There is mounting evidence that chemicals, asphyxiants and some heavy metals can affect hearing. Workers in many industries around the globe are exposed daily to chemicals that are ototoxic. Some research reveals that there is a synergistic effect when workers are exposed to chemicals and noise. This is an area of interest to me and I feel strongly that this issue needs to be addressed in workers compensation cases. Audiologists should be among those who are educating attorneys and others in related professions about the dangers of chemicals, asphyxiants and heavy metals when combined with exposure to noise.