As these exposures are common, this hearing impairment can affect many occupations and industries. Examples of activities that often have exposures to both noise and solvents include:
Printing
Painting
Construction
Fueling vehicles and aircraft
Firefighting
Weapons firing
Pesticide sprayingOtotoxic chemicals in the environment (from contaminated air or water) or in the workplace interact with mechanical stresses on the hair cells of the cochlea in different ways. For mixtures containing organic solvents such as toluene, styrene or xylene, the combined exposure with noise increases the risk of occupational hearing loss in a synergistic manner. The risk is greatest when the co-exposure is with impulse noise. Carbon monoxide has been shown to increase the severity of the hearing loss from noise. Given the potential for enhanced risk of hearing loss, exposures and contact with products such as fuels, paint thinners, degreasers, white spirits, exhaust, should be kept to a minimum. Noise exposures should be kept below 85 decibels, and the chemical exposures should be below the recommended exposure limits given by regulatory agencies. Drug exposures mixed with noise potentially lead to increased risk of ototoxic hearing loss. Noise exposure combined with the chemotherapeutic cisplatin puts individuals at increased risk of ototoxic hearing loss. Noise at 85 dB SPL or above added to the amount of hair cell death in the high frequency region of the cochlea in chinchillas.The hearing loss caused by chemicals can be very similar to a hearing loss caused by excessive noise.
Diagnosis
The presence of glucagonoma syndrome, the symptoms that accompany the pancreatic tumor, as well as elevated levels of glucagon in the blood, are what is used to diagnose glucagonoma. When a person presents with a blood glucagon concentration greater than 500 mg/mL along with the glucagonoma syndrome, a diagnosis can be established. It is important to note that not all cases of hyperglucagonemia will lead to a diagnosis of glucagonoma. Elevated blood levels of glucagon are associated with other disorders like pancreatitis and kidney failure.About 60% of people diagnosed with glucagonoma are women. Most of those that are diagnosed are between 45–60 years of age. Treatment
People who are diagnosed with sporadic glucagonoma often have an increased mortality rate compared to those with MEN1, as the latter group will go to the doctor for periodic visits. People whose tumor have metastasized cannot easily be treated as the tumor is resistant to chemotherapy. The only curative therapy for glucagonoma is surgery, and even this is not always successful.Heightened glucagon secretion can be treated with the administration of octreotide, a somatostatin analog, which inhibits the release of glucagon. Doxorubicin and streptozotocin have also been used successfully to selectively damage alpha cells of the pancreatic islets. These do not destroy the tumor, but help to minimize progression of symptoms. History
Fewer than 251 cases of glucagonoma have been described in the literature since their first description by Becker in 1942. Because of its rarity (fewer than one in 20 million worldwide), long-term survival rates remain unknown.