded to a 40-year exposure (L(eq-40y)). After we had adjusted the results for age, we found that workers carrying GSTM1 null, GSTT1 null, and GSTP1 Ile(105)/Ile(105) genotypes were susceptible to the HTLHF when their L(eq-40y) were above 90 dBA. Therefore, GST genetic polymorphisms might affect HTLHF only when workers are exposed to high noise levels.

Secondhand smoke exposure and the risk of hearing loss

Hearing loss has been associated with tobacco smoking, but its relationship with secondhand smoke is not known. We sought to investigate the association between secondhand smoke exposure and hearing loss in a nationally representative sample of adults. The National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional dataset, was utilised to investigate the association between secondhand smoke exposure and hearing loss. Data collected from non-smoking participants aged 20-69 years were included in the analysis if they had completed audiometric testing, had a valid serum continue value, and provided complete smoking, medical co-morbidity and noise exposure histories (N=3307). Hearing loss was assessed from averaged pure-tone thresholds over low- or mid-frequencies (500, 1000 and 2000 Hz) and high-frequencies (3000, 4000, 6000 and 8000 Hz), and was defined as mild or greater severity (pure-tone average in excess of 25 dB HL). Second-Hand Smoke (SHS) exposure was significantly associated with increased risk of hearing loss for low-/mid-frequencies (adjusted OR=1.14; 95% CI 1.02-1.28 for never smokers and 1.30; 1.10-1.54 for former smokers) and high-frequencies (1.40; 1.22-1.81 for former smokers), after controlling for potential confounders. Findings from the present analysis indicate that SHS exposure is associated with hearing loss in non-smoking adults.

Occupational disease among non-governmental employees in Malaysia: 2002-2006

In the absence of systematic occupational disease surveillance, other data collected by governmental agencies or industry is useful in the identification of occupational diseases and their control. We examined data on occupational diseases reported by non-governmental employees to the national workers' social security organization in Malaysia, 2002-2006. The overall incidence rate of occupational disease was 2.8 per 100,000 workers. There was an increase in the annual number and rates of occupational disease over time. The most frequently reported conditions were hearing impairment (32%) and musculoskeletal disorders (28%). Workers in the non-metallic manufacturing industry had the highest average incidence rate of hearing impairment (12.7 per 100,000 workers) and musculoskeletal disorders (3.5 per 100,000 workers), compared to all other industries. Preventive measures should focus on safety education, engineering control and workplace ergonomics. Enforcing workplace standards and incorporating an ongoing surveillance system will facilitate the control and reduction of occupational disease.

Candidate gene association study for noise-induced hearing loss in two independent noise-exposed populations

Millions of people are daily exposed to high levels of noise. Consequently, noise-induced hearing loss (NIHL) is one of the most important occupational health hazards worldwide. In this study, we performed an association study for NIHL based on a candidate gene approach. 644 Single Nucleotide Polymorphisms (SNPs) in 53 candidate genes were analyzed in two independent NIHL sample sets, a Swedish set and part of a Polish set. Eight SNPs with promising results were selected and analysed in the remaining part of the Polish samples. One SNP in PCDH15 (rs7095441), resulted in significant associations in both sample sets while two SNPs in MYH14 (rs667907 and rs588035), resulted in significant associations in the Polish sample set and significant interactions with noise exposure level in the Swedish sample set. Calculation of odds ratios revealed a significant association of rs588035 with NIHL in the Swedish high noise exposure level group. Our studies suggest that PCDH15 and MYH14 may be NIHL susceptibility genes, but further replication in independent sample sets is mandatory.

Ototoxicity of trichloroethylene in concentrations relevant for the working environment

Organic solvents can cause hearing loss themselves or promote noise-induced hearing loss. The objective of this study was to review the literature on the effects of low-level exposure to trichloroethylene on the auditory system and consider its relevance for the occupational settings. Both human and animal investigations were evaluated only for realistic exposure concentrations based on the Quebec permissible exposure limits: 50 ppm 8-h time-weighed average exposure value (TWAEV) and 200 ppm short-term exposure value (STEV). In humans, the upper limit for considering ototoxicity data relevant to the occupational exposure situation was set at the STEV. Animal data were evaluated only for exposure concentrations up to 100 times the TWAEV. There is no convincing evidence of trichloroethylene-induced hearing losses in workers. In rats, trichloroethylene affects the auditory function mainly in the cochlear mid- to high-frequency range with a lowest observed adverse effect level (LOAEL) of 2000 ppm. No studies on ototoxic interaction after combined exposure to noise and trichloroethylene were identified in humans. In rats, supra-additive interaction was reported. Further studies with sufficient data on the trichloroethylene exposure of workers are necessary to make a definitive conclusion. In the interim, we recommend considering trichloroethylene as an ototoxic agent.

Variations in HSP70 genes associated with noise-induced hearing loss in two independent populations

Noise-induced hearing loss (NIHL) is one of the most important occupational health hazards. Millions of people worldwide are exposed daily to harmful levels of noise. NIHL is a complex disease resulting from an interaction between genetic and environmental factors. Although the environmental risk factors have been studied extensively, little is known about the genetic factors. Heat-shock proteins (HSPs) are induced after exposure to severe noise. When first induced by exposure to moderate sound levels, they can protect the ear from damage from excessive noise exposure. This protection is highly variable between individuals. An association of HSP70 genes with NIHL has been described by Yang et al (2006) in a Chinese sample set of noise-exposed workers. In this study, three polymorphisms (rs1043618, rs1061581 and rs2227956) in HSP70-1, HSP70-2 and HSP70-hom, respectively, were genotyped in 206 Swedish and 238 Polish DNA samples of noise-exposed subjects and analyzed. One SNP, rs2227956 in HSP70-hom, resulted in a significant association with NIHL in both sample sets. In addition, rs1043618 and rs1061581 were significant in the Swedish sample set. Analysis of the haplotypes composed of the three SNPs revealed significant associations between NIHL and haplotype GAC in both sample sets and with haplotype CGT in the Swedish sample set. In conclusion, this study replicated the association of HSP70 genes with NIHL in a second and third independent noise-exposed sample set, hereby adding to the evidence that HSP70 genes may be NIHL susceptibility genes.

Hearing loss among licensed pesticide applicators in the agricultural health study

OBJECTIVE

We evaluated self-reported hearing loss and pesticide exposure in licensed private pesticide applicators enrolled in the Agricultural Health Study in 1993 to 1997 in Iowa and North Carolina.

METHODS

Among 14,229 white male applicators in 1999 to 2003, 4926 reported hearing loss (35%). Logistic regression was performed with adjustment for state, age, and noise, solvents, and metals. We classified pesticides by lifetime days of use.

RESULTS

Compared with no exposure, the odds ratio (95% confidence interval) for the highest quartile of exposure was 1.19 (1.04 to 1.35) for insecticides and 1.17 (1.03 to 1.31) for organophosphate insecticides. Odds of hearing loss were elevated for high pesticide exposure events (1.38, 1.25 to 1.54), pesticide-related doctor visits (1.38, 1.17 to 1.62) or hospitalization (1.81, 1.25 to 2.62), and diagnosed pesticide poisoning (1.75, 1.36 to 2.26).

CONCLUSIONS

Although control for exposure to noise or other neurotoxicants was limited, this study extends previous reports suggesting that organophosphate exposure increases risk of hearing loss.

Ototoxicity and noise trauma: electron transfer, reactive oxygen species, cell signaling, electrical effects, and protection by antioxidants: practical medical aspects

Ototoxins are substances of various structures and classes. This review provides extensive evidence for involvement of electron transfer (ET), reactive oxygen species (ROS) and oxidative stress (OS) as a unifying theme. Successful application is made to the large majority of ototoxins, as well as noise trauma. We believe it is not coincidental that these toxins generally incorporate ET functionalities (quinone, metal complex, ArNO(2), or conjugated iminium) either per se or in metabolites, potentially giving rise to ROS by redox cycling. Some categories, e.g., peroxides and noise, appear to operate via non-ET routes in generating OS. These highly reactive entities can then inflict injury via OS upon various constituents of the ear apparatus. The theoretical framework is supported by the extensive literature on beneficial effects of antioxidants, both for toxins and noise. Involvement of cell signaling and electrical effects are discussed. This review is the first comprehensive one based on a unified mechanistic approach. Various practical medical aspects are also addressed. There is extensive documentation for beneficial effects of antioxidants whose use might be recommended clinically for prevention of ototoxicity and noise trauma. Recent research indicates that catalytic antioxidants may be more effective. In addition to ototoxicity, a widespread problem consists of ear infections by bacteria which are demonstrating increasing resistance to conventional therapies. A recent, novel approach to improved drugs involves use of agents which inhibit quorum sensors that play important roles in bacterial functioning. Prevention of ear injury by noise trauma is also discussed, along with ear therapeutics.

Association between variations in CAT and noise-induced hearing loss in two independent noise-exposed populations

Noise-induced hearing loss (NIHL) is an important occupational hazard that results from an interaction between genetic and environmental factors. Although the environmental risk factors have been studied quite extensively, little is known about the genetic factors. On the basis of multiple studies, it was proposed that oxidative stress plays an important role in the development of NIHL. Here, we investigated whether variations (single nucleotide polymorphisms; SNPs) in the catalase gene (CAT), one of the genes involved in oxidative stress, influence noise susceptibility. Audiometric data from 1261 Swedish and 4500 Polish noise-exposed labourers were analysed. DNA samples were collected from the 10% most susceptible and the 10% most resistant individuals. Twelve SNPs were selected and genotyped. Subsequently, the interaction between noise exposure and genotypes and their effect on NIHL were analysed using logistic regression. Significant interactions were observed between noise exposure levels and genotypes of two SNPs for the Swedish population and of five SNPs for the Polish population. Two of these SNPs were significant in both populations. The interaction between predictor haplotypes and tagSNP haplotypes and noise exposure levels and their effect on NIHL were also analysed, resulting in several significant associations. In conclusion, this study identified significant associations between catalase SNPs and haplotypes and susceptibility to development of NIHL. These results indicate that catalase is a NIHL susceptibility gene, but that the effect of CAT polymorphisms can only be detected when noise exposure levels are taken into account.

Temporal and genetic influences on protection against noise-induced hearing loss by hypoxic preconditioning in mice

The protective benefits of hypoxic preconditioning (HPC) against permanent noise-induced hearing loss (NIHL) were investigated in mice. Hypoxia induced by exposure to 8% O2 for 4 h conferred significant protection against damaging broadband noise delivered 24-48 h later in male and female CBA/J (CBA) and CBA/CaJ mice. No protection was found in C57BL/6 (B6) mice, their B6.CAST-Cdh23(CAST) (B6.CAST) congenics, or in CBAxB6 F1 hybrid mice over the same interval, suggesting that the potential for HPC depends on one or a few autosomal recessive alleles carried by CBA-related strains, and is not influenced by the Cdh23 locus. Protection against NIHL in CBA mice was associated with significant up-regulation of hypoxia-inducible factor-1alpha (HIF-1alpha) within the organ of Corti, not found in B6.CAST. In both CBA and B6.CAST mice, some hypoxia-noise intervals shorter than 24 h were associated with exacerbation of NIHL. Cellular cascades underlying the early exacerbation of NIHL by hypoxia are therefore common to both strains, and not mechanistically linked to later protection. Elucidation of the events that underlie HPC, and how these are impacted by genetics, may lead to pharmacologic approaches to mimic HPC, and may help identify individuals with elevated risk of NIHL.

Consequences of brief exposure to high concentrations of carbon monoxide in conscious rats

Exposure to high-concentration carbon monoxide (CO) is of concern in military operations. Experimentally, the physiologic manifestations of a brief exposure to elevated levels of CO have not been fully described. This study investigated the development of acute CO poisoning in conscious male Sprague-Dawley rats (220-380 g). Animals were randomly grouped (n = 6) and exposed to either air or 1 of 6 CO concentrations (1000, 3000, 6000, 10,000, 12,000, or 24,000 ppm) in a continuous air/CO dynamic exposure chamber for 5 min. Respiration was recorded prior to and during exposures. Mixed blood carboxyhemoglobin (COHb) and pH were measured before and immediately after exposure. Before exposure the mean baselines of respiratory minute volumes (RMVs) were 312.6 +/- 43.9, 275.2 +/- 40.8, and 302.3 +/- 39.1 ml/min for the 10,000, 12,000 and 24,000 ppm groups, respectively. In the last minute of exposure RMVs were 118.9 +/- 23.7, 62.1 +/- 10.4, and 22.0 +/- 15.1% (p < .05) of their mean baselines in these 3 groups, respectively. Immediately after exposure, blood COHb saturations were elevated to 60.16, 63.42, and 69.37%, and blood pH levels were reduced to 7.43 +/- 0.09, 7.25 +/- 0.05, and 7.13 +/- 0.04 in the 3 groups, respectively. Mortality during exposure was 1/12 in the 12,000 ppm group and 4/12 in the 24,000 ppm group. Deaths occurred close to the end of 5 min exposure. In each animal that died by exposure, pH was <6.87 and COHb saturation was >82%. Blood pH was unaltered and no death occurred in rats exposed to CO at concentrations <6000 ppm, although COHb saturations were elevated to 14.52, 29.94, and 57.24% in the 1000, 3000, and 6000 ppm groups, respectively. These results suggest that brief exposure to CO at concentrations <10,000 ppm may produce some significant physiological changes. However, exposure to CO at concentrations >10,000 ppm for brief periods as short as 5 min may change RMV, resulting in acute respiratory failure, acidemia, and even death.

Issues with the integration of technical information in planning for and responding to nontraditional disasters

In the post-9/11 environment, it has become recognized that the response to man-made disasters (such as chemical spills, bioterrorism, and radiation dispersal) requires a much broader range of tools and technical knowledge than needed for natural disasters (i.e., hurricanes, earthquakes, or drought). This need also requires that those who develop technical information for disaster planning maintain a broader perspective of how the information will be used and what the priorities are for developing new information. In addition, the ability to communicate information within a context understandable to the "end user" has become more critical. The intent of this article is to present issues to help those who traditionally collect and interpret technical information (toxicology, risk assessment, mitigation planners, etc.) to better understand how their information is used in planning for and responding to incidents. These issues are similar to those experienced when trying to provide the users of information provided on material safety data sheets (MSDS) with an understanding of the value and limits of such information in decision making. Confounding the problem are the many sources that provide exposure limits and the limited amount of time the user has to understand the limits of the data during an emergency. While the Federal Response Plan integrates the efforts of multiple agencies, the "on-scene" responders are faced with trying to respond to contradictory strategies and applications of information. Sources of response technical information need to better communicate the limits of application/interpretation of that information in emergency situations.