Combined effects of noise and ototoxic drugs.

Although the treatment and rehabilitation of the hearing handicapped have reached highly sophisticated levels, man should not be overly impressed with his achievements. Two recently recognized causes of deafness are a result of our mechanized and "advanced" society. In nature sounds occurring louder than 100 decibels (dB) are a rarity; such intensities when frequently presented to the hearing mechanism can literally be deafening. Man in his industrial society has become more adept than nature in producing noises that are louder and last longer. The attitude that noise is the "price of progress" is a poor reason for condoning its damaging effects. Side effects of modern drug therapy have resulted in an iatrogenic etiology of deafness. Ototoxicity of noise has been intensively studied for 80 years and of drugs for approximately 20 years, but in contrast to the rather extensive research that has been done on their separate effects, their effects in combination have received little attention. As noise has become almost ubiquitous and as the use of ototoxic drugs increases, chances for their interaction are greater. The effects of both agents when simultaneously present deserve careful study so that appropriate precautions may be taken to prevent