2505000677
  • Open Access
  • Review
Occupational Co-Exposures to Noise and Chemicals—Review of Evidence and Regulatory Perspective 
  • Richard Cary-Clarke 1,   
  • Linh Truc Nguyen 2,   
  • Chandnee Ramkissoon 3, *

Received: 12 Mar 2025 | Revised: 03 Apr 2025 | Accepted: 16 May 2025 | Published: 23 May 2025

Abstract

The potential for harmful synergistic effects of workplace noise and chemical exposure is well-established. However, it is less conclusive whether such effects could still be seen if operators were complying with the relevant exposure standards for noise and/or chemicals. Bearing a regulatory perspective, this literature review explored whether any trends in the effects of combined exposure to noise and toxic chemicals could be established. A literature search was undertaken in seven databases, using key search terms on the combined effects of occupational noise and chemical exposures. A total of 1742 articles were identified, among which 82 were assessed in greater detail. Results in animals demonstrated a synergism of styrene, toluene and carbon disulfide when noise is delivered as a repeated ‘impulse’. Other evidence suggested that noise, although at high levels, was responsible for systemic toxicity in organs other than hearing or nerves. Another significant observation was the early signs of hearing loss associated with mixed solvent exposures and noise, each below the respective occupational exposure limits (OELs). Based on these findings, we wondered whether current workplace exposure standards for noise give adequate protection against damage to hearing for workers exposed to chemicals like styrene or toluene. Additionally, they questioned whether compliance with airborne exposure standards and noise levels gave adequate protection for chemicals with a ‘Skin’ notation.

References 

  • 1.
    Safe Work Australia. Managing Noise and Preventing Hearing Loss at Work: Code of Practice; Safe Work Australia: Canberra, Australia, 2024.
  • 2.
    Cary, R.; Clarke, S.; Delic, J. Effects of combined exposure to noise and toxic substances-critical review of the literature. Ann. Occup. Hyg. 1997, 41, 455–465. https://doi.org/10.1016/S0003-4878(97)00006-9.
  • 3.
    Metwally, F.M.; Aziz, H.M.; Mahdy-Abdallah, H.; et al. Effect of combined occupational exposure to noise and organic solvents on hearing. Toxicol. Ind. Health 2012, 28, 901–907. https://doi.org/10.1177/0748233711427051.
  • 4.
    Young, J.M.; Solomon, M.J. How to critically appraise an article. Nat. Clin. Pract. Gastroenterol. Hepatol. 2009, 6, 82–91. https://doi.org/10.1038/ncpgasthep1331.
  • 5.
    Fechter, L.D.; Klis, S.F.L.; Shirwany, N.A.; et al. Acrylonitrile produces transient cochlear function loss and potentiates permanent noise-induced hearing loss. Toxicol. Sci. 2003, 75, 117–123. https://doi.org/10.1093/toxsci/kfg169.
  • 6.
    Pouyatos, B.; Gearhart, C.A.; Fechter, L.D. Acrylonitrile potentiates hearing loss and cochlear damage induced by moderate noise exposure in rats. Toxicol. Appl. Pharmacol. 2005, 204, 46–56. https://doi.org/10.1016/j.taap.2004.08.015.
  • 7.
    Shahtaheri, S.J.; Goodarzi, Z.; Karami, E.; et al. Effects of acute exposure to Al2O3-NPs (α and γ) and white noise and their combination on cochlea structure and function in Wistar rats. Environ Sci. Pollut. Res. In. 2023, 30, 89859–89876. https://doi.org/10.1007/s11356-023-28745-w.
  • 8.
    Carlson, K.; Basu, N.; Fobil, J.N.; et al. Metal exposures, noise exposures, and audiometry from e-waste workers in Agbogbloshie, Ghana. IJERPH 2021, 18, 9639. https://doi.org/10.3390/ijerph18189639.
  • 9.
    Golbaghi, A.; Fouladi Dehagi, B.; Ahmadizadeh, M. Combined effect of cadmium and noise on rat’s kidney. J. Renal Inj. Prev. 2019, 8, 230–234. https://doi.org/10.15171/jrip.2019.43.
  • 10.
    Venet, T.; Carreres-Pons, M.; Chalansonnet, M.; et al. Continuous exposure to low-frequency noise and carbon disulfide: Combined effects on hearing. Neurotoxicology 2017, 62, 151–161. https://doi.org/10.1016/j.neuro.2017.06.013.
  • 11.
    Carreres Pons, M.; Chalansonnet, M.; Venet, T.; T et al. Carbon disulfide potentiates the effects of impulse noise on the organ of Corti. Neurotoxicology 2017, 59, 79–87. https://doi.org/10.1016/j.neuro.2017.02.003.
  • 12.
    Chalansonnet, M.; Carreres-Pons, M.; Venet, T.; et al. Effects of co-exposure to CS2 and noise on hearing and balance in rats: Continuous versus intermittent CS2 exposures. J. Occup. Med. Toxicol. 2020, 15, 9. https://doi.org/10.1186/s12995-020-00260-5.
  • 13.
    Chen, G.; McWilliams, M.L.; Fechter, L.D. Intermittent noise-induced hearing loss and the influence of carbon monoxide. Hear. Res. 1999, 138, 181–191. https://doi.org/10.1016/S0378-5955(99)00157-4.
  • 14.
    Chen, G.; Fechter, L.D. Potentiation of octave-band noise induced auditory impairment by carbon monoxide. Hear. Res. 1999, 132, 149–159. https://doi.org/10.1016/S0378-5955(99)00044-1.
  • 15.
    Rao, D.B.; Fechter, L.D. Increased noise severity limits potentiation of noise induced hearing loss by carbon monoxide. Hear. Res. 2000, 150, 206–214. https://doi.org/10.1016/S0378-5955(00)00202-1.
  • 16.
    Fechter, L.D.; Chen, G.; Deepa, R.A.O.; et al. Predicting exposure conditions that facilitate the potentiation of noise-induced hearing loss by carbon monoxide. Toxicol. Sci. 2000, 58, 315–323. https://doi.org/10.1093/toxsci/58.2.315.
  • 17.
    Bagheri, F.; Sheikhzadeh, M.; Raisi, A.; et al. The impact of carbon monoxide inhalation on developing noise-induced hearing loss in guinea pigs. Med. Gas Res. 2020, 10, 110–113. https://doi.org/10.4103/2045-9912.296040.
  • 18.
    Cappaert, N.L.M.; Klis, S.F.L.; Muijser, H.; et al. Simultaneous exposure to ethyl benzene and noise: Synergistic effects on outer hair cells. Hear. Res. 2001, 162, 67–79. https://doi.org/10.1016/S0378-5955(01)00373-2.
  • 19.
    Fechter, L.D.; Chen, G.; Johnson, D.L. Potentiation of noise-induced hearing loss by low concentrations of hydrogen cyanide in rats. Toxicol. Sci. 2002, 66, 131–138. https://doi.org/10.1093/toxsci/66.1.131.
  • 20.
    Carlson, K.; Schacht, J.; Neitzel, R.L. Assessing ototoxicity due to chronic lead and cadmium intake with and without noise exposure in the mature mouse. J. Toxicol. Environ. Health Part A 2018, 81, 1041–1057. https://doi.org/10.1080/15287394.2018.1521320.
  • 21.
    Jamesdaniel, S.; Rosati, R.; Westrick, J.; et al. Chronic lead exposure induces cochlear oxidative stress and potentiates noise-induced hearing loss. Toxicol. Lett. 2018, 292, 175–180. https://doi.org/10.1016/j.toxlet.2018.05.004.
  • 22.
    Masruri, B.; Alimohammadi, I.; Abyaz, M.R.; et al. Concurrent lead and noise exposure effects on testicular tissue of rat: An experimental study. J. Family Reprod. Health 2022, 16, 132–138. https://doi.org/10.18502/jfrh.v16i2.9483.
  • 23.
    Muthaiah, V.P.K.; Chen, G.; Ding, D.; et al. Effect of manganese and manganese plus noise on auditory function and cochlear structures. Neurotoxicology 2016, 55, 65–73. https://doi.org/10.1016/j.neuro.2016.05.014.
  • 24.
    Zahra, G.; Esmaeil, K.; Mohammad, F.; et al. Combined effects of the exposure to silver nanoparticles and noise on hearing function and cochlea structure of the male rats. Life Sci. 2022, 304, 120724. https://doi.org/10.1016/j.lfs.2022.120724.
  • 25.
    Belji Kangarlou, M.; Khavanin, A.; Nadri, F.; et al. Noise and silver nanoparticles induce hepatotoxicity via CYP450/NF-Kappa B 2 and p53 signaling pathways in a rat model. Toxicol. Ind. Health. 2024, 40, 206–219. https://doi.org/10.1177/07482337241233317.
  • 26.
    Lataye, R.; Campo, P.; Loquet, G. Combined effects of noise and styrene exposure on hearing function in the rat. Hear. Res. 2000, 139, 86–96. https://doi.org/10.1016/S0378-5955(99)00174-4.
  • 27.
    Mäkitie, A.A.; Pirvola, U.; Pyykkö, I.; et al. The ototoxic interaction of styrene and noise. Hear. Res. 2003, 179, 9–20. https://doi.org/10.1016/S0378-5955(03)00066-2.
  • 28.
    Lataye, R.; Campo, P.; Loquet, G.; et al. Combined effects of noise and styrene on hearing: Comparison between active and sedentary rats. Noise Health 2005, 7, 49. https://doi.org/10.4103/1463-1741.31633.
  • 29.
    Chen, G.; Henderson, D. Cochlear injuries induced by the combined exposure to noise and styrene. Hear. Res. 2009, 254, 25–33. https://doi.org/10.1016/j.heares.2009.04.005.
  • 30.
    Campo, P.; Venet, T.; Thomas, A.; et al. Neuropharmacological and cochleotoxic effects of styrene. Consequences on noise exposures. Neurotoxicol. Teratol. 2014, 44, 113–120. https://doi.org/10.1016/j.ntt.2014.05.009.
  • 31.
    Venet, T.; Campo, P.; Thomas, A.; et al. The tonotopicity of styrene-induced hearing loss depends on the associated noise spectrum. Neurotoxicol. Teratol. 2015, 48, 56–63. https://doi.org/10.1016/j.ntt.2015.02.003.
  • 32.
    Fetoni, A.R.; Rolesi, R.; Paciello, F.; et al. Styrene enhances the noise induced oxidative stress in the cochlea and affects differently mechanosensory and supporting cells. Free Radic. Biol. Med. 2016, 101, 211–225. https://doi.org/10.1016/j.freeradbiomed.2016.10.014.
  • 33.
    Haghighat, M.; Allameh, A.; Fereidan, M.; et al. Effects of concomitant exposure to styrene and intense noise on rats' whole lung tissues. Biochemical and histopathological studies. Drug Chem. Toxicol. 2022, 45, 120–126. https://doi.org/10.1080/01480545.2019.1662033.
  • 34.
    Lataye, R.; Campo, P. Combined effects of a simultaneous exposure to noise and toluene on hearing function. Neurotoxicol. Teratol. 1997, 19, 373–382. https://doi.org/10.1016/S0892-0362(97)00049-4.
  • 35.
    Brandt-Lassen, R.; Lund, S.P.; Jepsen, G.B. Rats exposed to Toluene and Noise may develop Loss of Auditory Sensitivity due to Synergistic Interaction. Noise & health 2000, 3, 33–44.
  • 36.
    Berenguer, P.; Soulage, C.; Fautrel, A.; et al. Behavioral and neurochemical effects induced by subchronic combined exposure to toluene at 40 ppm and noise at 80 dB-A in rats. Physiol. Behav. 2004, 81, 527–534. https://doi.org/10.1016/j.physbeh.2004.02.017.
  • 37.
    Lund, S.; Kristiansen, G. Hazards to hearing from combined exposure to toluene and noise in rats. IJOMEH 2008, 21, 47–57. https://doi.org/10.2478/v10001-008-0008-x.
  • 38.
    Abouee-Mehrizi, A.; Rasoulzadeh, Y.; Kazemi, T.; et al. Toxicopathological changes induced by combined exposure to noise and toluene in New Zealand White rabbits. Arh. Hig. Rada. Toksikol. 2022, 73, 31–42. https://doi.org/10.2478/aiht-2022-73-3602.
  • 39.
    Abouee-Mehrizi, A.; Rasoulzadeh, Y.; Mehdipour, A.; et al. Hepatotoxic effects caused by simultaneous exposure to noise and toluene in New Zealand white rabbits: A biochemical and histopathological study. Ecotoxicology 2021, 30, 154–163. https://doi.org/10.1007/s10646-020-02288-z.
  • 40.
    Abouee-Mehrizi, A.; Rasoulzadeh, Y.; Mesgari-Abbasi, M.; et al. Nephrotoxic effects caused by co-exposure to noise and toluene in New Zealand white rabbits: A biochemical and histopathological study. Life Sci. 2020, 259, 118254. https://doi.org/10.1016/j.lfs.2020.118254.
  • 41.
    Abouee-Mehrizi, A.; Rasoulzadeh, Y.; Solali, S.; et al. Hematotoxicity induced by simultaneous exposure to noise and toluene in New Zealand white rabbits: Synergistic and antagonistic effects. Toxicol. Ind. Health 2023, 39, 451–463. https://doi.org/10.1177/07482337231180404.
  • 42.
    Muijser, H.; Lammers, J.H.C.M.; Kullig, B.M. Effects of exposure to trichloroethylene and noise on hearing in rats. Noise Health 2000, 2, 57–66.
  • 43.
    Chang, S.; Shih, T.; Tzu-Chieh, C.; et al. Hearing loss in workers exposed to carbon disulfide and noise. Env. Health Perspect. 2003, 111, 1620–1624. https://doi.org/10.1289/ehp.6289.
  • 44.
    Lacerda, A.; Leroux, T.; Gagn, J. The combined effect of noise and carbon monoxide on hearing thresholds of exposed workers. J. Acoust. Soc. Am. 2005, 117, 2481. https://doi.org/10.1121/1.4787678.
  • 45.
    EU-OSHA. Combined Exposure to Noise and Ototoxic Substances; EU-OSHA: Luxembourg, 2009. https://doi.org/10.2802/16028.
  • 46.
    Ferreira, D.G.; Lima de Oliveira, G.; Meira, A.L.; et al. Auditory effects of combined exposure: Interaction between carbon monoxide, noise and smoking. Rev. Soc. Bras. Fonoaudio. 2012, 17, 405–411.
  • 47.
    Zeigelboim, B.; Santos da Carvalho, H.; Gonçalves, C.; et al. Otoneurological symptoms in Brazilian fishermen exposed over a long period to carbon monoxide and noise. Noise Health 2015, 17, 300–307. https://doi.org/10.4103/1463-1741.165053.
  • 48.
    Wu, T.; Chen-Yang, S.; Lai, J.; et al. Effects of lead and noise exposures on hearing ability. Arch. Environ. Occup. Health 2000, 55, 109.
  • 49.
    Hwang, Y.; Chiang, H.; Yen-Jean, M.; et al. The association between low levels of lead in blood and occupational noise-induced hearing loss in steel workers. Sci. Total Environ. 2009, 408, 43–49. https://doi.org/10.1016/j.scitotenv.2009.09.016.
  • 50.
    Rapisarda, V.; Ledda, C.; Ferrante, M.; et al. Blood pressure and occupational exposure to noise and lead (Pb): A cross-sectional study. Toxicol. Ind. Health 2016, 32, 1729–1736. https://doi.org/10.1177/0748233715576616.
  • 51.
    Morata, T.C.; Johnson, A.; Nylen, P.; et al. Audiometric findings in workers exposed to low levels of styrene and noise. J. Occup. Environ. Med. 2002, 44, 806–814. https://doi.org/10.1097/00043764-200209000-00002.
  • 52.
    Śliwińska-Kowalska, M.; Zamyslowska-Szmytke, E.; Szymczak, W.; et al. Ototoxic effects of occupational exposure to styrene and co-exposure to styrene and noise. Occup. Environ. Med. 2003, 45, 15–24. https://doi.org/10.1097/00043764-200301000-00008.
  • 53.
    Sisto, R.; Cerini, L.; Gatto, M.P.; et al. Otoacoustic emission sensitivity to exposure to styrene and noise. J. Acoust. Soc. Am. 2013, 134, 3739–3748. https://doi.org/10.1121/1.4824618.
  • 54.
    Chang, S.; Chen, C.; Lien, C.; et al. Hearing loss in workers exposed to toluene and noise. Environ. Health Perspect. 2006, 114, 1283–1286. https://doi.org/10.1289/ehp.8959.
  • 55.
    Schäper, M.; Seeber, A.; van Thriel, C. The effects of toluene plus noise on hearing thresholds: An evaluation based on repeated measurements in the German printing industry. Occup. Environ. Med. 2008, 21, 191–200. https://doi.org/10.2478/v10001-008-0030-z.
  • 56.
    Sliwinska-Kowalska, M.; Zamyslowska-Szmytke, E.; Szymczak, W.; et al. Effects of coexposure to noise and mixture of organic solvents on hearing in dockyard workers. Occup. Environ. Med. 2004, 46, 30–38. https://doi.org/10.1097/01.jom.0000105912.29242.5b.
  • 57.
    Sliwinska-Kowalska, M.; Zamyslowska-Szmytke, E.; Szymczak, W.; et al. Exacerbation of noise-induced hearing loss by co-exposure to workplace chemicals. Environ. Toxicol. Pharmacol. 2005, 19, 547–553. https://doi.org/10.1016/j.etap.2004.12.018.
  • 58.
    Kim, J.; Park, H.; Ha, E.; et al. Combined effects of noise and mixed solvents exposure on the hearing function among workers in the aviation industry. Ind. Health 2005, 43, 567–573. https://doi.org/10.2486/indhealth.43.567.
  • 59.
    De Barba, M.; Jurkiewicz, A.; Zeigelboim, B.; et al. Audiometric Findings in Petrochemical Workers Exposed to Noise and Chemical Agents; Medknow Publications and Media Pvt. Ltd: Mumbai, India, 2005.
  • 60.
    Prasher, D.; Al-Hajjaj, H.; Aylott, S.; et al. Effect of exposure to a mixture of solvents and noise on hearing and balance in aircraft maintenance workers. Noise Health 2005, 7, 31–39. https://doi.org/10.4103/1463-1741.31876.
  • 61.
    Chang, T.; Wang, V.; Hwang, B.; et al. Effects of co-exposure to noise and mixture of organic solvents on blood pressure. JOH 2009, 51, 332–339. https://doi.org/10.1539/joh.L8121.
  • 62.
    Fuente, A.; Slade, M.D.; Taylor, T.; et al. Peripheral and central auditory dysfunction induced by occupational exposure to organic solvents. Occup. Environ. Med. 2009, 51, 1202–1211. https://doi.org/10.1097/JOM.0b013e3181bae17c.
  • 63.
    Mohammadi, S.; Labbafinejad, Y.; Attarchi, M. Combined effects of ototoxic solvents and noise on hearing in automobile plant workers in Iran. Arh. Hig. Rada Toksikol. 2010, 61, 267–274. https://doi.org/10.2478/10004-1254-61-2010-2013.
  • 64.
    Hughes, H.; Hunting, K. Evaluation of the effects of exposure to organic solvents and hazardous noise among US Air Force Reserve personnel. Noise Health 2013, 15, 379–387. https://doi.org/10.4103/1463-1741.121224.
  • 65.
    Attarchi, M.; Golabadi, M.; Labbafinejad, Y.; et al. Combined effects of exposure to occupational noise and mixed organic solvents on blood pressure in car manufacturing company workers. Am. J. Ind. Med. 2013, 56, 243–251. https://doi.org/10.1002/ajim.22086.
  • 66.
    Unlu, I.; Kesici, G.G.; Basturk, A.; et al. A comparison of the effects of solvent and noise exposure on hearing, together and separately. Noise Health 2014, 16, 410–415. https://doi.org/10.4103/1463-1741.144422.
  • 67.
    Lobato, D.C.B.; Lacerda, A.B.M.D.; Gonçalves, C.G.D.O.; et al. Auditory effects of exposure to noise and solvents: A comparative study. Int. Arch. Otorhinolaryngol. 2014, 18, 136–141. https://doi.org/10.1055/s-0033-1361083.
  • 68.
    Bohn, V.; Morata, T.C.; Roggia, S.; et al. Temporary and permanent auditory effects associated with occupational coexposure to low levels of noise and solvents. IJERPH 2022, 19, 9894. https://doi.org/10.3390/ijerph19169894.
  • 69.
    Zhang, Y.; Liu, Y.; Li, Z.; et al. Effects of coexposure to noise and mixture of toluene, ethylbenzene, xylene, and styrene (TEXS) on hearing loss in petrochemical workers of southern China. Environ. Sci. Pollut. Res. Int. 2023, 30, 31620–31630. https://doi.org/10.1007/s11356-022-24414-6.
  • 70.
    Chen, Q.; Deng, Q.; Liu, Y.; et al. Co-exposure of petrochemical workers to noise and mixture of benzene, toluene, ethylbenzene, xylene, and styrene: Impact on mild renal impairment and interaction. Environ. Pollut. 2024, 346, 123628. https://doi.org/10.1016/j.envpol.2024.123628.
  • 71.
    Cabello-López, A.; Chávez-Gómez, N.L.; Torres-Valenzuela, A.; et al. Audiometric findings of printing press workers exposed to noise and organic solvents. Int. J. Audiol. 2021, 60, 8–15. https://doi.org/10.1080/14992027.2020.1795735.
  • 72.
    Lucas, D.; Guerrero, F.; Jouve, E.; et al. Effect of occupational exposure to welding fumes and noise on heart rate variability: An exposed-unexposed study on welders and airport workers' population. Front. Public Health 2022, 10, 937774. https://doi.org/10.3389/fpubh.2022.937774.
  • 73.
    Choi, Y.; Kim, K. Noise-induced hearing loss in Korean workers: Co-exposure to organic solvents and heavy metals in nationwide industries. PLoS ONE 2014, 9, e97538. https://doi.org/10.1371/journal.pone.0097538.
  • 74.
    Zhou, J.; Shi, Z.; Zhou, L.; et al. Occupational noise-induced hearing loss in China: A systematic review and meta-analysis. BMJ Open 2020, 10, e039576. https://doi.org/10.1136/bmjopen-2020-039576.
  • 75.
    Saraei, M.; Omidi, R.; Aminian, O.; et al. The combined effect of noise and solvent exposure on hearing loss in the tire factory workers. Indian J. Otolaryngol. Head Neck Surg. 2022, 74, 3887–3892. https://doi.org/10.1007/s12070-021-02697-4.
  • 76.
    Gedik Toker, Ö.; Kuru, E. The effect of occupational exposure to noise and chemical agents on hearing abilities. Arch. Environ. Occup. Health 2024, 79, 1–10. https://doi.org/10.1080/19338244.2024.2305803.
  • 77.
    Roslan, N.; Md Said, M.S. Chemical health risk assessment and evaluation of risk toward ototoxicants among workers at palm oil mills. ACA Chem. Health Safe. 2024, 31, 202–216. https://doi.org/10.1021/acs.chas.3c00090.
  • 78.
    Lewkowski, K.; Heyworth, J.S.; Li, I.W.; et al. Exposure to noise and ototoxic chemicals in the Australian workforce. Occup. Environ. Med. 2019, 76, 341–348. https://doi.org/10.1136/oemed-2018-105471.
  • 79.
    Lewkowski, K.; Heyworth, J.S.; Williams, W.; et al. The associations between workplace noise, ototoxic chemicals, and tinnitus. Ear Hear. 2023, 44, 1507–1513. https://doi.org/10.1097/AUD.0000000000001392.
  • 80.
    Lu, Y.; Liu, X.; Zhao, Z.; et al. Telomere length in peripheral leukocytes is a sensitive marker for assessing genetic damage among workers exposed to isopropanol, lead and noise: The case of an electronics manufacturer. Genes Environ. 2021, 43, 57. https://doi.org/10.1186/s41021-021-00226-x.
  • 81.
    Hormozi, M.; Ansari-Moghaddam, A.; Mirzaei, R.; et al. The risk of hearing loss associated with occupational exposure to organic solvents mixture with and without concurrent noise exposure: A systematic review and meta-analysis. J. Occup. Med. Environ. Health 2017, 30, 521–535. https://doi.org/10.13075/ijomeh.1896.01024.
  • 82.
    Nakhooda, F.; Govender, S.M.; Sartorius, B. The effects of combined exposure of solvents and noise on auditory function—A systematic review and meta-analysis. S. Afr. J. Commun. Disor. 2019, 66, 1–11. https://doi.org/10.4102/sajcd.v66i1.568.
  • 83.
    Ren, J.; Xie, H.; Hu, Y.; et al. Occupational hearing loss associated with the combined exposure of solvents and noise: A systematic review and meta-analysis. Safety 2023, 9, 71. https://doi.org/10.3390/safety9040071.
  • 84.
    Yang, H.; Shie, R.; Chen, P. Hearing loss in workers exposed to epoxy adhesives and noise: A cross-sectional study. BMJ Open 2016, 6, e010533. https://doi.org/10.1136/bmjopen-2015-010533.
Share this article:
How to Cite
Cary-Clarke, R.; Nguyen, L. T.; Ramkissoon, C. Occupational Co-Exposures to Noise and Chemicals—Review of Evidence and Regulatory Perspective . Work and Health 2025, 1 (1), 4. https://doi.org/10.53941/wah.2025.100004.
RIS
BibTex
Copyright & License
article copyright Image
Copyright (c) 2025 by the authors.