title: Effects of combined exposure to metals, solvents, and noise on permanent threshold shifts.
abstract: BACKGROUND
  Studies suggest metal and solvent exposure may damage hearing. This study evaluated the association between exposures classified as high for metals, solvents, and noise on permanent threshold shift (PTS) development.
  
  
  METHODS
  A total of 1,546 personnel at an industrial shipyard were divided into five exposure groups based on level of concentration: high noise, high metals/solvents, high metals/noise, high metals/solvents/noise, and a low metals/solvents/noise reference group. Hearing threshold changes were analyzed to identify development of a PTS.
  
  
  RESULTS
  Logistic regression indicated high metals/solvents and high metals/solvent/noise groups had significantly greater odds ratios of 2.4; 95%CI [1.02, 2.85] and 1.7; 95%CI [1.46, 3.94], respectively, compared to a reference group. Both groups were associated with PTSs while controlling for age, gender, and exposure duration.
  
  
  CONCLUSIONS
  Simultaneous exposures classified as high for metals and solvents may damage hearing. Results suggest the need for expanding hearing conservation programs to consider combinations of exposures to metals, solvents, and noise. Am. J. Ind. Med. 60:227-238, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Department of Industrial Hygiene, Department of the Navy, Naval Hospital Bremerton, Bremerton, Washington.|Department of Safety Sciences, Indiana University of Pennsylvania, Indiana, Pennsylvania.|Department of Preventive Medicine and Biostatistics, Division of Occupational and Environmental Health Sciences, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Schaal
authors.affiliation: Department of Safety Sciences, Indiana University of Pennsylvania, Indiana, Pennsylvania.|Department of Systems Engineering and Management, Department of the Air Force, Air Force Institute of Technology, Wright-Patterson AFB, Ohio.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Slagley
authors.affiliation: Department of Safety Sciences, Indiana University of Pennsylvania, Indiana, Pennsylvania.
authors.forename: Majed
authors.initials: M
authors.lastname: Zreiqat
authors.affiliation: Department of Safety Sciences, Indiana University of Pennsylvania, Indiana, Pennsylvania.
authors.forename: Helmut
authors.initials: H
authors.lastname: Paschold
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001309:Auditory Threshold; D005260:Female; D034381:Hearing Loss / Q000209:etiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008670:Metals / Q000032:analysis / Q000633:toxicity*; D008875:Middle Aged; D009623:Noise, Occupational / Q000009:adverse effects*; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D016017:Odds Ratio; D012997:Solvents / Q000032:analysis / Q000633:toxicity*; D014186:Transportation; D055815:Young Adult
chemical_list: D008670:Metals; D012997:Solvents
keywords: chemicals; hearing-loss; metals; noise; permanent threshold shift; shipyard; solvents