Introduction: This study examines the combined impact of chemical and noise exposure on hearing loss in high-risk industries. Utilizing information from audiometric testing, noise risk assessment, and chemical exposure monitoring. OBJECTIVES: This study investigated the relationship between hearing loss and simultaneous exposure to solvents and noise among workers in Malaysia’s high-risk industries, specifically focusing on paint manufacturing operators. METHODS: The surveillance study involves relevant respondents gathered from selected paint manufacturing operators, with a total sample size of 302. The data on injuries, illnesses, exposures, and audiometric tests were collected to assess ototoxic risk from noise exposure using Chemical Exposure Monitoring (CEM) and Noise Risk Assessment (NRA) reports and conducting audiometry tests on workers. Out of these, 244 responses were received and analysed. RESULTS: The logistic regression analysis of hearing impairment risk-based exposure groups. The group “Exposed to ototoxic chemicals & noise >85 dB” is at a higher risk of having a hearing impairment. This group has a β value of 0.9691 and an Exp(B) of 2.635616, indicating they are approximately 2.6 times more likely to develop hearing impairment compared to the non-exposed group. Despite the “Exposed to noise >85 dB” group having a very high β value, the associated high standard error and non-significant p-value (0.9991) suggest that the estimate is unreliable. CONCLUSIONS: This study highlighted the critical need to integrate measures addressing solvent and noise exposure in hearing conservation programs tailored for workers, particularly in high-risk industries. The results indicate the risk of noise-induced hearing loss (NIHL) increases significantly when solvents and noise are present together.