To determine the state of the research on ototoxic properties of Pb, evaluate possible synergistic effects with concurrent noise exposure, and identify opportunities to improve future research, we performed a review of the peer-reviewed literature to identify studies examining auditory damage due to Pb over the past 50 years. Thirty-eight studies (14 animal and 24 human) were reviewed. Of these, 24 suggested potential ototoxicity due to Pb exposure, while 14 found no evidence of ototoxicity. More animal studies are needed, especially those investigating Pb exposure levels that are occupationally and environmentally relevant to humans. Further investigations into potential interactions of Pb in the auditory system with other hazards and compounds that elicit ototoxicity are also needed in animal models. To better assess the effects of Pb exposure on the human auditory system and the possibility of a synergism with noise, future epidemiological studies need to carefully consider and address four main areas of uncertainty: (1) hearing examination and quantification of hearing loss, (2) Pb exposure evaluation, (3) noise exposure evaluation, and (4) the personal characteristics of those exposed. Two potentially confounding factors, protective factors and mixtures of ototoxicants, also warrant further exploration.

中文翻译：

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听力损失，铅（Pb）暴露和噪声：耳毒性探查的合理方法

为了确定铅的耳毒性特性的研究现状，评估与同时发生的噪声接触可能产生的协同效应，并确定改进未来研究的机会，我们对同行评审的文献进行了回顾，以鉴定检查铅对听觉损害的研究。在过去的50年中。回顾了38项研究（14个动物和24个人类）。在这些中，有24个提示了由于Pb暴露引起的潜在耳毒性，而14个没有发现耳毒性的证据。需要开展更多的动物研究，尤其是那些研究与人类职业和环境相关的铅暴露水平的动物。在动物模型中，还需要进一步研究铅在听觉系统中与其他危害和引起耳毒性的化合物之间的潜在相互作用。为了更好地评估Pb暴露对人类听觉系统的影响以及噪声协同作用的可能性，未来的流行病学研究需要仔细考虑并解决四个主要不确定性领域：（1）听力检查和听力损失量化，（2 ）铅暴露评估，（3）噪声暴露评估和（4）暴露者的个人特征。两个潜在的混杂因素，保护因素和耳毒性物质的混合物，也值得进一步探索。（4）暴露者的个人特征。两个潜在的混杂因素，保护因素和耳毒性物质的混合物，也值得进一步探索。（4）暴露者的个人特征。两个潜在的混杂因素，保护因素和耳毒性物质的混合物，也值得进一步探索。