HETA 97–0153–2694

The Grand Experience Salon

Chicago, Illinois

Daniel Almaguer, MS, RS

Robert Malkin, DDS, DrPH

This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally

applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.

Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports

This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally

applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.

Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports

This Health Hazard Evaluation (HHE) report and any recommendations made herein are for the specific facility evaluated and may not be universally

applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.

applicable. Any recommendations made are not to be considered as final statements of NIOSH policy or of any agency or individual involved.

Additional HHE reports are available at http://www.cdc.gov/niosh/hhe/reports
ii

PREFACE

The Hazard Evaluations and Technical Assistance Branch of NIOSH conducts field investigations of possible

health hazards in the workplace. These investigations are conducted under the authority of Section 20(a)(6)

of the Occupational Safety and Health Act of 1970, 29 U.S.C. 669(a)(6) which authorizes the Secretary of

Health and Human Services, following a written request from any employer or authorized representative of

employees, to determine whether any substance normally found in the place of employment has potentially

toxic effects in such concentrations as used or found.

The Hazard Evaluations and Technical Assistance Branch also provides, upon request, technical and

consultative assistance to Federal, State, and local agencies; labor; industry; and other groups or individuals

to control occupational health hazards and to prevent related trauma and disease. Mention of company names

or products does not constitute endorsement by the National Institute for Occupational Safety and Health.

ACKNOWLEDGMENTS AND AVAILABILITY OF REPORT

This report was prepared by Daniel Almaguer, MS, RS, and Robert Malkin, DDS, DrPH, of the Hazard

Evaluations and Technical Assistance Branch, Division of Surveillance, Hazard Evaluations and Field

Studies (DSHEFS). Field assistance was provided by Ana Navarrete–Contreras, MD. Analytical support

was provided by Data Chem Laboratories and Leroy May, Measurements Research Support Branch, Division

of Physical Sciences and Engineering. Desktop publishing was performed by Nichole Herbert. Review and

preparation for printing was performed by Penny Arthur.

Copies of this report have been sent to employee and management representatives at The Grand Experience

Salon and the OSHA Regional Office. This report is not copyrighted and may be freely reproduced. Single

copies of this report will be available for a period of three years from the date of this report. To expedite

your request, include a self–addressed mailing label along with your written request to:

NIOSH Publications Office

4676 Columbia Parkway

Cincinnati, Ohio 45226

800–356–4674

After this time, copies may be purchased from the National Technical Information Service (NTIS) at

5825 Port Royal Road, Springfield, Virginia 22161. Information regarding the NTIS stock number may be

obtained from the NIOSH Publications Office at the Cincinnati address.

For the purpose of informing affected employees, copies of this report shall be

posted by the employer in a prominent place accessible to the employees for a

period of 30 calendar days.
iii

Health Hazard Evaluation Report 97–0153–2694

The Grand Experience Salon

Chicago, Illinois

June 1998

Daniel Almaguer, MS, RS

Robert Malkin, DDS, DrPH

SUMMARY

On March 28, 1997, the National Institute for Occupational Safety and Health (NIOSH) received a confidential

employee request to evaluate employee exposures at The Grand Experience Salon, Chicago, Illinois. The

requestors expressed concern that certain health effects (i.e., allergic reactions, asthma, cancer) experienced by

employees of the salon may be associated with inadequate ventilation and exposures to chemical ingredients of

products used in the salon.

On June 11–13, 1997, NIOSH investigators conducted a site visit and collected general area air samples for total

and respirable particulate during the application of artificial nails; measured temperature, relative humidity (RH),

and carbon dioxide (CO2) concentrations at various locations within the salon; traced the ventilation system ducting

to determine the source of outside air; and conducted employee interviews. Verbal recommendations were

provided to the salon management at the closing conference on June 13, 1997.

Visual inspection of the ventilation system and duct work revealed that there was no provision for the introduction

of outside air to the salon. Consequently, the lack of adequate ventilation caused the CO2 concentrations to rapidly

rise after the salon was opened for the day, and it is expected that concentrations of other substances present (e.g.

cigarette smoke, allergens, chemical substances used in the salon) would also increase. All indoor CO2 readings,

with the exception of the morning readings, exceeded the NIOSH guideline of 800 parts per million parts of air

(ppm). Many temperature readings exceeded the range recommended by the American Society of Heating,

Refrigerating, and Air–Conditioning Engineers (ASHRAE) for indoor summer comfort, 73°F to 79°F. All relative

humidity readings were within the range (30% to 60%) recommended by ASHRAE, although the majority of

readings were at the upper extreme of the range.

During the application of artificial nails, total and respirable particulate concentrations were below the analytical

limit of detection, and the samples did not contain either quartz or cristobalite. Analysis of the acrylic polymer

powder used during the application of artificial nails did not reveal detectable quantities of quartz or cristobalite.

The salon did not have material safety data sheets (MSDSs) for products used in the salon, nor did they keep an

OSHA Log and Summary of Occupational Injuries and Illnesses (OSHA Form 200). The latex gloves issued to

employees for use when mixing bleaches, permanent wave solutions, and other chemicals, are not appropriate

protection against the potential skin hazards involved.
iv

NIOSH investigators were unable to determine the nature and extent of employees’ past exposures to hair dyes,

due to a number of unknown variables including changes in dye formulations. Thirty (3 males and 27 females)

of the 54 employees were interviewed regarding symptoms occurring at work. Nine reported a history of health

problems they thought might be related to their job. Three reported possible allergic reactions (involving cough

and nasal congestion) to some of the hair sprays used at the salon. In the last year, two workers reported having

had skin or eye irritation, two reported carpal tunnel syndrome, and two reported either headaches or sneezing

associated with pedicures. Two reported upper respiratory tract irritation at work, but they reported having had

those problems before working in this salon. 

There was no provision for the introduction of outside air to the salon, resulting in CO2 levels exceeding

800 ppm. Additionally, there were some potential chemical exposures and a number of occupational

safety and health administrative deficiencies. Although few symptoms were reported by most employees,

some symptoms reported by employees are plausibly related to inadequate ventilation which resulted in

increased CO2 concentrations and possibly other substances (e.g. chemicals, allergens, cigarette smoke)

present in the salon. Recommendations include: redesigning the ventilation system to provide outside air

to the salon, establishing a written hazard communications program, keeping an occupational illness and

injury log, obtaining MSDSs for all products used in the salon, providing the appropriate gloves to protect

employees from chemical hazards to the skin, and prohibiting smoking in the workplace.

Keywords: SIC 7231(Beauty Shops), beauty salons, beauticians, cosmetology, cosmetologists, hairdressers,

ventilation, HVAC, outside air
TABLE OF CONTENTS

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii

Acknowledgments and Availability of Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ii

Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . iii

Introduction ......................................................................... 2

Background ......................................................................... 2

Methods ........................................................................... 2

Industrial Hygiene ................................................................. 2

Ventilation, Temperature, Relative Humidity and Carbon Dioxide (CO2)..................... 3

Particulates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Medical . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Evaluation Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Particulates, Not Otherwise Classified . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Silica (Quartz, Cristobalite, Amorphous) ................................................ 4

Ventilation and Carbon Dioxide Concentrations .......................................... 5

Temperature and Relative Humidity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Health Effects Reported Among Hairdressers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Cancer Among Hairdressers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Results and Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Industrial Hygiene ................................................................. 7

General Industrial Hygiene Observations ................................................ 8

Medical Interviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Ventilation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Hazard Communications Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Page 2 Health Hazard Evaluation Report No. 97–0153–2694

INTRODUCTION

On March 28, 1997, the National Institute for

Occupational Safety and Health (NIOSH) received a

confidential employee request to evaluate employee

exposures at The Grand Experience Salon, Chicago,

Illinois. The requestors expressed concern that

certain health effects (i.e., allergic reactions, asthma,

cancer, etc.) experienced by employees of the salon

might have been associated with inadequate

ventilation and exposures to chemical ingredients of

products used in the salon.

On June 11–13, 1997, NIOSH investigators

conducted a site visit to evaluate the ventilation

system effectiveness and interview employees. The

temperature, relative humidity (RH), and carbon

dioxide (CO2) concentrations were measured at the

beginning of the workday, in the early afternoon, and

the early evening at several locations within the salon

to determine the efficiency of the ventilation system.

The ventilation system ducts were traced to

determine if the location of outside air (OA)–intakes.

General area air samples were collected for total and

respirable dust during the application of artificial

nails, and employee interviews were conducted. At

the closing conference on June 13, 1997, verbal

recommendations were provided to the management.

BACKGROUND

The Grand Experience Salon opened in April 1989 at

its present location on the first floor of a multi–story

condominium building. The salon is physically

separated from the condominium portion of the

building by concrete fire walls. The portion of the

building occupied by the salon is owned by the

owner of the salon business, while the condominium

portion is owned by the condominium owners

association.

The salon ceilings are approximately 26 feet above

floor level, except in the north central portion of the

salon, which is divided into two floors with ceiling

heights of about eight feet (from floor to ceiling).

The salon contains approximately 3,500 ft2

 of floor

space (800 ft2

 on the second floor). On the first floor

of the salon there are 20 hairstyling chairs, 6 hair

drying stations/chairs, 5 hair washing basins/chairs,

five nail stations, small office (5' x 5'), dispensary

(8' x 8'), restroom, waiting area, reception desk, and

refreshment area. The second floor of the salon

(approximately 800 ft2

) contains a hairstyling room

with four hairstyling chairs, one hair wash

basin/chair, facial room, message room, an employee

break room, storage room, and restroom. The

dispensary/product storage area is located in the back

of the salon. A washer/dryer unit located in the

dispensary is used for cleaning towels used on the

clients. Chemical mixtures (e.g., permanent wave

solutions, hair bleaches, etc.) are prepared in the

dispensary, which is equipped with general exhaust

ventilation.

The salon is served by one air–conditioning package

unit, which is located on the roof of the second floor,

between high rise buildings. The air handling unit

(AHU) for the system is located above the first floor

restroom, and is accessible by ladder. The false

ceiling serves as the return air plenum for the cooling

system. Air is supplied and distributed to the various

areas of the salon through a system of hard/flexible

ducting.

The salon is open for business from 8 a.m. to 9 p.m.

weekdays, and from 9 a.m. to 4 p.m. Saturdays. At

the time of the NIOSH survey the salon employed

54 full– and part–time employees (49 of whom are

women), including 18 hairdressers, 6 nail

technicians, as well as make–up artists, message

therapists, skin care technicians, receptionists, and

cleaning personnel. The owner reported that the

salon averages approximately 200–250 clients per

day.

METHODS

Industrial Hygiene

A walk–through evaluation was conducted on June

11, 1997, during which the NIOSH personnel
Health Hazard Evaluation Report No. 97–0153–2694 Page 3

familiarized themselves with the floor layout of the

salon. On June 12, 1997, a ventilation system

evaluation was conducted and general area air

samples for particulates were collected at one

artificial nail application station.

Ventilation, Temperature, Relative

Humidity and Carbon Dioxide (CO2)

The ventilation system effectiveness (or adequacy of

OA supply) was evaluated by measuring CO2,

temperature, and RH at 12 locations throughout the

salon and, for comparison, outside the building.

“Real–time” CO2 concentrations were measured

using a Gastech Model RI–411A portable CO2

indicator set in the 60–sec average mode. This

battery–powered instrument uses a non–dispersive

infrared–absorption detector to measure CO2 in the

range of 0–4975 parts per million (ppm), with a

sensitivity of ±25 ppm. Instrument zeroing and

calibration were performed prior to use with “zero

air” and a known concentration (800 ppm) of CO2

“span gas.”

The air temperature and RH were measured using a

Vaisala Model HM 34 battery–powered, direct

reading meter. This instrument is capable of

providing direct readings for dry–bulb temperature

and relative humidity, ranging from –4°F to 140°F

and 0% to 100%, respectively. Instrument

calibrations are performed monthly using primary

standards. The ventilation system evaluation also

included a visual inspection of accessible parts of the

AHUs and following the ductwork to determine the

location of the outdoor air intakes.

Particulates

Acrylic powders are used in the application of

artificial nails. To determine if the acrylic powder

used at this salon contained silica, a bulk sample of

the acrylic powder used was obtained and analyzed

for silica content via x–ray diffraction according to

NIOSH method 7500.1

 To determine airborne

concentrations of particulates general area air

samples for total and respirable particulate were

collected at one of five nail application stations.

Total particulate samples were collected on

pre–weighed polyvinyl chloride (PVC) filters

connected via Tygon® tubing to battery–powered

sampling pumps calibrated to provide a volumetric

airflow rate of 2.0 liters per minute (Rpm).

Respirable particulate samples were collected on

pre–weighed PVC filters attached to a 10–mm

cyclone and connected via Tygon® tubing to

battery–powered sampling pumps calibrated to

provide a volumetric airflow rate of 1.7 Rpm. The

filters were analyzed gravimetrically for total and

respirable particulate according to NIOSH Methods

0500 and 0600, respectively and via x–ray diffraction

for silica according to NIOSH method 7500.1

Medical

Fifty–four employees work at the salon (5 males and

49 females). All professional employees

(hairdressers, nail technicians, colorists, and hair

coloring specialist) and front desk personnel present

on the day of the evaluation were interviewed

(n=30). Questions asked during the interview

specifically concerned the presence of respiratory

symptoms, rashes, and eye irritation. Employees

were also asked about the existence of any other

symptoms that they felt were related to working at

the salon. MSDSs were obtained from the Goldwell

company, which is a major supplier of products to

the salon.

EVALUATION CRITERIA

As a guide to the evaluation of the hazards posed by

workplace exposures, NIOSH field staff employ

environmental evaluation criteria for the assessment

of a number of chemical and physical agents. These

criteria are intended to suggest levels of exposure to

which most workers may be exposed up to 10 hours

per day, 40 hours per week for a working lifetime

without experiencing adverse health effects. It is,

however, important to note that not all workers will

be protected from adverse health effects, even though

their exposures are maintained below these levels. A

small percentage may experience adverse health
Page 4 Health Hazard Evaluation Report No. 97–0153–2694

effects because of individual susceptibility, a

pre–existing medical condition, and/or a

hypersensitivity (allergy). In addition, some

hazardous substances may act in combination with

other workplace exposures, the general environment,

or with medications or personal habits of the worker

to produce health effects even if the occupational

exposures are controlled at the level set by the

criterion. These combined effects are often not

considered in the evaluation criteria. Also, some

substances are absorbed by direct contact with the

skin and mucous membranes, and thus potentially

increase the overall exposure. Finally, evaluation

criteria may change over the years as new

information on the toxic effects of an agent become

available.

The primary sources of environmental evaluation

criteria for the workplace are: (1) NIOSH

Recommended Exposure Limits (RELs)2

, (2) the

American Conference of Governmental Industrial

Hygienists' (ACGIH®) Threshold Limit Values

(TLVs®)

3

 and (3) the U.S. Department of Labor,

OSHA Permissible Exposure Limits (PELs)4

.

NIOSH encourages employers to follow whichever

are the more protective criterion. The OSHA PELs

reflect the feasibility of controlling exposures in

various industries where the agents are used, whereas

NIOSH RELs are based primarily on concerns

relating to the prevention of occupational disease. It

should be noted when reviewing this report that

employers are legally required to meet those levels

specified by an OSHA standard and that the OSHA

PELs included in this report reflect the 1971 values.

A time–weighted average (TWA) exposure refers to

the average airborne concentration of a substance

during a normal 8– to 10–hour workday. Some

substances have recommended short–term exposure

limits (STEL) or ceiling values which are intended to

supplement the TWA where there are recognized

toxic effects from higher exposures over the

short–term.

Particulates, Not Otherwise

Classified

Often a specific airborne particulate does not have an

established occupational health exposure limit. It has

been the convention to apply a generic exposure

criterion in such cases. Formerly referred to as

nuisance dust, the preferred terminology for the

non–specific particulate ACGIH TLV criterion is

now "particulates, not otherwise classified (PNOC),"

[or "particulates, not otherwise regulated" (PNOR)

for the OSHA PEL]. In comments to OSHA on

August 1, 1988, on their “Proposed Rule on Air

Contaminants,” NIOSH questioned whether the

proposed PEL for PNOR (10 mg/m3

) was adequate

to protect workers from recognized health hazards.2

The OSHA PEL for total PNOR is 15.0 mg/m3 and

5.0 mg/m3

 for the respirable fraction, determined as

an 8–hour TWA. The ACGIH TLV® for exposure to

a PNOC is 10.0 mg/m3

 (total dust, 8–hour TWA).

These are generic criteria for airborne dusts

originally intended for those that do not produce

significant disease or toxic effect when exposures are

kept under reasonable control.5

 These criteria are not

appropriate for dusts that have a biologic effect.

Silica (Quartz, Cristobalite,

Amorphous)

Crystalline silica (quartz) and cristobalite have been

associated with silicosis, a fibrotic disease of the lung

caused by the deposition of fine particles of

crystalline silica in the lungs. Symptoms usually

develop insidiously, with cough, shortness of breath,

chest pain, weakness, wheezing, and non–specific

chest illnesses. Silicosis usually occurs after years of

exposure, but may appear in a shorter period of time

if exposure concentrations are very high. The

NIOSH RELs for respirable quartz and cristobalite

are 50 :g/m3

, as TWAs, for up to 10 hours per day

during a 40–hour work week.2

 These RELs are

intended to prevent silicosis. However, evidence

indicates that crystalline silica is a potential

occupational carcinogen.6,7,8,9 The OSHA PEL for
Health Hazard Evaluation Report No. 97–0153–2694 Page 5

respirable quartz is 10 mg/m3 divided by the value

“%SiO2+2.” The PEL for cristobalite is 1⁄2 the

calculated value for quartz.12 The ACGIH TLVs for

respirable quartz and cristobalite are 100 and

50 :g/m3

, as 8–hour TWAs, respectively.

Amorphous silica does not have a crystalline lattice

molecular configuration. Historical evaluations of

amorphous silica suggest that it is of low toxicity

and, unlike crystalline silica (quartz), it has not been

reported to produce the fibrotic nodules in lung tissue

that are characteristic of crystalline silica

exposure.10,11 The NIOSH REL for exposure to

amorphous silica is a full–shift, total particulate

TWA of 6 mg/m3

, providing the silica contains less

than 1% crystalline forms.12 The OSHA PEL is

80 mg/m3

 divided by the %SiO2, as an 8–hour TWA.

The ACGIH TLV for amorphous silica containing

less than 1% crystalline silica is 10 mg/m3

, inhalable

particulate TWA over eight hours, and a respirable

particulate TWA of 3 mg/m3

.

Ventilation and Carbon

Dioxide Concentrations

The OA ventilation criteria usually referenced by

NIOSH investigators are those published by the

American Society of Heating, Refrigerating and

Air–conditioning Engineers (ASHRAE) in the

ASHRAE Standard on Ventilation for Acceptable

Indoor Air Quality (ASHRAE 62–1989).13 Table

2 of that document specifies outdoor (fresh) air

requirements for ventilation in commercial facilities.

ASHRAE recommends an OA ventilation rate of

25 cfm/person for beauty shops.

Carbon dioxide is a normal constituent of exhaled

breath and, if monitored, can be used as a screening

technique to evaluate whether adequate quantities of

OA are being introduced into an occupied space.

Indoor CO2 concentrations are normally higher than

the generally constant ambient CO2 concentration

(range 300–350 ppm). Carbon dioxide concentration

is used as an indicator of the adequacy of outside air

supplied to occupied areas. When indoor CO2

concentrations exceed 800 ppm in areas where the

only known source is exhaled breath, inadequate

ventilation is suspected.14 Elevated CO2

concentrations suggest that other indoor

contaminants may also be increased. It is important

to note that CO2 is not an effective indicator of

ventilation adequacy if the ventilated area is not

occupied at its usual level.

Temperature and Relative

Humidity

Temperature and RH measurements are often

collected as part of an indoor environmental quality

(IEQ) investigation because these parameters affect

the perception of comfort in an indoor environment.

The perception of thermal comfort is related to one's

metabolic heat production, the transfer of heat to the

environment, physiological adjustments, and body

temperature.15 Heat transfer from the body to the

environment is influenced by factors such as

temperature, humidity, air movement, personal

activities, and clothing. The American National

Standards Institute (ANSI)/ASHRAE Standard

55–1992 specifies conditions in which 80% or more

of the occupants would be expected to find the

environment thermally acceptable.16 Assuming slow

air movement and 50% RH, the operative

temperatures recommended by ASHRAE range from

68–74o

 F in the winter, and from 73–79oF in the

summer. The difference between the two is largely

due to seasonal clothing selection. ASHRAE also

recommends that RH be maintained between 30 and

60% RH.16 Excessive humidities can support the

growth of microorganisms, some of which may be

pathogenic or allergenic.

Health Effects Reported

Among Hairdressers

Services performed by hairdressers include

haircutting, cleansing, conditioning, and corrosive

treatments for the hair and scalp, as well as

treatments designed to hold the hair in place or

change its shape, configuration, or color.17

Cosmetologists also perform other beauty services
Page 6 Health Hazard Evaluation Report No. 97–0153–2694

such as massaging the face and neck with creams and

oils, coloring eyebrows and lashes, manicuring

fingernails and toenails, and hair removal.18

Many chemical compounds contained in beauty

products (e.g., hairsprays, permanent wave products,

dyes, bleaches, etc.) are capable of causing contact

dermatitis (skin irritation), respiratory problems

including bronchial irritation and occupational

asthma, and other symptoms through inhalation or

dermal absorption. 17,18,19,20

Contact dermatitis is a well–recognized, and possibly

the most frequent, occupational disease among

cosmetologists. Dermatitis can seriously inhibit the

effectiveness and ability of a beautician to perform

the basic services of the profession.21,22 Many of the

products used by beauticians, including permanent

wave solutions and oxidation–type hair coloring

preparations, contain both dermal irritants and

sensitizers. 

Occupational asthma has been linked to hairdressers

because of some of the chemicals used in the job.

Asthma is a lung disorder characterized by reversible

obstruction of the lung airway system (bronchial

tubes) and causes episodic respiratory symptoms,

including shortness of breath, wheezing, chest

tightness, and cough. In occupational asthma, airway

obstruction is caused or made worse by workplace

exposure to dusts, fumes, gases, or vapors.23 In the

U.S., asthma occurs in about 5–10% of the general

population; 15% of these cases are thought to be

occupational.24 Occupational asthma among hair

stylists has been associated with persulphate salts

used in hair bleaches, henna, and hair dyes

containing paraphenylenediamine.19,20 In addition to

asthmatic symptoms (i.e., shortness of breath, cough,

wheezing, and chest discomfort), eye, nose, and

throat irritation, headache, nausea, and vomiting

following exposure to various aerosols in

hairdressing salons have been recorded.19,25,26,27

Cancer Among Hairdressers

The question of whether exposure to hair dye is

associated with an increased risk of cancer,

particularly cancer of the breast, bladder, and

non–Hodgkins lymphoma, has been examined in

many epidemiologic studies of hairdressers and

women who had their hair dyed. Increased risk of

developing cancer is determined by having either a

statistically significant increased odds ratio (the odds

of having a given disease given a particular exposure

[OR]) or a statistically significant increased relative

risk (the risk of disease in an entire population that is

associated with a particular exposure [Relative

Risk–RR] ).28 Statistical significance is determined

by having a confidence interval (CI) that does not

include the number one. Recent studies of a possible

link between breast cancer and the use of dyes have

not shown a statistically significant association. One

study of over 118,000 women found that the rate of

breast cancer among women who used hair dye was

similar to that among women who did not use dye29

and another found an odds ration of 1.04 (95% CI

0.9–1.2).30 Studies of a possible link between hair

dye use, increased risk of bladder cancer, and

hematopoietic cancers, including multiple myeloma

and non–Hodgkins lymphoma, found conflicting

results, although the associations are strongest for

non–Hodgkins lymphoma. One incidence study

found increased risks for non–Hodgkins lymphoma

(RR 2.0; 95% CI 1.3–3.0) and leukemia (RR 1.8;

95% CI 1.1–2.7)31 and another case control study

found similar increased risk of hematopoetic cancers,

particularly non–Hodgkins lymphoma.32 In a

prospective study, use of black hair dye for 20 years

or more was associated with elevated rates of

hematopoetic diseases in women (for non–Hodgkins

lymphoma RR 4.4; 95% CI 1.3–15.2 and for multiple

myeloma RR 4.39; 95% CI 1.1–18.3). This

association was not seen in women who had “ever”

used hair dye of varying colors.33 However, a

prospective cohort study of nurses found no

increased risk from the use of hair dye “ever” for

hematopoietic cancers including non–Hodgkins

lymphoma (RR=1.1; 95% CI 0.8–1.6) or chronic

lymphocytic leukemia (RR 0.8; 95% CI 0.3–1.9).34

A review of patients diagnosed with multiple

myeloma found no relation in females between

myeloma and use of hair dyes (OR 1.0; 95% CI
Health Hazard Evaluation Report No. 97–0153–2694 Page 7

0.7–1.4) or previous employment as a hairdresser

(OR 1.1, 95% CI 0.75–2.9).35

The data for bladder cancer risk from exposure to

hair dyes is also conflicting. A retrospective cohort

study of cancer rates in Nordic countries found an

increase in bladder cancer (RR 2.1; (95% CI 1.5–2.8)

for hairdressers in Denmark, but not for hairdressers

in Norway or Finland. The authors noted that

cigarette smoking was unlikely to account for these

findings.36 Another study of hairdressers in Geneva,

Switzerland, found an excess of bladder cancer in

male hairdressers, but not in females, and the authors

speculate that the study suggests an exposure to a

“less potent” carcinogen than found in other dye

workers. According to the study authors, most male

hairdressers had never dyed hair and the authors

hypothesized (and state that there is no firm evidence

for this hypothesis) that the excess disease might be

due to the use of brilliantines containing

para–dimethylaminobenzene, which causes tumors

in dogs. These brilliantines may also have been

contaminated with 2–napthylamine, a known bladder

carcinogen. Brilliantines have not been used

extensively since approximately 1950.37 Other

studies have failed to find an association between

hair dye and bladder cancer.38,39

RESULTS AND

DISCUSSION

Industrial Hygiene

The results of CO2, temperature, and RH

measurements are presented in Table 1. These

results show that indoor CO2 concentrations rose

throughout the day of the survey, as is typical of

indoor CO2 concentrations. However, all CO2

readings, with the exception of the morning readings,

exceeded the NIOSH guidelines of 800 ppm.

Additionally, many temperature readings exceeded

the range recommended by ASHRAE for indoor

summer comfort, 73°F to 79°F. While all RH

readings were within the range (30% to 60%)

recommended by ASHRAE, the majority of readings

were at the upper end of the range.

The CO2 readings in the front section of the salon

(i.e., the artificial nail area, the reception area, and

the waiting area) were consistently the lowest. This

is most likely due to the infiltration of OA through

the front door of the salon, which is the only source

of OA. The temperature and RH readings in the

front section of the salon closely paralleled the

outside air temperature and RH readings, which

further suggests that OA is entering the salon through

the front entrance. The highest CO2 readings were

generally in the dispensary, a small 8 foot by 8 foot

room, located in the back of the salon, and the

furthest point away from the front entrance. The

lowest CO2 readings were generally located in the

stairway/upstairs area of the salon. This area had the

fewest occupants at any one time during the day.

Visual inspection of the HVAC system and duct

work revealed that there was no source of OA. The

inspection and discussions with the salon owner and

building maintenance personnel revealed that, at one

time, OA was supplied to the salon by two routes,

neither of which were operable at the time of the

NIOSH survey. The building maintenance

representative reported that the main OA intake had

been located above the front entrance to the

condominium lobby. However, inspection of the

salon AHU revealed that the air duct leading into the

AHU room begins just outside the fire wall

separating the salon from the condominium building,

thereby drawing air from the dead space above the

lobby ceiling, as well as the ceiling plenum of the

salon. Further discussions revealed that the

condomium lobby had undergone renovations

(sometime in the past two years). During the

remodeling the air duct may have been disconnected,

and the OA grill removed.

A second OA source was reported to come from an

OA intake grill located on the face of the building, at

the eastern end of the salon, about 10 feet above the

sidewalk. However, inspection revealed that the duct

leading from this OA intake grill to the second floor

hair styling room was disconnected. It was reported
Page 8 Health Hazard Evaluation Report No. 97–0153–2694

that these flexible ducts are connected only during

the cooler months of the year, and then disconnected

during the warmer months to prevent the

introduction of hot, humid air to the occupied space.

Visually tracing the duct from the OA intake grill to

the second floor revealed that the duct leads directly

to the second floor hair styling room (i.e., the air is

not properly filtered or tempered prior to being

introduced to the area).

Sampling for airborne particulates during the

application of artificial nails showed that total

particulate and respirable particulate concentrations

were less than the analytical limit of detection.

These samples showed no detectable quantitites of

either quartz or cristobalite. Additionally, the

chemical analyses of the bulk material sample of the

acrylic polymer powder used during the application

of artificial nails showed that the powder did not

contain detectable quantitites of quartz or

cristobalite.

General Industrial Hygiene

Observations

The salon dispensary was equipped with a general

exhaust vent that led to the area above the ceiling of

the condominium lobby. The area above the ceiling

was inaccessible and there were no building plans

available, resulting in an inabilty to trace the duct

past this point. It is unknown where the exhaust duct

leads or whether the dispensary exhaust is properly

discharged to an appropriate outdoor area.

Two ozone generators were used in the salon. Ozone

generators are marketed as air–purification devices

to reduce or remove chemical and particulate

contaminants and odors in indoor spaces. However,

ozone is a potent lung irritant and exposure to

elevated levels is a contributor to the exacerbation of

lung disease; it is especially dangerous for persons

with asthma and other chronic lung diseases,

children, and the elderly. Residential ozone is

produced directly by ozone generators and indirectly

by ion generators and some other electronic air

cleaners. There is no difference, despite some

manufacturers’ claims, between outdoor ozone and

ozone produced by these devices.40 In an evaluation

of ozone generators to determine if the use of ozone

had any effect on reducing formaldehyde

concentrations, the authors concluded that the use of

ozone is ineffective in reducing airborne

concentrations of formaldehyde. The authors further

concluded that because ozone has demonstrated

health hazards, and is a regulated air contaminant in

both the occupational and ambient environment, the

use of ozone to improve the quality of indoor air

does not appear to be warranted.41 In a separate

literature review, which appeared in the June

1995 issue of the American Industrial Hygiene

Association Journal, the author concluded that

“ozone is not a practical and effective means of

improving indoor air, especially in light of its

potentially serious risk to health.” The author further

concluded “introducing ozone in indoor air may

present a risk to human health” and that “detrimental

effects, primarily to the respiratory system, have

been well documented.”42

Medical Interviews

Thirty (3 males and 27 females) of the 54 workers

employed at the salon were interviewed. The

occupations of the employees interviewed included:

hairdresser, manicurist, hair coloring specialist, and

front desk personnel. Nine employees reported a

history of health problems they thought might be

related to their job. Three workers reported possible

allergic reactions (involving cough, nasal congestion)

to some of the hair spray used at the salon. In the last

year, two workers reported having had skin or eye

irritation, two reported carpal tunnel syndrome, and

two reported either headaches or sneezing associated

with pedicures. Two reported upper respiratory tract

irritation at work, but they reported having had those

problems before working in this salon. The

remaining 21 interviewed employees did not report

any work–related health problems. One hairdresser

reported a malignancy (bladder cancer) and was

concerned that it might be due to an exposure

incurred at work.
Health Hazard Evaluation Report No. 97–0153–2694 Page 9

Employees were permitted to smoke in the back

room and in the front (waiting area) of the salon, but

NIOSH investigators observed several employees

smoking in other areas of the salon and some patrons

were observed smoking while in the hairdressers’

chair. The salon owner reported that it was the

salon’s policy to allow the patrons to do so. All

employees interviewed who stated that they used hair

dyes or permanent wave solutions reported wearing

“personal protective clothing” (i.e., latex gloves and

smocks) which was provided by the owner of the

salon.

Hairdressers are licensed professionals in the State of

Illinois. The Illinois State Board of Cosmetology

requires 1200 hours of schooling, and 20 hours of

continuing education per year. This salon had no

written safety procedures for the mixing and

handling of the chemicals used by hairdressers.

According to the salon attorney, because safety

training is done at school, no further training is

considered necessary by the salon owners. At the

time of the site visit, the salon did not keep an OSHA

Log and Summary of Occupational Injuries and

Illnesses (Form 200) or MSDSs for the products used

in the salon.

CONCLUSIONS

Visual inspection of the ventilation system showed

that at the time of the NIOSH site visit, the system

was not designed for the introduction of OA to the

occupied spaces of the salon. Additionally, all

indoor CO2 measurements collected exceeded the

NIOSH guidelines of 800 ppm, with the exception of

those collected at the beginning of the workday. The

CO2 measurements showed that CO2 concentrations

rapidly rose after the salon was open for the day,

suggesting that other indoor contaminants may also

increase. The build–up of chemical emissions

generated by the use of the various beauty products

(i.e, permanent wave solutions, hair sprays, hair dyes,

artificial nail applications, etc.) may be partially

responsible for employee complaints of upper

respiratory tract irritation. Additionally, the use of

ozone generators and tobacco products in the

workplace (i.e., the reception area and waiting area)

may contribute to employee complaints. As

indicated in the Evaluation Criteria Section of this

report, CO2 concentrations are used as an indicator of

the adequacy of OA supplied to the occupied areas.

Because of the lack of an active OA–intake, the

excess CO2 concentrations measured, and the use of

chemical compounds in the salon, the ventilation

system should be redesigned to provide an OA

ventilation rate of 25 cfm/person as recommended by

the ASHRAE.

The salon management did not have MSDSs for

products used in the salon, nor did they keep an

OSHA Log of Injuries and Illnesses (Form 200) as

required by the Occupational Safety and Health Act.

Employees did not receive hazardous substances

training as required under the OSHA Standard

(29 CFR 1910.1200). Latex gloves issued to

employees for use when mixing bleaches, permanent

wave solutions, and other chemicals are not

appropriate protection against the potential skin

hazards involved.

NIOSH investigators were unable to determine the

nature and extent of employees’ past exposures to

hair dyes due to a number of unknown variables

including changes in dye formulations over the years.

RECOMMENDATIONS

The basic principles for controlling airborne

contaminants in the occupational environment

consist of substitution, isolation, and ventilation.

Product substitution and ventilation are the two

choices best suited for controlling airborne

contaminants in beauty salons. Product substitution

(i.e., elimination) is the first and most effective

method of controlling airborne contaminants and

should be used whenever possible. In instances

where product substitution is not feasible, local

exhaust or dilution ventilation should be used to

remove chemical contaminants generated from the

various beauty products used. Reports from the

Surgeon General and the National Research Council

(NRC) have concluded that exposure to
Page 10 Health Hazard Evaluation Report No. 97–0153–2694

environmental tobacco smoke (ETS) may be

associated with a wide range of health (e.g., lung

cancer) and comfort (e.g., eye, nose, and throat

irritation and odor) effects. 43,44,45,46,47,48 NIOSH has

concluded that ETS may be related to an increased

risk of lung cancer and possibly heart disease in

occupationally–exposed workers who do not

themselves smoke.49 As discussed at the closing

conference on June 13, 1997, the following

recommendations are offered to alleviate employee

symptoms.

Ventilation

The architectural redesign of the salon should

incorporate the ASHRAE recommendations for

acceptable indoor air quality to avoid the inherent

design problems that contributed to the current

indoor environmental quality problems in the

building.

1. The general exhaust duct leading from the

dispensary to the area above the condominium

ceiling lobby was inaccessible, and it should be

determined where this duct ultimately ends. The

dispensary should be designed to include a local

exhaust ventilation system to discharge potentially

contaminated air directly outdoors. The exhaust

stack should be located away from any area where

outside air intakes are located to prevent the potential

reentrainment of contaminated air. The dispensary

should be under negative pressure in relation to the

salon.

2. The HVAC system should be connected to an OA

intake and should introduce OA at a rate sufficient

for sustained occupancy of the maximum number of

persons expected in the salon at any one time. The

ASHRAE guidelines suggest that outside air be

supplied at a rate of 25 cfm/person for beauty salons.

To ensure adequate distribution of OA (currently

100% recirculated air) the ventilation system should

be modified to provide OA intakes, or it should be

replaced with a system that has this capability. The

OA intake rate should then be adjusted, and these

flowrates measured, to assure a minimum total rate

based on the maximum number of persons expected

to occupy the salon at any one time.

3. Negative pressure conditions are generally not

recommended for buildings for numerous reasons.

These include the possibility of capture and/or

re–entrainment of contaminants and odors exhausted

from inside the building and/or sources outside (e.g.,

vehicle exhausts), respectively, as well as

interference with the flue draw on gas– or oil–fired

appliances. Also, air infiltrating due to negative

pressure will enter by paths of least resistance rather

than according to any plan, so its distribution may

not occur in a desirable pattern (e.g., drafts may

occur, temperatures in some areas may be hard to

control, etc.). Also, if the building is under negative

pressure, exhaust flow for at least some of the

exhaust fans will be partially restricted as they work

against a greater–than–designed pressure differential.

Negative pressure leading to the infiltration of

substantial quantities of air may also lead to high

relative humidities in the building during the

summer, as humid outside air enters the building

without passing the cooling coils in the AHUs first.

To avoid these problems, total outside–air intake

rates for buildings should typically exceed total

exhaust rates by about 5% to 10% to ensure that the

building remains under slight positive pressure.50

However, there are current theories suggesting that

during the winter in northern climates, positive

pressure will force moisture in the building to

migrate from the interior building spaces through the

interstitial space of the exterior walls.51 Therefore, a

qualified engineering firm should be consulted to

insure the proper placement of vapor barrier systems.

4. Preventive maintenance is a critical component in

controlling biological growth in indoor

environments. The AHU should be inspected on a

monthly basis and cleaned as necessary. The air

supply should be properly filtered and the filters

should be changed regularly. The evaporator coils

and condensate drain pans should be cleaned

routinely to prevent the growth and/or accumulation

of microorganisms that could enter the airstream and

affect the indoor air quality. A record of all cleaning
Health Hazard Evaluation Report No. 97–0153–2694 Page 11

performed should be kept and any potential problems

corrected.

Hazard Communications

Program

Employers cannot comply partially, or on occasion,

with the hazard communications standard. In order to

be effective, worker protections must be complete,

ongoing, and permanent. Although many safety

issues are addressed in the hairdressers’ training,

workplace–specific hazard communication training

is a requirement of OSHA and must be incorporated

by the salon. At the time of the NIOSH site visit,

there was no written hazard communications

program and no MSDSs for any products used in the

salon.

The OSHA hazard communications standard

(29 CFR 1910.1200) states that employers shall

develop and implement a written Hazard

Communications (HAZCOM) Program that consists

of: (1) labeling; (2) MSDSs; (3) employee

information training; (4) a current list of all

chemicals used in the workplace updated to include

all new chemicals as they are received. The

information shall be kept in a central location that is

easily accessible to all employees, including any

contractor or subcontractor.

Employee Training: The OSHA standard specifies

that employees shall be trained in the following:

(1) methods used to detect the presence of hazardous

chemicals; (2) physical and health hazards of

chemicals used; (3) measures to protect themselves

from exposure; (4) the Hazard Communications

program itself; and (5) how to read and understand

an MSDS. Training shall be conducted annually,

and upon initial employment.

1. An inventory of all products used in the salon

should be conducted, and MSDSs for all products

used should be obtained from the manufacturer or

distributor.

2. Hairdressers should receive regular and repeated

education about the potential hazards in the

workplace. When possible, products that contain

known chemical allergens should be replaced by

those that do not. Hairdressers should remain aware

of proper work practices, such as handwashing, and

should be provided with appropriate protective

gloves, to minimize exposure to chemical

compounds.

3. Hairdressers with a history of asthma or allergic

reaction to chemicals, or who experience respiratory

or skin irritation problems, should inform their

physicians about their exposures at work.

General

1. To prevent hand–to–mouth transfer of workplace

chemicals, eating and drinking should be prohibited

at work stations.

2. Personal hygiene measures should be practiced,

such as washing prior to eating, drinking or smoking,

and prior to leaving the workplace.

3. Communication between management and

employees should be increased to facilitate the

exchange of concerns about environmental

conditions in the building. Employees should be

made aware of the problems with the building and

decisions made by management to address those

problems.

4. Worker exposure to ETS is most efficiently and

completely controlled by eliminating tobacco use

from the workplace. To facilitate elimination of

tobacco use, employers should implement smoking

cessation programs for employees. Customers

should be instructed not to smoke while in the salon

due to potential heath effects to employees.

Management and employees should work together to

develop appropriate policies consistent with the

following principles:

(a) The smoking policy should provide a

smoke-free environment for all employees.

This recommendation is in accordance with
Page 12 Health Hazard Evaluation Report No. 97–0153–2694

1. NIOSH [1994]. NIOSH manual of analytical

methods. 4th Edition. Cincinnati, OH: U.S.

Department of Health and Human Services, Public

Health Service, Centers for Disease Control and

Prevention, National Institute for Occupational

Safety and Health, DHHS (NIOSH) Publication

No. 94–113.

2. NIOSH [1992]. Recommendations for

occupational safety and health: compendium of

policy documents and statements. Cincinnati,

OH: U.S. Department of Health and Human

Services, Public Health Service, Centers for

Disease Control, National Institute for

Occupational Safety and Health, DHHS (NIOSH)

Publication No. 92–100.

3. ACGIH [1996]. 1996 TLVs® and BEIs®:

threshold limit values for chemical substances and

physical agents and biological exposure indices.

Cincinnati, OH: American Conference of

Governmental Industrial Hygienists.

4. Code of Federal Regulations [1989]. 29 CFR

1910.1000. Washington, DC: U.S. Government

Printing Office, Federal Register.

5. ACGIH [1986]. Documentation of threshold

limit values and biological exposure indices for

chemical substances and physical agents.

Cincinnati, OH: American Conference of

Governmental Industrial Hygienists.

6. NIOSH [1974]. Abrasive blasting respiratory

protective practices. Washington, DC: U.S.

Department of Health, Education, and Welfare,

Public Health Service, Center for Disease Control,

National Institute for Occupational Safety and

Health, DHEW (NIOSH) Publication No. 74–104,

p106.

7. IARC [1987]. IARC monograms on the

evaluation of carcinogenic risk of chemicals to

humans: silica and some silicates. Vol 42. Lyons,

France: World Health Organization, International

Agency for Research on Cancer, pp 49,51,73–111.

8. NIOSH [1988]. NIOSH testimony to the U.S.

Department of Labor: statement of the National

Institute for Occupational Safety and Health.

Presented at the public hearing on OSHA

PELs/crystalline silica, July 1988. NIOSH policy

statements. Cincinnati, OH: U.S. Department of

Health and Human Services, Public Health

Service, Centers for Disease Control, National

Institute for Occupational Safety and Health.

9. DHHS [1991]. Sixth annual report on

carcinogens: summary 1991. Research Triangle

Park, NC: U.S. Department of Health and Human

Services, Public Health Service, National Institute

for Environmental Health Sciences, pp 357–364.

10. Hathaway GJ, Proctor NH, Hughes JP, and

Fischman MJ [1991]. Proctor and Hughes'

Chemical Hazards of the Workplace. 3rd. ed.

New York, NY: Van Nostrand Reinhold.

NIOSH guidelines which recommend a

smoke-free environment in the workplace and

applies to smoking by clients and visitors, as

well as by employees.49

(b) The most direct and effective method of

eliminating ETS from the workplace is to

prohibit smoking in the workplace. However,

if smoking is permitted in the workplace, it

should be restricted to designated smoking

areas. These areas should be enclosed and

provided with a dedicated exhaust system

(room air directly exhausting to the outside),

an arrangement which eliminates the

possibility of re–entrainment and recirculation

of any secondary cigarette smoke. In addition,

the smoking area should be under negative

pressure relative to surrounding occupied

areas. ASHRAE recommends that ventilation

systems supplying the smoking lounge should

be capable of providing at least 60 cfm of

outdoor air per person.13 This air can also be

obtained from the surrounding spaces (transfer

air) if it is relatively uncontaminated.

REFERENCES
Health Hazard Evaluation Report No. 97–0153–2694 Page 13

11. NIOSH [1986]. Occupational respiratory

diseases. Cincinnati, OH: U.S. Department of

Health and Human Services, Public Health

Service, Centers for Disease Control, National

Institute for Occupational Safety and Health,

DHHS (NIOSH) Publication No. 86–102.

12. NIOSH [1994]. Pocket Guide to Chemical

Hazards. Cincinnati, Ohio: U.S. Department of

Health and Human Services, Public Health

Service, Centers for Disease Control and

Prevention, National Institute for Occupational

Safety and Health, DHHS (NIOSH) Publication

No. 94–116.

13. ASHRAE [1989]. Ventilation for acceptable

indoor air quality. Atlanta, Georgia: American

Society of Heating, Refrigerating, and Air

conditioning Engineers. ANSI/ASHRAE

Standard 62–1989.

14. 59 Federal Register 15969 [1994].

Occupational Safety and Health Administration:

indoor air quality; proposed rule. To be codified

at 29 Code of Federal Regulations, Parts 1910,

1915, 1926, and 1928. Washington, D.C.: U.S.

Government Printing Office.

15. NIOSH [1986]. Criteria for a recommended

standard: occupational exposure to hot

environments, revised criteria. Cincinnati, OH:

U.S. Department of Health and Human Services,

Public Health Service, Centers for Disease

Control, National Institute for Occupational

Safety and Health, DHHS (NIOSH) Publication

No. 86–13.

16. ASHRAE [1992]. Thermal environmental

conditions for human occupancy. American

National Standards Institute/ASHRAE standard

55–1992. Atlanta, GA: American Society for

Heating, Refrigerating, and Air–Conditioning

Engineers, Inc.

17. Center for Chemical Hazard Assessment,

Syracuse Research Corporation [1980].

Information profiles on potential occupational

hazards. Volume III. Industrial processes

(hairdressing and barbering). Prepared for the

National Institute for Occupational Safety and

Health (NIOSH) under Contract No.

210–78–0019.

18. Heacock HJ, Rivers JK [1986]. Occupational

diseases of hairdressers. Canadian Journal of

Public Health 77:109–113.

19. Blainey AD, Oliver S, Cundell D, Smith RE,

Davies RJ [1986]. Occupational asthma in a

hairdressing salon. Thorax 41:42–50.

20. Pepys J, Hutchcroft BJ, Breslin AB [1976].

Asthma due to chemical agents: pursulphate salts

and henna in hairdressers. Clinical Allergy

6:399–404.

21. Stovall GK, Levin L, Oler J [1983].

Occupational dermatitis among hairdressers.

JOM 25(12):871–878.

22. Nethercott JR, MacPherson M, Choi BCK,

Nixon P [1986]. Contact dermatitis in

hairdressers. Contact Dermatitis 14:73–79.

23. Newman–Taylor AJ [1980]. Occupational

asthma. Thorax 35:241–245

24. Blanc P. [1987]. Occupational asthma in a

national disability survey. Chest. 92(4):613–7.

25. Palmer A, Renzetti AD, Gillam D [1979].

Respiratory disease prevalence in cosmetologists

and its relationship to aerosol sprays. Env Res

19:136–153.

26. Schwartz HJ, Arnold JL, Strohl KP [1990].

Occupational allergic rhinitis in the hair care

industry: reactions to permanent wave solutions.

JOM 32(5):473–475.

27. NIOSH [1976]. Health hazard determination

report: Radiant Lady Beauty Salon, Inc., Denver,

CO. Cincinnati, OH: U.S. Department of Health,

Education, and Welfare, Public Health Service,
Page 14 Health Hazard Evaluation Report No. 97–0153–2694

National Institute for Occupational Safety and

Health, NIOSH Report No. 75–128–262.

28. Last JM [1995]. A Dictionary of

Epidemiology. Oxford: Oxford University Press,

pp. 145.

29. GreenA, Willett WC, Colditz, et al. [1987].

Use of permanent hair dyes and risk of breast

cancer, J Natl Cancer Inst, 79(2):253–257.

30. Nasca PC, Baptiste MS, Field NA, et al.

[1992]. An epidemiologic case–control study of

breast cancer and exposure to hair dyes, Annals of

Epidemiology 2(5):577–586..

31. Cantor KP, BlairA, Everett G [1988]. Hair

dye use and the risk of leukemia and lymphoma.

Amer J Public Health 78(5):570–1.

32. Zahm SH, Weisen urger DD, Babbitt PA,et

al. [1992]. Hair coloring products and the risk of

lymphoma, myultiple myeloma, and chronic

lymphocytic leukemia. Amer J Public Health

82(7):990–997.

33. Thun MJ, Altekruse SF, Namboodiri MM

[1994]. Hair dye use and risk of fatal cancers in

U.S.women. J Natl Cancer Inst 86(3):210–215.

34. Grodstein F, Hennekens CH, Colditz GA

[1994]. A prospective study of permanent hair

dye use and hematopoietic cancer. J Natl Cancer

Inst 86(19): 1466–1470.

35. Herrinton LJ, Weiss NS, Koepsell TD, et al.

[1994]. Exposure to hair–coloring products and

the risk of multiple myeloma. Amer Jrnl Pub Hlth

84(7):1142–4.

36. Skov T, Andersen A, Malker H, et al.

[1990]. Risk for cancer of the urinary bladder

among hairdressers in the Nordic countries. Am

J Ind Med, 17:217–223.

37. Gruberran E, Raymond L, Sweetnam P

[1985]. Increased risk for male bladder cancer

among a cohort of male and female hairdressers

from Geneva. Intl J of Epidemiology 14

(4):549–554.

38. Hartge P, Hoover R, Altman R. et al. [1992].

Use of hair dyes and risk of bladder cancer.

Cancer Research, 42(11):4784–4787.

39. Nomura A, Kolonel LN, Yoshizawa CN

[1989]. Smoking, alcohol, occupation, and hair

dye use in cancer of the lower urinary tract. Am

J of Epidemiology 130(6):1159–1163.

40. American Lung Association [1997].

Residential Air Cleaning Devices: Types,

Effectiveness, and Health Impact. American Lung

Association, 1726M Street, NW, Washington,

D.C.

41. Esswein EJ, Boeniger MF [1994]. Effect of

an Ozone–Generating Air–Purifying Device on

Reducing Concentrations of Formaldehyde in Air.

Appl. Occup. Environ. Hyg. 9(2), February 1994.

42. Boeniger MF [1995]. Use of Ozone

Generating Devices to Improve Indoor Air

Quality. Am. Ind. Hyg. Assoc, J. 56:590–598,

June 1995.

43. U.S. DHHS [1986]. The health consequences

of involuntary smoking. A report of the surgeon

general. U.S. Department of Health and Human

Services, Public Health Service, Office of the

Assistant Secretary of Health, Office of Smoking

and Health. DHHS Publication No.

(PHS)87–8398.

44. DHEW [1979]. Smoking and health: a report

of the Surgeon General. Office on Smoking and

Health. Washington, D.C.: U.S. Department of

Health, Education and Welfare, U.S. Government

Printing Office.

45. DHHS [1982]. The health consequence of

smoking––cancer: a report of the Surgeon

General. Office on Smoking and Health.

Washington, D.C.: U.S. Department of Health and

Human Services, U.S. Government Printing

Office.
Health Hazard Evaluation Report No. 97–0153–2694 Page 15

46. DHHS [1983]. The health consequences of

smoking––cardiovascular disease: a report of the

Surgeon General. Office on Smoking and Health.

Washington, D.C.:U.S. Department of Health and

Human Services, U.S. Government Printing

Office.

47. DHHS [1984]. The health consequences of

smoking––chronic obstructive lung disease: a

report of the Surgeon General. Office on

Smoking and Health. Washington D.C.: U.S.

Department of Health and Human Services, U.S.

Government Printing Office.

48. NRC [1987]. National Research Council

Committee on Indoor Air Quality. Policies and

procedures for control of indoor air quality.

National Academy Press, Washington, D.C.

49. NIOSH [1991]. Current Intelligence Bulletin

54: Environmental tobacco smoke in the

workplace: lung cancer and other health effects.

Cincinnati, OH: U.S. Department of Health and

Human Services, Public Health Service, Centers

for Disease Control, National Institute for

Occupational Safety and Health, DHHS (NIOSH)

Publication No. 91–108.

50. Klein, M. [1991]. Personal communications

of June 13, 1991. Cincinnati, OH: National

Institute for Occupational Safety and Health

(NIOSH), Hazard Evaluations and Technical

Assistance Branch.

51. Lstiburek J, Carmody J. [1994]. Moisture

Control Handbook: Principles and practices for

residential and small commercial buildings. New

York, NY: Van Nostrand Reinhold.
Page 16 Health Hazard Evaluation Report No. 97–0153–2694

The Grand Experience Beauty Salon

Chicago, Illinois

HETA 97–0153

Thursday

June 12, 1997

Time/Location Carbon Dioxide

(ppm)

Temperature (°F) Relative Humidity

Morning (9:08 a.m. to 9:44 a.m.)

 front (reception, waiting, nails) 650–750 75–76 55–57

 middle (first floor hair styling/shampoo areas) 650–675 76–78 53–55

 dispensary 825 79 52

 second floor (hairstyling, message, facial) 725–800 75–79 51–52

 outdoors 450 74 57

Midday (1:32 p.m. to 2:04 p.m.)

 front 1500–1525 72–77 55–58

 middle 1600–1675 79–82 52–54

 dispensary 1850 83 51

 second floor 1425–1550 78–82 50–51

 outdoors 425 71 57

Early evening (6:29 p.m. to 7:20 p.m.)

 front 1550–1575 73–74 54–57

 middle 1625–1750 76–78 52–53

 dispensary 1725 80 52

 second floor 1200–1500 74–80 49–51

 outdoors 400 73 56

NIOSH Guidelines

ASHRAE Recommendation

< 800

< 1000 73 –79 (summer) 30–60