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BMC Public Health volume 23、記事番号: 1576 (2023) この記事を引用

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1 オルトメトリック

メトリクスの詳細

美容師として働くと、ヘアトリートメント製品に含まれる複数の化学物質に複合的にさらされることがあり、気道や皮膚に症状を引き起こす可能性があります。

この横断研究では、スウェーデンのヘアサロン 10 軒の美容師が自覚している症状をアンケート調査しました。アルデヒドを含む揮発性有機化合物 (VOC) への個人曝露と、それに対応するハザード指数 (HI) との関連性が、がん以外の健康への影響の推定リスクに基づいて調査されました。 11 症状のうち 4 症状の有病率を、会社員と学校職員を対象とした他の 2 つの研究から入手可能な参照データセットと比較しました。

調査対象の 11 件の症状すべてが美容師の間で報告されました (n = 38)。研究グループ全体で最も多かった症状は鼻水（n = 7）と頭痛（n = 7）で、続いて湿疹（n = 6）、鼻詰まり（n = 5）、咳（n = 5）、強い臭気による不快感 (n = 5)。曝露と症状との間に有意な関係はほとんどありませんでした。例外は、職業上の勤続年数に調整された総VOC（TVOC）曝露量でした。職業歴0～5年の美容師と比較して、美容師歴20年以上のグループでは、あらゆる症状について差が観察された（ロジスティック回帰、OR 0.03、95% CI 0.001～0.70）。比較可能な 4 つの症状のうち、頭痛と咳の有病率は、美容師では対照よりも有意に高かった (それぞれ、OR 5.18、95% CI 1.86 ～ 13.43 および OR 4.68、95% CI 1.17 ～ 16.07)。

職業に関連した健康への悪影響は美容師の間で一般的であり、美容室での曝露防止対策の必要性を示唆しています。頭痛や咳の症状は、オフィスや学校のスタッフよりも美容師の方が多く報告されました。美容師における健康な労働者効果は、職業歴 0 ～ 5 年と比較して 20 年以上のグループで示されました。測定された曝露と症状との間の有意な関係はほとんどありませんでしたが、さまざまな曝露測定値の長所と短所についての情報は得られました。研究デザインは、研究対象集団のサイズを増やし、参照データのより適切な一致を使用し、測定された曝露の長期にわたる適用性と再現性を高めることによって改善できる可能性があります。

査読レポート

美容師として働くと、ヘアトリートメント製品に含まれる複数の化学物質に複合的に曝露され、さまざまな症状を引き起こす可能性があります。スウェーデンの美容師では、手湿疹 [1]、喘息 [2]、気道症状 [3、4] の症状が職業上発生するリスクが高いことが示されています。ヘアサロンやネイルサロンの従業員の曝露に関する2014年から2019年の国際的な文献レビューでは、呼吸器への影響のリスクが増加するという一貫した証拠があると結論付けられています[5]。職業的曝露による他の種類の健康への影響も研究されています。例としては、生殖に関する健康への影響[5、6]、内分泌への影響[5]、さまざまな臓器のがん[7、8、9、10、11、12、13]などがあります。しかし、人間関係に関する結論はこれまでのところ一貫性がありません。

ヘアサロンでの化学物質への曝露の複雑さと、美容師に誘発される可能性のあるさまざまな症状を考慮すると、実行可能で堅牢なリスク評価方法が必要です。ヘアサロンの室内空気を介した複数の化学物質への複合曝露による非がんの健康への影響のリスク評価について、ハザード指数 (HI) アプローチが de Gennaro らによって提案されました。 [14]。このアプローチは、ほとんどのヘアトリートメント製品の構成成分である揮発性有機化合物 (VOC) に関するものでした。 HI は、測定された VOC 室内空気濃度とそれに対応する基準値の商の合計、つまり、それ以下の濃度を下回ると、単一の VOC への慢性曝露が非がん以外の健康影響を引き起こす可能性が低い濃度に基づいていました。 HI アプローチは、美容師を対象とした最近のスウェーデンの研究にも適用され、10 軒中 4 軒の美容院で過度の暴露リスクが発見されました [15]。 HI アプローチは、複数の化学物質への複合曝露のリスク評価のための一般的な方法論に関する WHO/IPCS 枠組みの推奨事項と一致しており [16]、家庭、学校、オフィスなどの他の屋内環境にも適用されています [17]。美容室 [18]、幼稚園および小学校 [19、20]。

median (460 µg/m3) and HI > 1 were selected as delimiters between high and low exposure. HI represented the potential risk for non-cancer health effects, as described by De Brouwere et al. [17]. Additional practical considerations regarding HI and its application to the hairdressers, as well as the procedures used for sampling and chemical analysis, are presented elsewhere [15]./p> 1) were observed for the symptoms stuffed nose, cough (both OR 1.60, 95% CI 0.19–13.24) and headache (OR 1.67, 95% CI 0.28–10.09)./p> 1) were observed for the symptoms stuffed nose and discomfort with strong odors (both OR 3.50, 95% CI 0.32–38.23). However, after adjustment of the TVOC exposure to worked years in the profession, a significant difference was observed for any symptom between hairdressers in the group with 0–5 years compared to 20 + years in the profession (logistic regression, OR 0.03, 95% CI 0.001–0.70). This relationship was not detected between HI and symptoms. Neither was a difference observed for any symptom adjusted to TVOC exposure between the groups with 0–5 and 6–20 years in the profession (OR 0.32, 95% CI 0.02–4.80) nor between the groups with 6–20 and 20 + years in the profession (OR 0.11, 95% CI 0.01–1.09)./p> 14 days reported for hairdressers compared to office workers in a Norwegian study [25]. Similarly, no increased risk of cough at work was observed in hairdressers compared to office workers in a study from Greece [26]. On the other hand, an increased risk of dry cough among hairdressers compared to the general population was demonstrated in Sweden (incidence rate ratio (IRR) 1.5, 95% CI 1.2–1.9) [3] and an increased risk of cough with phlegm and dyspnoea with cough among hairdressers compared to saleswomen was shown in Finland (OR 1.4, 95% CI 1.1–1.9 and OR 1.6, 95% CI 1.0–2.7, respectively) [28]. Furthermore, the risk of dry cough was higher among hairdressers compared to office workers in a recent study from Iran (OR 2.18, 95% CI 1.26–3.77) [27] and the risk of work-related cough in hairdressers compared to non-hairdressing controls was reported to be higher in a study from the UK (OR 13.2, 95% CI 1.3–131.5) [29]. However, interpretation of the underlying reasons for the variation in risk quotients between studies is precarious due to multifactorial differences concerning study subjects, controls and methods./p> median or HI > 1 did not show a statistically significant increased risk for six out of the 11 symptoms included in the analysis (Table 4). However, for exposure expressed as TVOC > median, non-significant high ORs (3.50) were observed for two symptoms, i.e., stuffed nose and discomfort with strong odors. Similarly, exposure expressed as HI > 1 generated non-significant results but high ORs (1.60–1.67) for three symptoms – stuffed nose, cough and headache. Exposure expressed as both TVOC and HI showed a high OR for stuffed nose. The other two symptoms with high ORs for exposure expressed as HI, i.e., cough and headache, which were statistically significantly more common among the hairdressers compared to the controls, could imply a higher sensitivity of this measure for prediction of risk for certain symptoms. A high OR for discomfort with strong odors was only observed for TVOC. This may suggest that TVOC, to a larger extent than HI, was proportional to the volumetric usage of hair treatment products in the hair salons, and therefore also the aggregated strength of odor. Thus, TVOC exposure could reflect the working practice of the hairdressers. It is also possible that another delimiter, apart from the median concentration of TVOC between hairdressers with low and high exposure, could increase the sensitivity of this exposure measure for detecting symptoms. This would have been feasible to test with a larger population sample. However, the non-significant results concerning relationships between exposure and symptoms prevent definite conclusions./p> 40 years, although such an effect was not observed for airway symptoms [25]. In a later prospective study from Norway in which airway symptoms and biomarkers were studied after installation of local exhaust ventilation, hairdressers in the study population remaining in the profession over the time period 1995 to 1999, i.e., only 60%, were suggested to be a highly selected and healthy group of workers [43]. A healthy worker effect in relation to asthma has been suggested for Danish hairdressers [44] as well as Danish hairdresser apprentices [30]. However, in the latter study, the prevalence of rhinitis was higher in third year apprentices than in first year apprentices. A similar result was found in an Italian prospective study of hairdressers during the years 2006–2016, which showed that the prevalence of irritant skin and upper respiratory symptoms increased significantly over the study period [45]. In other words, a healthy worker effect did not seem to be apparent. Likewise, more respiratory symptoms were observed at follow-up in a five-year prospective study of Palestinian hairdressers, and working for more years was associated with lung function decline [46]. In a recent Iranian cross-sectional study of 140 hairdressers, increased duration of work in the profession was related to an increased risk of respiratory symptoms and decreased lung function [27]. Nevertheless, among hairdressers with the longest duration in work (> 15 years), a plateau effect was observed, likely due to a healthy worker effect, according to the authors. It is noteworthy that the plateau effect for irritative responses among the hairdressers appeared after > 15 years of work. This is similar to the exposure duration in the present study, where a similar effect was suggested for hairdressers with 20 + years in profession. Furthermore, both these exposure periods are longer than those used in the aforementioned prospective studies, which did not detect a healthy worker effect. Therefore, for at least some symptoms, the duration of the prospective studies might have been too short to observe the effect./p>