70 LETTERE IN REDAZIONE Asbestos exposure among hairdressers The Lombardy Mesothelioma Registry (Registro ers can determine asbestos fibres emissions in the environ- Mesoteliomi Lombardia, in Italian: RML) includes Malig- ment; as a consequence, the exposure of their users can be nant Mesothelioma (MM) cases whose exposure to as- considered moderate but most likely sufficient to determine bestos remains uncertain and therefore classifies them as a risk for the onset of mesothelioma. Fixing and mainte- having an “unknown exposure” (7). However the RML nance operations undoubtedly increase the level of expo- staff observed that some of these cases did the same job sure, even if such operations are not essential to classify a (hairdressers) and therefore tried to figure out whether subject as exposed; in fact, using the hairdryers can be con- there were possible exposure sources in this specific occu- sidered a source of risk by itself. pation. Following such considerations, the RML staff reevaluat- The last report by the National Mesothelioma Registry ed the criteria used to classify asbestos exposure in hair- (Registro Nazionale dei Mesoteliomi, in Italian: ReNaM) dressers and defined: (6) had already indicated asbestos as a potential component - occupational exposure as certain if the MM cases re- of some everyday household appliances: for instance, both ported that their personal hairdryers contained as- hand-held and hood-type hairdryers may have contained bestos; asbestos as insulation for the overheating of the electrical - occupational exposure as possible if the MM cases re- resistance. ported the use of hairdryers without giving informa- During the period 1979-1981 both the scientific com- tion about their characteristics, for at least one year be- munity and the US Governmental Agencies investigated as- fore asbestos was banned; bestos exposure – and its potential effects on human health - exposure as unknown if the MM cases reported that – in workers using hand-held and hood-type hairdryers. In they worked exclusively as “head-washer” and for a particular, in 1979 the Consumer Product Safety Commis- brief time-window (e.g. less than 1 year). sion (CPSC) – a US Governmental Agency in charge of Out of a total of 2,989 incident MM cases in Lombardy protecting the public from unreasonable risks of injury or (time-window: 2000-2009), RML selected 18 (0.6%) hair- death from consumer products – accepted a corrective ac- dressers with unknown exposure, and reclassified them as tion proposed by the major hairdryer manufacturers, provid- having certain (4 cases) or possible (13 cases) occupational ing for either repair, replacement or refund for hand-held exposure; only one case who had worked exclusively as a hairdryers containing asbestos (90% of all domestic hairdry- “head-washer” for a few months remained with unknown er sales annually) (1). In the same year the National Insti- exposure (7). RML excluded from the present reclassifica- tute for Occupational Safety and Health (NIOSH) con- tion the case of one hairdresser – previously reported on ducted an investigation on 30 asbestos-containing hairdry- this Journal (8) – who had been considered as occupation- ers, and observed airborne asbestos concentrations generat- ally exposed because his usual customers worked in an as- ed by these dryers ranging from 0 to 0.11 structures/cm3 (a bestos cement factory. unit of measurement accounting both for fibre count and We found 12 more MM cases who worked as hair- for sample volume), corresponding to a mass concentration dressers but had already reported other asbestos exposure of 7652 ng/m3 (3). Some epidemiological studies, after ex- sources: 9 occupational, two environmental, and one during trapolating low exposure levels of asbestos from studies on leisure time. According to the new criteria, all these cases subjects with high occupational exposure, obtained mortali- were reclassified as having a possible occupational exposure ty estimates (for lung or respiratory cancers) that were not to asbestos as hairdressers. consistent (2, 4). More recently (2006) the Health Safety Reconsidering the questionnaires allowed us to high- Laboratory (HSL) – a UK healthcare regulatory agency – light information that had been previously underestimated, conducted an investigation on two asbestos-containing such as the presence of usually more than one hairdryer in hood-type hairdryers, and observed airborne asbestos con- the workplace, operating nearly continuously for the entire centrations lower than the declared detection limit of 0.01 working day. Subjects who performed maintenance of the fibres/ml (5). The list of the major US and European manu- hairdryers declared they manually removed the old and facturers of asbestos-containing hairdryers can be found in crumbly asbestos protections. the CPSC and HSL documents, respectively. Four cases only were aware their hairdryers contained The RML staff could therefore affirm with reasonable asbestos; most of the subjects did not know or had not de- certainty that using either hand-held or hood-type hairdry- clared it when interviewed. This suggests it is important LETTERE IN REDAZIONE 71 and valuable to extend and detail the information that can http://www.cpsc.gov/cpscpub/prerel/prhtml79/79022. be obtained with the questionnaire. html In conclusion, RML identified a total of 30 hairdressers 2. ENTERLINE PE: Extrapolation from occupational stud- (14 males and 16 females); the availability of a wide MM ies: a substitute for environmental epidemiology. Environ case record, together with detailed information about occu- Health Perspect 1981; 42: 39-44 pational activities and lifestyle, allowed the RML staff to 3. GERACI CL, BARON PA, CARTER JW, SMITH DL: Test- hypothesize and then to confirm the existence of an occu- ing of Hair Dryers for Asbestos Emissions: Division of pational asbestos exposure risk, at least in the past. Such Physical Sciences and Engineering, NIOSH, U.S. De- exposures, though likely to be absent nowadays in the Ital- partment of Health, Education, and Welfare, Cincinnati, ian occupational context, can still represent a real public Ohio; 1979. Report No.: PB89165237 health problem, both due to the potential household use of 4. HALLENBECK WH: Consumer product safety: Risk as- old hairdryers, and to the importing of household appli- sessment of exposure to asbestos emissions from hand- ances from countries where asbestos is still normally used. held hair dryers. Environmental Management 1981; 5: 23-32 M. Carugno 5. LOMAS-FLETCHER D: Asbestos Emission Tests in Salon Post-Graduate School of Occupational Medicine, Hood-Style Hairdryers: Health & Safety Laboratory; Department of Occupational and Environmental Health, 2006. Report No.: HSL/2006/114. http://www.hse. Università degli Studi di Milano, Milan, Italy gov.uk/research/hsl_pdf/2006/hsl06114.pdf E-mail: firstname.lastname@example.org 6. MARINACCIO A, BINAZZI A, DI MARZIO D, et al: Il Registro Nazionale dei Mesoteliomi. Terzo Rapporto. Ro- Carolina Mensi, Claudia Sieno, ma: ISPESL, 2010 D. Consonni, L. Riboldi 7. NESTI M, ADAMOLI S, AMMIRABILE F, et al. Linee guida Department of Preventive Medicine, Fondazione per la rilevazione e la definizione dei casi di mesotelioma IRCCS Ca’ Granda - Ospedale Maggiore Policlinico, maligno e la trasmissione delle informazioni all’ISPESL da Milan, Italy parte dei centri operativi regionali. Roma: ISPESL; 2003. http://www.ispesl.it/dml/leo/download/RenamLinee Guida.pdf REFERENCES 8. RIBOLDI L, MENSI C, CANTI Z, et al: Mesotelioma ma- ligno della pleura in barbiere: caso di esposizione profes- 1. CPSC: CPSC Accepts Corrective Actions From Major sionale atipica ed indiretta ad amianto. Med Lav 2005; Hair Dryer Companies: U.S. Consumer Product Safety 96: 177-178 Commission; 1979. Report No.: Release # 79-022.
Pages to are hidden for
"Pagina tuttostoria - Ospedale Maggiore Policlinico"Please download to view full document