Hearing loss among hair stylists: A review of risk assessment

Globalization in the modern world is the key contributor to a shift in the beauty or cosmetic industry. Although the beauty industry is booming in the modern world, it accompanies with it several associated occupational health hazards. Among them, the most frequent health hazards comprise exposure to harmful chemicals (carcinogens and
toxic chemicals), musculoskeletal symptoms, allergy complaints and hearing loss. Hearing loss, deafness or hearing impairment are some of the common terms generally referred for a partial or total inability to hear things,
and caused by different factors including age, genetic, physical trauma, and auditory nerve infection and most frequently through chemicals and noise. Permanent hearing loss occurs due to the destruction of microscopic hair
cells present in the cochlea (part of inner ear). These cells move in response to mechanical sound vibrations and cannot be replaced or repaired by any presently known medical treatments or technology. Sound is the most
common and universal cause of hearing loss. It has been observed that continuous exposure to harmful sound (noise) over a period of time or a sudden pithy but loud noise can affect the functioning of the inner ear and cause
hearing loss also known as “Sensorineural hearing loss”. It is mainly due to the damage of the hair cells that receive the signals and accounts for 90% of permanent hearing losses. The exposure can take place at home in the
form of loud music or conditions at the workplace. The resulting loss may be of temporary or permanent nature affecting all age groups.
Hairdressing has long been internationally renowned as one of the most popular career choices among the individuals. It can be easily estimated from the statistics that on the whole, employment of cosmetologists, barbers,
and hairdressers is likely to grow 14 % on an average from 2010 to 2020, as fast as the average for all occupations. The world of beauty is getting louder and no wonder that hearing loss is at its peak here. The recurrent exposure of noise in salons due to equipment used poses a threat of noise induced hearing loss in the hair dressers and professionals. According to one of the survey reports, 1 in 10 Americans gets affected for his or her ability to understand normal speech and most of them are either exposed to hazardous noise (~22 million) or exposed to solvents and metals (Ototoxic chemicals, ~9 million) that put them at risk for hearing loss. The National Institute of Health (NIH) and Hearing Loss Association of America (HLAA), have ranked hearing loss as the third most common physical condition in America, which affects ~48 million of people. This statics of hearing loss continuously rise from 7% of the people to 10% and then soar to 17 % and finally stabilized at the record breaking level of 20% of American population. Because of the occupational risk of hearing loss, the National Institute for Occupational Safety and Health (NIOSH) has made standards and policies to regulate allowable noise exposure on work place. According to government standards, the recommended limit for occupational noise exposure encompasses, 85 decibels (the unit for measuring sound pressure is decibels), as an 8-hr time-weighted average (85 dBA as an 8-hr TWA). Exposures at and above this level are considered dangerous. The 85 dB or stronger sound level is responsible for causing permanent harm to hearing. Most of the equipment used in hairdressing and cosmetics industry are typically generating noise levels above the allowable limit (85 decibels) at workplace. Major sources of noise exposure in the surrounding magnificence beauty or cosmetic industry, comprises the use of hair dryers or hand held hair dryers; electric massagers, electric shavers, hair clippers, blow dryers, cosmetics and tattoo equipment, body massagers, electric nail flies and drills. Since, the noise arising due to the use of this equipment (especially hair dryers, blowers and drillers) generally falls around 90-95 decibels, therefore, professionals are at greater risk and need to follow precautionary measures to minimize the exposure to the damaging noises. Under the Noise at Work Regulations 2005, employers have a responsibility to ensure that workers’ hearing is not damaged by a noisy workplace. The effects of such a noisy environment become visible within a period of 5-10 years, a common observation reported among hair stylists, in the typically noisy beauty salons. Several case studies have documented the presence of partial impairment or complete hearing loss among hair stylists and hairdressers. Clinical studies suggest that loss of hearing not only affects the ability to communicate, but also has a profound effect on mental status, social behavior and people’s lives. Such loss not only impacts on personal but also professional as well as career advancement.
Apart from sound induced hearing loss, ototoxicity also plays an important role in bringing about hearing loss among hairstylists. Ototoxicity is generally referred to internal damage to the ear, particularly the cochlea or
auditory nerve by certain chemicals such as the antibiotics, aminoglycoside and potassium or sodium bromate. For decades, potassium or sodium bromate (2-10%) and thioglycolates were routinely used as perm lotion and hair neutralizer. Principally, curly hair is chemically softened using an ammonium thioglycolate hair wave lotion or cream to change or reduce the disulfide (S-S) bonds of hair keratins to S-H bonds and thus reduce the natural curl and makes hair flexible. Secondly, 2-10% of potassium bromide solution KBrO3 oxidizes the S-H bonds and regains the original S-S bonds to the hair and thereby stabilizes the curling of the hair. The reported toxic effects of potassium bromate and sodium bromate include diarrhea, hearing loss, peripheral neuropathy, hemolytic anaemia, vomiting, and acute renal failure. The most common symptom of bromated intoxication is deafness, which seems to be almost permanent. Studies have shown that cochlea appears to be the primary site of injury for bromate-induced ototoxicity. However, other possible targets include nerve and central auditory system. Research studies performed using animal models suggest that bromate damages the claudius and inner sulcus cells, stria vascularis, reissner’s membrane, inner and outer hair cells in the cochlea. At physiological level, these chemicals lower the cochlear microphonics, endocochlear potential, and electrophysiologic auditory thresholds. Several clinical investigations and case studies report complains of dizziness, vertigo, and hearing loss among hairstylists and hairdressers. It has been observed that in most of the cases, the professionals are continuously exposed (for more than 10 years) to the permanent hair styling solutions or neutralizers containing thioglycolate and potassium or sodium bromate. Besides this, infrequent reports of high-dose ingestion are also detected in many clinical populations, where symptoms onset is generally seen very rapidly that occur within 4–16 hrs.
Suggested Literature
•Occupational hearing loss.
•Noise and hearing loss prevention.
National goals, policies, and standards.
•Noise at work regulation 2005.
•Hairdresser spot hearing loss. Article
•Hair dressers suffering hearing loss.
•My Hearing Loss Experience.
•A Hard of Hearing Hairstylist.
•Bromate-induced ototoxicity.
•Toxic Effects of Potassium Bromate and Thioglycolate.
•Acute renal failure and hearing loss due to sodium bromate poisoning: a case report and
review of the literature. Article
•Bromate intoxication: hairdressers’ anuria.
•Hearing loss following potassium bromate: two case reports.

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