Reproductive disorders among cosmetologists and hairdressers: a meta-analysis

The cost of beauty: Perspectives of salon workers in Kisumu City, Kenya

Despite occupational exposure to hazardous chemicals in cosmetics and personal care products (PCPs), salon workers receive minimal formal protections. Consequently, most salon workers rely on personal safeguards. However, the nature of such individual-level safeguards remains unknown. Knowledge of risks associated with occupational use of cosmetics and PCPs and information needs of salon workers were investigated in Kisumu City, Kenya. Responses from 302 respondents showed that 84% were women and 30% had post-secondary education. Seventy percent reported knowing that ingestion, inhalation, dermal absorption, and injection are the pathways through which harmful products in cosmetics and PCPs may enter the body. Salon workers who had been employed for more than 5 years were at least twice more likely to report that it is not the case that cosmetics and PCPs only cause harm to children (5-10 years vs 1 year: OR = 2.440, 95% CI, 1.160-5.239; >10 years vs 1 year: OR = 8.857, 95% CI, 3.163-29.377); they were about three times more likely to either agree with the statement that cosmetics and PCPs only cause harm under prolonged exposure or to say that they did not know compared to their counterparts who had worked in the industry for 1 year (5-10 years vs 1 year: OR = 2.750, 95% CI, 1.144-7.179; >10 years vs 1 year: 3.179, 95% CI, 1.173-9.096). Over 50% of the respondents reported that they need information on how to protect themselves and others; on available protective measures; and on cosmetic products and PCPs that are safe. Sixty percent reported that they would prefer to get such information from the Ministry of Health at the county or national level and on product inserts. Overall, salon workers in Kisumu City are knowledgeable about the risks associated with their occupation but also appreciate gaps in their knowledge, which can be filled by government-mandated interventions.

[Male infertility, environment and lifestyle]

BACKGROUND

Since the 1970s, there has been a quantitative and qualitative decline in sperm parameters. The main hypothesis to explain such a rapid evolution is the involvement of environmental and behavioral phenomena.

METHODS

A bibliographic search limited to English and French literature in men published before 7/2023 was carried out on the links between fertility and pollution, xenobiotics, tobacco, narcotics, cannabis, alcohol, weight, sport, sedentary lifestyle, sleep and anabolics.

RESULTS

Profound changes in lifestyle have occurred over the past 50 years: reduced sleep time, sedentary lifestyle, dietary changes, tobacco consumption, use of narcotics and anabolics. These changes have a proven impact on spermogram parameters, and should be corrected in an effort to optimize reproductive health. Other environmental parameters: pollution, exposure to heavy metals, exposure to xenobiotics, phthalates and pesticides… will be more difficult to exclude from patients' daily lives, but deserve to be taken more into account.

CONCLUSION

This review should help the urologist to assess and counsel patients in order to improve their reproductive health. These factors should be routinely investigated in infertile men.

Optimizing preconception care and interventions for improved population health

There is growing literature indicating that optimal preconception health is associated with improved reproductive, perinatal, and pediatric outcomes. Given that preconception care is recommended for all individuals planning a pregnancy, medical providers and public health practitioners have a unique opportunity to optimize care and improve health outcomes for reproductive-aged individuals. Knowledge of the determinants of preconception health is important for all types of health professionals, including policy makers. Although some evidence-based recommendations have already been implemented, additional research is needed to identify factors associated with favorable health outcomes and to ensure that effective interventions are made in a timely fashion. Given the largely clinical readership of this journal, this piece is primarily focused on clinical care. However, we acknowledge that optimizing preconception health for the entire population at risk of pregnancy requires broadening our strategies to include population-health interventions that consider the larger social systems, structures, and policies that shape individual health outcomes.

Occupational respiratory morbidity and associated factors among hairdressers in Ethiopia: a cross-sectional study

OBJECTIVE

This study was designed to determine the prevalence and factors associated with occupational respiratory morbidity among hairdressers in Northwestern Ethiopia.

DESIGN

A cross-sectional study was conducted from 6 July 2022 to 17 August 2022. The data were collected using a standardised American Thoracic Society questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was conducted to identify factors associated with occupational respiratory morbidity. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05.

SETTING

The study was conducted in Gondar city, Northwestern Ethiopia.

PARTICIPANTS

A total of 403 hairdressers participated in this study.

OUTCOME MEASURES

The primary outcome is the prevalence of occupational respiratory morbidity.

RESULTS

The total response rate was 95.5%. The majority, 250 (62%) of the respondents were women. The mean age (±SD) of the respondents was 27 (±6.0) years. The overall prevalence of occupational respiratory morbidity during the past 12 months was found to be 134 (33.3%) (95% CI (28.7% to 38.1%)). Female hairdressers (18.6%) showed greater respiratory morbidity than male hairdressers (14.7%). Working experience 3-5 years (AOR: 3.05; 95% CI (1.76 to 5.30)) and working experience >5 years (AOR: 6.22; 95% CI (2.73 to 14.16)), overweight (body mass index (BMI)) (AOR: 3.01; 95% CI (1.19 to 7.58)) and working near roadsides (AOR: 2.15; 95% CI (1.33 to 3.37)) were risk factors of occupational respiratory morbidity among hairdressers.

CONCLUSIONS

This study concluded that one-third of hairdressers experienced occupational respiratory morbidity. Longer work experience, higher BMI and working near roadsides were identified as significant risk factors for respiratory morbidity in hairdressers. Dietary calorie restrictions for overweight individuals and the development and implementation of air pollution mitigation measures targeted at roadside workers are advised to curb the problem.

Nutrition paves the way to environmental toxicants and influences fetal development during pregnancy

Nutrition plays a major role in the healthy pregnancy and development of the fetus. In addition, nutrition can expose humans to a wide range of potentially hazardous environmental constituents, such as organic pollutants and heavy metals from marine or agricultural food products while processing, producing, and packaging. Humans constantly face these constituents through air, water, soil, food, and domestic products. During pregnancy, the rate of cellular division and differentiation is higher; exposure to any of these environmental toxicants can lead to developmental defects as they cross the placental barrier and, in some cases, can harm the successive generation too, as some contaminants can act on the reproductive cells of the fetus (Diethylstilbestrol). Pregnant women are considered a vulnerable population to food contaminant exposure and require a proper dietary chart and conscious food choices. Food is a source of both essential nutrients and environmental toxicants. Here, we have researched the possible toxicants of the food industry and their influence on the fetus's in-utero development, along with the importance of dietary interventions and the need to balance a healthy diet to overcome the harms. The cumulative exposure to environmental toxicants can influence the mother's prenatal environment and affect the fetus's development.

Environmental and occupational factors and higher risk of couple infertility: a systematic review study

Background

Infertility is a global health problem that represents an increasing trend due to new lifestyles following technological advances since individuals are facing more risk factors than before. The present systematic review study aimed to investigate the impact of environmental and occupational factors on reproductive parameters and increased risk of couple infertility.

Main body

Scopus, PubMed, SID, and Web of Science databases were searched for the available observational (i.e., cohort, case-control, and cross-sectional) systematic review, meta-analysis, and clinical trial studies between 2007 and 2019. To this end, keywords such as ‘Environmental exposure’, ‘Occupational exposure’, ‘Environmental pollutants’, ‘Environmental pollution’, ‘Couple infertility’, ‘Sterility’, and ‘Sub-fertility’ were used. The retrieved investigations examined the impact of environmental and occupational risk factors on reproductive indices and increased infertility risk. Totally, 66 out of 9519 papers were evaluated after considering the inclusion and exclusion criteria. The reported risk factors in the reviewed studies were heavy metals, cigarette smoking, and exposure to chemicals through consumer goods, urban life, and proximity to main roads. In addition, occupational factors included heavy physical activity, prolonged sitting, exposure to a hot environment, contact with formaldehyde, pesticides, insecticides, mechanical vibration, and contact with ionizing radiation, all of which affected the reproductive parameters. However, some researchers found no significant associations in this regard.

Short conclusion

In general, individuals with known impairments in reproductive parameters were more exposed to risk factors. Nonetheless, more studies are needed to determine the risk of infertility in the population.

The association of prenatal exposure to benzophenones with gestational age and offspring size at birth

In recent decades, emerging environmental pollutants such as endocrine-disrupting chemicals (EDCs) have become a particular concern. This study examined the association of maternal exposure to benzophenones as one of the EDCs with gestational age and evaluated their effects on birth outcomes including birth weight, birth length, head circumference, and Ponderal Index. We assessed 166 pregnant mothers of the PERSIAN cohort population of Isfahan, Iran, in the 1st and 3rd trimesters of pregnancy and their infants at birth. Four common benzophenones (BPs) including 2,4-dihydroxy benzophenone (BP-1), 2-hydroxy-4-methoxy benzophenone (BP-3), 4-hydroxy benzophenone (4-OH-BP), and 2,2'-dihydroxy-4-methoxy benzophenone (BP-8) were measured in maternal urine samples. The median urinary concentrations of 4-OH-BP, BP-3, BP-1, and BP-8 in the 1st trimester were 6.62, 7.5, 4.39, and 1.32 µg/g creatinine and those in the 3rd trimester were 3.15, 16.98, 9.95, and 1.04 µg/g creatinine, respectively. BP-3 was the predominant metabolite in both trimesters. There was a significant correlation between BP-3, BP-1, and 4-OH-BP levels (p < 0.05) but not BP-8. BP-1 showed a significant positive association with gestational age (GA) in all infants in the 1st trimester, but a negative association was observed between BP-3 and BP-1 levels and GA in girls. Classification of infants' birth weight for different GAs represented that the majority of them were appropriate for GA. However, boys' weights were heavier than girls. Also, birth outcomes of preterm (< 37 weeks) infants were noticeably lower than term infants (37-42 weeks). This study demonstrated that benzophenone derivatives especially BP-3 can affect the duration of pregnancy and consequently fetal growth in the early and late stages of pregnancy. This is more pronounced in girls; however, more investigations in a different population are needed to prove the results. Therefore, the application of these compounds as a UV protector requires precise regulation to reduce exposure, especially in pregnant women.

Occupational Exposure of Hairdressers to Airborne Hazardous Chemicals: A Scoping Review

INTRODUCTION

Exposure to hazardous chemicals released during hairdressing activities from hair care products puts hairdressers at risk of adverse health effects. Safety assessments of hair products are mainly focused on consumers, but exposure for professional hairdressers might be substantially higher.

OBJECTIVE

To identify and assess available research data on inhalation exposures of professional hairdressers.

METHODS

A systematic search of studies between 1 January 2000 and 30 April 2021 was performed in Medline, Embase, Web of Science and in Cochrane registry, toxicological dossiers of the Scientific Committee on Consumer Safety (SCCS) of the European Commission as well as the German MAK Commission. Studies reporting quantitative data on airborne concentrations of chemicals in the hairdresser's workplace were considered. The outcome was an airborne concentration of chemicals in the working environment, which was compared, when possible, with current occupational exposure limits (OEL) or guidance levels.

RESULTS

In total, 23 studies performed in 14 countries were included. The average number of hairdressing salons per study was 22 (range 1-62). Chemicals most frequently measured were formaldehyde (n = 8), ammonia (n = 5), total volatile organic compounds (TVOC) (n = 5), and toluene (n = 4). More than fifty other chemicals were measured in one to three studies, including various aromatic and aliphatic organic solvents, hydrogen peroxide, persulfate, and particulate matter. Most studies reported environmental air concentrations, while personal exposure was measured only in seven studies. The measured air concentrations of formaldehyde, ammonia, and TVOC exceeded OEL or guidance values in some studies. There was large variability in measuring conditions and reported air concentrations differed strongly within and between studies.

CONCLUSION

Hairdressers are exposed to a wide spectrum of hazardous chemicals, often simultaneously. Airborne concentrations of pollutants depend on salon characteristics such as ventilation and the number of customers but also on used products that are often country- or client-specific. For exposure to formaldehyde, ammonia, and TVOC exceeding OELs or guidance values for indoor air was observed. Therefore, occupational exposure should be taken into account by safety regulations for hair care products.

Association of hairdressing with cancer and reproductive diseases: A systematic review

OBJECTIVES

To review recent epidemiological studies investigating carcinogenic or reprotoxic effects among hairdressers who seem to be at greater risk for systemic adverse effects of chemicals released from hair care products than consumers.

METHODS

A systematic review according to the PRISMA-P guidelines was performed and included studies published from 2000 to August 2021, in which cancer or adverse reproductive effects were diagnosed in 1995 and onward. Data were synthetized qualitatively due to the small number of studies, heterogeneity of study designs, outcomes, and methods.

RESULTS

Four studies investigating cancer frequencies and six studies investigating effects on reproduction among hairdressers were identified. All were of good quality and with low risk of bias. Only one of the four studies found an increased risk of cancer reporting nine times higher odds for bladder cancer in hairdressers than the population-based controls. Three other studies investigating bladder and lung cancer, and non-Hodgins lymphoma did not find an increased risk in hairdressers. Regarding reprotoxic effects, numerous outcomes were investigated including menstrual disorders, congenital malformations, fetal loss, small-for-gestational age newborns, preterm delivery, and infertility. Increased risk was found for ventricular septal defect in newborns of fathers working as hairdressers. Furthermore, several indices of poor neonatal or maternal health were significantly associated with mothers working as hairdresser.

CONCLUSIONS

Despite the scarce evidence that hairdressers are at increased risk of carcinogenic or reprotoxic effects related to their trade, such health risks cannot be ruled out. Therefore, preventive efforts to diminish occupational exposures to hairdressing chemicals should be targeted.

Foetal ductus arteriosus constriction unrelated to non-steroidal anti-Inflammatory drugs: a case report and literature review

Foetal ductus arteriosus (DA) constriction can be found in complex foetal heart malformations, but rarely as an isolated defect. Although many cases of DA constriction are usually related to Non-steroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake, other causes remain without an established aetiology and are referred to as idiopathic. Recently, a wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) showed a definitive effect upon the pathway of inflammation, causing DA constriction. We report a case of a premature DA constriction in a woman whose possible risk factor was identified in her maternal occupational exposure to solvents and a comprehensive literature review of 176 cases of NSAID-unrelated DA constriction. A 30-year-old Asian woman was referred to our institution at 33 gestational weeks and 0 days because of suspicion of premature DA constriction. The woman had no history of medication intake, including NSAIDs, alcohol, tobacco or polyphenol-rich-food consumption during pregnancy. A detailed foetal echocardiography revealed a normal cardiac anatomy with hypertrophic, hypokinetic and a dilated right ventricle due to right pressure overload, holosystolic tricuspid regurgitation, and, at the level of the DA, high systolic and diastolic velocities, indicating premature ductal restriction. The right outflow showed dilatation of the pulmonary artery with narrow DA. An urgent caesarean section was performed at 33 gestational weeks and 4 days due to worsening of DA PI and signs of right pressure overload, despite the interruption of exposure to solvents. We assume a relationship exists between premature DA constriction and a maternal occupational exposure to solvents. This hypothesis is reinforced by the presence of associated foetal malformations in in two of the patient's children. Further research is needed to confirm the role of exposure to solvents and toxic chemicals in the pathogenesis of DA constriction, also with experimental animal models.KEY MESSAGESMany cases of DA constriction are usually related to Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) maternal intake.A wide range of risks factors or substances (polyphenol-rich foods intake, naphazoline, fluoxetine, caffeine and pesticides) can cause foetal DA constriction.Further investigation are needed to confirm the role of maternal exposure to solvents in the pathogenesis of DA constriction.

Phthalates, ovarian function and fertility in adulthood

Phthalates are a family of high-production volume industrial chemicals used in the manufacture of plastics. Some phthalates are regulated as endocrine disrupting chemicals (EDCs) and reproductive toxicants based on adverse effects in the male. Potential effects in females are less understood although exposure levels can be higher in women compared to men. Here, we review the literature on the effects of phthalate exposures in adulthood on ovarian function and fertility in women. Experimental studies using cell cultures and rodents combined with human evidence from epidemiological studies suggest that phthalates pose a hazard to ovaries. Phthalates can disrupt follicle growth pattern, increase oxidative stress and cause follicle death. These effects could lead to infertility, faster depletion of ovarian reserve, and earlier reproductive senescence. However, more studies using more realistic exposure levels will be needed to properly assess the risks in women.

Phthalates Exposure and Occupational Symptoms among Slovakian Hairdressing Apprentices

The objectives of the study were to examine occupational exposure to phthalates of hairdressing apprentices from Slovakia (n = 74, 89.2% females; 10.8% males), outcomes related to body composition and pulmonary functions. We used high-performance liquid chromatography and tandem mass spectrometry to the quantified urinary concentration of phthalates. Pulmonary function test (PFT), anthropometric measurements, and questionnaire were also conducted. We observed a decrease of % of predicted values of forced vital capacity (FVC% of PV) related exposure to mono(2-ethyl-5-oxohexyl) phthalate (MEOHP; p = 0.054) and sum of bis(2-ethylhexyl) phthalate metabolites (∑DEHP; p = 0.037), and a decrease of % of predicted values of vital capacity (VC% of PV) related to exposure to MEOHP, ∑DEHP (p = 0.008), and mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP; p = 0.014) in females. We detected associations between forced vital capacity (FVC) with weight (p = 0.002) and fat-free mass index (FFMI, p = 0.010). Vital capacity (VC) and VC% of PV increased with weight, body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-hip ratio (WHR), the waist-height ratio (WHtR), fat mass index (FMI) and FFMI in females (p ≤ 0.014). Results of multivariate regression between PFT and anthropometric parameters adjusted to phthalates indicated exposure to MnBP and MEHP, changing body structure (BMI and FMI), subsequently affecting values of FEV1/FVC.

Maternal cosmetics use during pregnancy and risks of adverse outcomes: a prospective cohort study

To probe into the associations between maternal personal cosmetics use during pregnancy and risk of adverse outcomes, and explore the potential dose-response relationships, we carried out a prospective cohort study involving 9710 pregnant women in Zhuzhou City and Xiangtan City in Hunan province during 2016-2017. A structured questionnaire was used to collection information for the pregnant women and their pregnancy outcomes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated by binary or multinomial logistic regressions. The study population included 4652 (47.9%) cosmetics non-users and 5058 (52.1%) cosmetics users. Cosmetics use was associated with an increased risk of small for gestational age (SGA) (aOR = 1.23, 95%CI 1.04 to 1.44), compared with cosmetics non-users. A positive dose-response relationship between frequency of cosmetics use and SGA was observed, although a borderline association was found at low use frequency (1-2 times per week; aOR = 1.18, 95%CI 0.99 to 1.40) and moderate use frequency (3-4 times per week; aOR = 1.23, 95%CI 0.92 to 1.64). High-frequency of cosmetics use (≥5 times per week) was significantly correlated with a higher risk of SGA (aOR = 1.83, 95%CI 1.25 to 2.69). No significant association between personal cosmetics use and the risk of preterm birth, low birth weight, macrosomia, or large for gestational age was observed. The present study suggests that personal cosmetics use will increase the risk of SGA, but further research is required to determine which cosmetic products may account for the higher risk of SGA.

Effects of environmental contaminants on fertility and reproductive health

Recent research indicates that the human infertility rate is increasing. Although various reasons have been hypothesized for the growing infertility rate, environmental contaminants are potentially important causal agents associated with this change. Chemical contaminants are widespread throughout our environment and human exposure is virtually unavoidable. The overall contribution of environmental exposure to infertility is unknown, but studies involving occupational exposure, together with results from animal experiments, suggest that environmental contaminants may adversely affect fertility. We reviewed the adverse effects of environmental exposure on fertility and related reproductive outcomes. Environmental contaminants covered in this review include heavy metals, organic solvents, pesticides and endocrine disrupting chemicals. It is hoped that this review will highlight the need for further research in this area.

Prevalence of abortion and adverse pregnancy outcomes among working women in Korea: A cross-sectional study

OBJECTIVES

To investigate incidence and distribution of major adverse reproductive health problems related to various kinds of industries in Korea and to compare risks for major reproductive outcomes to assess maternal health in working and non-working women.

METHODS

We requested claim data from the Korean National Health Insurance. We defined reference groups as (1) non-working women and (2) workers in the education field. Women working in each industry were compared with reference groups regarding rates of miscarriage, threatened abortion, preterm labor, and intrauterine growth restriction. Logistic regression was used for multivariate analysis, and age and income adjustment was performed.

RESULTS

The percentages of all adverse obstetric outcomes were higher in working women than in non-working women. Working women had higher and statistically significant adjusted odds ratios (ORs) for miscarriage in 18 of the 21 industries. The age and income-adjusted OR for miscarriage for all working women was 1.26 (95% confidence interval, 1.23-1.28). Business facilities management and business support services, manufacturing, human health and social work activities, wholesale and retail trade, and professional, scientific, and technical activities were major industries with higher adjusted ORs for adverse obstetric outcomes.

CONCLUSIONS

We confirmed that compared to non-working women, working women have a higher risk for adverse pregnancy outcomes. Thus, adverse pregnancy outcomes such as threatened abortion, preterm labor, and intrauterine growth restriction may be associated with working status. This exploratory study identified several industries where in-depth studies are required in future to improve occupational safety in women of reproductive age.