title: Occupational asthma, rhinitis, and contact urticaria caused by oxidative hair dyes in hairdressers.
abstract: BACKGROUND
  Oxidative hair dyes commonly contain paraphenylene diamine (PPD) and its derivatives, a well-known cause of delayed hypersensitivity among both consumers and hairdressers. They are also considered possible causes of occupational respiratory diseases. Despite the widespread use of hair dyes, there are only a few reports of asthma, rhinitis, and contact urticaria caused by PPD and related compounds.
  
  
  OBJECTIVE
  To characterize patients with occupational asthma, rhinitis, or contact urticaria associated with oxidative hair dyes and to evaluate the diagnostic methods.
  
  
  METHODS
  We reviewed the patient files of the Finnish Institute of Occupational Health for the period January 1, 2001, through May 31, 2011, to identify patients diagnosed as having asthma, rhinitis, or contact urticaria associated with oxidative hair dyes. The diagnoses of asthma and rhinitis were based on specific inhalation challenges with hair dye products. Skin prick tests were performed with hair dye ingredients as hapten conjugates of human serum albumin and with hair dye products and ingredients as is. Open skin tests confirmed the diagnosis of contact urticaria.
  
  
  RESULTS
  We describe 11 hairdressers with occupational asthma (5 cases), rhinitis (5 cases), and contact urticaria (3 cases) due to hair dyes. Of the 52 specific inhalation challenges performed, 9 (17%) had positive results. One patient who experienced an anaphylactic reaction when having her own hair dyed had positive skin prick test results to PPD and toluene-2,5-diamine sulfate.
  
  
  CONCLUSIONS
  Hairdressers are at risk for occupational asthma, rhinitis, and contact urticaria due to oxidative hair dyes. Skin prick testing may be insensitive for detecting immediate hypersensitivity to PPD and related compounds.
authors: Department of Occupational Medicine, Finnish Institute of Occupational Health, Helsinki, Finland; Department of Public Health, Hjelt Institute, University of Helsinki, Helsinki, Finland. Electronic address: eva.helaskoski@ttl.fi.
authors: Eva
authors: E
authors: Helaskoski
authors: Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Hille
authors: H
authors: Suojalehto
authors: Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland.
authors: Hannele
authors: H
authors: Virtanen
authors: Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Liisa
authors: L
authors: Airaksinen
authors: Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Outi
authors: O
authors: Kuuliala
authors: Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Kristiina
authors: K
authors: Aalto-Korte
authors: Control of Hypersensitivity Diseases, Finnish Institute of Occupational Health, Helsinki, Finland.
authors: Maria
authors: M
authors: Pesonen
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced; D059366:Asthma, Occupational / Q000139:chemically induced*; D005260:Female; D006202:Hair Dyes / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D010328:Patch Tests; D010655:Phenylenediamines / Q000009:adverse effects* / Q000276:immunology; D012129:Respiratory Function Tests; D012220:Rhinitis / Q000139:chemically induced*; D014581:Urticaria / Q000139:chemically induced*; D055815:Young Adult
chemical_list: D006202:Hair Dyes; D010655:Phenylenediamines; C007303:2,5-diaminotoluene; C029728:4-phenylenediamine