Lung function and respiratory symptoms among female hairdressers in Palestine: a 5-year prospective study

• Published in: The Lancet (British edition) Vol. 390; p. S6
• Main Authors: Nemer, Maysaa, Kristensen, Petter, Nijem, Khaldoun, Bjertness, Espen, Skare, Øivind, Skogstad, Marit
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 01-08-2017; Elsevier Limited
• Subjects: Asthma; Chest; Cough; Epidemiology; Exposure; Health problems; Informed consent; Lungs; Nose; Profession; Respiratory function; Tightness; Wheezing
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(17)32057-3

Hairdressers are at risk of respiratory health problems due to exposure to chemicals in the workplace. We aimed to examine possible changes in self-reported respiratory symptoms and lung function over 5 years. Also, we examined the associations between occupational factors and lung function changes between baseline and follow-up.
A cohort of 170 female hairdressers in Hebron answered a questionnaire and did a lung function test in 2008. A follow-up study was conducted on the same cohort in 2013. Changes in respiratory symptoms and lung function over the period were measured using generalised and linear mixed models. The lung function test was done using a PC spirometer and a disposable mouthpiece filter and nose clip. Participants were given instructions on the forced maximal expiratory manoeuvres. Respiratory symptoms that were assessed with the questionnaire included chest tightness, shortness of breath, wheezing, cough, and phlegm during the past 12 months. Furthermore, we asked questions on doctor-diagnosed asthma. Differences between current and former hairdressers in respiratory symptoms and lung function at follow-up were measured using mixed models. Written informed consent was obtained from all participants.
161 individuals participated in the follow-up study. 28 (16%) of the participants had left their profession. Current hairdressers reported significantly greater changes in chest tightness (prevalence difference [PD] 0·037, 95% CI 0·005 to 0·069) and shortness of breath (0·038, 0·001 to 0·076) between baseline and 2013, compared with former hairdressers Former hairdressers reported fewer symptoms at follow-up than did current hairdressers (PD 0·071, 95% CI –0·0167 to 0·024 for wheezing; 0·071, CI –0·167 to 0·023 for shortness of breath). At follow-up current hairdressers showed a significant decrease in forced expiratory volume in 1 s (FEV1) of 31 mL per year (95% CI 25 to 36). Hairdressers who had been working for 4 years or longer at baseline showed a stronger annual mean decline in FEV1 than those who had worked for less than 4 years (difference 13 mL, 95% CI 1 to 25).
Current hairdressers developed more respiratory symptoms and had a larger lung function decline than former hairdressers. Working for more years was associated with increased lung function decline. These findings suggest that workplace-related factors, including chemical exposures, might have a negative effect on the respiratory health of hairdressers. Thus, there might be a need to monitor exposures and eventually improve the workplace conditions.
NUFU “Building Competence in Epidemiology in Palestine” Pro 50-2002 and supportive measures 2008–2009.