{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:07:35Z","timestamp":1793102855310,"version":"4.5.0"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T00:00:00Z","timestamp":1485475200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Industrial Med"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Studies suggest metal and solvent exposure may damage hearing. This study evaluated the association between exposures classified as high for metals, solvents, and noise on permanent threshold shift (PTS) development.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1,546 personnel at an industrial shipyard were divided into five exposure groups based on level of concentration: high noise, high metals\/solvents, high metals\/noise, high metals\/solvents\/noise, and a low metals\/solvents\/noise reference group. Hearing threshold changes were analyzed to identify development of a PTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Logistic regression indicated high metals\/solvents and high metals\/solvent\/noise groups had significantly greater odds ratios of 2.4; 95%CI [1.02, 2.85] and 1.7; 95%CI [1.46, 3.94], respectively, compared to a reference group. Both groups were associated with PTSs while controlling for age, gender, and exposure duration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Simultaneous exposures classified as high for metals and solvents may damage hearing. Results suggest the need for expanding hearing conservation programs to consider combinations of exposures to metals, solvents, and noise. Am. J. Ind. Med. 60:227\u2013238, 2017. \u00a9 2017 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajim.22690","type":"journal-article","created":{"date-parts":[[2017,1,27]],"date-time":"2017-01-27T07:58:06Z","timestamp":1485503886000},"page":"227-238","source":"Crossref","is-referenced-by-count":21,"title":["Effects of combined exposure to metals, solvents, and noise on permanent threshold shifts"],"prefix":"10.1002","volume":"60","author":[{"given":"Nicholas","family":"Schaal","sequence":"first","affiliation":[{"name":"Department of Industrial Hygiene Department of the Navy Naval Hospital Bremerton Bremerton Washington"},{"name":"Department of Safety Sciences Indiana University of Pennsylvania Indiana Pennsylvania"},{"name":"Department of Preventive Medicine and Biostatistics Division of Occupational and Environmental Health Sciences F. 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