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Piapan L, Belloni Fortina A, Giulioni E, Larese Filon F. Sensitization to ethylenediamine dihydrochloride in patients with contact dermatitis in northeastern Italy from 1996 to 2021. Contact Dermatitis 2024; 90:253-261. [PMID: 38038148 DOI: 10.1111/cod.14454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/09/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Ethylenediamine dihydrochloride is a versatile aliphatic amine found in numerous medications and industrial compounds and is a known sensitiser. The sensitization prevalence is affected by geographical and socio-cultural factors. OBJECTIVES The objectives are to analyse the temporal trend of sensitization to ethylenediamine dihydrochloride in northeastern Italy and to investigate associations with occupations. METHODS Between 1996 and 2021, 30 629 patients with suspected allergic contact dermatitis were patch tested with the Triveneto baseline series. Individual characteristics were collected through a standardised questionnaire. RESULTS The overall prevalence of ethylenediamine dihydrochloride sensitization was 1.29% with percentages similar in both sexes. We observed a significant decreasing trend over time (p < 0.001), yielding a sensitization prevalence <1% in recent years. Among departments, residence in Pordenone area was protective for sensitization. No significant associations were observed with specific occupations. We found significant associations between ethylenediamine dihydrochloride sensitization and being 26-35 years old (odds ratio [OR], 1.47; 95% confidence interval [CI]: 1.05-2.08), and sensitization for many haptens, such as paraben mix (OR, 5.3; 95% CI: 3.3-8.5), epoxy resin (OR, 5.1; 95% CI: 3.0-8.7), neomycin sulphate and mercaptobenzothiazole. CONCLUSIONS Our study showed a downward time trend of ethylenediamine dihydrochloride sensitization in northeastern Italian population and pointed to an update of the Triveneto baseline series.
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Affiliation(s)
- Linda Piapan
- Department of Medical Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
| | | | - Erika Giulioni
- Dermatology Unit, Ospedale Santa Maria degli Angeli, Azienda Sanitaria Friuli Orientale, Pordenone, Italy
| | - Francesca Larese Filon
- Department of Medical Sciences, Clinical Unit of Occupational Medicine, University of Trieste, Trieste, Italy
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Ricklund N, Bryngelsson IL, Hagberg J. Self-reported symptoms in Swedish hairdressers and association with exposure to volatile organic compounds (VOCs), including aldehydes. BMC Public Health 2023; 23:1576. [PMID: 37596583 PMCID: PMC10436395 DOI: 10.1186/s12889-023-16446-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/02/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND Working as a hairdresser involves combined exposure to multiple chemicals in hair treatment products that may induce symptoms in airways and skin. METHODS In this cross-sectional study, perceived symptoms among Swedish hairdressers at 10 hair salons were surveyed through a questionnaire. Associations with personal exposure to volatile organic compounds (VOCs), including aldehydes, and their corresponding hazard index (HI), based on the estimated risk for non-cancer health effects, were examined. The prevalence of four out of 11 symptoms was compared to available reference datasets from two other studies of office workers and school staff. RESULTS All 11 surveyed symptoms were reported among the hairdressers (n = 38). For the whole study group, the most prevalent symptoms were dripping nose (n = 7) and headache (n = 7), followed by eczema (n = 6), stuffed nose (n = 5), cough (n = 5) and discomfort with strong odors (n = 5). Significant relationships between exposure and symptoms were scarce. The exception was total VOC (TVOC) exposure adjusted to worked years in the profession; a difference was observed for any symptom between hairdressers in the group with 20 + years compared to 0-5 years in the profession (logistic regression, OR 0.03, 95% CI 0.001-0.70). Out of the four symptoms available for comparison, the prevalence of headache and cough was significantly higher in hairdressers than in controls (OR 5.18, 95% CI 1.86-13.43 and OR 4.68, 95% CI 1.17-16.07, respectively). CONCLUSIONS Adverse health effects related to occupation was common among the hairdressers, implying a need for exposure control measures in hair salons. Symptoms of headache and cough were more frequently reported by hairdressers than staff in offices and schools. A healthy worker effect among the hairdressers was indicated in the group with 20 + years compared to 0-5 years in the profession. Significant relationships between measured exposure and symptoms were scarce but gave information about advantages and disadvantages of the different exposure measures. The study design could be improved by increasing the size of the study population, using a better match of reference data and increasing the applicability and representability over time of the measured exposure.
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Affiliation(s)
- Niklas Ricklund
- Department of Occupational and Environmental Medicine, Örebro University Hospital, Region Örebro County, PO Box 1613, 701 16, Örebro, Sweden.
| | - Ing-Liss Bryngelsson
- Department of Occupational and Environmental Medicine, Örebro University Hospital, Region Örebro County, PO Box 1613, 701 16, Örebro, Sweden
| | - Jessika Hagberg
- Department of Occupational and Environmental Health, Faculty of Business, Science and Engineering, Örebro University, 70182, Örebro, Sweden
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Piapan L, Di Taranto D, Patriarca E, Rui F, Larese Filon F. Hand Eczema in Apprentice Nurses during the COVID-19 Pandemic after a Skin Prevention Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2992. [PMID: 36833687 PMCID: PMC9964949 DOI: 10.3390/ijerph20042992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Healthcare workers, particularly nurses and apprentice nurses, are at high risk of the development of hand eczema due to daily exposure to wet work. This study aimed to assess the occurrence of hand eczema in a group of first-, second-, and third-year apprentice nurses at the University Hospitals of Trieste (northeastern Italy) during the COVID-19 pandemic. METHODS Two hundred forty-two Nursing School students were recruited. Data were collected using a standardized questionnaire based on the Nordic Occupational Skin Questionnaire, and all patients underwent a medical examination to evaluate their skin condition based on standard scores. Transepidermal water loss was also measured. The factors associated with hand eczema were investigated using univariate and multivariate logistic regression analyses. RESULTS The prevalence of hand eczema was low in students both before and after the traineeship (17.9 and 21.5%, respectively), but clinical signs of mild skin damage, mainly skin dryness, were present in 52.3 and 47.2%, respectively. The factor associated with hand eczema was a personal history of atopic eczema (odd ratios 2.61, 95% confidence intervals 1.18-5.80), while exposure to irritants and glove use did not reach statistical significance. CONCLUSIONS Our findings might be explained by the preventive measures adopted for skin protection among healthcare workers in Trieste since the apprenticeship.
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Affiliation(s)
| | | | | | | | - Francesca Larese Filon
- Unità Clinico Operativa di Medicina del Lavoro, Università di Trieste, Via della Pietà 2/2, 342129 Trieste, Italy
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Kasbi F, Tohidast SA, Mokhlesin M, Mansuri B, Jazem F, Ghorbani R, Kaviani S, Scherer RC. Voice Problems and Related Risk Factors Among Hairdressers. J Voice 2022:S0892-1997(22)00233-8. [PMID: 36163069 DOI: 10.1016/j.jvoice.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Hairdressers are more prone to respiratory diseases, bronchitis, asthma, shortness of breath, and cough due to the nature of their occupation and the constant use of cosmetics. Therefore, they may be prone to voice disorders or laryngeal problems. Voice problems may affect not only their social and emotional relationships but also their jobs. The current study was conducted to investigate voice problems and related risk factors in hairdressers. DESIGN Cross-sectional, descriptive-analytical. PATIENTS AND METHODS A total number of 293 women participated in the study. The study group consisted of 147 hairdressers and the control group consisted of 146 women with other jobs. All study participants were requested to complete a self-reported questionnaire. This questionnaire investigated demographic characteristics, voice problems and symptoms, laryngeal discomfort, working features, and workplace conditions. Chi-square, independent t-test, Fisher's exact test, and logistic regression were used to analyze the data. RESULTS The prevalence of voice problems in hairdressers and the control group was 33.33% and 15.75%, respectively, and this difference was statistically significant (P < 0.001). Results of the Chi-Square test showed that prevalence of hoarseness, vocal fatigue, dryness, and cough were higher in hairdressers than the control group (P < 0.05). According to regression logistic results, work time (hours per week) (P = 0.014; OR = 2.35; CI = 1.18-4.66) and presence of phonotraumatic behaviors (P = 0.012; OR = 2.73; CI = 1.24-5.96) increased the possibility of increasing the presence of voice symptoms among hairdressers. CONCLUSION The findings revealed that self-reported voice problems were more prevalent in the hairdressers group than in the control group and therefore the hairdressers were more prone to an increased risk of developing voice problems. The most common symptoms in the hairdressers group were cough, hoarseness, and dryness in the vocal tract. Based on these results, in addition to paying attention to recommendations related to environmental issues and exposure to chemical hazards, hairdressers may benefit from receiving appropriate training in voice production, voice disorders, and the prevention of voice disorders.
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Affiliation(s)
- Fatemeh Kasbi
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Seyed Abolfazl Tohidast
- Department of Speech Therapy, School of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran.
| | - Maryam Mokhlesin
- Department of Speech Therapy, School of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran
| | - Banafshe Mansuri
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Jazem
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Raheb Ghorbani
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Epidemiology and Biostatistics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Shohre Kaviani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Ronald Callaway Scherer
- Department of Communication Sciences and Disorders, Bowling Green State University, Bowling Green, Ohio
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Shao Y, Kavi L, Boyle M, Louis LM, Pool W, Thomas SB, Wilson S, Rule AM, Quiros-Alcala L. Real-time air monitoring of occupational exposures to particulate matter among hairdressers in Maryland: A pilot study. INDOOR AIR 2021; 31:1144-1153. [PMID: 33682973 DOI: 10.1111/ina.12817] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
Hairdressers are exposed to particulate matter (PM), a known air pollutant linked to adverse health effects. Still, studies on occupational PM exposures in hair salons are sparse. We characterized indoor air PM concentrations in three salons primarily serving an African/African American (AA) clientele, and three Dominican salons primarily serving a Latino clientele. We also assessed the performance of low-cost sensors (uRAD, Flow, AirVisual) by comparing them to high-end sensors (DustTrak) to conduct air monitoring in each salon over 3 days to quantify work shift concentrations of PM2.5 , respirable PM (RPM), and PM10 . We observed high spatial and temporal variability in 30-min time-weighted average (TWA) RPM concentrations (0.18-5518 μg/m3 ). Readings for the uRAD and AirVisual sensors were highly correlated with the DustTrak (R2 = 0.90-0.99). RPM 8-hour TWAs ranged from 18 to 383 µg/m3 for AA salons, and 9-2115 µg/m3 for Dominican salons. Upper 95th percentiles of daily RPM exposures ranged from 439 to 2669 µg/m3 . The overall range of 30-min TWA PM2.5 and PM10 concentrations was 0.13-5497 and 0.36-,541 μg/m3 , respectively. Findings suggest that hairdressers could be overexposed to RPM during an 8-hour shift. Additional comprehensive monitoring studies are warranted to further characterize temporal and spatial variability of PM exposures in this understudied occupational population.
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Affiliation(s)
- Yuan Shao
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lucy Kavi
- School of Public Health, Maryland Institute of Applied Environmental Health (MIAEH, University of Maryland, College Park, Maryland, USA
| | - Meleah Boyle
- School of Public Health, Maryland Institute of Applied Environmental Health (MIAEH, University of Maryland, College Park, Maryland, USA
| | - Lydia M Louis
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Stephen B Thomas
- Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, Maryland, USA
| | - Sacoby Wilson
- School of Public Health, Maryland Institute of Applied Environmental Health (MIAEH, University of Maryland, College Park, Maryland, USA
| | - Ana M Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lesliam Quiros-Alcala
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- School of Public Health, Maryland Institute of Applied Environmental Health (MIAEH, University of Maryland, College Park, Maryland, USA
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Contact Dermatitis Associated With Hair Care Products: A Retrospective Analysis of the North American Contact Dermatitis Group Data, 2001-2016. Dermatitis 2021; 33:91-102. [PMID: 34149001 DOI: 10.1097/der.0000000000000760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Hair care products (HCPs) may cause both allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD). OBJECTIVES The aims of the study were to determine the prevalence of HCP-associated ICD/ACD and to characterize relevant allergens. METHODS This study is a retrospective analysis of North American Contact Dermatitis Group (NACDG) patch test data, 2001-2016. RESULTS Of 38,775 patients tested, 3481 (9.0%) had positive patch test reactions associated with HCPs. The HCP-positive patients were significantly more likely to be female (79.9% vs 66.0%) and/or have primary sites of dermatitis on the face (32.0% vs 27.8%) or scalp (15.4% vs 2.2%) compared with the HCP-negative patients (P < 0.0001). Of 4908 HCP-associated positive patch test reactions, 86.9% (n = 4263) were due to allergens on the NACDG screening series; p-phenylenediamine (35.8%), methylisothiazolinone (9.7%), methylchloroisothiazolinone/methylisothiazolinone (8.7%), and cocamidopropyl betaine (5.9%) were the most frequent. Most reactions (87.7%, 3736/4263) were currently clinically relevant. The most common job associated with 366 occupationally related NACDG HCP-associated allergens was hairdresser/cosmetologist (71.9%). Two hundred eighty-two patients (0.7%) had ICD associated with HCPs. Shampoo/conditioners were the most frequent source of NACDG HCP-associated reactions (47.3%) and HCP-associated ICD (45.0%). CONCLUSIONS Of the HCP-positive patients, 18.5% had HCP reactions to allergens not on the NACDG screening series, underscoring the importance of patch testing to expanded series in patients suspected of HCP allergy.
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Thá EL, Canavez ADPM, Schuck DC, Gagosian VSC, Lorencini M, Leme DM. Beyond dermal exposure: The respiratory tract as a target organ in hazard assessments of cosmetic ingredients. Regul Toxicol Pharmacol 2021; 124:104976. [PMID: 34139277 DOI: 10.1016/j.yrtph.2021.104976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 05/30/2021] [Accepted: 06/11/2021] [Indexed: 10/21/2022]
Abstract
Dermal contact is the main route of exposure for most cosmetics; however, inhalation exposure could be significant for some formulations (e.g., aerosols, powders). Current cosmetic regulations do not require specific tests addressing respiratory irritation and sensitisation, and despite the prohibition of animal testing for cosmetics, no alternative methods have been validated to assess these endpoints to date. Inhalation hazard is mainly determined based on existing human and animal evidence, read-across, and extrapolation of data from different target organs or tissues, such as the skin. However, because of mechanistic differences, effects on the skin cannot predict effects on the respiratory tract, which indicates a substantial need for the development of new approach methodologies addressing respiratory endpoints for inhalable chemicals in general. Cosmetics might present a particularly significant need for risk assessments of inhalation exposure to provide a more accurate toxicological evaluation and ensure consumer safety. This review describes the differences in the mechanisms of irritation and sensitisation between the skin and the respiratory tract, the progress that has already been made, and what still needs to be done to fill the gap in the inhalation risk assessment of cosmetic ingredients.
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Affiliation(s)
- Emanoela Lundgren Thá
- Graduate Program in Genetics, Department of Genetics - Federal University of Paraná (UFPR), Curitiba, PR, Brazil.
| | | | | | | | - Márcio Lorencini
- Grupo Boticário, Product Safety Management- Q&PP, São José dos Pinhais, PR, Brazil
| | - Daniela Morais Leme
- Department of Genetics - Federal University of Paraná (UFPR), Curitiba, PR, Brazil.
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Piapan L, Mauro M, Martinuzzo C, Larese Filon F. Characteristics and incidence of contact dermatitis among hairdressers in north‐eastern Italy. Contact Dermatitis 2020; 83:458-465. [DOI: 10.1111/cod.13687] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/08/2020] [Accepted: 08/10/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Linda Piapan
- Clinical Unit of Occupational Medicine, Department of Medical Sciences University of Trieste Trieste Italy
| | - Marcella Mauro
- Clinical Unit of Occupational Medicine, Department of Medical Sciences University of Trieste Trieste Italy
| | - Chiara Martinuzzo
- Clinical Unit of Occupational Medicine, Department of Medical Sciences University of Trieste Trieste Italy
| | - Francesca Larese Filon
- Clinical Unit of Occupational Medicine, Department of Medical Sciences University of Trieste Trieste Italy
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Havmose M, Thyssen JP, Zachariae C, Johansen JD. Use of protective gloves by hairdressers: A review of efficacy and potential adverse effects. Contact Dermatitis 2020; 83:75-82. [PMID: 32311093 DOI: 10.1111/cod.13561] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/15/2020] [Accepted: 04/16/2020] [Indexed: 11/29/2022]
Abstract
Occupational hand eczema is common among hairdressers, and protective gloves are important in limiting exposure to irritants and allergens. Various glove types may differ in their protective ability, and their use may lead to hand eczema due to skin irritancy and allergy. MEDLINE was searched for studies investigating permeation of gloves to irritants and allergens used in the hairdressing trade, as well as adverse effects of glove use affecting hairdressers. Forty-four studies were identified; nine reported on permeation. Of those, two in vitro studies found nitrile rubber (NR) gloves to give the best protection when handling hair dyes. Polyethylene (PE) gloves had the lowest reported break-through time. The prevalence of sensitization to rubber materials in European hairdressers was as follows: thiuram mix, median 2.5% (range 0%-8.2%), weighted average 3.0% (95% confidence interval [CI] 3.0%-3.1%); mercapto mix, median 0.4% (range 0%-3.3%), weighted average 0.5% (95% CI 0.47%-0.50%), mercaptobenzothiazole, median 0.6% (range 0%-6.6%), weighted average 0.7% (95% CI 0.6%-0.7%), NRL-type I allergy, median 1.3% (range 1%-16.4%), weighted average 4.0% (95% CI 3.6%-4.5%). In conclusion, NR gloves provide the best skin protection for hairdressers, although natural rubber latex (NRL) and polyvinylchloride (PVC) gloves may be sufficient in most cases. PE gloves are not recommended. Synthetic rubber gloves with low or no levels of accelerators are preferred.
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Affiliation(s)
- Martin Havmose
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jacob P Thyssen
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Claus Zachariae
- Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
| | - Jeanne D Johansen
- National Allergy Research Center, Department of Dermatology and Allergy, Herlev and Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
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Irritant Contact Dermatitis: Why It Happens, Who Suffers It and How to Manage. CURRENT TREATMENT OPTIONS IN ALLERGY 2020. [DOI: 10.1007/s40521-020-00247-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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