Noise-induced hearing loss in pre-industrial era. Early contributions in "De Morbis Artificum" by Bernardino Ramazzini (1633-1714)

Objective. Noise-induced hearing loss (NIHL) is the most prevalent occupational disease worldwide and is historically associated with the Industrial Revolution. This study analyses early descriptions of this disorder during the pre-industrial period in the work of the Italian physician Bernardino Ramazzini (1633-1714). Methods. Primary and secondary historical literature were reviewed. Results. Ramazzini described hearing loss in corn millers and in coppersmiths and recognised that this disorder is irreversible and progressive when exposure to noise continues. He also seemed to describe tinnitus. He further suggested the use of earplugs as a preventive measure for these classes of workers. Ramazzini's anatomical and pathological knowledge appears to be based on ancient authors; he did not discuss contemporaneous medical authors' work on hearing function. Conclusion. Despite these limitations, Ramazzini's work appears pioneering for his time and represents an important milestone in the history of otolaryngology.