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Table 1 Group allocation scheme for certainty of specific occupational causation* among n = 147 hairdressers

From: Respiratory afflictions during hairdressing jobs: case history and clinical evaluation of a large symptomatic case series

Group: Specific occupational causation

1: Confirmed (n = 24)

2: Likely, but not conclusively proven (n = 11)

3: Unclear (n = 25)

4: Unlikely (n = 66)

5: No occupat. Causation (n = 21)

Airway disease verified

Yes

Yes

Yes

Yes

No

 I. Obstructive ventilation disease confirmed

n = 5

n = 1

n = 5

n = 23

 II. Work-related rhinoconjunctivitis

n = 9

n = 3

n = 7

n = 19

 III. both

n = 10

n = 7

n = 13

n = 24

Immediate-type-like hypersensitivity reaction to AP or hair dyes

Confirmed

Likely, but not unequivocally confirmed

Unlikely

No

No

 IV. “Positive” reaction to AP or blonde dye in skin (prick) testing

n = 21 with CRa

n = 1 CR unsurea

n = 1 CR unlikelya

 V. “Questionable” reaction to AP or blonde dye in skin (prick) testing

n = 1 with CRa (positive SIC)

n = 4b

n = 3 CR unlikelya (1x neg. SIC)

n = 3 without CRa(2x neg. SIC)

n = 1 without CRa (neg. SIC)

 VI. “Negative” skin prick test to AP/blonde dye

n = 2b, c

n = 14d

n = 63e

n = 20

 VII. Rating of skin testing for immediate-type-like reactions to AP / blonde dye: “not appraisable”

n = 2 but positive SIC

n = 3b

n = 6d

 VIII. No skin prick test to AP/blonde dye conducted

n = 1b

n = 1

  1. *Specific occupational causation primarily based on affirmation status of an airway disease and verifiability of a specific hypersensitivity reaction (AP Ammonium persulfate; CR Clinical relevance; SIC Specific inhalation challenge), for more details on the reasoning of the hypersensitivity reaction please also see Additional file 2
  2. a Clinical relevance based on anamnesis (suitable, exposure-dependent / disputable / incongruous / no symptoms at contact) and, if performed, SIC-result (negative SIC = CR unlikely or excluded)
  3. b No SIC performed, but with clear anamnestic indications for an occupational causation (such as urticaria at skin contact to hair/blonde dyes, hints at anaphylactic reactions to hair dyes, peakflow protocol showing workplace-related deterioration)
  4. c One case with positive prick test to henna and contact urticaria to p-phenylendiamine and henna and recurrent angioedema and respiratory symptoms after dark dyes; other case with contact urticaria to blonde dye and positive peakflow protocol
  5. d Some, but less conclusive indications for a substance-specific occupational causation
  6. e Anamnestically no / few indications for a substance-specific occupational causation