title: Hearing loss and heavy metal toxicity in a Nicaraguan mining community: audiological results and case reports.
abstract: We measured fingernail metal levels, Békésy-type pure-tone thresholds and distortion product otoacoustic emission (DPOAE) levels in 59 subjects residing in the gold mining community of Bonanza, Nicaragua. Auditory testing revealed widespread hearing loss in the cohort. Nail metal concentrations (mercury, lead, aluminum, manganese and arsenic) far exceeded reference levels. No relationship was found between metal levels and auditory test results for the group as a whole. Statistically significant relationships were found between DPOAE response amplitudes and metal concentrations in a subgroup with less than 40 h per week of significant noise exposure; however, conclusions regarding these relationships should be tempered by the large number of analyses performed. Several young individuals with high metal levels reported neurological symptoms and had poor hearing. The data suggest that metal levels in artisanal mining communities present a significant public health problem and may affect hearing.
authors.affiliation: Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. james.saunders@hitchcock.org
authors.forename: J E
authors.initials: JE
authors.lastname: Saunders
authors.forename: B G
authors.initials: BG
authors.lastname: Jastrzembski
authors.forename: J C
authors.initials: JC
authors.lastname: Buckey
authors.forename: D
authors.initials: D
authors.lastname: Enriquez
authors.forename: T A
authors.initials: TA
authors.lastname: MacKenzie
authors.forename: M R
authors.initials: MR
authors.lastname: Karagas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000535:Aluminum / Q000633:toxicity; D001151:Arsenic / Q000633:toxicity; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold; D002648:Child; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis* / Q000453:epidemiology*; D000075322:Heavy Metal Poisoning; D006801:Humans; D007854:Lead / Q000633:toxicity; D008297:Male; D008345:Manganese / Q000633:toxicity; D008628:Mercury / Q000633:toxicity; D008875:Middle Aged; D008906:Mining / Q000706:statistics & numerical data*; D009262:Nails; D009527:Nicaragua / Q000453:epidemiology; D009622:Noise / Q000009:adverse effects; D017084:Otoacoustic Emissions, Spontaneous; D011041:Poisoning / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007854:Lead; D008345:Manganese; D000535:Aluminum; D008628:Mercury; D001151:Arsenic