Predicting occupational allergy in culinary and hairdressing apprentices.

BACKGROUND: Apprentices are usually exposed to the same workplace agents as qualified professionals. There is therefore a risk of the development of occupational allergy in apprentices exposed to high (HMW-A) and low molecular inhalant allergens (LMW-A). AIMS: To evaluate and compare the occurrence of work-related allergy-like symptoms in apprentices exposed to HMW-A and LMW-A in a culinary and hairdressing school during the first and second year of vocational training. METHODS: We asked culinary and hairdressing apprentices in their first and second year of vocational training to complete a questionnaire about work-related allergy-like symptoms. In first-year apprentices, we undertook spirometry, skin prick tests for occupational allergens and blood tests for allergen-specific Immunoglobulin E (IgE) antibodies. RESULTS: Hypersensitivity to occupational allergens was more frequent in first-year apprentices exposed to HMW-A compared to LMW-A (P < 0.05). Apprentices exposed to LMW-A reported increasing occurrence of skin disorders and upper respiratory tract symptoms between the first and second years of training. First-year apprentices exposed to HMW-A more frequently reported rhino-conjunctivitis and dyspnoea (approximately P < 0.001 and P < 0.05) and those exposed to LMW-A more often reported skin symptoms (P < 0.05). CONCLUSIONS: Periodic skin and respiratory health surveillance for apprentices exposed to LMW-A or HMW-A might help with early identification and management of occupational allergy.

Factors related to skin health in hairdressing apprentices from two Croatian regions.

BACKGROUND: Hairdressing apprentices are at high risk for developing occupational contact dermatitis. OBJECTIVES: The objective of this study was to analyse whether there are differences in skin health, skin protection and health-related quality of life between apprentices from two Croatian regions (Zagreb and Dalmatia). MATERIALS AND METHODS: Final-year hairdressing apprentices from Zagreb (n = 101) and Dalmatia (n = 77) were enrolled in the study. Clinical examination of hands was performed by use of the Osnabrück Hand Eczema Severity Index. Transepidermal water loss (TEWL) was measured on forearm and hand. A history of self-reported skin symptoms, work-related exposure to skin hazards and health-related quality of life were assessed with validated questionnaires. RESULTS: Apprentices from Zagreb reported having been engaged in practical work more days per month than Dalmatian apprentices (median 12 days vs 8 days, respectively, P < 0.001), and washing their hands >20 times per day more frequently (28% vs 10%, respectively, P = 0.004), and consequently more frequently having dry hands (37% vs 16%, respectively, P = 0.002), and significantly higher TEWL values on the hand and forearm, which was confirmed by the results obtained with multiple linear regression models. CONCLUSIONS: A higher extent of exposure to skin hazards was related to poorer skin barrier function, which confirms the need for improvement of appropriate safety practices in hairdressing schools.

Invasive Scalp Melanoma: Role for Enhanced Detection Through Professional Training.

BACKGROUND: Scalp and neck melanomas (SNMs) have a relatively poor prognosis compared to other sites, and represent an anatomically challenging area for detection. The aim of this study was to identify the role of the hairdresser in detection of SNMs. METHODS: A tertiary surgical oncology institutional database was retrospectively reviewed for all patients undergoing resection of a scalp, posterior neck, or retro auricular invasive primary melanoma between 2008 and 2014. RESULTS: SNMs accounted for 128 melanoma patients during the study period, with median age 66 years, 88 % male, and median Breslow thickness 1.55 mm. Hairdressers detected 10 % of all SNMs, with hairdresser-detected SNMs presenting 13 years younger (53 vs. 66 years, P = 0.015), and with a trend towards lower Breslow depth (1.15 vs. 1.63) and more frequent discovery in AJCC Stage Ia or Ib (66.7 % vs. 44.8 %) than otherwise-detected SNMs. Women with SNMs were 1.8-fold more likely than men to have their SNMs detected by a hairdresser (P = 0.001), and presented at higher AJCC clinical stage than men and required wider surgical resection margins (P = 0.011). Women with hairdresser-detected SNMs were younger, with lower Breslow thickness and lower AJCC Clinical Stage than women with otherwise-detected SNM. CONCLUSION: This study suggests that hairdressers play a critical role in detection of invasive primary scalp and neck melanoma, accounting for 10 % of all melanomas referred to a tertiary surgical oncology center. Quality improvement initiatives aimed at increasing early detection of scalp and neck melanoma should include members of the cosmetology community.

Knowledge and occupational hazards of barbers in the transmission of hepatitis B and C was low in Kumasi, Ghana.

INTRODUCTION: Blood borne viral hepatitis transmission still ranges between 4-20% in many Ghanaian communities. Hepatocellular carcinoma (HCC) also called liver cancer is reported as the leading cause of cancer mortality among males in Ghana. We studied the knowledge and risk factors associated with barbers' occupation in the transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV). METHODS: A randomized cross-sectional survey of 200 barbershops was conducted in Kumasi between January and August 2013. Barbershops, which operated continuously for more than 8 months, were selected for the study. Structured questionnaires were administered to the study participants. Data was entered and analysed in Microsoft Excel spread sheet and SPSS v12. The percentage value of each question was calculated. RESULTS: All the barbers involved in this study used a new razor blade on every client and claimed to sterilize the hair trimmers after use on every client. The methods of sterilization; 46.5% of the barbers used the ultraviolet radiation sterilizer cabinet, 29% used 70% alcohol and 23% used antiseptic solutions. More than thirty-six percent (36.5%) and 5% of the barbers had heard of HBV and HCV respectively. Only 7% and none knew the route of transmission of HBV and HCV respectively, whereas 7% knew sharing razor blade or hair trimmer could transmit both HBV and HCV. More so, 2% knew HBV and HCV could cause cancer and 2% had received the HBV vaccine. The majority of barbers (63%) had education up to the junior secondary school level. None of the barbers used a new apron nor washed their hands after work on each client. CONCLUSION: Awareness of barbers about HBV or HCV and job-related factors contributing to spread of infections was very poor among the vast majority of the barbers studied. Thus, giving training for the barbers is required toward prevention of blood- borne infections associated to their profession.

Educational Intervention among Barbers to Improve Their Knowledge regarding HIV/AIDS: A Pilot Study from a South Asian Country.

One of the Millennium Development Goals is to combat HIV, the burden of which continues to increase in developing countries, like Pakistan. The prevalence is high among the high-risk population, and the use of unsterilized surgical instruments, traditional straight razors, and blades adds to the spread of this disease. This study assesses the effect of an educational intervention on the knowledge of 70 barbers practising in a suburban community in Pakistan regarding HIV and its symptoms and transmission. At baseline, only 10% of the barbers reported that they had ever heard about HIV compared to 49% after the intervention. Similarly, 4% and 6% of them had good knowledge at baseline about symptoms and transmission of the disease, increasing to 39% and 43% respectively, after the intervention (p<0.001). The results of this educational intervention warrant consideration of activation of mass campaigns to increase public awareness about bloodborne diseases and to educate personnel who might harm the persons in their communities by unsafe practices.

Prevention of hand eczema among Danish hairdressing apprentices: an intervention study.

OBJECTIVES: To investigate whether an evidence-based intervention could reduce the incidence of hand eczema in a cohort of Danish hairdressing apprentices during their training, as hairdressing apprentices are known to have a high risk of developing hand eczema. METHODS: This study was a clinically controlled, prospective intervention study. Within 2 weeks of starting their training, 502 hairdressing apprentices were enrolled in the study on occupational hand eczema. Approximately half of the apprentices were assigned to an intervention group and received an evidence-based training program developed for this study and delivered by teachers specially trained in the prevention of hand eczema; the other half received normal training and served as a control group. All apprentices completed self-administered questionnaires including questions regarding hand eczema, use of gloves and degree of wet work, and were all clinically examined for hand eczema three times during the 18-month study period. The three examinations were scheduled as school visits and consisted of a baseline examination and two follow-up examinations approximately 8 and 18 months later. RESULTS: More apprentices from the intervention group used gloves during wet work procedures and significantly fewer developed hand eczema compared with apprentices from the control group (p=0.04). A logistic regression model showed that atopic dermatitis had a significant influence on the development of hand eczema in the cohort irrespective of the intervention. CONCLUSIONS: We were able to increase the use of gloves and reduce the incidence of hand eczema in hairdressing apprentices by implementing a training program in hairdressing schools.

Self-reported work-related symptoms in hairdressers.

BACKGROUND: Detailed studies of current symptoms reported by hairdressers and of the training received to reduce the health risks associated with this work are uncommon. AIMS: To document current levels of self-reported health problems in hairdressers, compared to non-hairdressing controls. METHODS: An interviewer-led questionnaire recording demographic information, work history, health training levels and the presence of self-reported respiratory, skin, musculoskeletal and non-specific symptoms was administered. RESULTS: In total, 147 hairdressers, 86% of whom were female (median age 27 years) and 67 non-hairdressing controls, all female (median age 38 years) were recruited. Following adjustment for age, smoking and years worked, hairdressers reported significantly higher levels of musculoskeletal problems, including work-related shoulder pain (OR 11.6, 95% CI 2.4-55.4), work-related wrist and hand pain (2.8, 1.1-7.6), work-related upper back pain (3.8, 1.0-14.9), work-related lower back pain (4.9, 1.5-15.9) and work-related leg/foot pain (31.0, 3.8-267.4). The frequency of self-reported asthma was similar in both groups (hairdressers 16%, controls 17%) as was chest tightness and wheeze. Work-related cough was significantly more frequently reported in hairdressers than in controls (13.2, 1.3-131.5). While hairdresser training was commonplace, such training did not always appear to have resulted in awareness of potential workplace health risks. CONCLUSIONS: This study identified frequently reported musculoskeletal, skin and respiratory symptoms in hairdressers. This points to a need to develop training that not only deals with risk assessment but also informs hairdressers about the health risks of their work.

Validation of self-reporting of hand eczema among Danish hairdressing apprentices.

BACKGROUND: Hairdressing apprentices have a high incidence of hand eczema. Most studies use self-reported hand eczema as a cost-effective method to estimate the prevalence of hand eczema. No validation studies on self-reported hand eczema among hairdressing apprentices exist. OBJECTIVES: To evaluate the validity of self-reporting of hand eczema among Danish hairdressing apprentices. METHODS: During their first 2 weeks of training, 502 hairdressing apprentices were enrolled in this study. All apprentices completed a self-administered questionnaire including questions regarding, for example, current hand eczema, and they were all clinically examined for hand eczema three times during the first part of their education by use of the Hand Eczema Severity Index. The validity of self-reporting of hand eczema was measured with the clinical examination as the gold standard. RESULTS: The sensitivity of self-reporting of hand eczema was 70.3%, and the specificity was 99.8%. The positive predictive value was 96.3%, and the negative predictive value was 98.5%. CONCLUSIONS: We found good agreement between self-reporting of hand eczema and clinical examination. There was good sensitivity and high specificity. Self-reporting of hand eczema among hairdressing apprentices is considered to be a valid method for estimating the prevalence of hand eczema, although it might underestimate the true prevalence.

Teaching interventions in contact dermatitis.

Prevention of occupational contact dermatitis is of utmost significance for both insurers and legislators because it can preserve the individual's ability to work and result in decreased costs for public health. In the last 20 years, many concepts for educational interventions and a multitude of teaching aids have been developed by insurance associations and public institutions from different countries (eg, the United States, Sweden, Denmark, Switzerland, and Germany). For didactic purposes, terms of different levels of prevention have been inaugurated in northern Europe in the context of occupational dermatology. This review presents different educational interventions in the fields of primary, secondary, and tertiary prevention as well as evaluation studies of these measures, especially among health care workers, hairdressers, metalworkers, and bakers' apprentices. Special emphasis is put on the prevention of allergic contact dermatitis.

Hepatitis B and C viral infection: prevalence, knowledge, attitude and practice among barbers and clients in Gharbia governorate, Egypt.

A study in Egypt determined the prevalence of hepatitis B and C virus infections among barbers (n = 308) and their clients (n = 308) in Gharbia governorate, and assessed knowledge, attitude and practices during hair-cutting and shaving. HBsAg was detected among 4.2% of barbers and 3.9% of clients (more urban than rural). Anti-HC antibodies were detected in 12.3% of barbers and 12.7% of clients. HCV-RNA prevalence was 9.1% among both barbers and clients (more rural than urban). Knowledge was high among the majority of participants and good practices during shaving and hair-cutting were observed for the majority of barbers. Barbers appeared to have no job-related risk of acquiring viral hepatitis.

Educational intervention among barbers about liver cancer-inducing viruses: a pilot study from a developing country.

Liver cancer is among the most prevalent cancers in the world and it is mainly related to the hepatitis B virus (HBV) and hepatitis C virus (HCV). This study evaluated the effectiveness of educational intervention on knowledge and practices regarding hepatitis B and hepatitis C among barbers. After completion of baseline interviews of 70 barbers in Karachi, Pakistan, a 30-min educational session was conducted. The same sessions were repeated twice for all barbers at an interval of 1 month each for reinforcement. Post-intervention interviews were conducted after 1 month of the last session. Before intervention, only 11.4% of the study participants had scored "good" about the knowledge of HBV, which improved to 74.3% after intervention (p < 0.001). Similarly, for HCV, significant improvement was observed after intervention. Regarding the safe practices to prevent HBV and HCV infections, <2% had scored to the level of "good" at baseline, which improved to 48.6% after intervention (p < 0.001). Educational interventions to prevent cancer-induced viruses are highly effective even in illiterate/low-educated people.

Knowledge, attitudes and practices of barbers about hepatitis B and C transmission in Hyderabad, Pakistan.

Hepatitis B and C virus (HBV/HCV) infections are serious global health problems. Shaving by barbers has been identified as the key risk factor for spread of HBV. We conducted a cross-sectional survey of barbers in Hyderabad city, Pakistan in 2007 to establish their knowledge and attitudes to the risk of HBV and HCV transmission and their working patterns. Observations showed that 96.2% washed razors with antiseptic after each client and 95.7% used a new blade with new clients. However, knowledge about the diseases and modes of transmission were poor and only 36.6% knew that hepatitis can be transmitted via shaving instruments. Only 3.2% of 186 barbers were vaccinated against HBV. Strategies are needed for raising awareness and regulations of barbers' practices.