Research on occupational toxicants and stylists' reproductive health

Reproductive disorders affect >10 million U.S. women annually, result in >$200 billion in healthcare and lost productivity costs and increase chronic disease risk. Recognized and suspected endocrine disrupting chemicals (EDCs) in hair products, like phthalates and certain volatile organic compounds (VOCs), may play a role. However, data on EDCs’ effects on women’s reproductive health remain limited, particularly in groups experiencing chronic elevated exposures, hampering the development of effective public health interventions. Understanding knowledge, attitudes and behaviors (KABs) associated with EDC exposures is critical to develop feasible and effective interventions. The role of increased workplace EDC exposures on women’s reproductive health reflects a major avenue for public health interventions. Over 700,000 U.S. hairstylists, largely low-income, reproductive-aged women, are an at increased risk of elevated EDC exposures that pose a major reproductive concern. Emerging studies show increased EDC exposures in salon workers, but many lack objective measures, and none focused on salons serving women of color, despite hair products marketed to this demographic posing an elevated exposure risk. We developed a robust community partnership with salon owners, stylists, and a non-profit organization with vast community outreach expertise, to conduct pilot studies in salons. Our pilot found that hairstylists serving women of color have elevated EDC exposures of reproductive concern and report a higher prevalence of reproductive problems compared to office workers, representing a “canary in a coal mine”. We will recruit stylists in salons primarily serving women of color, situating this study at the intersection of social and environmental factors. Our main goal is to identify and prioritize avenues for intervention to mitigate exposures and reproductive health risks in this high-risk workforce by: 1) assessing the role of recognized and suspected EDCs (VOCs, phthalates and their replacements) on reproductive health indicators; and 2) understanding knowledge, attitudes, and behaviors among hairstylists associated with EDC exposures to inform future exposure interventions. To accomplish this, we will: 1) determine if exposures to target EDCs are associated with menstrual cycle length; 2) determine if target EDC exposures are associated with diminished ovarian reserve; and 3) assess if results report-back improves KABs related to EDC exposures in hairstylists. This translational study, motivated by concerns among hairstylists and co-designed with our community team will yield novel data on EDC exposures, reproductive health risks, and their prevention in a high-risk group. Findings will lead to a community-driven public health action plan that integrates the social ecological model with the occupational hierarchy of controls to mitigate exposures and improve health. By focusing on highly exposed women, we will more clearly identify health impacts to inform policies, interventions, and personal choices to reduce exposures and protect health. Project Number: 1R01ES038299-01 | Fiscal Year: 2026 | NIH Institute/Center: National Institute of Environmental Health Sciences (NIEHS) | Principal Investigator: Lesliam Quiros-Alcala (+2 co-PIs) | Institution: JOHNS HOPKINS UNIVERSITY, BALTIMORE, MD | Award Amount: $796,093 | Activity Code: R01 | Study Section: Special Emphasis Panel[ZRG1 SCIL-B (90)] View on NIH RePORTER: https://reporter.nih.gov/project-details/11277383