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Hair product use and breast cancer risk among African American and White women
Abstract
Exposures to carcinogens in hair products have been explored as breast cancer risk factors, yielding equivocal findings. We examined hair product use (hair dyes, chemical relaxers and cholesterol or placenta-containing conditioners) among African American (AA) and White women, and explored associations with breast cancer. Multivariable-adjusted models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) to describe the associations of interest among 2,280 cases (1,508 AA and 772 White) and 2,005 controls (1,290 AA and 715 White). Among controls, hair dye use was more common among Whites than AAs (58% vs. 30%), while relaxer (88% vs. 5%) and deep conditioner use (59% vs. 6%) was more common among AAs. Among AAs, use of dark hair dye shades was associated with increased breast cancer risk (OR=1.51, 95% CI: 1.20-1.90) and use of dark shades (OR=1.72, 95% CI: 1.30-2.26) and higher frequency of use (OR=1.36, 95% CI: 1.01-1.84) were associated with ER+ disease. Among Whites, relaxer use (OR=1.74, 95% CI: 1.11- 2.74) and dual use of relaxers and hair dyes (OR=2.40, 95% CI: 1.35-4.27) was associated with breast cancer; use of dark hair dyes was associated with increased ER+ disease (OR=1.54, 95% CI: 1.01-2.33), and relaxer use was associated with increased ER- disease (OR=2.56, 95% CI: 1.06-6.16). These novel findings provide support a relationship between the use of some hair products and breast cancer. Further examinations of hair products as important exposures contributing to breast cancer carcinogenesis are necessary.
... Due to widespread use of hair products, even if they only slightly increase breast cancer risk, they pose tremendous negative consequences for public health. However, previous studies have reached discordant conclusions regarding the impact of personal use of hair chemicals on breast cancer risk by virtue of differences in study design, characteristics of the study population and changes in the chemical formulations of hair products [4,[17][18][19][20][21][22][23][24]; the results of three relevant meta-analyses reinforced this contradiction due to differences in included trials and methodology [8,25,26]. To provide instructional evidence-based medical data to inform public health, we undertook a meta-analysis to summarize all the scientific data on the association between hair chemicals and new-onset breast cancer. ...
... Therefore, 34 studies were left for full-text scrutiny, and 20 of them were deleted because they lacked useful data (n = 10), were reviews (n = 6) or were letters (n = 4)). Ultimately, 14 eligible publications [4,15,[18][19][20][21][22][23][24][30][31][32][33][34] with 210319 unique subjects met the inclusion criteria. The PRISMA flow diagram of the inclusion process is shown in Fig 1. ...
... The most common interview method was a questionnaire survey alone (35.7%) ( Table 1). As outlined in Table 2, seven studies [4,15,18,19,23,31,33] examined semipermanent or permanent hair dyes and rinses, and two [15,24] examined straighteners, while the Green et al. article [20] only examined permanent hair coloring. Several studies specifically considered the impact of race (n = 5), hair dye color (n = 4) and usage duration (n = 8) on the association between hair products and breast cancer risk. ...
Background
The association between personal hair dye use and breast cancer risk is currently debated. The aim of this work is to investigate the association between the use of hair care products and breast cancer risk in women.
Methods
Based on the PRISMA-IPD statement, the PubMed, Embase, Cochrane Library, Web of Science, OVID and Scopus databases were used to identify eligible studies published from inception to 22 April 2020. A pooled odds ratio (OR) with a 95% confidential interval (CI) was calculated to assess this correlation via fixed- or random-effect Mantel-Haenszel models using a heterogeneity Chi ² test with a significance level of p<0.1. All statistical tests were performed using StataSE software (version 12.0).
Results
The analyzed data comprised 14 eligible studies with 210319 unique subjects. The pooled results suggested that there was a significant association between the use of hair dyes and breast cancer occurrence (pooled OR = 1.07; 95% CI, 1.01–1.13). Regarding the individual analysis regarding the different types of hair chemicals, permanent hair dye users (pooled OR = 1.08; 95% CI, 1.03–1.14) and rinse users (pooled OR = 1.17; 95% CI, 1.02–1.35) were both found to have a significantly elevated breast cancer risk compared to natural hair subjects, whereas there was an insignificant relationship between the use of semipermanent hair dyes (pooled OR = 1.09; 95% CI, 0.92–1.28) and straighteners (pooled OR = 1.04; 95% CI, 0.96–1.14) and breast cancer risk. No impact on the overall correlation between hair dyes and breast cancer risk due to race (White vs non-White) (pooled OR = 1.05; 95% CI, 0.86–1.29), timing of use (<10 years vs ≥10 years) (pooled OR = 0.96; 95% CI, 0.85–1.08) or dye color (Darker than natural hair vs Lighter than natural hair) (pooled OR = 0.91; 95% CI, 0.62–1.32) was found.
Conclusions
Chemicals in hair dyes may play a role in breast carcinogenesis and increase breast cancer risk.
... The Black Women's Health Study surveyed African American women and found that 94% under age 45 and 89% over age 45 use perms or relaxers [17]. The Women's Circle of Health Study corroborates findings, reporting 87% of African American women, but 6% of European American women have a history of regularly using chemical relaxers [18]. Moreover, in the Greater New York Hair Products Study, of 16 specific brands of hair products that were identified as commonly used among the participants, 69% of the products contained parabens [15]. ...
... Specifically, two studies recently found an increase in the odds of breast cancer risk associated with hair dye use in adulthood. One recent study found a 23% increase in the odds of breast cancer risk associated with hair dye use in Finnish women (OR 1.2, 95% CI 1.1, 1.4) [30] and another study using the Women's Circle of Health found that among black women, the use of dark hair dye shades was associated with a 50% increased odds of breast cancer (OR 1.5, 95% CI 1.2, 1.9) [18]. In contrast, a meta-analysis of 14 breast cancer studies, that included cohort and casecontrol studies, reported a null association between hair dye use and breast cancer (RR 1.06, 95% CI 0.95, 1.18) [29]. ...
... However, within the Women's Circle of Health Study, findings suggest that adult use of relaxers was associated with breast cancer in white women, but not black women. In white women, the regular use of relaxers in adulthood was associated with a 1.6-fold increased odds of breast cancer compared to those who were non-regular users of relaxers in adulthood [18]. Rosenberg and colleagues found among over 48,000 black women with approximately 266,000 person-years of follow-up and 574 incident cases, that there was no increased risk of breast cancer associated with perm/relaxer use [17]. ...
Background:
Select hair products contain endocrine disrupting chemicals (EDCs) that may affect breast cancer risk. We hypothesize that, if EDCs are related to breast cancer risk, then they may also affect two important breast cancer risk factors: age at menarche and mammographic breast density.
Methods:
In two urban female cohorts (N = 248): 1) the New York site of the National Collaborative Perinatal Project and 2) the New York City Multiethnic Breast Cancer Project, we measured childhood and adult use of hair oils, lotions, leave-in conditioners, root stimulators, perms/relaxers, and hair dyes using the same validated questionnaire. We used multivariable relative risk regression models to examine the association between childhood hair product use and early age at menarche (defined as <11 years of age) and multivariable linear regression models to examine the association between childhood and adult hair product use and adult mammographic breast density.
Results:
Early menarche was associated with ever use of childhood hair products (RR 2.3, 95% CI 1.1, 4.8) and hair oil use (RR 2.5, 95% CI 1.2, 5.2); however, additional adjustment for race/ethnicity, attenuated associations (hair products RR 1.8, 95% CI 0.8, 4.1; hair oil use RR 2.3, 95% CI 1.0, 5.5). Breast density was not associated with adult or childhood hair product or hair oil use.
Conclusions:
If confirmed in larger prospective studies, these data suggest that exposure to EDCs through hair products in early life may affect breast cancer risk by altering timing of menarche, and may operate through a mechanism distinct from breast density.
... Previous epidemiologic research on hair products has largely been inconclusive, focusing primarily on the relationship between adult use of hair dye use and breast cancer risk, largely in populations that were not racially/ethnically diverse. [21][22][23][24][25][26] In the Sister Study, we previously reported positive associations of permanent hair dye and straighteners with overall breast cancer risk focusing on use in the year prior to enrollment; associations for permanent dye were notably stronger in black women. 27 In this study, we have expanded on our previous study focused on adult hair product use by investigating the association between adolescent use of various types of hair products and incident breast cancer risk in a large, prospective cohort of women. ...
... 27 Other studies considering the risk associated with hair straighteners have been able to evaluate the risk associated with exposure during childhood or adolescence in addition to adult use. In the Women's Circle of Health Study (WCHS), a case-control study of women in New York, use of relaxers before age 12 and between the ages of 13-19 years was positively, but imprecisely, associated with ER− breast cancer among African-American women 24 ; which is consistent with our finding of a suggestive higher risk for ER− tumors. In the Ghana Breast Health study, use of relaxers was associated with a higher risk overall and risk was elevated regardless of age of first use, including in the youngest age category (<21 years). ...
... The null association for adolescent hair dye use is largely consistent with previous studies of adult hair dye which have suggested that any hair dye-associated risks with overall breast cancer may be small. [21][22][23][24][25][26][27]42 However, most, but not all, of these studies have been conducted in predominately white study populations; therefore, these findings may not be applicable to black women. ...
Hair products can contain hormonally active and carcinogenic compounds. Adolescence may be a period of enhanced susceptibility of the breast tissue to exposure to chemicals. We therefore evaluated associations between adolescent hair product use and breast cancer risk. Sister Study participants (ages 35‐74 years) who had completed enrollment questionnaires (2003‐2009) on use of hair dyes, straighteners/relaxers, and perms at ages 10‐13 years (N = 47 522) were included. Cox proportional hazards regression was used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for associations between hair products and incident breast cancer (invasive cancer or ductal carcinoma in situ), with consideration of heterogeneity by menopausal status and race/ethnicity. Over an average of 10 years of follow‐up, 3380 cases were diagnosed. Frequent use of straighteners and perms was associated with a higher risk of premenopausal (HR = 2.11, 95% CI 1.26‐3.55 and HR = 1.55, 95%CI: 0.96‐2.53, respectively) but not postmenopausal breast cancer (HR = 0.99, 95% CI: 0.76‐1.30 and HR = 1.09, 95% CI: 0.89‐1.35, respectively). Permanent hair dye use during adolescence was uncommon (<3%) and not associated with breast cancer overall (HR = 0.97, 95% CI: 0.78‐1.20), though any permanent dye use was associated with a higher risk among Black women (HR = 1.77, 95% CI: 1.01‐3.11). Although frequency of use of perms (37% non‐Hispanic white vs 9% Black) and straighteners (3% non‐Hispanic white vs 75% Black) varied by race/ethnicity, associations with breast cancer did not. Use of hair products, specifically perms and straighteners, during adolescence may be associated with a higher risk of premenopausal breast cancer. This article is protected by copyright. All rights reserved.
... Self-reported ever usage of any hair products, including hair oils, and hair relaxers during childhood, has been associated with earlier age of menarche in cohorts of AA women [10,11]. Among AA women, ever use of dark shades of hair dyes was associated with increased risk of breast cancer [16]. In a separate study, ever use of dark hair dyes during pregnancy was associated with higher odds of delivering a low birth weight infant among 315 Chinese mother-infant pairs [17]. ...
... Our results for chemical relaxer or straightening product usage had noteworthy similarities and differences with prior studies. Similar to our study, prior studies reported a high lifetime prevalence of ever usage of chemical relaxers or straighteners among AA women, ranging from 60% to 97% [12,16,46,47]. However, two cohort studies of AA women in New York prior to 2010 reported a lower prevalence of ever use of chemical relaxers and leave-in conditioners during childhood than observed in this study of AA women in Detroit, Michigan [10,11]. ...
... Despite these limitations, our descriptive study has important strengths and extends the prior literature. We captured childhood, adolescent, and adulthood usage of commonly used hair products that have been positively associated with EDCs and poor health outcomes among a particularly vulnerable population [10][11][12][13]16]. To our knowledge, this is the first study to describe leave-in/leaveon conditioner and chemical relaxer/straightener use beyond ever and never categorizations across childhood and adulthood. ...
Few studies have characterized life course hair product usage beyond ever/never. We investigated hair product use from childhood to adulthood, usage patterns in adulthood, and socioeconomic status (SES) correlates among African-American (AA) women. Using self-reported data from 1555 AA women enrolled in the Study of Environment, Lifestyle, and Fibroids (2010–2018), we estimated the usage frequency of chemical relaxer/straightener (≥twice/year, once/year, and rarely/never) and leave-in/leave-on conditioner (≥once/week, 1–3 times/month, and rarely/never) during childhood, adolescence, and adulthood. Latent class analysis was used to identify patterns of adulthood usage of multiple hair products. SES was compared across latent classes. With a mean age of 33 ± 3.4 years, most women reported ever using chemical relaxers/straighteners (89%), and use ≥twice/year increased from childhood (9%) to adolescence (73%) but decreased in adulthood (29%). Leave-in/leave-on conditioner use followed the same pattern. Each of three identified latent classes reported frequent styling product use and infrequent relaxer/straightener use. Class One was unlikely to use any other products, Class Two moderately used shampoo and conditioner, and Class Three frequently used multiple product types (e.g., moisturizers and conditioners). Participants in the latter two classes reported higher SES. Ever/never characterization may miss important and distinctive patterns of hair product use, which may vary by SES.
... Research on cancer disparities has not been able to conclusively explain Black women's elevated risk of breast cancer mortality or their more aggressive phenotypes, but differences in prognosis and etiology have been correlated with race [6], genetics [7], lifestyle and behavioral factors [8], and environmental exposures [9]. One environmental factor that has been gaining increasing attention in breast cancer research is hair and personal care products [9][10][11]. A growing body of literature [9][10][11][12][13][14] supports an association between use of some hair care products (e.g., hair dyes, relaxers, and deep conditioners) and breast cancer risk. ...
... One environmental factor that has been gaining increasing attention in breast cancer research is hair and personal care products [9][10][11]. A growing body of literature [9][10][11][12][13][14] supports an association between use of some hair care products (e.g., hair dyes, relaxers, and deep conditioners) and breast cancer risk. Data from animal models [15][16][17] suggest exposures to compounds found in some hair products, particularly those containing endocrine-disrupting chemicals (EDCs) and chemicals with mutagenic properties, may be important etiologic risk factors for several human cancers, including breast cancer. ...
... The authors concluded some hair and skin care products have ingredients that can mimic estrogen functioning. Llanos and colleagues [11] also examined the association between breast cancer risk and use of hair dye, chemical relaxers, and deep conditioners in a sample of African American and White women. They found, among the dark hair dye shades, African American use was associated with increased breast cancer risk (OR = 1.51, 95% CI: 1.20-1.90). ...
Introduction
Across the African Diaspora, hair is synonymous with identity. As such, Black women use a variety of hair products, which often contain more endocrine-disrupting chemicals than products used by women of other races. An emerging body of research is linking chemicals in hair products to breast cancer, but there is no validated instrument that measures constructs related to hair, identity, and breast health. The objective of this study was to develop and validate the Black Identity, Hair Product Use, and Breast Cancer Scale (BHBS) in a diverse sample of Black women to measure the social and cultural constructs associated with Black women’s hair product use and perceived breast cancer risk.
Methods
Participants completed a 27-item scale that queried perceptions of identity, hair products, and breast cancer risk. Principal Component Analyses (PCA) were conducted to establish the underlying component structures, and confirmatory factor analysis (CFA) was used to determine model fit.
Results
Participants (n = 185) were African American (73%), African, and Caribbean Black women (27%) aged 29 to 64. PCA yielded two components that accounted for 61% of total variance. Five items measuring sociocultural perspectives about hair and identity loaded on subscale 1 and accounted for 32% of total variance (α = 0.82; 95% CI = 0.77–0.86). Six items assessing perceived breast cancer risk related to hair product use loaded on subscale 2 and accounted for 29% of total variance (α = 0.82 (95% CI = 0.74–0.86). CFA confirmed the two-component structure (Root Mean Square Error of Approximation = 0.03; Comparative Fit Index = 0.91; Tucker Lewis Index = 0.88).
Conclusions
The BHBS is a valid measure of social and cultural constructs associated with Black women’s hair product use and perceived breast cancer risk. This scale is useful for studies that assess cultural norms in the context of breast cancer risk for Black women.
... Thus, our data in aggregate do not raise large concerns regarding the effects of skin lighteners on breast cancer risk among African women, despite their very common usage. Although there has been much attention on the relation of hair dyes to breast cancer risk, with the relationship remaining unresolved (34), only two previous epidemiologic studies have assessed the relation of hair relaxers to breast cancer risk (35,36). In one investigation that focused on African-American women (36), there were no increases in risk associated with any categories of duration of hair relaxer use, frequency of use, age at first use, number of burns experienced during use or type of relaxer used. ...
... However, in that same investigation, an enhanced risk of uterine leiomyomas was observed in relation to hair relaxer use, with positive trends observed for frequency of use, duration of use and number of burns (37), suggesting that these products could have harmful hormonal effects. In contrast, in the most recent investigation on the relation of hair relaxers to breast cancer risk, that included both African-American and white women (35), use among white women was associated with significantly elevated breast cancer risks, particularly for estrogen receptor negative diseases. No association with use, however, was seen among the African-American women in the study. ...
Skin lighteners and hair relaxers, both common among women of African descent, have been suggested as possibly affecting breast cancer risk. In Accra and Kumasi, Ghana, we collected detailed information on usage patterns of both exposures among 1,131 invasive breast cancer cases and 2,106 population-controls. Multivariate analyses estimated odds ratios (OR) and 95% confidence intervals (CIs) after adjustment for breast cancer risk factors. Control usage was 25.8% for ever use of skin lighteners and 90.0% for use of hair relaxers for >1 year. The OR for skin lighteners was 1.10 (95% CI 0.93-1.32), with higher risks for former (1.21, 0.98-1.50) than current (0.96, 0.74-1.24) users. No significant dose-response relations were seen by duration, age at first or frequency of use. In contrast, an OR of 1.58 (95% CI 1.15-2.18) was associated with hair relaxers, with higher risks for former (2.22, 1.56-3.16) than current (1.39, 1.00-1.93) users. Although numbers of burns were inconsistently related to risk, associations increased with duration of use, restricted to women who predominately used non-lye products (p for trend<0.01). This was most pronounced among women with few children and those with smaller tumors, suggesting a possible role for other unmeasured lifestyle factors. This study does not implicate a substantial role for skin lighteners as breast cancer risk factors, but the findings regarding hair relaxers were less reassuring. The effects of skin lighteners and hair relaxers on breast cancer should continue to be monitored, especially given some biologic plausibility for their affecting risk.
... For example, use of hair oil and hair relaxers has been associated with earlier menarche [10,26] and use of hair relaxers with higher incidence of fibroids [27]. Use of hair dye and hair relaxers is associated with increased breast cancer risk, with Black women experiencing higher risk than White women [28][29][30][31]. Another study found more frequent use of beauty and skincare products, and not hair products generally, is associated with increased risk of breast cancer [32]. ...
... Use of certain hair products-hair relaxers and hair dyes -has been associated with increased breast cancer risk [28][29][30][31], among other adverse health conditions. In this study, use of hair perms/relaxers/chemical straighteners was similarly prevalent among Black and Asian women although used slightly more frequently by Black women. ...
Background
Personal care product use may contribute to elevated body burdens of consumer product chemicals among women of color; however, racial/ethnic differences in product use has been understudied. Community-engaged research can support the recruitment of diverse participants.
Objective
To document personal care product use among a diverse group of women (aged 18–34 years) living in California.
Methods
Through a community-academic partnership, we surveyed 357 women in California about product use information for 54 cosmetic, hair, menstrual/intimate care, and leave-on and rinse-off personal care products. We compared type and frequency of product use among Black, Hispanic/Latinx, Asian, and White women. We also summarized use of scented products and reasons women select products.
Results
Women reported using a median of 8 products daily, with some women reporting up to 30 products daily. Hispanic/Latinx and Asian women used more cosmetics, and Black women used more hair and menstrual/intimate products than other women. Of the 54 products compared, there were significant differences in use by race/ethnicity for 28 products, with the largest number of significant differences between Black and White women.
Significance
There is growing information on chemical exposures from personal care products and consequent adverse health effects, with implications for health disparities. Yet, there remains limited information on the range and types of products used by diverse racial/ethnic communities. This study helps close an important gap on product use inventories that can enable more informed public health interventions to limit exposures from personal care products.
... There have been numerous controversies surrounding cosmetics and their chemical constituents with carcinogenesis. Examples include associations of parabens and aluminum with breast cancer (1,(2)(3)(4), talc powder with ovarian cancer (5)(6)(7)(8)(9)(10), and, most recently, hair dye with breast cancer (11). These articles have often been covered extensively by the media and have stoked consumer concerns. ...
... Since the IARC evaluations were made, additional studies have been published, including, for example, data concerning occupational (54) and personal exposure (55). One other study has indicated that personal use of darker hair dyes and relaxants was linked to estrogen receptor-positive (ERþ) and ER-breast cancer (11). Some studies have demonstrated mutagenicity of hair dye chemicals, particularly arylamine p-phenylenediamine (PPD) in conjunction with hydrogen peroxide, in animal models through the formation of reactive oxygen species (56,57). ...
There have been numerous controversies surrounding cosmetic products and increased cancer risk. Such controversies include associations between parabens and breast cancer, hair dyes and hematologic malignancies, and talc powders and ovarian cancer. Despite the prominent media coverage and numerous scientific investigations, the majority of these associations currently lack conclusive evidence. In 2016, the US Food and Drug Administration (FDA) made publically available all adverse event reports in Center for Food Safety and Applied Nutrition's Adverse Event Reporting System (CAERS), which includes complaints related to cosmetic products. We mined CAERS for cancer-related reports attributed to cosmetics. Between 2004 and 2017, cancer-related reports caused by cosmetics represented 41% of all adverse events related to cosmetics. This yielded 4427 individual reports of cancer related to a cosmetic product. Of these reports, the FDA redacted the specific product names in 95% of cancer-related reports under the Freedom of Information Act exemptions, most likely due to ongoing legal proceedings. For redacted reports, ovarian cancer reports dominated (n = 3992, 90%), followed by mesothelioma (n = 92, 2%) and malignant neoplasm unspecified (n = 46, 1%). For nonredacted reports, or those reports whose product names were not withheld (n = 218), 70% were related to ovarian cancer attributed to talc powders, followed by skin cancer (11%) and breast cancer (5%) attributed to topical moisturizers. Currently, CAERS is of limited utility, with the available data having been subjected to significant reporter bias and a lack of supportive information such as demographic data, medical history, or concomitant product use. Although the system has promise for safeguarding public health, the future utility of the database requires broader reporting participation and more complete reporting, paired with parallel investments in regulatory science and improved molecular methods.
... In particular, hair products marketed towards and more commonly used by non-Hispanic Black women have been shown to contain multiple EDCs, including parabens, phthalates, and phenols [15,16], and recent evidence suggests that these products may be hormonally active [17,18]. Furthermore, the use of certain hair products has been associated with multiple hormonally-mediated health outcomes, such as earlier age at menarche, breast cancer, and uterine leiomyomata [19][20][21][22][23][24][25][26][27], indicating that differences in hair product use patterns could potentially contribute to the observed disparities in EDC exposure and women's reproductive health outcomes [13,28]. However, research on the use of EDC-associated hair products during pregnancy and risk of preterm birth or earlier gestational age at delivery is lacking. ...
Background
Prenatal endocrine disrupting chemical (EDC) exposure has been associated with increased risk of preterm birth. Non-Hispanic Black women have higher incidence of preterm birth compared to other racial/ethnic groups and may be disproportionately exposed to EDCs through EDC-containing hair products. However, research on the use of EDC-associated hair products during pregnancy and risk of preterm birth is lacking. Therefore, the objective of this pilot study was to estimate associations of prenatal hair product use with gestational age at delivery in a Boston, Massachusetts area pregnancy cohort.
Methods
The study population consisted of a subset of participants enrolled in the Environmental Reproductive and Glucose Outcomes (ERGO) Study between 2018 and 2020. We collected self-reported data on demographics and hair product use using a previously validated questionnaire at four prenatal visits (median: 12, 19, 26, 36 weeks’ gestation) and abstracted gestational age at delivery from medical records. We compared gestational age and hair product use by race/ethnicity and used linear regression to estimate covariate-adjusted associations of product use and frequency of use at each study visit with gestational age at delivery. Primary models were adjusted for maternal age at enrollment and delivery method.
Results
Of the 154 study participants, 7% delivered preterm. Non-Hispanic Black participants had lower mean gestational age at delivery compared to non-Hispanic White participants (38.2 vs. 39.2 weeks) and were more likely to report ever and more frequent use of hair products. In regression models, participants reporting daily use of hair oils at visit 4 had lower mean gestational age at delivery compared to non-users (β: -8.3 days; 95% confidence interval: -14.9, -1.6). We did not find evidence of associations at earlier visits or with other products.
Conclusions
Frequent use of hair oils during late pregnancy may be associated with shorter gestational duration. As hair oils are more commonly used by non-Hispanic Black women and represent potentially modifiable EDC exposure sources, this may have important implications for the known racial disparity in preterm birth.
... The first one, the Women's Circle of Health Study (WCHS), was a population-based case-control study established in 2003 that recruited newly diagnosed Black and White women with breast cancer and matched controls. Participants were initially recruited from the New York City metropolitan areas, and beginning in 2006, from 10 counties in New Jersey [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. ...
Purpose:
The Women's Circle of Health Follow-Up Study is an ongoing longitudinal study of African American/Black breast cancer survivors in New Jersey, specifically designed to evaluate the impact of obesity and related comorbidities on breast cancer survival and health-related quality-of-life in this understudied population. Here, we describe our recruitment and data collection methods and compare characteristics of the overall cohort and the subcohort with follow-up data.
Methods:
Newly diagnosed breast cancer cases have been recruited into the study since 2006. Pre-diagnosis data on relevant factors and a saliva sample are collected during an in-person interview within 12 months from diagnosis. In 2013, we began active follow up by recontacting participants annually, including two home visits at approximately 2 and 3 years post-diagnosis, during which blood samples are collected. Mortality outcomes (all-cause and breast cancer-specific mortality) are ascertained through linkage with New Jersey State Cancer Registry files. We expect to assemble a cohort of over 2000 Black breast cancer survivors with at least 800 of them having detailed post-diagnosis data.
Results:
Distribution of sociodemographic characteristics, body mass index, comorbidities, clinicopathologic characteristics, and treatment modalities were very similar between those in the full cohort and the subset with follow-up data and blood samples. Obesity (> 50%), hypertension (> 58%), and diabetes (22%) were common in this population.
Conclusions and implications for cancer survivors:
This ongoing longitudinal study represents a unique resource to better understand breast cancer outcomes, patient-reported symptoms, and health-related quality of life among Black breast cancer survivors.
... Although white women have historically experienced higher breast cancer incidence than black women, black and white breast cancer rates appeared to converge circa 2012 ( Figure 1A), reflecting stable rates among whites and rising rates among blacks (5,6). These racial trends were heralded as a reversal in the historically lower incidence rates among blacks, possibly even foreshadowing a worsening of the black-to-white breast cancer mortality disparity (6) and motivating new breast cancer research (7)(8)(9)(10)(11)(12)(13). ...
Recent reports of converging black and white breast cancer incidence rates have gained much attention, potentially foreshadowing a worsening of the black-white breast cancer mortality disparity. However, these incidence rates also reflect the sum of non-Hispanics and Hispanics that may mask important ethnicity-specific trends. We therefore assessed race- and ethnicity-specific breast cancer trends using the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) 13 Registries Database (1992-2014). Age-period-cohort models projected rates for 2015-2030. Results confirmed merging of age-standardized incidence rates for blacks and whites circa 2012, but not for non-Hispanic black (NHB) and non-Hispanic white (NHW) women. Incidence rates were highest for NHW women (n = 382 290), followed by NHB women (n = 51 074), and then Hispanic white women (n = 48 651). The sample size for Hispanic blacks was too small for analysis (n = 693). Notably, future incidence rates are expected to slowly increase (2015 through 2030) among NHW women (0.24% per year, 95% confidence interval [CI] = 0.17 to 0.32) and slowly decrease for NHB women (-0.14% per year, 95% CI = -0.15 to -0.13). A putative worsening of the black-white mortality disparity, therefore, seems unlikely. Ethnicity matters when assessing race-specific breast cancer incidence rates.
... The association between the use of hair product (dye, relaxer/ straightener) and breast cancer was studied in a case-control study conducted among 4285 adult women between 2002 and 2008. The percentage of users, the frequency of use, the usual shade and application used (home-kit or salon) and the total duration of use were collected and results were presented depending on origin (African or white American women) (Llanos et al., 2017). ...
According to the European Regulation (EC) No. 1223/2009, cosmetic products should be safe for human health when used under normal or foreseeable conditions of use. To perform a safety evaluation, consumption data of finished cosmetic product are necessary to assess the corresponding consumer's exposure. The aim of this review was to highlight consumption (percentage of users, frequency of use, amount used, number of products daily used, types of products co-used …) and exposure data to cosmetic products available in the literature. A systematic approach was used following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. Literature search was performed in February 2018 using Pubmed and Scopus databases. The following information was collected for the 82 publications included in this review: type of study, characteristics of the population (number, age, sex, region of origin), period of data collection, types of products studied, method(s) of data collection, consumption and/or exposure parameters obtained. Because of the high number of quantitative results obtained in the different studies, these data are not presented here. Readers interested in one or more studies are invited to consult the results available in the original publication(s). This work could be very useful for safety assessors or other persons working in the risk assessment field.
... Emerging evidence suggests the use of hair and other personal care products may contribute to breast cancer development (Breast Cancer Prevention Partners, 2018;Eberle et al., 2019;Helm et al., 2018;Llanos et al., 2017;Stiel et al., 2016). Personal care products may contain endocrine disrupting chemicals (EDCs)-chemicals that may interfere with the body's endocrine system and produce negative developmental, reproductive, neurological, and immune effects in both humans and animals (National Institute of Environmental Health Sciences, 2020). ...
Racial disparities in breast cancer are well-documented, and Black women assume a disproportionate burden of breast cancer mortality. Black women also commonly use hair products containing endocrine disrupting chemicals (EDCs) more often at an increased rate, as compared to other racial/ethnic groups. Emerging findings have reported the use of hair and other personal care products containing EDCs may contribute to breast cancer risk. While some sociocultural perspectives about hair and identity have been explored, the role of beauty expectations upheld by males has not been studied. Through a community-based participatory methodology, we explored perceptions and beliefs held by Black men regarding Black women’s hair, chemical exposures in hair products, and breast cancer risk. Focus groups and key informant interviews—among men with and without partners with a history of breast cancer—were used to examine the male perspective regarding the attractiveness of Black hairstyles, opinions of beauty norms, and knowledge of breast cancer risk factors. Interviews were audio-recorded, transcribed, and analyzed guided by grounded theory methods. From the 66 participants interviewed, there was general support for natural hairstyles, which were associated with confidence and self-esteem in women. Men agreed that beauty standards and societal pressures play notable roles in the women’s personal behaviors though they mostly lacked knowledge of women’s breast cancer risk related to EDCs found in personal care products. Participants suggested a multipronged strategy centered on community education involving social and traditional media campaigns, and the engagement of policy makers in intervention efforts.
... This association was more pronounced for non-serous ovarian cancer, a heterogeneous group of histologic subtypes. Frequent use of straighteners has been previously associated with breast cancer risk, in both this study population as well as in others (9,10,19,20). To the best of our knowledge, there have been no previous studies considering how straighteners are associated with the incidence of ovarian cancer or any other cancer types aside from breast cancer. ...
We evaluated whether hair products, which may contain carcinogens and endocrine disruptors that can be absorbed into the bloodstream, are related to ovarian cancer incidence in a prospective cohort. After excluding women with a history of ovarian cancer or bilateral oophorectomy, 40,559 Sister Study participants ages 35-74 at enrollment (2003-2009) were included. Participants completed questionnaires on hair product use, including hair dyes, straighteners/relaxers and permanents/body waves, in the past 12 months. Cox regression was used to estimate adjusted hazard ratios (HRs) and 95% Confidence Intervals (CIs) for the association between hair products and incident ovarian cancer. We assessed associations stratified by tumor type (serous, non-serous). Over a mean follow-up of 10 years, 241 women were diagnosed with ovarian cancer. Ever use of any of the examined hair products during the past year was not associated with ovarian cancer risk. However, frequent use (>4 times/year) of straighteners/relaxers or pressing products in the past year was associated with an increased risk of ovarian cancer (HR=2.19, 95% CI: 1.12-4.27). Ever use of permanent hair dye was positively associated with non-serous (HR=1.94, 95% CI 1.12-3.37), but inversely associated with serous (HR=0.65, 95% CI: 0.43-0.99) tumors (p-for-heterogeneity=0.002). Our novel findings suggest that frequent use of hair straighteners/relaxers or pressing products, which are primarily used by African American/Black women, and possibly permanent hair dye, may be associated with the occurrence of ovarian cancers.
... Also, hair relaxers consist of caustic chemicals that may damage the scalp (Aguh and Okoye 2017). And most concerning, recent research suggests that the use of hair relaxers increases the risk of developing breast cancer among African American women (Stiel et al. 2016;Llanos et al. 2017;Brinton et al. 2018). ...
A culturally cultivated ignorance with regard to the care and presentation of tightly-curled hair pervades American society. This ignorance masquerades as a discourse of manageability, which supports institutional prohibitions of historically Black American hairstyles. In other words, rather than acknowledging our knowledge deficits, we attribute the medical and aesthetic consequences of our ignorance to the hair itself. The insidious implication is that the display of tightly curled hair is not a matter of taste but indicative of a lack of self-care. I conclude that this trend is racially prejudicial and that laws and education are possible mechanisms of redress.
... Recent research suggests that EDCs in common consumer products, including hair products, contribute to these hormone-mediated diseases. For example, use of hair oil and hair relaxers is associated with earlier menarche (James-Todd et al., 2011;McDonald et al., 2018), higher incidence of fibroids (Wise et al., 2012), and increased risk of breast cancer (Brinton et al., 2018;Heikkinen et al., 2015;Llanos et al., 2017). Higher urinary concentrations of phthalate metabolites have been associated with fibroids (Huang et al., 2014;Kim et al., 2017Kim et al., , 2016, earlier indicators of puberty (Watkins et al., 2014), less successful IVF outcomes (Hauser et al., 2016) and preterm birth . ...
Background:
Personal care products are a source of exposure to endocrine disrupting and asthma-associated chemicals. Because use of hair products differs by race/ethnicity, these products may contribute to exposure and disease disparities.
Objective:
This preliminary study investigates the endocrine disrupting and asthma-associated chemical content of hair products used by U.S. Black women.
Methods:
We used gas chromatography/mass spectrometry (GC/MS) to test 18 hair products in 6 categories used by Black women: hot oil treatment, anti-frizz/polish, leave-in conditioner, root stimulator, hair lotion, and relaxer. We tested for 66 chemicals belonging to 10 chemical classes: ultraviolet (UV) filters, cyclosiloxanes, glycol ethers, fragrances, alkylphenols, ethanolamines, antimicrobials, bisphenol A, phthalates, and parabens.
Results:
The hair products tested contained 45 endocrine disrupting or asthma-associated chemicals, including every targeted chemical class. We found cyclosiloxanes, parabens, and the fragrance marker diethyl phthalate (DEP) at the highest levels, and DEP most frequently. Root stimulators, hair lotions, and relaxers frequently contained nonylphenols, parabens, and fragrances; anti-frizz products contained cyclosiloxanes. Hair relaxers for children contained five chemicals regulated by California's Proposition 65 or prohibited by EU cosmetics regulation. Targeted chemicals were generally not listed on the product label.
Conclusions:
Hair products used by Black women and children contained multiple chemicals associated with endocrine disruption and asthma. The prevalence of parabens and DEP is consistent with higher levels of these compounds in biomonitoring samples from Black women compared with White women. These results indicate the need for more information about the contribution of consumer products to exposure disparities. A precautionary approach would reduce the use of endocrine disrupting chemicals in personal care products and improve labeling so women can select products consistent with their values.
... [60][61][62][63] In another study, it has been reported that personal use of darker hair dyes and relaxants are involved in estrogen receptor-positive and estrogen-receptor breast cancer. 64 Moreover, the use of other hair products has a significant correlation with cancer risk factors. In 2011, the FDA issued warning letters to designers of a certain heated hair treatment, Brazilian Blowout, due to the release of formaldehyde with heat. ...
... Epidemiological studies have suggested chemical hair colorants and dyes to be a risk factor for many cancers (Heikkinen, Pitkäniemi, Sarkeala, Malila, & Koskenvuo, 2015;Towle, Grespin, & Monnot, 2017;Venitt & Searle, 1976). Furthermore, a large case-control study of African American and White women provided epidemiological data to support a relationship between the use of hair dye and some types of relaxers (hair straighteners) and breast cancer (Llanos et al., 2017). ...
The use of consumer products presents a potential for chemical exposures to humans. Toxicity testing and exposure models are routinely employed to estimate risks from their use; however, a key challenge is the sparseness of information concerning who uses products and which products are used contemporaneously. Our goal was to demonstrate a method to infer use patterns by way of purchase data. We examined purchase patterns for three types of personal care products (cosmetics, hair care, and skin care) and two household care products (household cleaners and laundry supplies) using data from 60,000 households collected over a one‐year period in 2012. The market basket analysis methodology frequent itemset mining (FIM) was used to identify co‐occurring sets of product purchases for all households and demographic groups based on income, education, race/ethnicity, and family composition. Our methodology captured robust co‐occurrence patterns for personal and household products, globally and for different demographic groups. FIM identified cosmetic co‐occurrence patterns captured in prior surveys of cosmetic use, as well as a trend of increased diversity of cosmetic purchases as children mature to teenage years. We propose that consumer product purchase data can be mined to inform person‐oriented use patterns for high‐throughput chemical screening applications, for aggregate and combined chemical risk evaluations.
... [60][61][62][63] In another study, it has been reported that personal use of darker hair dyes and relaxants are involved in estrogen receptor-positive and estrogen-receptor breast cancer. 64 Moreover, the use of other hair products has a significant correlation with cancer risk factors. In 2011, the FDA issued warning letters to designers of a certain heated hair treatment, Brazilian Blowout, due to the release of formaldehyde with heat. ...
To look superior and acceptable in society, people from all over the world use various types of cosmetic products to enhance or alter their facial appearance and body texture. In recent times, an exponential surge in cosmetic use has been observed in Pakistan, and hence spending money on personal-care products is high. However, there are many reported facts about high loads of lead, mercury, copper, and others hazardous and cancerous elements in local Pakistani cosmetic brands. Consumers of these brands are at high risk of many clinical issues, including cancer. As such, it is a necessity to make people aware of the devastating harmful effects related to cosmetic use. The aim of this study was to provide information for stakeholders and raise awareness in the general public about the use of these local unauthorized personal-care cosmetic products, along with government strategies to stop this cosmetic blight on human health.
... Black girls reach menarche earlier [8] and Black women have higher mortality due to breast cancer, often due to a higher incidence of a subtype of the disease that is less responsive to hormone therapy treatment [54]. Considering data evaluating hair products and these conditions, two studies found associations between hair products (e.g., hair dyes and relaxers) with an increased breast cancer risk [55,56]. In the present study, it is worth noting that while three of the products showed estrogen agonist properties, one of these three along with two others showed estrogen antagonist properties. ...
Background
Certain types of hair products are more commonly used by Black women. Studies show hair products contain several endocrine-disrupting chemicals that are associated with adverse health outcomes. As chemical mixtures of endocrine disruptors, hair products may be hormonally active, but this remains unclear.
Objective
To assess the hormonal activity of commonly used Black hair products.
Methods
We identified six commonly used hair products (used by >10% of the population) from the Greater New York Hair Products Study. We used reporter gene assays (RGAs) incorporating natural steroid receptors to evaluate estrogenic, androgenic, progestogenic, and glucocorticoid hormonal bioactivity employing an extraction method using bond elution prior to RGA assessment at dilutions from 50 to 500.
Results
All products displayed hormonal activity, varying in the amount and effect. Three samples showed estrogen agonist properties at levels from 12.5 to 20 ng/g estradiol equivalent concentrations All but one sample showed androgen antagonist properties at levels from 20 to 25 ng/g androgen equivalent concentrations. Four samples showed antagonistic and agonistic properties to progesterone and glucocorticoid.
Significance
Hair products commonly used by Black women showed hormonal activity. Given their frequent use, exposure to hormonally active products could have implications for health outcomes and contribute to reproductive and metabolic health disparities.
... The majority of these webpages discussed elevated risks in both African-American and White women from a recent study on hair product use and breast cancer risk (n=24, 10.2%). 73 Five webpages focused on minorities in general, without specifying any given race/ethnicity and discussed exposure to PCBs and its relationship with breast cancer risk. The mean CSAT score was 3.6 with a range of 1.8-4.0, ...
Background:
Effective online communication about the environmental risk factors of breast cancer is essential because of the multitude of environmental exposures and debate regarding the conclusiveness of scientific evidence.
Purpose:
The aim of this study was to assess the content, readability, and cultural sensitivity of online resources focused on the environmental risks factors of breast cancer.
Methods:
A purposive sample of webpages focused on environmental risk factors of breast cancer was obtained through a Google search using 17 search terms. Using nonparametric statistics, we assessed the content, readability, and cultural appropriateness of 235 webpages.
Results:
Eighty-two percent of webpages referred to research studies in their content. For the majority of sites, readability was at a high-school reading grade level. Webpages were not explicitly intended for specific racial/ethnic groups.
Discussion:
Technical language and non-culturally specific messages may hinder users' attention to and comprehension of online breast cancer information. Additional research is needed to examine in-depth the accuracy of this online content.
Translation to health education practice:
Findings suggest that collaborations between scientists, health educators, website designers/media professionals, and the community will be critical to the delivery of accurate, up-to-date, plain-language, and culturally sensitive information about breast cancer and the environment.
Research within the specialties of Obstetrics and Gynecology is impacting, and tries to solve many of today’s clinical problems. In these pages, we present summaries of abstracts of current research published in institutional documents and in important magazines of our specialty. References are included.
The natural hairstyle mirrors in various contexts self-expression; in particular, it expresses female beauty. The types of hair care and styles available, as well as the side effects of the techniques employed, are often poorly taken into account. The nail and skin glands are also here briefly considered.
Many hair products contain endocrine-disrupting compounds and carcinogens potentially relevant to breast cancer. Products used predominately by black women may contain more hormonally-active compounds. In a national prospective cohort study, we examined the association between hair dye and chemical relaxer/straightener use and breast cancer risk by ethnicity. Sister Study participants (n = 46,709), women ages 35-74, were enrolled between 2003 and 2009, and had a sister with breast cancer but were breast cancer-free themselves. Enrollment questionnaires included past 12-month hair product use. Cox proportional hazards models estimated adjusted hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association between hair products and breast cancer; effect measure modification by ethnicity was evaluated. During follow-up (mean = 8.3 years), 2,794 breast cancers were identified. Fifty-five percent of participants reported using permanent dye at enrollment. Permanent dye use was associated with 45% higher breast cancer risk in black women (HR = 1.45, 95% CI: 1.10-1.90), and 7% higher risk in white women (HR = 1.07, 95% CI: 0.99-1.16; heterogeneity p = 0.04). Among all participants, personal straightener use was associated with breast cancer risk (HR = 1.18, 95% CI 0.99-1.41); with higher risk associated with increased frequency (p for trend = 0.02). Nonprofessional application of semipermanent dye (HR = 1.28, 95% CI 1.05-1.56) and straighteners (HR = 1.27, 95% CI 0.99-1.62) to others was associated with breast cancer risk. We observed a higher breast cancer risk associated with any straightener use and personal use of permanent dye, especially among black women. These results suggest that chemicals in hair products may play a role in breast carcinogenesis.
Hair relaxers and leave-in conditioners and oils, commonly used by Black/African American women, may contain estrogens or estrogen-disrupting compounds. Thus, their use may contribute to breast cancer risk. Results of the few previous studies on this topic are inconsistent. We assessed the relation of hair relaxer and leave-in conditioner use to breast cancer incidence in the Black Women's Health Study, a nationwide prospective study of Black women. Among 50,543 women followed from 1997 to 2017, 2,311 incident breast cancers occurred. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards regression for breast cancer overall and by estrogen receptor (ER) status. For heavy use (≥15 years of use for ≥7 times/ year) of hair relaxers relative to never/light use (<4 years, no more than 1-2 times/year), the multivariable HR for breast cancer overall was 1.13 (95%CI: 0.96-1.33). Duration, frequency, age at first use and number of scalp burns were not associated with overall breast cancer risk. For heavy use of hair relaxers containing lye, the corresponding HR for ER+ breast cancer was 1.32 (95% CI: 0.97, 1.80); there was no association for non-lye products. There was no association of conditioner use and breast cancer. Results of this study were largely null, but there was some evidence that heavy use of lye-containing hair relaxers may be associated with increased risk of ER+ breast cancer. Consistent results from several studies are needed before it can be concluded that use of certain hair relaxers impacts breast cancer development.
Cosmetics has been used, since ancient times, for enhancing the beauty and self-care. But the difference lies in the chemicals that have been constantly used for the manufacturing of cosmetics in the present timeconcerning the natural cosmetics that were been in use in ancient civilization and still used by many people. Many controversies arose in past years targeting the companies the company to ban the use of such chemicals but none seem to lead to any result. Cosmetics manufactured today are added with a load of chemicals to increase their shelf life, to enhance their quality, for selective and assorted colors or any other desired property. But no one could have ever thought of how these would affect the humans and the environment too. The cosmetics lead to prolonged exposure to chemicals and indirect ingestion that give rise to health-related issues like allergy, hypersensitivity and some are even be reported to have carcinogenic effects. Many experimental pieces of evidence have supported the presence of substances like phthalates, coal tar, heavy metals, parabens etc. in the cosmetics. They have been reported to have dangerous impacts on biological things. Apart from this, the cosmetics are also tested on animals in such an inhuman way that can't be imagined of and set out for sale, keeping the fact at a corner that animal and humans have different issues and body build-ups and effects won't be the same. This also gives rise to animal related ethical issues. Safety evaluation for cosmetics 1774 http://annalsofrscb.ro needs to be updated. This review is a compilation of information from the reviewed literature related to cosmetics. More strict safety evaluation rules, banning for such harmful chemicals, giving break to excessive animal abuse in the industry and use of more and more natural products and herbal formulations should be encouraged.
The incidence rate of breast cancer for African American women has recently converged with that of non-Hispanic White women in the United States, although African Americans have a higher mortality rate due to this disease. Although most research exploring health disparities associated with this phenomenon has focused on differences between women based on biology and behavior, both the academic and lay communities have begun to explore the potential role of environmental exposure to estrogen and endocrine disrupting chemicals (EDCs). This study reviews the current state of the science associating one such means of exposure, hair products containing EDCs, with breast cancer risk in African American women. We found a growing body of evidence linking: (1) environmental estrogen and EDC exposures to breast cancer risk, (2) the presence of such chemicals in personal care products, including hair products, and (3) the use of certain hair products with potential breast cancer risk in African Americans. At the same time, there is also increasing concern in the lay community about this risk. These results indicate the need for additional research, and the opportunity to benefit from strategic partnerships in community-collaborative approaches in order to better understand the potential "cost of beauty."
Introduction:
Role of hair dyes in the etiology of breast cancer has occasionally raised concern but previous research has concluded with mixed results. Remnants of prohibited aromatic amines have been found in many hair dye products, and elevated levels of DNA-adducts of these amines have been detected from breast epithelial cells of hair dye users. However, the IARC working group has concluded that there is inadequate evidence for carcinogenicity of personal hair dye use and limited evidence in experimental animals for carcinogenicity of hair colorants.
Material and methods:
We investigated whether the use of hair dyes is associated with breast cancer risk in women. The study design was a retrospective population-based case-control study in Finland, with a self-administered questionnaire from 6,567 breast cancer patients, aged 22-60 years and diagnosed in 2000-2007, and their 21,598 matched controls. We report odds ratios (OR) with 95% confidence interval (95% CI) from a conditional logistic regression model applied to the frequency matched sets of cases and controls. Bias-adjusted odds ratios from the sensitivity analysis are also presented.
Results:
After adjusting for potential confounders, the odds of breast cancer increased by 23% (OR: 1.23, 95% CI: 1.11-1.36) among women who used hair dyes compared to those who did not. In women born before 1950 an increase of 28% was noted (OR: 1.28, 95% CI: 1.10-1.48). We also observed a significant trend between the OR and cumulative use of hair dyes (P: 0.005). Bias-adjusted odds ratios varied between 1.04 and 2.50.
Conclusions:
Our results suggest that use of hair dyes is associated with breast cancer incidence. The impact on public health may be substantial due to vast popularity of hair coloring in modern societies. It should be noted that regardless of all efforts, a possibility of bias cannot definitively be ruled out and use of a prospective design is warranted. Based on the present results, it may be concluded however that safety of hair dyes in relation to breast cancer cannot yet be fully acknowledged and lack of external safety assessment within the cosmetics industry is of major concern.
Obesity has been shown to be inversely associated with breast cancer risk in premenopausal women, while increasing risk in postmenopausal women. However, the current evidence is largely based on studies in Caucasian populations. Associations in women of African ancestry (AA), who have a higher prevalence of obesity, have been evaluated in few studies and results suggest different effects.
We evaluated the impact of body size, body fat distribution, and body composition on breast cancer risk among AA women (978 cases and 958 controls) participating in the Women's Circle of Health Study, a multi-site case--control study in New York City (NYC) and New Jersey (NJ). Cases were newly diagnosed with histologically confirmed ductal carcinoma in situ or invasive breast cancer, age 20--75 yrs. In NYC, cases were recruited through hospitals with the largest referral patterns for AA women and controls through random digit dialing (RDD). In NJ, cases were identified in seven counties in NJ thorough the NJ State Cancer Registry, and controls through RDD and community-based recruitment. During in-person interviews, questionnaires were administered and detailed anthropometric measurements were obtained. Body composition was assessed by bioelectrical impedance analysis.
BMI did not have a major impact on pre- or post-menopausal breast cancer, but was significantly associated with reduced risk of ER-/PR- tumors among postmenopausal women (OR: 0.37; 95% CI: 0.15-0.96 for BMI > 30 vs. BMI < 25). Furthermore, increased premenopausal breast cancer risk was found for higher waist and hip circumferences after adjusting for BMI, with ORs of 2.25 (95% CI: 1.07-4.74) and 2.91 (95% CI: 1.39-6.10), respectively, comparing the highest vs. lowest quartile. While ORs for higher fat mass and percent body fat among postmenopausal women were above one, confidence intervals included the null value.
Our study suggests that in AA women BMI is generally unrelated to breast cancer. However, higher waist and hip circumferences were associated with increased pre-menopausal breast cancer risk, while general obesity was associated with decreased risk of ER-/PR- tumors. Larger studies are needed to confirm findings and to evaluate the impact of obesity on breast cancer subtypes.
Background
Recruitment of controls remains a challenge in case–control studies and particularly in studies involving minority populations.
Methods
We compared characteristics of controls recruited through random digit dialing (RDD) to those of community controls enrolled through churches, health events and other outreach sources among women of African ancestry (AA) participating in the Women’s Circle of Health Study, a case–control study of breast cancer. Odds ratios and 95% confidence intervals were also computed using unconditional logistic regression to evaluate the impact of including the community controls for selected variables relevant to breast cancer and for which there were significant differences in distribution between the two control groups.
Results
Compared to community controls (n=347), RDD controls (n=207) had more years of education and higher income, lower body mass index, were more likely to have private insurance, and less likely to be single. While the percentage of nulliparous women in the two groups was similar, community controls tended to have more children, have their first child at a younger age, and were less likely to breastfeed their children. Dietary intake was similar in the two groups. Compared to census data, the combination of RDD and community controls seems to be more representative of the general population than RDD controls alone. Furthermore, the inclusion of the community group had little impact on the magnitude of risk estimates for most variables, while enhancing statistical power.
Conclusions
Community-based recruitment was found to be an efficient and feasible method to recruit AA controls.
Previous studies suggest that hair products containing endocrine disrupting chemicals could alter puberty. We evaluated the association between childhood hair product use and age at menarche in a racially diverse study population.
We recruited 300 African-American, African-Caribbean, Hispanic, and white women from the New York City metropolitan area who were between 18-77 years of age. Data were collected retrospectively on hair oil, lotion, leave-in conditioner, perm, and other types of hair products used before age 13. Recalled age at menarche ranged from 8 to 19 years. We used multivariable binomial regression to evaluate the association between hair product use and age at menarche (<12 vs. ≥12), adjusting for potential confounders.
African-Americans were more likely to use hair products and reached menarche earlier than other racial/ethnic groups. Women reporting childhood hair oil use had a risk ratio of 1.4 (95% confidence interval [CI]: 1.1-1.9) for earlier menarche, adjusting for race/ethnicity and year of birth. Hair perm users had an increased risk for earlier menarche (adjusted risk ratio = 1.4, 95% CI: 1.1-1.8). Other types of hair products assessed in this study were not associated with earlier menarche.
Childhood hair oil and perm use were associated with earlier menarche. If replicated, these results suggest that hair product use may be important to measure in evaluating earlier age at menarche.
Breast cancer in African-American (AA) women occurs at an earlier age than in European-American (EA) women and is more likely to have aggressive features associated with poorer prognosis, such as high-grade and negative estrogen receptor (ER) status. The mechanisms underlying these differences are unknown. To address this, we conducted a case-control study to evaluate risk factors for high-grade ER- disease in both AA and EA women.
With the onset of the Health Insurance Portability and Accountability Act of 1996, creative measures were needed to adapt case ascertainment and contact procedures to this new environment of patient privacy. In this paper, we report on our approach to establishing a multicenter study of breast cancer in New York and New Jersey, provide preliminary distributions of demographic and pathologic characteristics among case and control participants by race, and contrast participation rates by approaches to case ascertainment, with discussion of strengths and weaknesses.
A population-based case-control study was conducted in Los Angeles, California, which involved 1,514 incident cases of bladder cancer and an equal number of age-, sex- and ethnicity-matched controls. Information on personal use of hair dyes was obtained from 897 cases and their matched controls. After adjustment for cigarette smoking, a major risk factor for bladder cancer, women who used permanent hair dyes at least once a month experienced a 2.1-fold risk of bladder cancer relative to non-users (p for trend = 0.04). Risk increased to 3.3 (95% CI = 1.3-8.4) among regular (at least monthly) users of 15 or more years. Occupational exposure to hair dyes was associated with an increased risk of bladder cancer in this study. Subjects who worked for 10 or more years as hairdressers or barbers experienced a 5-fold (95% CI = 1.3-19.2) increase in risk compared to individuals not exposed.
Use of hair dyes has been suggested recently as a risk factor for several types of cancer in epidemiologic studies. This alarming news and controversial declarations by scientific organizations and general media have made necessary a systematic evaluation of the epidemiologic evidence.
To examine the association between personal use of hair dyes and relative risk of cancer.
We retrieved studies published in any language by systematically searching the MEDLINE (1966-January 2005), EMBASE, LILACS, and ISI Proceedings computerized databases and by manually examining the references of the original articles, reviews, and monographs retrieved.
We included cohort and case-control studies reporting relative risk estimates and 95% confidence intervals (CIs) (or data to calculate them) of personal hair dye use and cancer. We excluded studies that dealt with occupational exposure. We carried out separate analyses for bladder, breast, and hematopoietic cancers and cancers of other sites. Seventy-nine studies were included of 210 articles identified in the search.
Data were extracted independently by 2 investigators. We used a standardized questionnaire to record information on study design, sample size, type of controls, year of publication, adjustment factors, and relative risks of cancer among ever users of hair dyes. When possible, we extracted association measures on use of permanent dyes and extensive use (>200 lifetime episodes of dye use).
Study-specific relative risks were weighted by the inverse of their variance to obtain fixed- and random-effects pooled estimates. The pooled relative risk for ever users of hair dyes was 1.06 (95% CI, 0.95-1.18) for breast cancer (14 studies), 1.01 (95% CI, 0.89-1.14) for bladder cancer (10 studies), and 1.15 (95% CI, 1.05-1.27) for hematopoietic cancers (40 studies). Other cancers were examined by only 1 or 2 studies, of which the pooled or single relative risk was elevated for brain cancer, ovarian cancer, and cancer of the salivary glands. No effect was observed for use of permanent dyes or for extensive use.
We did not find strong evidence of a marked increase in the risk of cancer among personal hair dye users. Some aspects related to hematopoietic cancer and other cancers that have shown evidence of increased risk in 1 or 2 studies should be investigated further.
An epidemiologic case-control study of 118 breast cancer patients and 233 controls was conducted to test the hypothesis that hair dyes are related to breast cancer. Matched controls were selected by “random digit dialing,” and all epidemiologic data were collected by telephone interviews. No overall association was detected. On a prospective basis, the interaction between hair dye exposure and six variables known to be risk factors for breast cancer then were examined: previous benign breast disease (BBD), “ever” versus “never” pregnant, age at first pregnancy, menopause induced by operation, age at menarche, and education. A statistically significant increased risk of breast cancer was found for women with a history of BBD and exposure to hair dyes as compared to women with BBD but no hair dye exposure: The relative risk (RR) was 4.5, and the 95% confidence intervals (CI) were 1.20 and 15.78. A total of 24 women (19 patients and 5 controls) reported a history of BBD and hair dye use. Further analysis revealed a significant association between hair dye use and breast cancer among women 40–49 years of age (RR = 3.33; 95% CI: 1.1 and 10.85) and a highly significant (P = 0.0008) dose-response relationship among women who used hair dyes for changing their natural color as opposed to covering gray hair. The numbers of patients and controls included in this study were small and several hypotheses were tested. Additional epidemiologic studies are needed before firm conclusions can be reached concerning the nature of these associations.
In this article, the American Cancer Society provides the estimated number of new cancer cases and deaths for blacks in the United States and the most recent data on cancer incidence, mortality, survival, screening, and risk factors for cancer. Incidence data are from the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries, and mortality data are from the National Center for Health Statistics. Approximately 189,910 new cases of cancer and 69,410 cancer deaths will occur among blacks in 2016. Although blacks continue to have higher cancer death rates than whites, the disparity has narrowed for all cancers combined in men and women and for lung and prostate cancers in men. In contrast, the racial gap in death rates has widened for breast cancer in women and remained level for colorectal cancer in men. The reduction in overall cancer death rates since the early 1990s translates to the avoidance of more than 300,000 deaths among blacks. In men, incidence rates from 2003 to 2012 decreased for all cancers combined (by 2.0% per year) as well as for the top 3 cancer sites (prostate, lung, and colorectal). In women, overall rates during the corresponding time period remained unchanged, reflecting increasing trends in breast cancer combined with decreasing trends in lung and colorectal cancer rates. Five-year relative survival is lower for blacks than whites for most cancers at each stage of diagnosis. The extent to which these disparities reflect unequal access to health care versus other factors remains an active area of research. Progress in reducing cancer death rates could be accelerated by ensuring equitable access to prevention, early detection, and high-quality treatment. CA Cancer J Clin 2016. © 2016 American Cancer Society.
In this article, the American Cancer Society provides an overview of female breast cancer statistics in the United States, including data on incidence, mortality, survival, and screening. Approximately 231,840 new cases of invasive breast cancer and 40,290 breast cancer deaths are expected to occur among US women in 2015. Breast cancer incidence rates increased among non-Hispanic black (black) and Asian/Pacific Islander women and were stable among non-Hispanic white (white), Hispanic, and American Indian/Alaska Native women from 2008 to 2012. Although white women have historically had higher incidence rates than black women, in 2012, the rates converged. Notably, during 2008 through 2012, incidence rates were significantly higher in black women compared with white women in 7 states, primarily located in the South. From 1989 to 2012, breast cancer death rates decreased by 36%, which translates to 249,000 breast cancer deaths averted in the United States over this period. This decrease in death rates was evident in all racial/ethnic groups except American Indians/Alaska Natives. However, the mortality disparity between black and white women nationwide has continued to widen; and, by 2012, death rates were 42% higher in black women than in white women. During 2003 through 2012, breast cancer death rates declined for white women in all 50 states; but, for black women, declines occurred in 27 of 30 states that had sufficient data to analyze trends. In 3 states (Mississippi, Oklahoma, and Wisconsin), breast cancer death rates in black women were stable during 2003 through 2012. Widening racial disparities in breast cancer mortality are likely to continue, at least in the short term, in view of the increasing trends in breast cancer incidence rates in black women. CA Cancer J Clin 2015. © 2015 American Cancer Society.
How African American hair fragility relates to hair care practices and biologic differences between races is not well understood. To assess the differences between perceptions of hair health, hair care practices, and several biologic hair parameters between Caucasian and African American women. A questionnaire on perceptions of hair health and hair care practices was administered. Biological and structural parameters of hair shaft and scalp, including growth, density, diameter, cycle, breakage, and scalp blood flow were also assessed in this case-control study. Significant differences between the Caucasian and African American women were observed in the questionnaire and biologic study data. Regarding self-reported perceptions of hair health, there were differences in the following: hair shaft type (P < 0.001), hair breakage (P = 0.040), and desire to change hair (P = 0.001). Regarding self-reported hair care practices, there were differences in the following: location of haircutting (P = 0.002) and washing (P = 0.010), washing frequency (P < 0.001), chemical relaxer use (P < 0.001), hooded hair dryer use (P < 0.001), and hair shaft conditioner use (P = 0.005). The two groups had similar practices in regard to the use of hair color, frequency of hair color use, chemical curling agents, and handheld blow dryer use. Regarding biological and structural parameters, there were differences in the following: hair growth rate (P < 0.001), density (P = 0.0016), diameter (P = 0.01), number of broken hairs (P < 0.001), and blood flow (P = 0.03). There was no significant difference in hair cycle parameters.The differences in hair care practices and hair fiber morphology among African American women may contribute to clinically observed variation in hair fragility and growth.
© 2015 Wiley Periodicals, Inc.
The effects of reproductive factors on breast cancer risk appear to differ by estrogen receptor (ER) status. Menarche and first live birth (FLB) tend to occur at younger ages in African-Americans (AAs) than European-Americans (EAs), and could play a role in breast cancer disparities. In the Women's Circle of Health Study (WCHS) a case-control study of breast cancer in EA and AA women, in-person interviews were conducted to collect epidemiological data, including reproductive histories. Data on ER status, abstracted from pathology reports, were available for 814 AA and 538 EA breast cancer cases, and were analyzed with 1015 AA and 715 EA controls to evaluate associations between subgroups and age at menarche, age at FLB and the interval between those ages. Among AA women, later age at menarche (≥14 yrs) was associated with reduced risk of both ER+ and ER-breast cancer, with odds ratios (ORs) strongest for ER- disease (OR =0.57; 95% CI, 0.37-0.88); associations were weaker and non-significant for EA women. There were no significant associations with age at FLB, but AA women with a FLB within 15 years of menarche had increased risk of ER- disease (OR=2.26; 95% CI, 1.29-3.95), with no significant associations among EAs. In the WCHS, earlier age at menarche and shorter intervals until FLB are associated with ER- breast cancer in AA women; differential distributions by race of these and other reproductive risk factors could contribute to the higher prevalence of ER - breast cancer in AA women.
Despite considerable research, the issue of hair dyes and bladder cancer is still open to discussion. In January 2013, we searched in PubMed/EMBASE to identify observational studies investigating the association between personal use of hair dyes and bladder cancer incidence/mortality. Pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) were calculated using random-effects models. Fifteen case-control and 2 cohort studies were available for meta-analysis (8,504 cases/deaths, 14,102 controls and 617,937 persons-at-risk). Compared to no use, the pooled RR of bladder cancer for personal use of any type of hair dyes was 0.93 (95% CI, 0.82-1.05), with moderate heterogeneity among studies (I2=34.1%, p=0.07). Similar RRs were found for females (RR=0.95) and males (RR=0.81). Based on 7 studies, the pooled RR for personal use of permanent hair dyes was 0.92 (95% CI, 0.77-1.09). Compared to no use, no association was observed for the highest categories of duration of use and lifetime frequency of use of both any type of dyes and permanent dyes. The pooled RR from the 4 studies reporting results for use of dark-colored dyes was 1.29 (95% CI, 0.98-1.71). This meta-analysis allows to definitely exclude any appreciable excess risk of bladder cancer among personal hair dye users.
There is growing evidence that body size in early life influences lifetime breast cancer risk, but little is known for African American (AA) women.
We evaluated body size during childhood and young adulthood and breast cancer risk among 1,751 cases [979 AA and 772 European American (EA)] and 1,673 controls (958 AA and 715 EA) in the Women's Circle of Health Study. Odds ratio (OR) and 95 % confidence intervals (CI) were computed using logistic regression models while adjusting for potential covariates.
Among AA women, being shorter at 7-8 years compared to peers was associated with increased postmenopausal breast cancer risk (OR 1.68, 95 % CI 1.02-2.74), and being heavier at menarche with decreased postmenopausal breast cancer risk, although of borderline significance (OR 0.45, 95 % CI 0.20-1.02). For EA women, being shorter from childhood through adolescence, particularly at menarche, was associated with reduced premenopausal breast cancer risk (OR 0.55, 95 % CI 0.31-0.98). After excluding hormone replacement therapy users, an inverse association with postmenopausal breast cancer was found among EA women reporting to be heavier than their peers at menarche (OR 0.18, 95 % CI 0.04-0.79). The inverse relationship between BMI at age 20 and breast cancer risk was stronger and only statistically significant in EA women. No clear association with weight gain since age 20 was found.
Findings suggest that the impact of childhood height on breast cancer risk may differ for EA and AA women and confirm the inverse association previously reported in EA populations with adolescent body fatness, in AA women.
Research on the role of red meat and poultry consumption in breast carcinogenesis is inconclusive, but the evidence in African-American (AA) women is lacking. The association between consuming meat and breast cancer risk was examined in the Women's Circle of Health Study involving 803 AA cases, 889 AA controls, 755 Caucasian cases, and 701 Caucasian controls.
Dietary information was collected using a Food Frequency Questionnaire. Odds ratios (OR) and 95 % confidence intervals (CI) were obtained from logistic regression models adjusting for potential covariates.
Comparing the fourth versus the first quartiles, among Caucasian women, processed meat (OR = 1.48; 95 % CI 1.07-2.04), unprocessed red meat (OR = 1.40; 95 % CI 1.01-1.94), and poultry intakes (OR = 1.42; 95 % CI 1.01-1.99) increased breast cancer risk. Risk associated with poultry intake was more dominant in premenopausal women (OR = 2.33; 95 % CI 1.44-3.77) and for women with ER- tumors (OR = 2.55; 95 % CI 1.29-5.03) in the Caucasian group. Associations in AA women were mostly null except for a significant increased risk trend with processed meat consumption for ER+ tumors (OR = 1.36; 95 % CI 0.94-1.97, p trend = 0.04).
Overall, associations between breast cancer risk and consumption of red meat and poultry were of different magnitude in AA and Caucasian women, with further differences noted by menopausal and hormone receptor status in Caucasian women. This is the first study to examine racial differences in meat and breast cancer risk and represents some of the first evidence in AA women.
African American (AA) women are more likely than European American (EA) women to be diagnosed with breast cancer at younger ages and to develop poor prognosis tumors. However, these racial differences are largely unexplained. Folate and other methyl-group nutrients may be related to breast carcinogenesis, but few studies have examined these associations in AA populations. We examined the associations of dietary intake of these nutrients with breast cancer risk overall, by menopausal and estrogen receptor (ER) status among 1,582 AA (749 cases) and 1,434 EA (744 cases) women using data from a case-control study, the Women's Circle of Health Study. Unconditional multivariable logistic regression models were used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for the association of each nutrient and breast cancer risk. In AA women, inverse associations were observed for natural food folate intake among premenopausal women (4(th) vs. 1(st) quartile: OR=0.57, 95% CI, 0.33-1.00; P for trend=0.06) and for ER positive tumors (4(th) vs. 1(st) quartile: OR=0.58, 95% CI, 0.36-0.93; P for trend=0.03), whereas in EA women, a positive association was observed for intake of synthetic folate (4(th) vs. 1(st) quartile: OR=1.53, 95% CI, 1.06-2.21; P for trend=0.03). Our findings suggest that natural food folate intake is inversely associated with breast cancer risk and that this association may vary by race, menopausal or ER status. The finding of an increased risk observed among EA women with the highest intake of synthetic folate from fortified foods warrants further investigation. © 2013 Wiley Periodicals, Inc.
The reported mutagenic and carcinogenic effects of some chemicals present in hair dyes have raised concern that hair dye use could increase breast cancer risk. This case-control study evaluated how detailed aspects of hair coloring and hair spray application by reproductive-age women may affect breast cancer risk.
Cases were white female residents of three counties of western Washington state 45 years of age or less, who were diagnosed with breast cancer between 1983 and 1990 (n = 844). A sample of similarly aged women residing in the same counties served as controls (n = 960). Information on hair coloring and hair spray use, as well as other exposures, was ascertained during in-person interviews.
Breast cancer cases were slightly more likely than controls to report ever having used some type of hair coloring application, including use of rinses, semi-permanent or permanent dyes, as well as bleaching then dyeing or frosting their hair (relative risk [RR] = 1.3, 95% CI = 1.0-1.6, adjusted for age, fullterm pregnancies, family history of breast cancer, and weight). In subgroup analyses, women with exclusive use of just one of these methods of hair coloring application had no elevation in risk (similarly adjusted RR = 1.1, 95% CI = 0.9-1.3), whereas women who used two or more of these methods did have an elevated risk (RR = 1.9, 95% CI = 1.4-2.5). Hair spray use was not related to the risk of breast cancer (ever versus never users: RR = 1.0, 95% CI = 0.8- 1.3).
The lack of an association between exclusive use of a single type of hair coloring application and breast cancer risk argues that hair coloring application does not influence breast cancer risk among reproductive-age women. Thus, the results of the present study, as well as negative ones from most (but not all) prior studies, are most consistent with the conclusion that neither hair coloring application nor hair spray application influences breast cancer risk.
Aromatic amine components in hair dyes and polymorphisms in genes that encode enzymes responsible for hair dye metabolism may be related to bladder cancer risk. We evaluated the association between hair dye use and bladder cancer risk and effect modification by N-acetyltransferase-1 (NAT1), NAT2, glutathione S-transferase Mu-1 (GSTM1) and glutathione S-transferase theta-1 (GSTT1) genotypes in a population-based case-control study of 1193 incident cases and 1418 controls from Maine, Vermont and New Hampshire enrolled between 2001 and 2004. Individuals were interviewed in person using a computer-assisted personal interview to assess hair dye use and information on potential confounders and effect modifiers. No overall association between age at first use, year of first use, type of product, color, duration or number of applications of hair dyes and bladder cancer among women or men was apparent, but increased risks were observed in certain subgroups. Women who used permanent dyes and had a college degree, a marker of socioeconomic status, had an increased risk of bladder cancer [odds ratio (OR) = 3.3, 95% confidence interval (CI): 1.2-8.9]. Among these women, we found an increased risk of bladder cancer among exclusive users of permanent hair dyes who had NAT2 slow acetylation phenotype (OR = 7.3, 95% CI: 1.6-32.6) compared to never users of dye with NAT2 rapid/intermediate acetylation phenotype. Although we found no relation between hair dye use and bladder cancer risk in women overall, we detected evidence of associations and gene-environment interaction with permanent hair dye use; however, this was limited to educated women. These results need confirmation with larger numbers, requiring pooling data from multiple studies.
Estrogen and endocrine-disrupting chemicals (EDCs) that are associated with several health outcomes have been found in hair products. We evaluated the proportion, frequency, duration, and content of hair products in a racially/ethnically diverse population. We recruited n = 301 African-American, African-Caribbean, Hispanic, and white women from the New York metropolitan area. We collected data on hair oil, lotion, leave-in conditioner, root stimulator, perm, and other product use. Estrogen and EDC information was collected from commonly used hair products' labels (used by >3% of population). African-American and African-Caribbean women were more likely to use all types of hair products compared to white women (P < 0.0001). Among hair product users, frequency varied significantly by race/ethnicity, but not duration. More African-Americans (49.4%) and African-Caribbeans (26.4%) used products containing placenta or EDCs compared to whites (7.7%). African-American and African-Caribbean women were more likely to be exposed to hormonally-active chemicals in hair products.
Although widely studied over the past 40 years, personal use of hair dye generally has not been associated with overall cancer risk. The association between hair dye use and risk of bladder and hematopoietic cancers has been less conclusive. Most hair dye studies have been case-control studies conducted in Caucasian populations. We examined the relationship between personal hair dye use and cancer risk in a prospective cohort of 70,366 Chinese women. After an average of 7 years of follow up, 2437 women were newly diagnosed with cancer by 31 December 2005. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) of cancer risk associated with hair dye use, adjusting for potential confounding factors. Compared with women who reported no hair dye use, ever users had an overall cancer risk of 0.89 (95% CI 0.82, 0.97). No significant association was observed for several common cancers, including cancers of the breast (RR 0.93, 95% CI 0.78, 1.09), lung (RR 0.81, 95% CI 0.62, 1.09), stomach (RR 0.90, 95% CI 0.66, 1.21), and colorectum (RR 1.04, 95% CI 0.84, 1.28). We also found no significant association with most other cancers, including bladder cancer (RR 1.14, 95% CI 0.56, 2.35) and hematopoietic cancers overall (RR 0.89, 95% CI 0.59, 1.35) or their subtypes, including non-Hodgkin lymphoma, multiple myeloma, and leukemia. We generally found no evidence of an association between personal use of hair dye and cancer risk, although our study is limited by small numbers for certain cancer types.
A survey of 120 557 married, female, registered U.S. nurses, aged 30 to 55 years, carried out in 1976, showed that 38 459 (31·9%) had at some time used hair dyes, and 3548 (2·9%) had had cancer. For all cancers combined, the risk ratio (R.R.) for the development of cancer among women who had used hair dyes at any time, compared with those who had never used them, was 1·10 (P=0·02). When cancers were subdivided by anatomical site into 16 main groups, only those of the cervix uteri (R.R.=1·44, P<0·001) and those of the vagina and vulva (R.R.=2·58, P=0·02) showed statistically significant associations with use of permanent hair dyes. Both these associations were reduced but remained significant after standardisation for cigarette smoking, and neither showed increases in risk of cancer with increasing years since first use of hair dyes. Women who had used permanent dyes for 21 years or more before the onset of cancer had a significant increase in risk for all sites combined (R.R.=1·38, P=0·02), compared with "never users". This increase was primarily due to an excess number of observed to expected cases of breast cancer (24 versus 16·3). However, among those who had first used dye 16 to 20 years before diagnosis of breast cancer, there was an almost equal deficit in numbers of cancers at this site (16 observed versus 25·1 expected). The present evidence does not indicate that any material risk of cancer is likely to have occurred during the initial 20 years following first use of permanent hair dyes.
A case-control study of the relationship between hair dye use and breast cancer included 129 breast cancer patients and 193 control women drawn from the records of a multiphasic screening clinic. Information was obtained by telephone interview on a number of risk factors for breast cancer and on variables pertaining to hair dye use: chronologic time, duration, frequency, type, and color. From this, quantitative measures of cumulative hair dye use at various intervals prior to breast cancer (or an equivalent for controls) were obtained. A multivariate risk factor score was used to control for confounding variables. The adjusted relative risks for breast cancer versus hair dye use were greater than unity but were not generally significant. However, integral measures of hair dye use (No. of yr times frequency per yr) were significantly related to breast cancer when confounding variables were controlled. The association between hair dye use and breast cancer was greatest among women over 50 years of age and among those at lower natural risk for breast cancer. An analysis of temporal patterns showed that breast cancer was related mainly to hair dye use 10 or more years before cancer diagnosis. Because of the retrospective nature of the hair dye data and the small sample size, these results require further validation.
A case-control study was undertaken of use of permanent and semipermanent hair dyes by women with cancers of several sites, including breast and endometrium. In London, Ontario, 50 cases of of breast cancer and in Toronto 35 cases of breast cancer and 36 cases of endometrial cancer were identified in cancer treatment centers. In London, controls were selected from hospitalized women with diseases other than cancer; in Toronto, controls were selected from women living in the same neighborhood as the patients with cancer. The results did not suggest an increased risk of either breast or endometrial cancer in users of permanent or permanent and semipermanent dyes combined. Although the numbers of cases and controls were small, the consistency of the results for both sites, in both study centers, and the absence of any clear positive relationship between various measures of intensity of use and risk of cancer provided evidence that a large increase in risk was not missed.
The recent finding that many permanent and semipermanent hair dyes are strongly mutagenic in a laboratory test, together with the fact that single female hair-dressers had higher than expected death rates from breast-cancer in 1959-63, prompted a study into the use of hair dyes by patients with breast cancer and by matched controls. There was no difference between the patients and their controls in their use of hair dyes. There were also no significant differences between the two groups when the analysis was confinedto women who had used dyes over four years and over nine years before diagnosis. The only significant findings were a higher proportion of past or present smokers among women aged over 50 who used hair dyes and an association between hair dyes use and age at first pregnancy. Further epidemiological studies are clearly needed in view of the mutagenicity found in the Ames test, and the fact th & several human carcinogens are also mutagenic according to this test.
We have previously described a sensitive bacterial test for dectecting carcinogens as mutagens. We have previously described a sensitive bacterial test for detecting carcinogens as mutagens. We show here that 89% (150/169) of commercial oxidative-type (hydrogen peroxide) hair dye formulations are mutagenic in this test. Of the 18 components of these hair dyes, nine show various degrees of mutagenicity:2,4-diaminoanisole, 4-nitro-o-phenylenediamine, 2-nitro-p-phenylenediamine, 2,5-diaminoanisole, 2-amino-5-nitrophenol, m-phenylenediamine, o-phenylenediamine, 2-amino-4-nitrophenol, and 2,5-diaminotoluene. Three hair dye components (p-phenylenediamine, 2,5-diaminotuluene, and 2,5-diaminoanisole) become strongly mutagenic after oxidation by H2O2: the mutagenic product of p-phenylenediamine is identified as the known trimer, Bandrowski's base. 2,4-Diaminotoluene, a hair dye component until recently, is also shown to be mutagenic: this compound has been shown to be a carcinogen in rats and is used in large amounts in the polyurethane foam industry. About 20,000,000 people (mostly women) dye their hair in the U.S. and the hazard could be considerable if these chemicals are actually mutagenic and carcinogenic in humans.
An epidemiologic case-control study of 1617 patients with a primary breast cancer and 1617 control subjects was conducted to test the hypothesis that use of hair dyes is related to breast cancer. No overall association was observed between breast cancer risk and "ever use" of hair dyes (odds ratio, 1.04; 95% confidence interval, 0.90 to 1.21), age when hair dye use started and age when it stopped, duration of hair dye use (years), types of hair dyes used, and estimated lifetime number of individual applications. The current data set also failed to show an increased risk for breast cancer in women who had been diagnosed with benign breast disease and were exposed to hair dyes.
To investigate whether hair dye use increases the risk of breast cancer, a case-control study was conducted among patients attending a screening center in New York City. The study group consisted of 398 breast cancer cases identified at the screening center between 1977 and 1981, and 790 randomly selected controls screened during the same period. Subjects were interviewed by telephone to obtain information on known risk factors for breast cancer, along with a complete history of hair dye use detailing type of dye, color, duration, frequency, and temporal periods of use. Most subjects (77%) had used hair dye at least once, 38% of the subjects at least 100 times. However, little increased risk of breast cancer was found among hair dye users. The adjusted odds ratio for ever having used hair dye was 0.8 (95% confidence interval 0.6-1.1), and there was no evidence of a trend in risk with increasing number of hair dye uses. The results were the same whether all past exposures were considered or only exposures more than 10 years before disease. Breast cancer risk did not increase with increasing intensity of exposure, as measured by frequency of use or darkness of color. No effect was seen for different types or colors of dye, or for use during different periods of reproductive life. Although personal hair dye use was unrelated to breast cancer risk, there was an adjusted odds ratio of 3.0 (95% confidence interval 1.1-7.8) for 5 or more years of work as a beautician. Overall, the results of this study, taken in conjunction with the findings of other epidemiologic studies, do not implicate hair dye use as an important cause of human breast cancer.
Two-generation reproduction and chronic toxicity-carcinogenicity studies were conducted in Sprague-Dawley rats receiving topical applications of six oxidative hair-colouring formulations. These formulations were prepared as prototypes of permanent hair colourings using the base ingredients and primary intermediates and couplers most often used in this kind of product. Among the dyes included in the various formulations were p-phenylenediamine, p-toluenediamine, p-aminophenol, resorcinol, m-aminophenol, 1-naphthol, 2-amino-4-nitrophenol, 4-chlororesorcinol, p-aminodiphenylamine hydrochloride and N-methyl-p-aminophenol sulphate. The dye solutions were mixed with an equal volume of 6% hydrogen peroxide prior to application. In the reproduction study the samples were applied topically twice weekly throughout the growth, mating, gestation and lactation phases of the F0 parents to the weaning of the F1a and F2b litters. Fertility, gestation and foetal viability indices and body weights were evaluated for the six treatment groups and these were compared with the values for the three concurrent control groups. Weanlings selected from the F1a litters were the subjects for the lifetime carcinogenesis study. For 24 months they received twice-weekly topical applications of the same dyes as were administered to their parents. Clinical chemistry, haematological and urinalysis studies were performed at months 3, 12, 18 and 24, and five animals/sex/group were killed at month 12 and autopsied for histological examination of the rat tissues. All animals in the chronic study were evaluated for incidence of neoplastic and non-neoplastic lesions. In the reproduction phase the application of hair dyes had no adverse effect on the fertility of the males or females, or on gestation, lactation and weaning indices. The average number weaned per litter and the mean body weights of the weanlings were comparable among the treated and control groups. No treatment-related gross lesions were observed in any animals necropsied at month 12 or at study termination, or in any rats that died during the course of the carcinogenicity study. Comparison of the tumour incidences among the six treated and three control groups showed some significant variations among those tumours occurring most frequently in this strain of rats, and pituitary adenomas were also increased significantly (P less than 0.05) in the females of one of the treated groups. The incidence of this tumour is known to be high and variable in untreated female Sprague-Dawley rats.(ABSTRACT TRUNCATED AT 400 WORDS)
Aromatic amines contained in permanent hair dyes can be absorbed percutaneously and are mutagenic and carcinogenic in some laboratory studies. Concern has been raised that use of these dyes may increase the risk of human cancers. Therefore, the present study examined the relationship between permanent hair dye use and incidence of breast cancer among 118,404 U.S. women aged 30-55 years who were followed prospectively for 6 years. Among women who had ever used permanent hair dyes, 353 developed breast cancer during 246,848 person-years of follow-up, while 505 cases occurred during 397,460 person-years among never users (age-adjusted rate ratio = 1.1; 95% confidence interval = 0.9-1.2). Identical rate ratios were observed when women who had ever used hair dyes were subdivided into current and past users. Adjustment for known determinants of breast cancer in multivariate models did not alter these relationships. The risk of breast cancer did not increase with more frequent use, longer duration of use, or interval since first use. On the basis of these data and previous findings, it appears unlikely that the use of permanent hair dyes causes any important increase in risk of breast cancer.
para-Phenylenediamine (p-PD), a widely used aromatic amine in the preparation of commercial oxidative-type hair dyes, has been previously demonstrated
to have neither mutagenic activity to Salmonella typhimurium nor carcinogenic activity in rats and mice. In this study, the mutagenicity of p-PD after an oxidation by hydrogen peroxide towards S. typhimurium TA98 and its carcinogenkity in Wistar rats were examined both by topical application to the shaved skin and by s.c. injection.
Hie oxidation product was found to be strongly muta-genic to the bacterial tester strain in the presence of rat liver S-9
fraction. Interestingly, in female rats, both topical application and s.c. injection for 18 months of oxidized p-PD could induce a statistically significant incidence of mammary gland tumors (>50%, P < 0.05). In addition, uterine tumors and soft tissue tumors of both malignant and benign types were also significantly induced
(43% and 57%, P < 0.05) hi the s.c. injection group. On the other hand, tumors of mammary gland and soft tissue were not observed in male
rats under similar experimental conditions. However, tumors of other organs including liver, kidney, adrenal gland, thyroid
gland, urinary bladder and lung were occasionally observed in male rats of both groups and might be related to the p-PD treatment.
In a case-control study of 401 breast cancer cases and 625 age-matched controls, the possible etiologic role of hair dye usage was investigated. No association was found between hair dye use and breast cancer (odds ratio = 1.02; 95% confidence interval = 0.77-1.32) or any factors affecting dosage, frequency, duration, type, or color of hair dye. Important confounders of hair dye use included religion and smoking status. When stratified by 10-year age groups, there was no appreciable trend in risk status between case and referent populations. No dose-response relationship (frequency X duration X shade X type of dye used) was found, even after controlling for factors affecting hair dye use. A multiple logistic regression analysis supported the absence of this relationship.
An epidemiologic case-control study of 118 breast cancer patients and 233 controls was conducted to test the hypothesis that hair dyes are related to breast cancer. Matched controls were selected by "random digit dialing," and all epidemiologic data were collected by telephone interviews. No overall association was detected. On a prospective basis, the interaction between hair dye exposure and six variables known to be risk factors for breast cancer then were examined: previous benign breast disease (BBD), "ever" versus "never" pregnant, age at first pregnancy, menopause induced by operation, age at menarche, and education. A statistically significant increased risk of breast cancer was found for women with a history of BBD and exposure to hair dyes as compared to women with BBD but no hair dye exposure: The relative risk (RR) was 4.5, and the 95% confidence intervals (C) were 1.20 and 15.78. A total of 24 women (19 patients and 5 controls) reported a history of BBD and hair dye use. Further analysis revealed a significant association between hair dye use and breast cancer among women 40-49 years of age (RR = 3.33; 95% CI: 1.1 and 10.85) and a highly significant (P = 0.0008) dose-response relationship among women who used hair dyes for changing their natural color as opposed to covering gray hair. The numbers of patients and controls included in this study were small and several hypotheses were tested. Additional epidemiologic studies are needed before firm conclusions can be reached concerning the nature of these associations.
F344 female rats were fed 2,4-diaminoanisole sulfate (2,4-DAA) (a hair dye component) at three concentration levels up to 86 weeks. The administration of hair dye was interrupted after 10 weeks' feeding for 15 animals at the highest concentration level. Both the early effect of 2,4-DAA on the thyroid gland and the late effect on thyroid, mammary, clitoral, and pituitary glands were studied. In a few weeks, 2,4-DAA showed goitrogenic effects on the thyroid gland. However, the nodular phase of the goiter did not develop. Cystic colloid-filled follicles became lined with basophilic flattened epithelium that continued to proliferate and to form adenomatous or papillary neoplasms. Only 10 weeks of feeding at the high level of 2,4-DAA produced a 42% tumor incidence, and one-fourth of the animals had thyroid tumors. Dark pigment in the thyroid epithelium was still present 70 weeks after the feeding of 2,4-DAA had been interrupted. Feeding of high levels of 2,4-DAA for 82 weeks produced a 78% thyroid tumor incidence. Mammary tumor incidence was nearly five times higher at the 0.24% 2,4-DAA feeding level than among controls. At this same feeding level, 45% of the rats had clitoral tumors. Lesions of the pituitary gland were present in all groups, but tumors were encountered only among the 2,4-DAA-fed animals.
Epidemiological data on occupational exposure and personal use of hair dyes was reviewed with specific focus on bladder cancer and lymphoid neoplasms. At least seven cohort and 11 case-control studies included data on occupational exposure to hair dyes by hairdressers, barbers and beauticians, and their subsequent bladder cancer risk. The relative risk (RR) estimate was 1.4 (183 observed vs 129 expected) for cohort studies, and in several case-control studies the RRs were somewhat above unity. These results are compatible with some moderate association between past professional exposure to hair dyes and subsequent bladder cancer risk, but also with errors and biases in observational epidemiological studies, particularly since allowance for smoking was lacking or inadequate in most studies. An open question is whether current occupational exposure to modern hair dyes is still related to some excess bladder cancer risk. Five case-control studies included information on personal use of hair dyes and bladder cancer risk. There was no evidence of any association. Nine cohort and eight case-control studies considering occupational exposure to hair dyes and lymphoid neoplasms were reviewed. In the cohort studies, a total of 100 lymphoid neoplasms was observed compared with 84.4 expected (RR 1.2). The RR estimates were 1.5 for non-Hodgkin's lymphomas (NHL, 17 observed vs 11.2 expected) and 1.1 for multiple myeloma (MM, 19 observed cases vs 16.8 expected). Interpretation of case-control studies of occupational exposure is seriously hampered by the small number of exposed cases. Five case-control studies considered personal use of hair dyes and the risk of lymphoid neoplasms. Of these, three reported some association, particularly with NHL and MM. However, the RR estimates were only moderately above unity, and inadequate allowance was made for potential confounding factors, including social class and greying hair, which could be correlates of both hair dye use and lymphoid neoplasms. Further, there is little information on the biodistribution and bioavailability of potential carcinogens in hair dyes, particularly their concentrations in lymphoid tissue. These findings, therefore, require further research, particularly since they may be influenced by selective publication of positive findings (publication bias). None of the other neoplasms extensively studied, including breast, skin and lung was related to hair dye use.
Permanent hair dyes are used by about one third of adult American women. Several epidemiologic studies associate hair dye use with increased risk of non-Hodgkin's lymphoma and multiple myeloma. In one study, risk increased with more prolonged exposure to darker, more concentrated, permanent dyes.
The purpose of our study was to examine the relationship between hair dye use and development of certain cancers associated with hair dye use in previous studies.
We examined prospectively the relationship between the use of permanent hair dyes and selected fatal cancers in 573,369 women. The participants provided information in 1982 on the frequency and duration of hair dye use and the color of hair dye used. Death rates were measured through 1989. Relative risks (RRs) were computed with subjects who had not used hair dyes serving as the referent group, and 95% confidence intervals (CIs) were calculated on the basis of approximate-variance formulas.
Women who had ever used permanent hair dyes showed decreased risk of all fatal cancers combined (RR = 0.93; 95% CI = 0.89-0.98) and of urinary system cancers (RR = 0.65; 95% CI = 0.49-0.87) and no increase in risk of any type of hematopoietic cancer. Women who had used black hair dyes for 20 years (0.6% of women hair dyers) or more had increased risk of fatal non-Hodgkin's lymphoma (RR = 4.37; 95% CI = 1.3-15.2) and multiple myeloma (RR = 4.39; 95% CI = 1.1-18.3). These positive findings are based on three cases of non-Hodgkin's lymphoma and two cases of multiple myeloma. We found no relationship between use of permanent hair dyes and fatal cancers of the mouth, breast, lung, bladder, or cervix, areas that were of interest as the result of earlier studies.
Women using permanent hair dyes are not generally at increased risk of fatal cancer. Women with prolonged use of dark, particularly black, hair dyes may have increased risk of fatal non-Hodgkin's lymphoma and multiple myeloma, but these women are a small fraction of hair dye users. Nonetheless, the removal of carcinogens from hair dyes and appropriate labeling of hair-coloring products would help reduce this potential risk.
Four African-American girls aged 14 months to 93 months developed breast or pubic hair 2 to 24 months after starting the use of estrogen or placenta-containing hair products. Discontinuing the use of the hair products resulted in regression of the breast or pubic hair. Serum gonadotropins and estradiol levels were variable. No other cause for early sexual development was noted in these girls.
Diet and environmental exposures are often regarded as significant etiologic factors in human breast cancer. Chemicals that may be involved in these exposures include heterocyclic amines, aromatic amines, and polycyclic aromatic hydrocarbons, which also serve as strong mammary carcinogens in different animal models. In this study, we chose to quantify the major DNA adducts derived from one member of each of these classes of carcinogens, that is, 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP), 4-aminobiphenyl (ABP), and benzo[a]pyrene (B[a]P), respectively, in DNA isolated from exfoliated ductal epithelial cells in human breast milk. Milk was collected from healthy, nonsmoking mothers. The isolated DNA was digested to 3' nucleotides and subjected to (32)P-postlabeling. Adduct enrichment was achieved using Oasis Sep-Paks and the analyses were conducted by HPLC using radiometric detection. Critical to the analyses were the syntheses of bis(phosphate) standards for the C8-dG adducts of PhIP and ABP, and the N(2)-dG adduct of B[a]P, which were added to each reaction as UV markers. Of the 64 samples analyzed, adducts were found in 31 samples. Thirty samples contained detectable levels of PhIP adducts, with a mean value of 4.7 adducts/10(7) nucleotides; 18 were positive for ABP adducts with a mean value of 4.7 adducts/10(7) nucleotides; and 13 were found to contain B[a]P adducts with a mean level of 1.9 adducts/10(7) nucleotides. These data indicate that women are exposed to several classes of dietary and environmental carcinogens and that these carcinogens react with DNA in breast ductal epithelial cells, the cells from which most breast cancers arise.
This case-control study was designed to test the hypothesis that the risk of breast cancer varies by type and colour of the hair colouring products used. A total of 608 cases and 609 controls were included in the study. We found no increased risk associated with the overall use of hair dye products or exclusive use of permanent or temporary types of hair dye products. Among those who reported to have exclusively used semi-permanent types of hair colouring products, some of the ORs were elevated. However, none of the ORs related to age at first use, duration of use, total number of applications, and years since first use, was statistically significant. There was also no increased risk of breast cancer associated with exclusive use of dark or light hair colouring products, or use of mixed types or colours of hair dye products. We also found no increased risk of breast cancer associated with hair dye use based on an individual's reason for using a hair colouring product, such as to cover grey or to change natural hair colour. These data suggest that the use of hair colouring products does not have a major impact on the risk of breast cancer.
A recent epidemiological study suggested that aromatic amines present in hair dyes may contribute to an increased risk of bladder cancer (Gago-Dominguez, et al. (2003) Carcinogenesis 24, 483-489). Moreover, a preliminary study linked frequent hair dye usage with elevated levels of DNA adducts of 4-aminobiphenyl (4-ABP) in human epithelial breast cells (Gorlewska, et al. Proc. Am. Assoc. Cancer Res. 43, 1018-1019). Therefore, we sought to determine if 4-ABP, a recognized human urinary bladder carcinogen, is present in commercial hair dyes. 4-ABP was isolated from dyes by solvent extraction with hexane, followed by silica gel chromatography, either with or without chemical treatment of the extract with Zinc/HCl, and a final purification with a mixed cation exchange reversed-phase resin. The identity of 4-ABP was confirmed by both HPLC with electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) and gas chromatography with negative ion chemical ionization mass spectrometry (GC-NICI-MS) following chemical derivatization with pentafluoropropionic anhydride (PFPA). The levels of 4-ABP ranged from not detectable (<0.29 parts per billion (ppb)) up to 12.8 ppb. The noncarcinogenic isomer 2-aminobiphenyl (2-ABP) was also found at quantities up to 310 ppb. 4-ABP was detected in eight of the 11 hair dyes and found in black, red, and blonde hair dyes but not in brown hair dyes. 1,4-Phenylenediamine (PPD) is a key constituent for color development of many permanent hair dyes. Some batches of chemical research grade PPD were contaminated with 4-ABP (up to 500 ppb) and 2-ABP (up to 70 parts per million) and may be a source of ABP contamination in hair dyes. These analytical data demonstrate that 4-ABP is present in some hair dyes. Studies on dermal absorption and bioavailability of 4-ABP from hair dyes are required to determine if this aromatic amine contributes to the increased risk of bladder cancer reported in frequent users of hair dyes.
We investigated the absorption of a commercial [14C]-PPD-containing oxidative dark-shade hair dye in human volunteers as well as in vitro using human or pig ear skin. The hair of eight male volunteers was cut to a standard length, dyed, washed, dried, clipped and collected. Hair, washing water, materials used in the study and a 24-h scalp wash were collected for determination of radioactivity. Blood, urine and faeces were analysed up to 120 h after hair dyeing. An identical [14C]-PPD-containing hair dye formulation was applied in vitro for 0.5 h to human and pig ear skin, and radioactivity was determined in skin compartments after 24 h. In humans, the recovery rate was 95.7+/-1.5% of the applied radioactivity. Washing water, cut hair, gloves, paper towels, caps or scalp wash contained a total of 95.16+/-1.46% of the applied [14C]. Absorbed radioactivity amounted to 0.50+/-0.24% in the urine and 0.04+/-0.04% in the faeces, corresponding to a mean of 7.0+/-3.4 mg [14C]-PPD-equivalents absorbed. Within 24 h after application, most of the radioactivity was eliminated. The Cmax of [14C]-PPD-equivalents in the plasma was 0.087 microgeq/ml, the Tmax was approximately 2 h, and the mean the AUC(0-12h) was 0.67 microgeq h/ml. In vitro tests in human or pig skin found total absorbed amounts of 2.4+/-1.6% (10.6+/-6.7 microgeq/cm2) or 3.4+/-1.7% (14.6+/-6.9 microgeq/cm2), respectively. Percentage-based in vitro results were considerably higher than corresponding in vivo data, whereas, in units of microg/cm2, they corresponded to a total absorbed amount of 7.40 or 10.22 mgeq for human or pig skin, respectively. All results suggested that hair dyeing with oxidative hair dyes produces minimal systemic exposure that is unlikely to pose a risk to human health.
The pharmacokinetics and metabolism following dermal application of [(14)C]-para-aminophenol (PAP) or [(14)C]-para-phenylenediamine (PPD) were investigated. Groups of rats were treated under occlusion for 24 h with 12.5 mg/kg [(14)C]-PAP, or for 4h with 50 mg/kg [(14)C]-PPD on 10% or 20% of their body surface area, respectively. A female minipig was also treated dermally (24 h, occlusion) with 4.7 mg/kg [(14)C]-PAP on 10% of its body surface area. Blood and plasma samples were analysed for radioactivity and presence of metabolites. In PAP-treated rats, mean plasma levels at 0.5, 1, 2, 4, 8 or 24h were 0.16, 0.24, 0.38, 0.50, 0.36 or 0.14 microg [(14)C]-PAP equivalents/ml, respectively. The plasma half-life was 5.95 h, the C(max) was 0.5 microg/ml, the t(max) was 4 h, and the AUC(0-infinity) was 9.27 microg-equivalentsh/ml. No free PAP was detected in the plasma, but 3 metabolites (M1, M2 and M3) were found in 2-, 4- or 8-h samples at ranges from 0% to 17.7% (M1), 27.6% to 45.0% (M2) or 46.9% to 70% (M3) of the total plasma radioactivity. M2 was identified as acetylated PAP (paracetamol, acetaminophen, APAP), whereas M1 and M3 were identified as O-glucuronide or O-sulfate conjugates of APAP, respectively. In the pig, very low levels of radioactivity (C(max) of approximately 10 ng/ml) were found in the blood, and identified as APAP. Analysis of plasma of PPD-treated rats at 4 h after topical treatment revealed levels of 1.41 +/- 0.34 microg/ml [(14)C]-PPD-equivalents in males, and 7.40 +/- 1.83 microg/ml in females. Radioactivity, reflected a single metabolite, which was identified to be N,N'-diacetylated PPD. Comparison of the plasma APAP levels in rats or the pig following topical PAP with corresponding human plasma levels after a single oral therapeutic dose of APAP suggested a substantial margin of safety. Overall, the results suggest that topically applied PAP or PPD are metabolised in the skin, presumably by N-acetyltransferase-1 resulting in systemic exposure to acetylated metabolites, and not to their parent arylamines.
We monitored the exposure of hairdressers to oxidative hair dyes for 6 working days under controlled conditions. Eighteen professional hairdressers (3/day) coloured hairdresser’s training heads bearing natural human hair (hair length: approximately 30 cm) for 6 h/working day with a dark-shade oxidative hair dye containing 2% [¹⁴C]-para-phenylenediamine (PPD). Three separate phases of hair dyeing were monitored: (A) dye preparation/hair dyeing, (B) rinsing/shampooing/conditioning and (C) cutting/drying/styling. Ambient air and personal monitoring samples (vapours and particles), nasal and hand rinses were collected during all study phases. Urine (pre-exposure, quantitative samples for the 0–12, 12–24, 24–48 h periods after start of exposure) and blood samples (blank, 4, 8 or 24 h) were collected from all exposed subjects. Radioactivity was determined in all biological samples and study materials, tools and washing liquids, and a [¹⁴C]-mass balance was performed daily.
Established models of breast cancer risk, such as the Gail model, do not account for patterns of the disease in women under the age of 35, especially in African Americans. With the possible exceptions of ionizing radiation or inheriting a known genetic mutation, most of the known risk factors for breast cancer are related to cumulative lifetime exposure to estrogens. Increased risk of breast cancer has been associated with earlier onset of menses or later age at menopause, nulliparity or late first parity, use of hormonal contraceptives or hormone replacement therapy, shorter lactation history, exposure to light at night, obesity, and regular ingestion of alcohol, all of which increase circulating levels of unbound estradiol. Among African Americans at all ages, use of hormone-containing personal care products (PCPs) is more common than among whites, as is premature appearance of secondary sexual characteristics among infants and toddlers. We hypothesize that the use of estrogen and other hormone-containing PCPs in young African American women accounts, in part, for their increased risk of breast cancer prior to menopause, by subjecting breast buds to elevated estrogen exposure during critical windows of vulnerability in utero and in early life. These early life and continuing exposures to estrogenic and xenoestrogenic agents may also contribute to the increased lethality of breast cancer in young women in general and in African American women of all ages. Public disclosure by manufacturers of proprietary hormonally active ingredients is required for this research to move forward.
Hair relaxers (straighteners) have been used by millions of African American women, often for many years. Relaxer ingredients can enter the body through scalp lesions and burns. Because manufacturers are not required to list all ingredients, these products may contain unknown harmful substances. We assessed hair relaxer use in relation to breast cancer incidence in the Black Women's Health Study, a nationwide follow-up study of African American women. Information on hair relaxer use was collected in 1997; 48,167 women were followed subsequently through 2003 for incident breast cancer. Incidence rate ratios of breast cancer were estimated with Cox regression. During 266,298 person-years of follow-up, 574 incident cases of breast cancer were ascertained. There were no increases in breast cancer risk associated with any categories of duration of hair relaxer use, frequency of use, age at first use, number of burns experienced during use, or type of relaxer used. The incidence rate ratio for use at least seven times a year for 20 or more years relative to use for less than a year was 0.98 (95% confidence interval, 0.78-1.39). These results suggest that hair relaxer use does not increase the incidence of breast cancer in African American women.
Diet and environmental exposures to aromatic and heterocyclic amines, and polycyclic aromatic hydrocarbons, are thought to be etiologic factors for breast cancer risk. In this study, we chose to quantify the major DNA adduct derived from one member of each of these classes of carcinogens in epithelial cell DNA isolated from human breast milk. Appreciable adducts were detected for each class, namely 2-amino-6-phenylimidazo[4,5-b]pyridine (PhIP), 4-aminobiphenyl (ABP) and benzo[a]pyrene. The effect of several metabolic genotypes on adduct levels were also investigated and higher PhIP and ABP adducts were associated with the rapid NAT2 and/or rapid NAT1 genotypes. The presence of ABP adducts was also significantly associated with the use of hair coloring products (OR=11.2, 95% CI=1.1-109.2) but not tobacco usage. These data indicate that women are exposed to several classes of dietary and environmental carcinogens and that metabolic genotype can be a susceptibility factor.
Process for Relaxing Keratin Fibres. L'Oreal, Paris (FR)
- X Radisson
- P Barbarat
- G Malle
- S Diridollou
Radisson X, Barbarat P, Malle G, Diridollou S. 2010. Process for Relaxing
Keratin Fibres. L'Oreal, Paris (FR). United States Patent Application. US
2010/0284954.