The effects of hair lacquer sprays on the lungs

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The results of a pilot X-ray survey of the chests of 505 hairdressers (including47 men's hairdressers used as controls) are reported. The women's hairdressers were drawn from establishments in which (i) only shellac-based sprays, (ii) only polyvinylpyrrolidone (PVP)-based sprays and (iii) in which both types were used. In (i) 24·2 % had been exposed to sprays for more than 6 yr; in (ii) 21·1 % and in (iii) 37%. No abnormal X-ray appearances suggesting the presence of thesaurosis were discovered in the X-ray survey. The majority of particles of spray both from hand sprays and pressure aerosol sprays were less than 1 μ in diameter, and were thus capable of being inhaled and retained in the lungs. Environmental studies of the atmosphere of four hairdressing establishments showed marked variation in the concentration of particles according to the amounts of spray being used and according to the conditions of ventilation. In two of the establishments where PVP-based sprays were being used, the concentrations of particles were very low. A well-documented case of interstitial pulmonary fibrosis with many giant cells and periodic acid-Schiff(PAS)-staining granules in a woman exposed for 11 yr to shellac-based hair-sprays is also reported. Lung biopsy studies show that the lesion is not sarcoidosis, nor idiopathic interstitial pulmonary fibrosis including the Hamman-Rich syndrome. A diagnosis of thesaurosis has been made in her case. It is suggested that PVP and gum shellac might produce different tissue reactions; a sarcoid reaction appears to be associated with PVP, and a foreign-body one with gum shellac, which has previously been shown to cause fibrosis of the lungs.It is probable that thesaurosis occurs only in susceptible or hypersensitive people and at the present time there is no evidence to suggest a dose-response relationship between lacquer hairsprays and pulmonary disease. But our one case of thesaurosis had had a prolonged and substantial exposure. There is at present no way of detecting those people who may be susceptible to the sprays. The few reported cases, having regard to the widespread use of hair-sprays, indicate that the risk of the onset of lung disease from this cause is small. But it is clear that more research and the examinations of larger numbers of hairdressers and users of hair-sprays are needed. In the meantime it is desirable that attention should be paid to the ventilation of hairdressing rooms in order to keep the concentration of hair-spray particles as low as possible, and that people who use lacquers on their own hair should avoid inhalation of the spray.