Mills J H, Going J A
Environ Health Perspect. 1982 Apr;44:119-27. doi: 10.1289/ehp.8244119.
The major nongenetic causes of sensorineural hearing loss are exposure to noise, aging, ototoxic drugs, viral and bacterial infections, and interactions between these factors. Regarding exposure to continuous noise, the data base from laboratory and field studies indicates that a risk of hearing loss is present when noise levels exceed 75-80 dBA. As noise level, duration and number of exposures increase so does risk. The data base for other forms of noise (intermittent, impact) is not as established. Risk of hearing loss due to impulse noise increases as the peak SPL exceeds 145-155 dB and as the duration of the impulse, the number of impulses and the number of exposures increase. High-level acoustic impulses can cause severe, permanent hearing loss. Interaction between some steady-state noises and some acoustic impulses can be synergistic, producing extensive injuries to the organ of Corti. Noise can also interact synergistically with some aminoglycoside antibiotics to produce severe injuries in the inner ear. These antibiotics are also capable of producing hearing loss and indeed may do so in up to 55% of the one million persons who receive aminoglycoside antibiotics during the course of treatment for tuberculosis or severe gram-negative infections. Bacterial and viral infections may also produce mild to severe hearing loss. With the development of rubella vaccine and Rhogam, cytomegalovirus may have become the most common cause of congenital deafness. Aging is also a major cause of hearing loss. Exposure to occupational and environmental noise, certain diseases and life styles (diet, stress, drugs) may interact with the specific effects of aging. The result is moderate to severe hearing loss in a majority of older persons.
感音神经性听力损失的主要非遗传病因包括接触噪声、衰老、耳毒性药物、病毒和细菌感染以及这些因素之间的相互作用。关于接触持续性噪声，实验室和现场研究的数据库表明，当噪声水平超过75 - 80分贝(A)时，存在听力损失风险。随着噪声水平、持续时间和接触次数的增加，风险也会增加。其他形式噪声（间歇性、冲击性）的数据库尚不明确。由于脉冲噪声导致的听力损失风险随着峰值声压级超过145 - 155分贝以及脉冲持续时间、脉冲次数和接触次数的增加而增加。高强度声脉冲可导致严重的永久性听力损失。一些稳态噪声与一些声脉冲之间的相互作用可能具有协同性，会对柯蒂氏器造成广泛损伤。噪声还可与一些氨基糖苷类抗生素产生协同作用，对内耳造成严重损伤。这些抗生素也能够导致听力损失，在因结核病或严重革兰氏阴性感染接受氨基糖苷类抗生素治疗的100万人中，实际上可能有多达55%的人会出现听力损失。细菌和病毒感染也可能导致轻度至重度听力损失。随着风疹疫苗和抗D免疫球蛋白的发展，巨细胞病毒可能已成为先天性耳聋的最常见原因。衰老也是听力损失的主要原因。接触职业和环境噪声、某些疾病以及生活方式（饮食、压力、药物）可能与衰老的特定影响相互作用。结果是大多数老年人出现中度至重度听力损失。
