Mills · Environmental health perspectives 1982 · narrative review · n=?

Review of environmental factors affecting hearing.

Cited 37 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative review synthesizing laboratory and field literature without systematic methodology.

PubMed 7044773 · doi:10.1289/ehp.8244119 · record verified 2026-08-26

What was done

This paper reviewed literature on non-genetic causes of sensorineural hearing loss, focusing on laboratory and field evidence concerning continuous noise, impulse noise, ototoxic medications (specifically aminoglycosides), viral and bacterial infections, aging, and synergistic interactions among these exposures.

What was found

The review reported that risk of hearing loss emerges at continuous noise levels above 75–80 dBA, scaling with intensity, duration, and exposure frequency. Impulse noise risk increases at peak sound pressure levels above 145–155 dB SPL. Synergistic organ of Corti injury occurs between certain steady-state noises and acoustic impulses, as well as between noise and aminoglycoside antibiotics. Aminoglycosides were reported to cause hearing loss in up to 55% of the estimated one million individuals receiving them for tuberculosis or severe gram-negative infections. Following rubella vaccination and Rhogam, cytomegalovirus was noted as likely the most frequent cause of congenital deafness. Aging combined with lifestyle and environmental exposures leads to moderate-to-severe hearing loss in most older adults.

Why it matters

It outlines foundational exposure thresholds for acoustic injury and highlights the combined risks of ototoxic drug administration and environmental noise.

Limits

The abstract describes a broad narrative synthesis rather than a systematic review; it does not detail search methods, study counts, inclusion criteria, or quantitative risk estimates beyond general thresholds and single-point drug incidence estimates.

Cited by