Blainey A D, Ollier S, Cundell D, Smith R E, Davies R J
Thorax. 1986 Jan;41(1):42-50. doi: 10.1136/thx.41.1.42.
Occupational asthma among hairdressers has been recognised for some years and cases of work related asthma due to hair bleaches containing persulphates and hair dyes have been reported. The extent of the disease among hairdressers remains unknown. An investigation was carried out on an entire hairdressing salon, which specialised in hair bleaching and colouring and which employed 23 staff. On the basis of history and specific and non-specific bronchial provocation testing, four out of 23 staff were found to have occupational asthma due to the persulphate salts contained in hair bleaches. Only one of these had a positive skinprick test response to persulphate salts. Tests for non-specific bronchial reactivity to histamine in this work force were more sensitive for the diagnosis of asthma than simple lung function tests or recordings of peak flow rates performed four times daily for three weeks. The response to these agents was studied in greater detail by specific bronchial provocation tests in 14 members of the salon as well as one hairdresser from elsewhere with occupational asthma, three individuals with non-occupational asthma, and four normal subjects. Only those with a history of work related asthma and bronchial hyperreactivity responded positively, confirming that the response to bleach powders was specific. Studies of pulmonary mechanics after challenge showed that the response arose from changes in airway calibre not lung volumes. Measurement of neutrophil chemotactic activity after challenge showed significant rises in those affected, suggesting that mast cells may play a part in the pathogenesis of occupational asthma due to persulphates.
美发师职业性哮喘已被认识多年，且已有因含过硫酸盐的头发漂白剂和染发剂导致的与工作相关哮喘病例的报告。美发师中该疾病的发病程度仍不清楚。对一家专门从事头发漂白和染色且雇佣了23名员工的美发沙龙进行了一项调查。根据病史以及特异性和非特异性支气管激发试验，23名员工中有4人被发现因头发漂白剂中所含的过硫酸盐而患有职业性哮喘。其中只有一人对过硫酸盐的皮肤点刺试验呈阳性反应。在该员工群体中，组胺非特异性支气管反应性测试对哮喘诊断比简单的肺功能测试或连续三周每天进行四次的峰值流速记录更敏感。通过特异性支气管激发试验，对该沙龙的14名成员以及一名来自其他地方的患有职业性哮喘的美发师、三名患有非职业性哮喘的个体和四名正常受试者，对这些物质的反应进行了更详细的研究。只有那些有与工作相关哮喘病史和支气管高反应性的人呈阳性反应，证实了对漂白粉的反应是特异性的。激发试验后肺力学研究表明，反应源于气道口径的变化而非肺容积的变化。激发试验后中性粒细胞趋化活性的测量显示，受影响者有显著升高，这表明肥大细胞可能在过硫酸盐所致职业性哮喘的发病机制中起作用。
