Impact of ototoxic agents and noise exposure on hearing loss among healthcare personnel in a medical university: a cross-sectional analytical study

Ototoxic agents, such as xylene, formaldehyde, mercury, and antineoplastic agents, are routinely used in hospitals. Studies on hearing loss (HL) among healthcare workers (HCWs) exposed to ototoxic agents and noise remain limited in Thailand. In this study, we aimed to investigate the combined effects of low-level occupational noise and ototoxic agent exposure and evaluate the prevalence of HL among HCWs. This cross-sectional analytical study was conducted at a university hospital in Thailand between December 2022 and October 2023. Ototoxic exposure was assessed using self-reported data verified by the researchers. Occupational noise exposure levels were measured using a dosimeter, and HL was evaluated using audiometry. Multiple regression analysis was performed to identify factors associated with HL. Of 169 participants who underwent audiometric tests, 17.2% (29/169 participants) had HL, with 20.3% (16/79 exposed) in the exposed group and 14.4% (13/90 unexposed) in the non-exposed group (p > 0.05). HCWs exposed to antineoplastic drugs and those working in the pharmacy department demonstrated the highest mean noise levels (75.20 ± 3.94 dBA and 77.68 ± 3.81 dBA, respectively). Furthermore, the average number of elevated unweighted peak noise events was observed in the pharmacy (232.89 ± 88.66 events) and emergency (230.96 ± 60.56 events) departments. Age, sex, and obesity were significantly associated with HL. A high prevalence of HL was observed among HCWs despite low noise exposure levels, underscoring the substantial impact of combined exposure to occupational noise and ototoxic agents. The identification of groups that are particularly vulnerable to antineoplastic drugs, such as HCWs, guides targeted preventive measures and further research in this area.