OCCUPATIONAL EXPOSURE TO HAIRDRESSING CHEMICALS IN PREGNANCY

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(Date of issue: October 2017, Version: 2)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

A corresponding patient information leaflet on working as a hair dresser in pregnancy is available at www.medicinesinpregnancy.org.

Summary

Hairdressers can be exposed to a variety of chemicals on a daily basis due to their use of hair products, shampoos, permanent wave solutions, hair dyes, and hair sprays.

The chemicals involved can include ammonia, hydrogen peroxide, para-phenylenediamine (PPD), resorcinol, hydrocarbon solvents, isopropanol, phthalates and formaldehyde. As different hairdressing salons use different products, and formulations have changed over time which is not always stipulated on the product, the available published data summarised in this document may not apply to all hairdressers and should be considered with these caveats in mind.

The available data relating to pregnancy outcomes for hairdressers are limited, and generally methodologically flawed. Collectively, however, these data do not suggest that maternal hairdressing as an occupation increases the risk of congenital malformation or stillbirth. While the available data do not robustly support an association between working as a hairdresser and spontaneous abortion, because data are conflicting and several studies identify non-significant increases in risk (suggesting a possible trend), they do not rule it out. Although meta-analysis has suggested an increased incidence of preterm delivery, low birth weight and small for gestational age infants, the differences between the exposed and non-exposed groups were small. The only study which investigated adverse neurodevelopmental outcome in the offspring of hairdressers showed no increase in risk. 

The limited data regarding the risk of childhood cancer following in utero exposure to hairdressing chemicals are conflicting.

The available data show no association between paternal occupation as a hairdresser and an increased overall risk of congenital malformation in the offspring.

Where occupational exposure to chemicals used in the hairdressing industry is expected to occur in pregnancy, precautions should be taken to minimise this. The area should be adequately ventilated and protective personal equipment (PPE) should be used where appropriate. In addition, any chemical exposure should be well within the recommended exposure limits for the particular chemical involved and not associated with toxic symptoms. Where available, an occupational health assessment is recommended as early in pregnancy as possible.

Where exposure to hairdressing chemicals at any stage in pregnancy is not associated with maternal toxicity and does not exceed recommended limits, no additional fetal monitoring is indicated. However, other risk factors may be present in individual cases which independently increase the risk of adverse pregnancy outcome. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments. Please contact UKTIS or refer to the respective UKTIS monograph, where available, for further information on exposure to individual chemicals referred to in this document.

This document is regularly reviewed and updated. Only use full UKTIS monographs downloaded directly from TOXBASE.org to be sure you are using the most up-to-date version. The summaries of these monographs are openly available on UKTIS.org.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.