The Beauty and the Beast: pleural plaques due to asbestos exposure in a beauty salon worker. Who is guilty?

Our plain-English summary of The Beauty and the Beast: pleural plaques due to asbestos exposure in a beauty salon worker. Who is guilty?, by A.K. Medeiros, F.M. da Costa, B.B. Libânio, et al (Revista Brasileira de Medicina Do Trabalho, 2024).

The study

• Authors: A.K. Medeiros, F.M. da Costa, B.B. Libânio, P.R.P. Santana, U.P. Santos
• Journal: Revista Brasileira de Medicina Do Trabalho
• Published: 2024;22(4):e20241262
• Type of article: Case report
• Read it: PubMed · Publisher · Free full text

Abstract

This report highlights the occupational health risk of asbestos exposure in the hair and beauty salon industry, exemplified by the case of a 67-year-old hairdresser and manicurist. The patient's medical history, work activities, and examination findings indicated potential asbestos-related pleural plaques. Occupational exposure to harmful chemicals, including asbestos in talc products, poses serious health risks. Despite asbestos bans in many countries, Brazil experienced extensive asbestos usage until 2012-2015, with a complete ban taking effect in 2023. This report emphasizes the need for ongoing discussions on asbestos detection and strict enforcement of bans, while ensuring asbestos-free talcum powders to protect the health of beauty industry workers.

In plain English

This case report described one 67-year-old woman in Brazil who sought medical care for shortness of breath and chest discomfort during her regular activities. She had chronic coronary artery disease, high blood pressure and a past smoking history of 35 pack-years. She had worked as a hairdresser and manicurist for about 32 years (1990-2022), 5 days a week in 12-14-hour shifts. She reported handling talcum powder and wheat flour to make a "plaster hair cap" for hair straightening, and using a hot-air hair dryer. A chest X-ray showed a nodular shadow in the upper right chest. A chest CT scan showed large pleural plaques on both sides, calcified on the right diaphragm, with no changes in the lung tissue. Lung function tests gave a forced vital capacity of 2.52 L (100%). The doctors made a presumptive diagnosis of pleural plaques related to asbestos exposure. The authors suspected asbestos-contaminated talc and judged hair dryers a possible but unlikely source. The article does not report testing her products or tissue for asbestos, or name a fiber type. The authors called for asbestos-free talc and strict enforcement of asbestos bans.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report (single patient)
• Who was studied: One 67-year-old woman in Brazil (seen at a São Paulo hospital) with chronic coronary artery disease, systemic arterial hypertension and a previous smoking history of 35 pack-years
• Exposure: Work as a hairdresser and manicurist for about 32 years (1990-2022), 5 days a week, 12-14-hour shifts. She handled talcum powder and wheat flour to make a "plaster hair cap" for hair straightening, and used a hot-air hair dryer. The authors suspected asbestos-contaminated talc. No fiber type is named and no testing of the products is reported.
• Main results:
  • Chest CT in this patient showed large bilateral pleural plaques, calcified on the right diaphragm, with no parenchymal (lung tissue) changes
  • Chest X-ray showed a nodular opacity in the upper third of the right hemithorax and calcifications projected into the right diaphragm
  • Pulmonary function tests (09/01/2022): FVC 2.52 L (100%), FEV1 2.07 L (102%), FEV1/FVC ratio 0.82, unresponsive to bronchodilators
  • A presumptive diagnosis of pleural plaques related to asbestos exposure was made based on the whole clinical scenario
  • Given her period of exposure, the authors judged hair dryers a possible but unlikely direct source of asbestos exposure
• The authors' conclusion: The authors concluded that the case is a warning for nail, hair and beauty salon workers. They wrote that the patient's pleural plaques are a risk marker for lung cancer and mesothelioma. They also wrote that long hours in confined, poorly ventilated workplaces may explain potential cumulative exposure to asbestos in talc cosmetics. They called for strict enforcement of asbestos bans and asbestos-free talcum powders.
• Limitations the authors state:
  • The diagnosis of asbestos-related pleural plaques was presumptive, based on the clinical scenario.

Topics

Medical terms in this study, explained in our Lexicon: Pleural Plaques, Asbestos Exposure, Occupational Exposure, Talc.

Related studies

• Asbestos content of lung tissue, lymph nodes, and pleural plaques from former shipyard workers — R.F. Dodson, M.G. Williams, et al. (1990)
• Analysis of asbestos fibers in lung parenchyma, pleural plaques, and mesothelioma tissues of North American insulation workers — N. Kohyama, Y. Suzuki (1991)
• Detection of pleural plaques in workers exposed to inhalation of natural fluoro-edenite fibres — V. Rapisarda, C. Ledda, et al. (2015)
• Railroad workers with pleural plaques: I. Spirometric and nitrogen washout investigation on smoking and nonsmoking asbestos-exposed workers — U. Hjortsberg, P. Orbaek, et al. (1988)
• FBLN-3 as a biomarker of pleural plaques in workers occupationally exposed to carcinogenic fibers: a pilot study — V. Rapisarda, C. Ledda, et al. (2015)
• Incidence of bronchial carcinoma in shipyard workers with pleural plaques — J.R. Edge (1979)

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