Abstract A077: Chemical hair relaxer use and chemicals of concern in select hair relaxer products in two counties in Kenya: An analysis of inequities in environmental exposures from personal care products
Authors: Jenkins Nia C. , Rockson Amber , Schaefer Alexis , Dunkin Dustin T. , Teteh-Brooks Dede K. , Terry Mary Beth , McDonald Jasmine A. , Irungu Beatrice , Matu Esther , Kimani Cecilia , Olisa Teresa , Ashrafi Adiba , Llanos Adana A.M. 
Published: September 2024

Abstract
Despite the widespread use of hair products, including chemical relaxers, little is known about the prevalence and patterns of use in populations outside the United States. Furthermore, there is emerging interest in the investigation of these products as key sources of exposure to chemicals of concern (CoCs), some of which may be associated with breast cancer. This study aimed to examine the prevalence and patterns of use of chemical relaxers among women in Embu and Nakuru Counties in Kenya, along with addressing key knowledge gaps about hair product use, practices, and perceptions of use. Additionally, we aimed to assess the presence of CoCs by examining product labels of selected relaxers widely used by women in these counties, where breast cancer incidence rates are increasing and concern about exposure to toxic chemicals in hair products is high. A total of 746 women aged 15-50 years enrolled in a questionnaire-based study, which ascertained sociodemographics, ever and current use of chemical relaxers, and perceptions of harm around hair product use. Multivariable-adjusted regression models were used to evaluate associations between participants’ sociodemographic characteristics and perceptions of hair product use in relation to the use of relaxers. Based on respondents’ responses, we purchased 22 commonly used hair relaxers in the target counties and recorded label information (including the ingredient lists). To identify CoCs, we cross-checked the lists of ingredients against the Campaign for Safe Cosmetics (CSC) Red List and European Union (EU) Prohibited/Restricted Substances Annex II and III, Regulation 1223/2009. Nearly 60% of participants reported ever use of chemical relaxers, with a little over one-third (35.7%) reporting current use of these products. On average, participants reported moderate-to-high levels of concern about exposures and general health effects from using hair products, and relatively high levels of perceived risk of breast cancer related to product use. We found that all 22 relaxers evaluated listed ≥1 CoCs in the products’ ingredients list. We documented 27 CoCs in total: 6 (23.08%) are categorized as Tier 1 (do not use CoCs for everyone) per the CSC Red List and 4 (14.81%) are prohibited substances per the EU Annex II of Regulation. This study contributes to a growing body of literature documenting CoCs listed on cosmetics labels, particularly products that are disproportionately used among Black and African ancestry populations globally. Further, this study justifies the need for increased public awareness of potentially harmful chemicals in hair products marketed and sold in Kenya. Improving the understanding of patterns of use of specific products and their chemical ingredients – which may be hormone disruptors and/or carcinogens – and exploring the role of environmental health literacy on product use is critical for developing interventions to reduce potentially harmful exposures found in these products.
Citation Format: Nia C. Jenkins, Amber Rockson, Alexis Schaefer, Dustin T. Dunkin, Dede K. Teteh-Brooks, Mary Beth Terry, Jasmine A. McDonald, Beatrice Irungu, Esther Matu, Cecilia Kimani, Teresa Olisa, Adiba Ashrafi, Adana A.M. Llanos. Chemical hair relaxer use and chemicals of concern in select hair relaxer products in two counties in Kenya: An analysis of inequities in environmental exposures from personal care products [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A077.