Objectives This study explored the effects of occupational exposure to
solvents and noise on the hearing of rotogravure printing workers fro
m Sao Paulo, Brazil. Methods The study group comprised 124 workers exp
osed to various levels of noise and an organic solvent mixture of tolu
ene, ethyl acetate, and ethanol. Data on work history, psychosocial as
pects of the job, medical history, present health, stress, occupationa
l and nonoccupational exposures to noise or chemicals, and life-style
factors were collected through an interview. The participants underwen
t pure-tone audiometry and immittance audiometry testing. Their exposu
res to noise and solvents were assessed. Results Forty-nine percent of
the workers had hearing loss. From the numerous variables that were a
nalyzed for their contribution to the development of hearing loss (age
, tenure, noise dose, solvent concentrations in air, biological marker
for toluene, job category, work and medical history items, smoking, a
lcohol consumption, work perception scores, nonoccupational exposures)
, age and hippuric acid (the biologic marker for toluene in urine) wer
e the only variables that met the significance level criterion in the
final multiple logistic regression model. The odds ratio estimates for
hearing loss were 1.07 times greater for each increment of 1 year of
age [95% confidence interval (95% CI) 1.03-1.11] and 1.76 times greate
r for each gram of hippuric acid per gram of creatinine (95% CI 1.00-2
.98). Conclusions The findings suggest that exposure to toluene has a
toxic effect on the auditory system. Further research is needed on the
mechanisms underlying the effects of toluene and on the adequacy of c
urrent recommended exposure limits.