Simultaneous exposure to carbon disulfide and noise may have a combined effect on hearing impairment. In this study we investigated hearing loss in 131 men with exposure to noise [80-91 A-weighted decibels; dB(A)] and CS(2) (1.6-20.1 ppm) in a viscose rayon plant. These men were compared with 105 men in the adhesive tape and electronic industries who were exposed to noise only and with 110 men employed in the administrative office of the rayon plant who were exposed to low noise and no CS(2). We conducted interviews to obtain sociodemographic information and exposure assessments, and we performed physical examinations, including hearing tests. Results showed that the prevalence of hearing loss of > 25 dB hearing loss (dBHL) in rayon workers (67.9%) was much higher than that in administrative workers (23.6%) and in the adhesive tape and electronic industrial workers (32.4%). Hearing loss occurred mainly for speech frequencies of 0.5, 1, and 2 kHz. When the CS(2) exposure was measured by the product of CS(2 )exposure level and employment years, the adjusted odds ratios of hearing loss of > 25 dBHL in rayon workers, compared with administrative workers, were 3.8 [95% confidence interval (CI), 1.5-9.4] for those with the exposure of 37-214 year-ppm, 14.2 (95% CI, 4.4-45.9) with 215-453 year-ppm exposure, and 70.3 (95% CI, 8.7-569.7) with exposure of > 453 year-ppm. The study suggests that CS(2) exposure enhances human hearing loss in a noisy environment and mainly affects hearing in lower frequencies.