Approaches to managing ototoxicity in the workplace

Objective: Ototoxic chemicals in the workplace can pose a risk to hearing and balance functions. Our objective was to identify evidence-based practices for occupational health settings in managing ototoxicity. This resulted in the document, Health Management of Workers Exposed to Ototoxic Chemicals, created by the International Ototoxicity Management Group. Design: To develop a practical approach for any workplace, we reviewed a variety of sources and used an international panel of interdisciplinary experts. Evidence included data from experimental, observational, and review studies. Thirty-two subject matter experts were invited to review the document; twenty-two completed the review and unanimously endorsed the ototoxicity management system as proposed. Results: Six key action steps were proposed to: (1) identify workers exposed to ototoxic chemicals, (2) perform auditory and vestibular assessments, (3) follow-up after monitoring health, (4) document worker data, (5) maintain healthy safety culture, and (6) review ototoxicity management approach. These steps focus on the management of workers who are at-risk for workplace ototoxic chemical exposure at any level (with or without concurrent noise exposures). Conclusions: Early identification strategies include self-report questionnaires; auditory testing; vestibular screening; referrals for diagnosis; management of cases; and monitoring of exposure scenarios to prevent further cases.