title: Dust-free bleaching powder may not prevent symptoms in hairdressers with bleaching-associated rhinitis.
abstract: OBJECTIVE
  Hairdressers have an increased risk for airway symptoms especially when using hair-bleaching powder containing persulfate. To minimize exposure, dust-free bleaching powder (DFP) has been made available. We studied the effects of regular powder (RP) or DFP on the airway symptoms of hairdressers with hair-bleaching associated rhinitis.
  
  
  METHODS
  Twelve hairdressers each performed three hair-bleachings on a wig in an exposure chamber. Half of the subjects used RP and half used DFP. Exposure to persulfate and ammonia was measured. Before and after each bleaching, the participants stated their degree of airway symptoms on a visual analogue scale. Nasal lavage and blood were sampled before exposure, after the last bleaching, and in the morning after exposure to measure inflammatory markers.
  
  
  RESULTS
  Exposure to persulfate was higher when using RP compared to DFP, 22 (11-55) vs. 12 (8-13) μg/m3; median (min-max). Exposure to ammonia did not differ between the groups. Both groups reported an increase in asthma-like symptoms and this increase was significant. Neutrophils, lymphocytes, and monocytes increased after exposure in both groups; monocytes decreased the day after. In nasal lavage, IL-8 was increased the morning after for both types of powder, and the increase was significant in the total group. IL-6 increased immediately after exposure and the day after only in the group using RP.
  
  
  CONCLUSIONS
  Although DFP powder emits lower levels of persulfate, effects are still elicited in symptomatic hairdressers.
authors.affiliation: Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University.
authors.forename: Jörn
authors.initials: J
authors.lastname: Nielsen
authors.forename: Patrik
authors.initials: P
authors.lastname: Nilsson
authors.forename: Anna
authors.initials: A
authors.lastname: Dahlman-Höglund
authors.forename: Kerstin
authors.initials: K
authors.lastname: Kronholm Diab
authors.forename: Maria
authors.initials: M
authors.lastname: Albin
authors.forename: Monica
authors.initials: M
authors.lastname: Kåredal
authors.forename: Bo
authors.initials: B
authors.lastname: Jönsson
authors.forename: Aneta
authors.initials: A
authors.lastname: Wierzbicka
authors.forename: Anders
authors.initials: A
authors.lastname: Gudmundsson
mesh_terms: D000641:Ammonia / Q000009:adverse effects*; D001249:Asthma / Q000139:chemically induced*; D001505:Beauty Culture; D015415:Biomarkers / Q000097:blood; D017259:Dimaprit / Q000009:adverse effects / Q000031:analogs & derivatives*; D004391:Dust; D058206:Hair Bleaching Agents / Q000009:adverse effects*; D006801:Humans; D009297:Nasal Mucosa / Q000276:immunology; D009784:Occupational Diseases / Q000139:chemically induced; D016273:Occupational Exposure / Q000009:adverse effects*; D012220:Rhinitis / Q000139:chemically induced*; D013147:Spirometry; D064232:Visual Analog Scale
chemical_list: D015415:Biomarkers; D004391:Dust; D058206:Hair Bleaching Agents; C025838:nordimaprit; D000641:Ammonia; D017259:Dimaprit