title: Work-related airway symptoms, nasal reactivity and health-related quality of life in female hairdressers: a follow-up study during exposure.
abstract: OBJECTIVE
  Hairdressers often complain of work-related rhinitis (WR). They are infrequently sensitized to persulphates. The cause and mechanism of the symptoms and the effects on their health-related quality of life (HRQoL) remains unclear. The objectives were to follow female hairdressers with WR mainly from bleaching powder regarding nasal reactivity to persulphate and to evaluate symptoms, HRQoL and inflammatory markers in nasal lavage during a working period after vacation and compared with hairdressers without symptoms and pollen allergic women.
  
  
  METHODS
  Skin prick tests to persulphate were performed in the hairdressers. Participants kept a diary of symptoms and of work tasks (hairdressers only). They completed HRQoL questionnaires. Eosinophil cationic protein (ECP) in nasal lavage fluid was examined. The symptomatic hairdressers performed nasal challenges with persulphate before and after the exposure.
  
  
  RESULTS
  Skin prick tests were negative. Although the nasal reactivity to persulphate did not change a steady increase in nasal symptoms, especially blockage, and in ECP was noticed in the symptomatic hairdressers. The HRQoL deteriorated in the symptomatic hairdressers indicating an effect on their working situation and daily life. The atopics had more, but varying symptoms (itching, sneezing and secretion).
  
  
  CONCLUSIONS
  The difference in the clinical picture between the symptomatic hairdressers and the pollen allergic women, the increase in symptoms and ECP in the nasal lavage support the view that a sensitization to hairdresser chemicals by a mechanism not yet understood is operating. The deterioration of the HRQoL in the symptomatic hairdressers indicates a considerable effect on their life.
authors.affiliation: Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 221 85, Lund, Sweden, kerstin.diab@med.lu.se.
authors.forename: K
authors.initials: K
authors.lastname: Kronholm Diab
authors.forename: B A G
authors.initials: BA
authors.lastname: Jönsson
authors.forename: A
authors.initials: A
authors.lastname: Axmon
authors.forename: J
authors.initials: J
authors.lastname: Nielsen
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects*; D001505:Beauty Culture; D015415:Biomarkers / Q000378:metabolism; D016022:Case-Control Studies; D047150:Eosinophil Cationic Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006197:Hair; D058206:Hair Bleaching Agents / Q000009:adverse effects; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D017817:Nasal Lavage Fluid / Q000737:chemistry; D009299:Nasal Provocation Tests; D009784:Occupational Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D016273:Occupational Exposure / Q000009:adverse effects*; D017680:Potassium Compounds / Q000009:adverse effects*; D011446:Prospective Studies; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000139:chemically induced* / Q000175:diagnosis / Q000378:metabolism; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis; D012882:Skin Tests; D013431:Sulfates / Q000009:adverse effects*
chemical_list: D000395:Air Pollutants, Occupational; D015415:Biomarkers; D058206:Hair Bleaching Agents; D017680:Potassium Compounds; D013431:Sulfates; C009007:potassium persulfate; D047150:Eosinophil Cationic Protein; C479220:RNASE3 protein, human