Respiratory toxicity of persulphate salts and their adverse effects on airways in hairdressers: a systematic review

Abstract

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.

Systematic review on skin adverse effects of important hazardous hair cosmetic ingredients with a focus on hairdressers

“…These range from contact urticaria to rhinitis or bronchial asthma to even more severe, anaphylactic reactions. Respiratory effects of the target hair cosmetic substances have been systematically reviewed elsewhere 134 . Beyond a number of case reports (see Online Supplement ), few systematic studies on the frequency of such reactions have been published 111,135,136 …”

“…Regarding persulfates, successful secondary prevention measures have been described by the Finnish Institute of Occupational Health (FIOH) 135 . Certainly, this is also a very useful measure of primary prevention of airborne (skin and inhalatory) exposure, although this has not yet been confirmed by actual exposure studies 134 …”

Skin Toxicity of Selected Hair Cosmetic Ingredients: A Review Focusing on Hairdressers

“…Within the framework of the project, "Promoting the autonomous implementation of the European framework agreement on occupational health and safety in the hairdressing sector", a series of systematic reviews has been performed, synthesizing evidence on several key hazardous substances [3,[15][16][17][18][19]. As further important, but less well-investigated ingredients of hair cosmetics, cysteamine hydrochloride (cysteamine HCl; CAS no.…”

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

“…Many of the chemicals are classified in regard to their toxicological properties and labeled according to the European Chemical Agency (ECHA) and the Regulation (EC) No 1272/2008 on classification, labeling, and packaging of substances and mixtures (CLP) 1,2 . Typical hair cosmetic products and uses related to hairdressing are shown in Table 1 2,3 …”

“…1,2 Typical hair cosmetic products and uses related to hairdressing are shown in Table 1. 2,3 The risk for consumers using hairdressing products has been deemed acceptable by the Scientific Committee on Consumer Safety (SCCS), namely if pertinent restrictions according to Annex III of the Cosmetics Regulation EC 1223/2009 are applied. [4][5][6] The SCCS risk assessment however does not cover risk for professionals in daily contact with hairdressing products at work.…”