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https://pubs.asha.org/doi/10.1044/2023_PERSP-23-00153

https://www.audiology.org/news-and-publications/audiology-today/articles/incorporating-ototoxicity-management-into-clinical-pathways/

International Ototoxicity Management Group (IOMG): A global effort to improve ototoxicity management for at-risk populations. DeBacker, J. R.; Garinis, A. C.; Konrad-Martin, D.; Brewer, C. C.; Morata, T. C.; Clark, K.; Petersen, L.; Steyger, P. S.; Poling, G. L. Journal of Hearing Science, 2022, Vol 12, Issue 1, p100 ISSN: 2083-389X

Ototoxicity of cancer treatment (chemo/radiation therapy)
Cancer treatment has both immediate and late effects that impact quality of life if left untreated. These can include hearing loss, tinnitus and balance problems. Consensus for clinical care, enhanced tools and health promotion are needed to manage ototoxicity from cancer treatment. This group's goals are to develop a roadmap/call to action to a global template for implementation of ototoxicity management for cancer treatment, identify solutions to address gaps in ototoxicity research and management across the lifespan (including impacts to quality of life beyond hearing loss and recognition of immediate and late effects), identify effective tools, policy enhancements, and delivery frameworks for universal ototoxicity management, and develop resources and strategies that educate, empower, and engage stakeholders (including patients, families, and care teams).

Relevant publications:

 * Poling, G. L., Vlosich, B., & Dreisbach, L. E. (2019). Emerging distortion product otoacoustic emission techniques to identify preclinical warning signs of basal cochlear dysfunction due to ototoxicity. Applied Sciences, 9(15), 3132. https://www.mdpi.com/2076-3417/9/15/3132
 * Konrad-Martin, D., Poling, G. L., Garinis, A. C., Ortiz, C. E., Hopper, J., O’Connell Bennett, K., & Dille, M. F. (2018). Applying US national guidelines for ototoxicity monitoring in adult patients: perspectives on patient populations, service gaps, barriers and solutions. International journal of audiology, 57(sup4), S3-S18. https://www.tandfonline.com/doi/full/10.1080/14992027.2017.1398421
 * https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579718/ '
 * DeBacker, J. R., McMillan, G. P., Martchenke, N., Lacey, C. M., Stuehm, H. R., Hungerford, M. E., & Konrad-Martin, D. (2023). Ototoxicity prognostic models in adult and pediatric cancer patients: a rapid review. Journal of cancer survivorship : research and practice, 17(1), 82–100. https://doi.org/10.1007/s11764-022-01315-8
 * Konrad-Martin, D., Polaski, R., DeBacker, J. R., Theodoroff, S. M., Garinis, A., Lacey, C., Johansson, K., Mannino, R., Milnes, T., Hungerford, M., & Clark, K. D. (2023). Audiologists' perceived value of ototoxicity management and barriers to implementation for at-risk cancer patients in VA: the OtoMIC survey. Journal of cancer survivorship : research and practice, 17(1), 69–81. https://doi.org/10.1007/s11764-022-01316-7
 * Konrad-Martin, D., O'Connell Bennett, K., Garinis, A., & McMillan, G. P. (2021). A Randomized Controlled Trial Using Automated Technology for Improving Ototoxicity Monitoring in VA Oncology Patients. American journal of audiology, 30(3S), 870–886. https://doi.org/10.1044/2021_AJA-21-00032

Aminoglycoside-induced ototoxicity
Patients who are treated with aminoglycosides are more likely to develop hearing loss, tinnitus and/or balance problems than those who do not receive aminoglycoside treatment. Patients are not routinely monitored for hearing loss, tinnitus and/or balance problems. This group's goals are to collate/review existing recommendations, work with patients and providers to develop recommendations for applying audiology practice guidelines for ototoxicity management in patients treated with aminoglycosides, survey patients and providers regarding the acceptance and utility of recommendations, and submit consensus document for publication.

Relevant publications:

 * "Functional Impacts of Aminoglycoside Treatment on Speech Perception and Extended High-Frequency Hearing Loss in a Pediatric Cystic Fibrosis Cohort" AJA, 2021 Jan 19;1-20. doi: 10.1044/2020_AJA-20-00059
 * "Cost-effectiveness of implementing routine hearing screening using a tablet audiometer for pediatric cystic fibrosis patients receiving high-dose IV aminoglycosides" JMCP, Volume 27 Issue (2) Huang, McKinzie, Tak
 * "An Ototoxicity Grading System Within a Mobile App (OtoCalc) for a Resource-Limited Setting to Guide Grading and Management of Drug-Induced Hearing Loss in Patients With Drug-Resistant Tuberculosis: Prospective, Cross-Sectional Case Series" (Monitoring Editor: Gunther Eysenbach)
 * "Exposure to lead, mercury, styrene, and toluene and hearing impairment: Evaluation of dose-response relationships, regulations, and controls" (by Ehsan Hemmativaghef)
 * Harris, T., Bardien, S., Schaaf, H. S., Petersen, L., De Jong, G., & Fagan, J. J. (2012). Aminoglycoside-induced hearing loss in HIV-positive and HIV-negative multidrug-resistant tuberculosis patients. South African Medical Journal, 102(6). https://www.ajol.info/index.php/samj/article/view/79022
 * Petersen, L., & Rogers, C. (2015). Aminoglycoside-induced hearing deficits-a review of cochlear ototoxicity. South African Family Practice, 57(2), 1-6. https://journals.co.za/doi/abs/10.1080/20786190.2014.1002220ï»¿
 * https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579718/
 * https://www.proquest.com/docview/199064841?pq-origsite=gscholar&fromopenview=true&sourcetype=Scholarly%20Journals
 * Garinis, A. C., Poling, G. L., Rubenstein, R. C., Konrad-Martin, D., Hullar, T. E., Baguley, D. M., Burrows, H. L., Chisholm, J. A., Custer, A., Hawe, L. D., Hunter, L. L., Marras, T. K., Ortiz, C. E., Petersen, L., Steyger, P. S., Winthrop, K., Zettner, E. M., Clark, K., Hungerford, M., Vachhani, J. J., … Brewer, C. C. (2021). Clinical Considerations for Routine Auditory and Vestibular Monitoring in Patients With Cystic Fibrosis. American journal of audiology, 30(3S), 800–809. https://doi.org/10.1044/2021_AJA-21-00031
 * Garinis, Angela C.; Poling, Gayla L.; Rubenstein, Ronald C.; Konrad-Martin, Dawn; Hullar, Timothy E.; Baguley, David M.; et al. (2021). Ototoxicity management and cystic fibrosis (Garinis et al., 2021). ASHA journals. Dataset. https://doi.org/10.23641/asha.16624366.v1

Environmental and occupational ototoxicants
There are no standard methods for the auditory surveillance of individuals exposed to environmental or occupational chemicals. Consensus guidelines for the clinical care of exposed persons and tools for implementation and health promotion are needed to manage ototoxicity from environmental and occupational exposures. This group's goals are to collate existing recommendations, update reviews, work with stakeholders in the fields of occupational health, hearing care and audiology to develop recommendations for applying audiology practice guidelines for ototoxicity management at work and in the clinic, and submit this consensus document for publication.

Relevant publications:

 * Chapter 142. Occupational exposure to chemical and hearing impairment from The Nordic Expert Group for Criteria Documentation of Health Risks from Chemical
 * Hong, O., Kerr, M. J., Poling, G. L., & Dhar, S. (2013). Understanding and preventing noise-induced hearing loss. Disease-a-month, 59(4), 110-118. https://www.sciencedirect.com/science/article/abs/pii/S0011502913000217
 * Zhang, Meibian1; Xie, Hongwei1; Zhou, Jiena1; Sun, Xin2; Hu, Weijiang2; Zou, Hua1; Zhou, Lifang1; Li, Jingsong3; Zhang, Ming4; Kardous, Chucri A.5; Morata, Thais C.5; Murphy, William J.5; Zhang, Jane Hongyuan6; Qiu, Wei7. New Metrics Needed in the Evaluation of Hearing Hazard Associated With Industrial Noise Exposure. Ear and Hearing 42(2):p 290-300, March/April 2021. | DOI: 10.1097/AUD.0000000000000942
 * Roggia, Simone Mariotti&#x3B; Zucki, Fernanda&#x3B; Fuente, Adrian&#x3B; Lacerda, Adriana Bender Moreira de&#x3B; Gong, Wei&#x3B; Carlson, Krystin&#x3B; Morata, Thais C. (2023-11). "Audiological Tests Used in the Evaluation of the Effects of Solvents on the Human Auditory System: A Mixed Methods Review". Seminars in Hearing 44 (04): 437–469. doi:10.1055/s-0043-1769585. ISSN 0734-0451. PMID 37818148. PMC PMC10562058.
 * https://pubs.asha.org/doi/full/10.1044/2021_AJA-20-00226
 * https://www.mdpi.com/1660-4601/19/16/9894
 * https://www.scielo.br/j/codas/a/dDHgD9WpYfYFR4dMXF6YXLy/?lang=en&format=html

International considerations
Patients treated with ototoxic medications get their healthcare differently depending on the health care structures in their regions and their access to care. Practice recommendations and implementation toolkits tailored to the healthcare structures and global region are needed to increase access and value of ototoxicity management. This group's goals are to collate/review existing recommendations, survey patients and providers to develop recommendations for applying ototoxicity management guidelines in different health care structures and global regions, and submit findings for publication.

Relevant publications:

 * Lindeborg, M. M., Jung, D. H., Chan, D. K., & Mitnick, C. D. (2022). Prevention and management of hearing loss in patients receiving ototoxic medications. Bulletin of the World Health Organization, 100(12), 789–796A. https://doi.org/10.2471/BLT.21.286823
 * Meijer AJM, van den Heuvel-Eibrink MM, Brooks B, et al. Recommendations for Age-Appropriate Testing, Timing, and Frequency of Audiologic Monitoring During Childhood Cancer Treatment: An International Society of Paediatric Oncology Supportive Care Consensus Report. JAMA Oncol. 2021;7(10):1550–1558. doi:10.1001/jamaoncol.2021.2697 Pediatric
 * https://www.sciencedirect.com/science/article/abs/pii/S2173573522000746 Pediatric

Brazil

 * Jacob LCB, Aguiar FP, Tomiasi AA, Tschoeke SN, de Bitencourt RF. Auditory monitoring in ototoxicity. Rev Bras Otorrinolaringol (Engl Ed). 2006. Nov-Dec;72(6):836–44. 10.1016/S1808-8694(15)31053-3

China

 * Liu, C., Wang, A., Huang, Y. et al. Development of a community-based hearing loss prevention and control service model in Guangdong, China. BMC Public Health 19, 1601 (2019). https://doi.org/10.1186/s12889-019-7910-y

India

 * Duggal P, Sarkar M. Audiologic monitoring of multi-drug resistant tuberculosis patients on aminoglycoside treatment with long term follow-up. BMC Ear Nose Throat Disord. 2007. Nov 12;7(1):5. 10.1186/1472-6815-7-5
 * Sarin R, Behera D, Khanna A, Singh V, Narang P, Deepak TS. Second-line injectable induced ototoxicity in drug resistant tuberculosis: a systematic review of Indian studies. Indian J Tuberc. 2019. Apr;66(2):279–87. 10.1016/j.ijtb.2019.04.007

Italy

 * Gambacorta, V.; Orzan, E.; Faralli, M.; Gullà, M.; Lapenna, R.; Baietta, I.; De Angelis, V.; Ricci, G. Practice of Monitoring Cisplatin-Induced Ototoxicity by Audiology, ENT, and Oncology Specialists: A Survey-Based Study in a Single Italian Medical Center. Audiol. Res. 2023, 13, 779-790. https://doi.org/10.3390/audiolres13050069

Netherlands

 * Diepstraten F, Meijer A, van Grotel M, Plasschaert S, Hoetink A, Fiocco M, Janssens G, Stokroos R, van den Heuvel-Eibrink M A Study on Prevalence and Determinants of Ototoxicity During Treatment of Childhood Cancer (SOUND): Protocol for a Prospective Study JMIR Res Protoc 2022;11(4):e34297  URL: https://www.researchprotocols.org/2022/4/e34297  DOI: 10.2196/34297

Portugal

 * Ferreira Penêda J, Barros Lima N, Ribeiro L, Helena D, Domingues B, Condé A. Cochleotoxicity monitoring protocol. Acta Otorrinolaringol Esp (Engl Ed). 2018. Mar-Apr;69(2):105–9. 10.1016/j.otoeng.2018.03.001

South Africa

 * Professional Board for Speech, Language, and Hearing Professions. (2018). Audiological Management of Patients on Treatment That Includes Ototoxic Medications: Guidelines Year 2018. Health Professions Council of South Africa. https://www.hpcsa.co.za/Uploads/professional_boards/slh/guidelines/Guidelines_for_Audiological_Management_of_Patients_on_Treatment_that_includes_Ototoxic_Medications.pdf
 * Souleymane MB, Piubello A, Lawan IM, Hassane-Harouna S, Assao-Neino MM, Soumana A, et al. High rifampicin-resistant TB cure rates and prevention of severe ototoxicity after replacing the injectable by linezolid in early stage of hearing loss. Eur Respir J. 2021. Jan 21;57(1):2002250. 10.1183/13993003.02250-2020
 * Khoza-Shangase K, Stirk M. Audiological testing for ototoxicity monitoring in adults with tuberculosis in state hospitals in Gauteng, South Africa. S Afr J Infect Dis. 2016. Jul;31(2):44–9. 10.1080/23120053.2016.1128143
 * Khoza-Shangase K, Masondo N. What Are the current audiological practices for ototoxicity assessment and management in the South African healthcare context? Int J Environ Res Public Health. 2020. Apr 10;17(7):2613. 10.3390/ijerph17072613
 * Stevenson, L. J., Biagio-de Jager, L., Graham, M. A., & Swanepoel, W. (2021). Community-Based Ototoxicity Monitoring for Drug-Resistant Tuberculosis in South Africa: An Evaluation Study. International journal of environmental research and public health, 18(21), 11342. https://doi.org/10.3390/ijerph182111342
 * https://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2225-47652020000100006

United States

 * https://www.audiology.org/practice-guideline/position-statement-and-practice-guidelines-on-ototoxicity-monitoring/
 * https://www.asha.org/policy/gl1994-00003/
 * Moser C. A proposed ototoxicity monitoring protocol based on specificity, feasibility, and early identification [poster presentation]. Plattsburgh: SUNY Open Access Repository; 2018. Available from: https://soar.suny.edu/handle/20.500.12648/1061
 * https://www.osha.gov/publications/shib030818

Members of IOMG

 * Dawn Konrad-Martin, Ph.D.
 * Overall Chair of IOMG
 * National Center for Rehabilitative Auditory Research and Oregon Health & Science University
 * Portland, Oregon, United States of America
 * Khaya Clark, Ph.D.
 * Director of Dissemination
 * National Center for Rehabilitative Auditory Research and Oregon Health & Science University
 * Portland, Oregon, United States of America
 * Lucretia Peterson, Ph.D.
 * Co-chair of International Emphasis
 * University of Cape Town
 * Cape Town, South Africa
 * Laura Dreisbach, Ph.D.
 * Co-Chair of International Emphasis | Liaison for American Speech-Language Hearing Association
 * San Diego State University
 * San Diego, California, United States of America
 * Angela Garinis, Ph.D.
 * Chair of Ototoxicity of Aminoglycoside Treatment
 * National Center for Rehabilitative Auditory Research and Oregon Health & Science University
 * Portland, Oregon, United States of America