Cancer incidence in female cosmetologists and manicurists in California, 1988-2005.

Health concerns have been pronounced for cosmetologists and manicurists, who are exposed daily to cosmetic products containing known or suspected human carcinogens and endocrine disruptors. In this retrospective cohort study, the authors used probabilistic record linkage between California's statewide cosmetology licensee and cancer surveillance files to identify newly diagnosed invasive cancers among female workforce members during 1988-2005. Rate ratios and 95% confidence intervals for cancer among workforce members compared with the general female population in California were estimated via Poisson regression. For comparison, site-specific proportional incidence ratios were computed. The authors identified 9,044 cancer cases in a cohort of 325,228 licensees. Rate ratios for all sites combined suggested lower incidence among both cosmetologists (rate ratio = 0.84, 95% confidence interval (CI): 0.82, 0.86) and manicurists (rate ratio = 0.87, 95% CI: 0.84, 0.90). Proportional incidence ratios were modestly elevated for thyroid cancer among all licensees (proportional incidence ratio = 1.13, 95% CI: 1.04, 1.23) and for lung cancer among manicurists (proportional incidence ratio = 1.21, 95% CI: 1.07, 1.36). Although there did not appear to be a cancer excess, these findings may be artifactually influenced by limitations in demographic information available from the licensee files. Additionally, the relatively young ages of cohort members and demographic shifts in the industry composition in recent years suggest a need for further follow-up.