Combined exposure to noise and ototoxic solvents: contributions to the revision of legal limits based on the literature

Work-related hearing loss resulting from combined exposure to noise and ototoxic solvents remains underestimated in occupational prevention practices. Substances such as toluene, xylene, and styrene, which are widely present in industrial environments, potentiate auditory damage even at levels below the tolerance limits considered safe. By conditioning the implementation of the Hearing Conservation Program solely on the action level for isolated noise exposure, Brazilian legislation proves insufficient in addressing the complexity of contemporary occupational risks. This opinion article proposes a critical reflection on the current regulatory limits and advocates for the revision of occupational hearing health prevention policies. Integrated strategies are discussed, including the simultaneous monitoring of exposure to noise and ototoxic chemical agents, the revision of occupational exposure limits, the continuous training of professionals in the field, and the adoption of hierarchical control measures. Protecting workers’ hearing health requires more comprehensive approaches capable of recognizing the interaction among different risk agents and promoting truly safe work environments.