Occupational healthcare is implicit in public law via regulatory laws and explicit in private law in the employment law sub-branch via the occupational health and safety laws. There are at least 11 laws, within public law (administrative law) and private law (commercial law) branches, requiring Background: Occupational health laws must recognise the constitutional requirement of substantive equality, and its role in 'the progressive realisation' of the rights provided by Section 27.Objectives: Our main aim is to review current South African occupational health law (vis-àvis workers' constitutional rights) in relation to hearing loss. We focus on gaps in the law regarding occupational hearing loss in South Africa.Method: Our review of legal texts relies on experience as a methodological device augmented by the use of a critical science. Guided by literature or evidence synthesis methodologies, South African primary and secondary laws were reviewed along with unpublished (non-peerreviewed) grey literature. An established six-step framework guided our thematic analysis. A semantic approach aided the critical interpretation of data using the Bill of Rights as a core analytical framework.Results: Four themes are discussed: (1) separate and unequal regulatory frameworks; (2) monologic foregrounding of noise; (3) minimisation of vestibular disorders; and (4) dilution of ototoxic agents. The highly divided legal framework of occupational health and safety in South Africa perpetuates a monologic 'excessive noise-hearing loss' paradigm that has implications for the rights of all workers to equal protections and benefits. There is a need to harmonise occupational health and safety law, and expand the scope of hearing-protection legislation to include the full range of established ototoxic hazards. Conclusion:Occupational audiology is dominated by efforts to address noise-induced hearing loss. A 'noise' despite the reality of workers' exposures to a range of ototoxic stressors that act synergistically on the ear, resulting in audio-vestibular disorders.