title: Fertility disorders and pregnancy complications in hairdressers - a systematic review.
abstract: BACKGROUND
  Hairdressers often come into contact with various chemical substances which can be found in hair care products for washing, dyeing, bleaching, styling, spraying and perming. This exposure can impair health and may be present as skin and respiratory diseases. Effects on reproduction have long been discussed in the literature.
  
  
  METHODS
  A systematic review has been prepared in which publications from 1990 to 2010 were considered in order to specifically investigate the effects on fertility and pregnancy. The results of the studies were summarised separately in accordance with the type of study and the examined events.
  
  
  RESULTS
  A total of 2 reviews and 26 original studies on fertility disorders and pregnancy complications in hairdressers were found in the relevant databases, as well as through hand searches of reference lists. Nineteen different outcomes concerning fertility and pregnancy are analysed in the 26 original studies. Most studies looked into malformation (n = 7), particularly orofacial cleft. Two of them found statistically significant increased risks compared to five that did not. Small for gestational age (SGA), low birth weight (LBW) and spontaneous abortions were frequently investigated but found different results. Taken together the studies are inconsistent, so that no clear statements on an association between the exposure as a hairdresser and the effect on reproduction are possible. The different authors describe increased risks of infertility, congenital malformations, SGA, LBW, cancer in childhood, as well as effects from single substances.
  
  
  CONCLUSIONS
  On the basis of the identified epidemiological studies, fertility disorders and pregnancy complications in hairdressers cannot be excluded. Although the evidence for these risks is low, further studies on reproductive risks in hairdressers should be performed as there is a high public health interest.
authors: Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistr, 52, 20246 Hamburg, Germany. a.nienhaus@uke.uni-hamburg.de.
authors: Claudia
authors: C
authors: Peters
authors: Melanie
authors: M
authors: Harling
authors: Madeleine
authors: M
authors: Dulon
authors: Anja
authors: A
authors: Schablon
authors: José
authors: J
authors: Torres Costa
authors: Albert
authors: A
authors: Nienhaus