TY - JOUR
T1 - Respiratory toxicity of persulphate salts and their adverse effects on airways in hairdressers
T2 - a systematic review
AU - Macan, Jelena
AU - Babić, Željka
AU - Hallmann, Sarah
AU - Havmose, Martin S
AU - Johansen, Jeanne D
AU - John, Swen M
AU - Macan, Marija
AU - Symanzik, Cara
AU - Uter, Wolfgang
AU - Weinert, Patricia
AU - van der Molen, Henk F
AU - Kezic, Sanja
AU - Turk, Rajka
N1 - © 2022. The Author(s).
PY - 2022/10
Y1 - 2022/10
N2 - OBJECTIVE: To review the literature on respiratory effects of persulfate salts (PS) or hair bleaches in hairdressers and animal models exploring mechanisms behind PS-induced asthma.METHODS: A systematic review according to the PRISMA guidelines was performed. Studies published from 2000 to July 2021 that fulfilled predefined eligibility criteria were retrieved. Data were not quantitatively synthesized due to the heterogeneity of study designs, outcomes and methods.RESULTS: Forty-two articles were included. PS are indicated as the main cause of occupational rhinitis and asthma in hairdressers, and one of the leading causes of occupational asthma in some European countries. Bleaching products are indicated as the most important factor for development of respiratory symptoms, lung function decline, and leaving the hairdressing profession. Risk estimates from a good quality prospective study showed up to 3.9 times higher risk for wheezing and breathlessness in hairdressers aged ≥ 40 years than in matched controls, and 20 times higher risk in hairdressers to develop respiratory symptoms from exposure to bleaching powder than controls. Pathophysiological mechanisms of the respiratory response to PS are not yet fully elucidated, but may include non-specific and specific immune responses.CONCLUSIONS: Hairdressing is associated with a wide spectrum of respiratory adverse effects, of which bleaching products were indicated as the most hazardous. Preventive measures for reducing inhalatory exposure to PS in hair salons should be re-evaluated, including adopting occupational exposure limits at EU level, and encouraging use of safer bleach formulations.PROSPERO REGISTRATION NUMBER: CRD42021238118.
AB - OBJECTIVE: To review the literature on respiratory effects of persulfate salts (PS) or hair bleaches in hairdressers and animal models exploring mechanisms behind PS-induced asthma.METHODS: A systematic review according to the PRISMA guidelines was performed. Studies published from 2000 to July 2021 that fulfilled predefined eligibility criteria were retrieved. Data were not quantitatively synthesized due to the heterogeneity of study designs, outcomes and methods.RESULTS: Forty-two articles were included. PS are indicated as the main cause of occupational rhinitis and asthma in hairdressers, and one of the leading causes of occupational asthma in some European countries. Bleaching products are indicated as the most important factor for development of respiratory symptoms, lung function decline, and leaving the hairdressing profession. Risk estimates from a good quality prospective study showed up to 3.9 times higher risk for wheezing and breathlessness in hairdressers aged ≥ 40 years than in matched controls, and 20 times higher risk in hairdressers to develop respiratory symptoms from exposure to bleaching powder than controls. Pathophysiological mechanisms of the respiratory response to PS are not yet fully elucidated, but may include non-specific and specific immune responses.CONCLUSIONS: Hairdressing is associated with a wide spectrum of respiratory adverse effects, of which bleaching products were indicated as the most hazardous. Preventive measures for reducing inhalatory exposure to PS in hair salons should be re-evaluated, including adopting occupational exposure limits at EU level, and encouraging use of safer bleach formulations.PROSPERO REGISTRATION NUMBER: CRD42021238118.
KW - Asthma/etiology
KW - Humans
KW - Occupational Diseases/chemically induced
KW - Occupational Exposure/adverse effects
KW - Powders/adverse effects
KW - Prospective Studies
KW - Salts/adverse effects
UR - http://www.scopus.com/inward/record.url?scp=85126853413&partnerID=8YFLogxK
U2 - 10.1007/s00420-022-01852-w
DO - 10.1007/s00420-022-01852-w
M3 - Review
C2 - 35316371
VL - 95
SP - 1679
EP - 1702
JO - Internationales Archiv für Gewerbepathologie und Gewerbehygiene
JF - Internationales Archiv für Gewerbepathologie und Gewerbehygiene
SN - 0340-0131
IS - 8
ER -