title: Personal use of hair dyes and risk of bladder cancer: a meta-analysis of epidemiologic data.
abstract: OBJECTIVE
  We compared, updated, and expanded the analyses of two previous meta-analyses of personal hair dye exposure and bladder cancer, and briefly discussed the biological plausibility of a systemic hazard to human health from exposure to para-phenylenediamine (PPD), a key chemical in hair dyes.
  
  
  METHODS
  The meta-analysis included 11 case-control studies and one cohort study. We evaluated heterogeneity across studies and conducted sensitivity and influence analyses.
  
  
  RESULTS
  No association was found between any personal use of hair dye and bladder cancer among women (meta-relative risk [mRR] = 1.01, 95% CI: 0.89-1.14), men (mRR = 0.82, 95% CI: 0.60-1.14), or both sexes combined (mRR = 0.97, 95% CI: 0.87-1.08). No statistically significant mRRs were found among the studies that reported data for permanent hair dye use (mRR = 1.06, 95% CI: 0.89-1.27), duration of any hair dye use (mRR = 1.00, 95% CI: 0.85-1.19), duration of permanent hair dye use (mRR = 1.31 95% CI 0.78-2.19), lifetime applications of any hair dye use (mRR = 1.12 (95% CI: 0.72-1.72) or permanent hair dye use (mRR = 1.59, 95% CI 0.69-3.64), or dark color hair dye use (mRR = 0.94, 95% CI: 0.74-1.19).
  
  
  CONCLUSIONS
  The results of this meta-analysis of epidemiologic studies do not indicate a causal association between personal hair dye use and bladder cancer.
authors.affiliation: Exponent, 149 Commonwealth Drive, Menlo Park, CA 94025, USA. mkelsh@exponent.com
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kelsh
authors.forename: Dominik D
authors.initials: DD
authors.lastname: Alexander
authors.forename: Renee M
authors.initials: RM
authors.lastname: Kalmes
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Buffler
mesh_terms: D005260:Female; D006202:Hair Dyes / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010655:Phenylenediamines / Q000009:adverse effects*; D012306:Risk; D001749:Urinary Bladder Neoplasms / Q000209:etiology*
chemical_list: D006202:Hair Dyes; D010655:Phenylenediamines; C029728:4-phenylenediamine