J. Soc. Cosmetic Chemists 15 45-50 (1964) ¸ 196•t Society o/Cosmetic Chemists o. I Great Britais SOCIETY OF COSMETIC CHEMISTS OF GREAT BRITAIN Scientific Committee Toxicology Group REPORT ON THE PRESENT POSITION REGARDING THE TOXICOLOGY OF HAIR SPRAYS December 1963 Surveys oi personnel in hairdressing establishments, both here and abroad, have lailed to reveal evidence o• lung disease resulting •rom the use o• hair slyrays. To date there is no valid evidence oi l•ulmonary storage oi hair slyray materials in man. Accordingly the term "hair slyray thesaurosis" can no longer be regarded as a valid descrilffion oi the l•ublished clinical cases, since it suggests an aetiological connection with a storage syndrome. The alterna- tive name, "hair slyray lung disease" is intended to reier to the l•ossibility that sensitization to one or more hair slyray ingretlients, and in particular shellac, may be the basis oi the case oi l•ulmonary disease rel•or•ed by McLaughlin et The question oi the size oi hair spray l•articles remains unresolved. It is certain, however, that under some circumstances a l•ropor•ion oi hair slyray l•ar•icles are oi resl•irable size. This being the case, the animal exl•eriments carried out to date are inadequate to l•ermit the firm conclusion that there is no lung storage oi hair slyray ingredients in animals. Therelore they l•rovitle no indication oi what might or might not hal•l•en in man. Should hyl•ersensitivity to shellac be demonstrated in the case described by McLaughlin et al* be, it might be a matter lot serious consideration whether the use oi shellac as a constituent oi hair slyrays should be eontinuetl. * lrood and Cosmetics Toxicology 1 171 (1963) Background to the controversy "Thesaurosis" results when the body stores up in one or other tissue unusual amounts of a normal, abnormal or foreign substance. In 1958 Bergmann et al [New Engl. J. Med. 258 471 (1958)] extended this term to cover lung storage of hair-spray polymer. In this, and a subsequent paper [ibid 266 750 (1962)• they described what purported to be the clinical picture, X-ray findings in the chest, results of histopathological and histochemical examination of lymph nodes and lungs in cases of so-called "hair-spray thesaurosis". Others reported similar cases [Edelston Lancet ii 112 (1959) Caldwell et al, Calif. Med. 95 246 (1961)]. Editorials were written 45

46 JOURNAL OF THE SOCIETY OF COSMETIC CHEMISTS •. Am. Med. Assoc. 17,[ 1320 (1960) ibid, 181, 632 (1962) Brit. Med. J. ii 1042 (1962)]. Letters to the Editor followed [Brunner J. Am. Med. Assoc. 176 1055 (1961) Bergmann ibid 176 1055 (1961) Greenfield Lancet ii 412 (1959) Morgan ibid ii 412 (1959) Leonard ibid ii 412 (1959)]. M. White was concerned about the hazard of "open plan" hairdressing salons [Brit. Med. J. ii 259 (1962)]. Full publicity in the popular press and radio led to public disquiet and resulted in investigations being started by the Medical Research Council in this country. A conclusive publication In "Pulmonary Disease and Hair-Spray Polymers: A Disputed Relation- ship" [Brunner et al, J. Am. Med. Assoc. 184 851 (1983)] and in an Editorial in the same issue [ibid 184 888 (1963)• the hair-spray thesaurosis concept, shaky at the best of times, is dealt a shattering blow. The following issues are dealt with in this paper: (1) Does the clinical and histopathological evidence in man prove a connection between the use of hair sprays and the condition described as thesaurosis ? (2) When put to the test of animal experiment, do hair sprays or hair- spray polymers induce a pathological state corresponding in any way to the human condition ? The first of these questions is readily answered. Schepers rJ. Am. Med. Assoc. 181 635 (1962)• suggested that sarcoidosis, a well-known clinical and pathological entity, was the basis of the published descriptions. Brunner et al point out the large number of agents both chemical and microbiological, capable of inducing a "sarcoid reaction". They refer to a suspected case of hair-spray storage disease that proved on close study to involve organisms of Histoplasma capsulatum. The key test on which reliance was placed by Bergmann et al to link the nonspecific lung and lymph node changes with hair sprays was the finding of PAS-positive granules (PAS refers to the periodic acid-Schiff reagent). Now Brunner and his colleagues demonstrate the presence of similar granules in lungs and lymph nodes taken frmn patients with a variety of common disease states or intoxications. All were collected prior to the introduction of hair sprays in 1949. Making assurance doubly sure, 6 typical hair-spray polyxners have been tested in vitro and in tissue none gave a positive PAS reaction. The results of this and several other histochemical tests were completely different frmn those obtained with the granules present in cells that were supposed by Bergmann et al to have taken up and stored hair- spray polymers. Turning now to studies on hair sprays themselves, the first and most