title: Trends in occupational airway diseases in German hairdressers: frequency and causes.
abstract: BACKGROUND
  Hairdressers are exposed to several allergens and irritants known to cause obstructive airway diseases (OAD). In the early 1990s, high incidence rates of OAD were observed in German hairdressers. It was expected that modification of formulations would resolve the problem of high OAD rates in hairdressers.
  
  
  METHODS
  The numbers of confirmed cases are reported of allergen-, latex- and irritant-induced OAD in German hairdressers, as registered by the responsible compensation board during 1998 and 2007. Hairdressing components reported as causative for OAD in hairdressers were analyzed. The incidence rates of OAD in hairdressers were compared with rates in healthcare professionals, as both occupations had high rates of OAD in the 1990s.
  
  
  RESULTS
  From 1998 until 2003, the total number of confirmed cases of allergen-, latex- and irritant-induced OAD stayed at a plateau of 60 cases annually in hairdressers, after which a downward trend was apparent. The number of irritant-induced OAD cases did not fall during this overall downward trend. Hair dyes and acid perms were most often identified as the substances causing OAD in hairdressers. In healthcare professionals, the downward trend in OAD is more pronounced than in hairdressers, mainly due to a decrease in latex-induced cases.
  
  
  CONCLUSIONS
  The number of allergen- and irritant-induced cases of OAD in German hairdressers is still high. Exposure to known airway irritants is still occurring in spite of modification of the formulations. Continuous medical surveillance of hairdressers is recommended, in order to detect individual susceptibility, especially in apprentices.
authors.affiliation: BGW (Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services), Hamburg, Germany. madeleine.dulon@bgw-online.de
authors.forename: Madeleine
authors.initials: M
authors.lastname: Dulon
authors.forename: Claudia
authors.initials: C
authors.lastname: Peters
authors.forename: Dana
authors.initials: D
authors.lastname: Wendeler
authors.forename: Albert
authors.initials: A
authors.lastname: Nienhaus
mesh_terms: D000485:Allergens / Q000009:adverse effects*; D005858:Germany / Q000453:epidemiology; D006202:Hair Dyes / Q000009:adverse effects* / Q000633:toxicity; D006801:Humans; D015994:Incidence; D007509:Irritants; D020315:Latex Hypersensitivity; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D010476:Perfume / Q000009:adverse effects / Q000633:toxicity; D011159:Population Surveillance; D018570:Risk Assessment; D012307:Risk Factors; D017132:Workplace
chemical_list: D000485:Allergens; D006202:Hair Dyes; D007509:Irritants; D010476:Perfume