Environmental ototoxicants: an update.

Approximately 5 years ago, we proposed the establishment of a new category of ototoxicants: environmental ototoxicants, in addition to the recognized categories of occupational and drug-related ototoxicants. Since the publication of our review, the scientific literature has confirmed the potential for hearing impairment (HI) caused by the general population's exposure to various chemicals. However, the extent of this exposure's contribution to the global incidence of hearing loss (HL) has yet to be estimated. Due to the growing health, financial, and social challenges related to HL in the general population, we have reviewed the literature on HL in individuals exposed to environmental chemicals. Additionally, we have broadened the list of environmental ototoxicants to include several previously recognized as occupational ototoxicants. These substances include the following: organophosphate insecticides (OPIs), organochlorine pesticides (OCPs): hexachlorocyclohexane (HCH), dieldrin, dichlorodiphenyldichloroethylene (DDE), and hexachlorobenzene (HCB); pyrethroids, bisphenol A (BPA), benzophenone-3 (BP-3), triclosan (TCS), parabens (PBs), per- and polyfluorinated compounds (PFCs), metals and trace elements (such as cadmium (Cd), lead (Pb), manganese (Mn), iron (Fe), mercury (Hg), selenium (Se), barium (Ba), and arsenic (As)), polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), styrene. Additionally, we have included alcohol, which is widely consumed and known for its ototoxic effects.