Airway inflammation and ammonia exposure among female Palestinian hairdressers: a cross-sectional study

Little is known about the working conditions and airway inflammation in hairdressers in Palestine. This study aimed to investigate if hairdressers in Palestine have a higher level of airway inflammation as compared to a control group. In addition, the hairdressers’ physical working conditions and exposure to ammonia gases at the hair salons was assessed. Lastly, the authors investigated the association between ammonia levels and inflammation markers in the airways and the blood. The study participants were 33 non-smoking hairdressers (aged 19-50 years) and 35 non-smoking control subjects (aged 18-49 years). Both groups answered a questionnaire on respiratory symptoms, and performed lung function and exhaled nitric oxide (eNO) tests. Blood and sputum samples were collected from all participants and air concentration levels of ammonia were measured in 13 salons. Hairdressers had a higher level of sputum neutrophil count (absolute numbers/mg sputum (median (25th-75th centiles)) compared to controls, 376 (183-980) and 182 (96-358), respectively. Hairdressers also had significantly elevated eNO and blood C reactive protein (CRP) levels compared to the control subjects, controlled for age and body mass index. Exposure measurements showed that the hairdressers in salons with scarce ventilation were exposed to ammonia concentration, ranging from 3 to 61 mg/m(3). The authors concluded that compared to unexposed controls, the hairdressers had signs of neutrophilic airway inflammation, higher eNO levels and higher CRP. The hairdressers were exposed to high concentrations of ammonia from hairdressing chemicals and their working conditions were unsatisfactory.

Authors: Nemer M, Sikkeland LI, Kasem M, Kristensen P, Nijem K, Bjertness E, Skare Ø, Bakke B, Kongerud J, Skogstad M. ;Full Source: Occupational & Environmental Medicine. 2015 Feb 4. pii: oemed-2014-102437. doi: 10.1136/oemed-2014-102437. [Epub ahead of print] ;