The Adverse Effects of Heavy Metals with and without Noise Exposure on the Human Peripheral and Central Auditory System: A Literature Review

Int J Environ Res Public Health. 2016 Dec 9;13(12):1223. doi: 10.3390/ijerph13121223.


Exposure to some chemicals in the workplace can lead to occupational chemical-induced hearing loss. Attention has mainly focused on the adverse auditory effects of solvents. However, other chemicals such as heavy metals have been also identified as ototoxic agents. The aim of this work was to review the current scientific knowledge about the adverse auditory effects of heavy metal exposure with and without co-exposure to noise in humans. PubMed and Medline were accessed to find suitable articles. A total of 49 articles met the inclusion criteria. Results from the review showed that no evidence about the ototoxic effects in humans of manganese is available. Contradictory results have been found for arsenic, lead and mercury as well as for the possible interaction between heavy metals and noise. All studies found in this review have found that exposure to cadmium and mixtures of heavy metals induce auditory dysfunction. Most of the studies investigating the adverse auditory effects of heavy metals in humans have investigated human populations exposed to lead. Some of these studies suggest peripheral and central auditory dysfunction induced by lead exposure. It is concluded that further evidence from human studies about the adverse auditory effects of heavy metal exposure is still required. Despite this issue, audiologists and other hearing health care professionals should be aware of the possible auditory effects of heavy metals.

Keywords: auditory brainstem response; hearing loss; heavy metals; humans; noise; pure-tone audiometry.

Publication types

  • Review

MeSH terms

  • Auditory Perception / drug effects*
  • Environmental Monitoring
  • Hearing Loss, Noise-Induced / epidemiology*
  • Humans
  • Metals, Heavy / adverse effects
  • Metals, Heavy / analysis
  • Metals, Heavy / toxicity*
  • Noise / adverse effects*
  • Noise / prevention & control
  • Occupational Diseases / chemically induced*
  • Occupational Exposure / adverse effects*
  • Workplace


  • Metals, Heavy