Maternal occupation as a nail technician or hairdresser during pregnancy and birth defects, National Birth Defects Prevention Study, 1997-2011

Occup Environ Med. 2022 Jan;79(1):17-23. doi: 10.1136/oemed-2021-107561. Epub 2021 Jun 30.


Objective: Nail technicians and hairdressers may be exposed to chemicals with potential reproductive effects. While studies have examined birth defects in children of hairdressers, those in children of nail technicians have not been evaluated. We investigated associations between selected birth defects and maternal occupation as a nail technician or hairdresser versus a non-cosmetology occupation during pregnancy.

Methods: We analysed population-based case-control data from the multisite National Birth Defects Prevention Study, 1997-2011. Cases were fetuses or infants with major structural birth defects; controls were live-born infants without major birth defects. Expert raters classified self-reported maternal jobs as nail technician, combination nail technician-hairdresser, hairdresser, other cosmetology work or non-cosmetology work. We used logistic regression to calculate adjusted ORs and 95% CIs for associations between occupation during pregnancy and birth defects, controlling for age, smoking, education and race/ethnicity.

Results: Sixty-one mothers worked as nail technicians, 196 as hairdressers, 39 as combination nail technician-hairdressers and 42 810 as non-cosmetologists. The strongest associations among nail technicians included seven congenital heart defect (CHD) groups (ORs ranging from 2.7 to 3.5) and neural tube defects (OR=2.6, CI=0.8 to 8.4). Birth defects most strongly associated with hairdressing included anotia/microtia (OR=2.1, CI=0.6 to 6.9) and cleft lip with cleft palate (OR=2.0, CI=1.1 to 3.7). All oral cleft groups were associated with combination nail technician-hairdresser work (ORs ranging from 4.2 to 5.3).

Conclusions: Small samples resulted in wide CIs. Still, results suggest associations between maternal nail technician work during pregnancy and CHDs and between hairdressing work and oral clefts.

Keywords: epidemiology; occupational health; reproductive medicine.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Barbering / statistics & numerical data*
  • Beauty Culture / statistics & numerical data*
  • Case-Control Studies
  • Cleft Lip / epidemiology
  • Cleft Palate / epidemiology
  • Congenital Abnormalities / epidemiology*
  • Congenital Microtia / epidemiology
  • Female
  • Heart Defects, Congenital / epidemiology
  • Humans
  • Maternal Exposure*
  • Neural Tube Defects / epidemiology
  • Occupational Exposure*
  • Pregnancy
  • Pregnant Women*
  • United States / epidemiology

Supplementary concepts

  • Microtia-Anotia