Adverse health outcome of cosmetologists and hairdressers : a systematic review

Introduction: The number of cosmetologists and hairdressers is increasing. According to the data of US Bureau of Labor Statistics in 1991, there were more than half million people worked as cosmetologists in America. The number is keeping increasing during decades. In 2008, the number of licensed manicurists has increased by 345%, to more than 393000 since 1991 and the 10-year employment growth of nail technicians is 28%. The booming of cosmetologists leads to many potential health problems. As the occupation which is labor intensive and frequently exposed to cosmetics, the health conditions of cosmetologists and hairdressers should be taken seriously. The frequent exposure of harmful cosmetic ingredients and intensive labor work increase the health risks of cosmetology practitioners. Serious health outcomes are reported by cosmetology practitioners. However their health conditions of is seldom considered in public health policy making due to the low proportion of population. Moreover, the low income level of cosmetology practitioner makes them harder to access qualified healthcare services and insurance. In this case, the study of the health outcome of cosmetology practitioners is needed. \nObjective: The aim of this review is to examine the association between occupation of cosmetologist and different adverse health outcomes. \nMethod: A narrative review is conducted to examine the cosmetology practitioners’ adverse health outcomes, which are adverse pregnancy outcome, loss of fertility, cancer, diabetes and certain kind of physical disorders. This review identified 20 researches for further analysis, in the identified studies, 9 from North America (1 from Canada and 8 from USA), 9 from EU, 1 from Asia (Taiwan) and 1 from Africa (Egypt). The reference groups are people from other professionals and average prevalence in the whole population. \nResult: Serious health outcomes are reported by cosmetology practitioners. The adverse pregnancy outcome was reported by 13 studies. The occupation of cosmetologists would not only affect pregnant cosmetologists, but also their children. Spontaneous abortion, SGA (small for gestational age) and stunted development for children were mainly reported as adverse health outcomes of fetus and children. One of those 13 studies had examined the cohort from two different period of time, and found out that the prevalence of adverse pregnancy outcomes were decreasing over time due to the development of technology and regulation. The loss in fertility (n=2), diabetes (n=1), cancer (n=3) and physical disorders (n=3) were also significantly associated with the occupation of cosmetology practitioners. Two studies examined the loss in fertility of cosmetology practitioners; one study from Sweden indicated a higher risk of conceiving failure among cosmetologists, while one study from UK indicated a no significant association of premature ovarian failure. One study from USA found out a higher prevalence of gestational diabetes among manicurists and cosmetologists. 3 studies were about the health outcome of cancer, all those three studies indicted significant associations. 3 researchers studied the health outcome of physical disorders; one study from Egypt indicated a significant association of elbow, shoulder, back and knee pain, especially among old and male cosmetologists. However, other two studies indicated no significant association. \nConclusion and implication: the review of adverse health outcomes of cosmetology practitioners indicated that cosmetologists have higher risks of adverse pregnancy outcome, loss of fertility, cancer, diabetes and certain kind of physical disorders, in comparison with people from other professionals. In order to improve the health condition of cosmetology practitioners, Restrict occupational performance regulation and guidelines, policy supports for cosmetologists and hairdressers, and comprehensive health education and information will be helpful for the health promotion for cosmetology practitioners and common people who contact with cosmetic products frequently.

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