Noise induced hearing loss (NIHL) is one of the most prominent occupational diseases in all regions of the world which could be caused by exposure to loud sounds or noise at a work in wide spectrum of industries. Globally, it is accounting for 16% of the disabling hearing loss in adults (over 4 million DALYs) with a range of 7% to 21% in the differentsubregions(1,2). It has been estimated that more than 30 million workers in the United States of America and around 30 millions of people in European courtiers are exposed to loud sounds (defined as hazardous by WHO) which might result in hearing loss(3). Occupations at highest risk for NIHL include firemen, armed police, police motorcyclists, soldiers, construction and factory workers, printers, foundry workers, musicians, farmers, lorry drivers and miners. Noise is considered one of the most pervasive and harmful agents in crowded cities as well. In a study conducted in South Eastern city of Iran-Zahedan, approximately more than 80 % of the studied subjects ranked noise pollution too high at streets(4).Importantly, noise is no longer noticeable as the only source of work-related hearing loss and more attention is essential to the matter of joint risks for workers exposed to hazardous noise with work-related substances. Most threshold limit values are established for a single chemical substance and a single physical agent(5). However, the work environment is often composed of multiple chemical agent exampletoluene, styrene and benzene exposures and physical exposure such as noise, vibration and other stress.There is some evidence that employees exposed to the chemical substances suffered significantly from hearing impairment whereas noise levels were considerably lower than their corresponding individuals. The harmful effect of a chemical substance on ear function was first described by the Persian philosopher Avicenna (Abu Ali alHusaynibnAbd-AllahibnSinaBalkhi). He notified in his Canon of Medicine that using mercury vapor for treatment of head lice could causedeafness in patients(6). Accordingly, workers at the abovementioned occupations might be possibly exposed to multiple agents simultaneously.
Combined Effect of Noise and Chemical Substances Mirzaei R et al.
Health Scope. :() 156Interactions can occur in a variety of ways and by a number of mechanisms such as alterations in absorption, biotransformation and protein binding. The response of the organism to combinations of toxicants may be also increased or decreased because of the toxicological responses at the site of action. The effects of two chemicals can be additive when combined effect of two chemicals is equal to the sum of the effect of each agent (i.e. 2+3 equal 5), synergistic effect is the situation in which the combined effect of two chemicals is much greater than the sum of the effect of each agent given alone (i.e. 2+2 equal 20) and potentiation in which one substance does not have a toxic effect on a certain organ or system, but it makes the later much more toxic (i.e. 0 + 2 = 10) in addition to...