Asthma, respiratory and skin allergies up to and including cancers from handling cosmetic products, musculoskeletal disorders, work pace-related stress… ll these and more are health risks run by those who work in the hairdressing and beauty care sectors. The European industry federation for services is proposing a European framework agreement to prevent health being injured in this way.

Appearances are deceptive – hairdresser and beautician are high-risk jobs by any standards. The scale of occupational diseases in the hairdressing sector has been revealed by a series of recent studies done in France in particular. The data produced concern mainly male and female hairdressers, but can be applied to beauty salon workers.

According to the most recent statistics put out by the Ile-de-France regional health insurance fund, the number of recognized occupational diseases for hairdressing workers in 2000 was more than five times that for the total employed population in all sectors combined.

The most frequent occupational diseases suffered by hairdressers are allergy-related ill health conditions – eczema, asthma or rhinitis – and musculoskeletal disorders (MSDs). And these are only recognized occupational diseases – i.e., ones actually reported by workers, who very often do not know their rights. The hairdressing sector is made up of a very large number of very small businesses employing staff barely up to double figures, and mostly women. Very few have an employee rep, and even fewer a health and safety committee.

Chemical hazards

Hairdressers daily handle hundreds of chemicals that go into making shampoos, lotions, hair colourings, bleaching/lightening products for highand lowlighting, perming and curling products, hair lacquer and other sprays. These products are treated as cosmetics, and so fall outside the rules on chemicals used on work places (see box p. 44). But repeated use of shampoos destroys the skin barrier and can produce irritation and allergic reactions. Hair bleaching, colouring and perming products, in particular, contain many corrosive substances, irritants and allergens that affect the skin, eyes and airways.

A field survey by an occupational health service among hairdressers in the Côte d’Or département (Burgundy) found that 41% of hairdressing salon workers have skin problems1. A quarter of hairdressers have eczema or irritant contact dermatitis of the hands. Oxidation dyes and tints are most often to blame. Most hairdressing salons have no effective ventilation systems to remove pollutants, so hairdressers breathe in irritant toxic and/or sensitising particles and fumes. The Côte d’Or survey found that hairdressing workers reported respiratory symptoms like rhinitis, persistent coughs and shortness of breath. While the causal link between the respiratory symptoms and the products used may not always be firmly made, hairdressing has one of the highest rates of occupational asthma. In the Côte d’Or field study, 3% of the interviewees had asthma. While none of the workers interviewed had reported their condition as an occupational disease, the study's authors considered that approximately 1% of the workers had asthma that was “clearly work-related”. Among women, nearly 20% of occupational asthma cases originate in the hairdressing sector, according to the most recent data published by the national occupational asthma monitoring centre. The alkaline persulphate used to lighten and bleach hair is the primary cause of occupational asthma among hairdressers.


Potentially carcinogenic and reprotoxic

As well as skin and airway problems, repeated daily exposure to many cosmetics is suspected to cause occupational cancers. An expert group set up by the World Health Organization’s International Agency for Research on Cancer recently classified the occupation of hairdresser and barber as “probably carcinogenic” (see box).

Various researchers have also looked at the possible toxicity for reproduction of products used by hairdressers. A study by the University Hospital Department of Occupational Medicine at Lund in Sweden found that hairdressers had a slight increased risk of having intrauterine growth-retarded infants and infants with birth defects. The researchers were unable to make a link with a specific chemical but did note an association between intrauterine growth retardation and frequent permanent waving or use of hair sprays by workers. Another Scandinavian study has looked at the link between facial malformations – cleft palates and hare lips – in newborns and their mother’s occupation during pregnancy. They found a higher incidence of cleft palates among the children of mothers who were hairdressers. Other studies, however, have found no significant association between the mother’s occupation as a hairdresser and the risk of birth defects. The IARC experts, however, do not consider the findings of these different studies show sufficient evidence of the existence of a reprotoxic risk.

Diseases of the bones, joints and blood vessels

Back bowed, head bent over, elbow raised, arms stretched, wrist twisted: when shampooing, cutting or blow-drying, hairdressers’ bodies are under strain all day long. “Hairdressing is a physically exhausting job, I was stood up all day long, in a warm, humid atmosphere”, recalls Sandrine, a former hairdresser who left the line of work. Prolonged standing positions and constrained postures are the main factors associated with MSDs, which are particularly common ill health conditions among hairdressing salon workers. Breaks that are too-short and too far apart, long working stretches, unsuitable equipment like unwieldy hair driers, hair-washing sinks that are set too low or customer seating with no height adjustment can also contribute to the development of MSDs.

According to a study by the Orbis improvement of working conditions department in the Netherlands, half of hairdressers suffer from neck, shoulder and wrist MSDs, and a third complain of low back pain5. The Côte d’Or survey finds approximately the same prevalences: low back pain among at least half, and neck pains among a third, of respondents. Shoulder and wrist conditions are common.

As hairdressers work mainly standing and walking, they often have vein problems. In the Côte d’Or survey, 60% of workers complained of aching legs and 20% had varicose veins, although the average age of interviewees was under 30. A quarter took venotonic drugs, while some also wore support stockings, in a bid to relieve their physical pain.

Tired and stressed

The Côte d’Or occupational health service doctors also quizzed hairdressers about their stress levels. Half reported feeling fatigued and/or stressed. Many suffered from sleep disorders. Permanent client contact, customer satisfaction requirements, secrets imparted by clients during styling, were sources of stress. But it was time pressures that most professionals cited as stress factors, with stylists having to organize themselves to minimise customer waiting times.

EVEREST (small firm risk assessment and monitoring by a health and safety at work network), a French network run by occupational hygienists and doctors, investigated work organization in 22 hairdressing salons in Brittany6. They found a high incidence of part-time work, but that unbroken days were the norm. Salons may work long opening hours to fit in with customers’ hours of work.

Françoise Wellecam, an activist with the Lille regional branch of the Force Ouvrière union, receives many calls from hairdressers exhausted by their work paces. “The working conditions themselves are pretty harsh. On top of that, employers are constantly changing work and leave rosters to suit themselves”, she says. The union official for hairdressers in her region reports that many workers are dropping out of the job because of these constraints. This is borne out by a snapshot of the Côte d’Or hairdressing salon workforce, which shows most to be under 30. “A lot of women are getting out because they are fed-up with the working conditions. It is a particularly high turn-over sector”, Françoise Wellecam adds. Low pay combined with unstable working hours do little for work-life balance.

Towards a European framework agreement?

It was this body of medical research describing these work hazards that prompted the European industry federation Uni Europa Hair & Beauty to put a draft framework agreement forward to the employers' federations last spring. The hairdressing and beauty care sectors employ more than a million workers in Europe. “Our strategy is to propose a ready-to-go agreement. Even if changes are made, hopefully we can get an agreement before the end of this year”, says François Laurent, national secretary of the Confederation of Christian Trade Unions in Belgium, and Uni Europa’s chief negotiator.

The draft framework agreement comes at a time when the European Parliament has just voted for a revision of the Cosmetics Directive. “We wanted the new directive to take occupational exposures into account, but the EU wouldn’t go down that road”, complains François Laurent. The framework agreement is a good opportunity for management and labour to look again at the prevention of risks from handling cosmetic products. “The tubes sold to hairdressers often come without either gloves or the warning notices that you get with products sold to the public”, adds Guy Marin, a former hairdresser and national secretary of Force Ouvrière’s Hairdressers’ Federation. “Manufacturers are very reluctant to tell us what goes into the cosmetics we use in our salons”, he says.

The draft framework agreement seeks to reduce cosmetics-related occupational diseases by getting the signatory parties to pledge to continue working for Community rules that address professionals’ concerns. Specifically, this includes developing a health and safety certification system for hairdressing cosmetics. The agreement calls for effective ventilation, and preferably an extraction system in equipment rooms, for aerosol sprays to be scrapped if possible, and for powders to be replaced by gels. It wants employers to have certain obligations, like providing protective gloves, informing and training staff in preventive measures, storing products safely, etc. As well as prevention of chemical hazards, the agreement contains recommendations for averting MSDs (see box), stress and fatigue, and for improving the work environment. The trade unionists are hopeful of seeing their draft agreement endorsed, because the social dialogue in the hairdressing sector has been established for several years, and the social partners have already adopted EU-level agreements on professional training, quality standards and even health and safety•.

From the unions

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Hairdressing and beauty care: European action for safer workplaces