Maysaa Nemer1, Liv I B Sikkeland2, Mayes Kasem3, Petter Kristensen4, Khaldoun Nijem5, Espen Bjertness6, Øivind Skare7, Berit Bakke3, Johny Kongerud8, Marit Skogstad7. 1. Occupational Epidemiology and Biological Research Lab, Department of Biology, Hebron University, Hebron, Palestine Section for Preventive Medicine and Epidemiology, Institute of Health and Society, University of Oslo, Oslo, Norway. 2. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. 3. Department of Chemical and Biological Work Environment, National Institute of Occupational Health, Oslo, Norway. 4. Section for Preventive Medicine and Epidemiology, Institute of Health and Society, University of Oslo, Oslo, Norway Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway. 5. Occupational Epidemiology and Biological Research Lab, Department of Biology, Hebron University, Hebron, Palestine. 6. Section for Preventive Medicine and Epidemiology, Institute of Health and Society, University of Oslo, Oslo, Norway. 7. Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway. 8. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
Abstract
OBJECTIVES: Little is known about the working conditions and airway inflammation in hairdressers in Palestine. We aimed to investigate if hairdressers in Palestine have a higher level of airway inflammation as compared to a control group. We also assessed the hairdressers' physical working conditions and exposure to ammonia gases at the hair salons. Lastly, we investigated the association between ammonia levels and inflammation markers in the airways and the blood. METHODS: Our study participants were 33 non-smoking hairdressers (aged 19-50 years) and 35 non-smoking control subjects (aged 18-49 years). Both groups answered a questionnaire on respiratory symptoms, and performed lung function and exhaled nitric oxide (eNO) tests. Blood and sputum samples were collected from all participants and air concentration levels of ammonia were measured in 13 salons. RESULTS: Hairdressers had a higher level of sputum neutrophil count (absolute numbers/mg sputum (median (25th-75th centiles)) compared to controls, 376 (183-980) and 182 (96-358), respectively. Hairdressers also had significantly elevated eNO and blood C reactive protein (CRP) levels compared to the control subjects, controlled for age and body mass index. Exposure measurements showed that the hairdressers in salons with scarce ventilation were exposed to ammonia concentration, ranging from 3 to 61 mg/m(3). CONCLUSIONS: Compared to unexposed controls, the hairdressers had signs of neutrophilic airway inflammation, higher eNO levels and higher CRP. The hairdressers were exposed to high concentrations of ammonia from hairdressing chemicals and their working conditions were unsatisfactory. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVES: Little is known about the working conditions and airway inflammation in hairdressers in Palestine. We aimed to investigate if hairdressers in Palestine have a higher level of airway inflammation as compared to a control group. We also assessed the hairdressers' physical working conditions and exposure to ammonia gases at the hair salons. Lastly, we investigated the association between ammonia levels and inflammation markers in the airways and the blood. METHODS: Our study participants were 33 non-smoking hairdressers (aged 19-50 years) and 35 non-smoking control subjects (aged 18-49 years). Both groups answered a questionnaire on respiratory symptoms, and performed lung function and exhaled nitric oxide (eNO) tests. Blood and sputum samples were collected from all participants and air concentration levels of ammonia were measured in 13 salons. RESULTS: Hairdressers had a higher level of sputum neutrophil count (absolute numbers/mg sputum (median (25th-75th centiles)) compared to controls, 376 (183-980) and 182 (96-358), respectively. Hairdressers also had significantly elevated eNO and blood C reactive protein (CRP) levels compared to the control subjects, controlled for age and body mass index. Exposure measurements showed that the hairdressers in salons with scarce ventilation were exposed to ammonia concentration, ranging from 3 to 61 mg/m(3). CONCLUSIONS: Compared to unexposed controls, the hairdressers had signs of neutrophilic airway inflammation, higher eNO levels and higher CRP. The hairdressers were exposed to high concentrations of ammonia from hairdressing chemicals and their working conditions were unsatisfactory. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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