Vol. 299 No. 22

CORRESPONDENCE

HAIR DYES AND BREAST CANCER To the Editor: The possible association of breast-cancer incidence with hair-dye use has recently received wide newspaper publicity,' based on as yet unpublished work done at New York University; such an effect was also claimed in a report of clinical observations by Shafer and Shafer.2 On the other hand, several widely differing epidemiologic investigations, conducted at Oxford,3 Yale,4 the American Cancer Society,5 and Harvard,6 have found no relation between the two. In evaluating the likelihood of such an association, the following facts should be considered: many aromatic amines have been shown to induce breast cancer in rodents, but the compounds in question are almost exclusively conjugated or fused rings,7 whereas practically all the oxidative hair dyes are simple ring structures; in animal experiments using large doses and different routes of administration, a variety of target tissues may be encountered8'9 (with known human carcinogens, the human target organ is almost invariably also a target in animal tests9); and none of the 13 hair dyes tested in the National Cancer Institute bioassay program have caused cancer of the breast, or indeed of any reproductive organ, in rats or mice a striking observation, because the protocol is designed to maximize the detection of carcinogenic potential. It is worth noting that two recently tested compounds, 2,4-dinitrotoluene and ethylene dichloride, have induced a high incidence of mammary cancer in rats'0"l - the susceptibility of the current test strain is thus demonstrated. In the light of these facts, the claim that exposure to hair dyes is associated with a risk of breast cancer carries a heavy burden of proof.

C. M. BURNETT J. MENKART Clairol, Inc.

Stamford, CT 06902 1. Anderson J: Deadly dyes. Washington Post, September 16, 1978, p E47 2. Shafer N, Shafer RW: Potential of carcinogenic effects of hair dyes. NY State J Med 76:394-396, 1976 3. Kinlen LJ, Harris R, Garrod A, et al: Use of hair dyes by patients with breast cancer: a case control study. Br Med J 2:366-368, 1977 4. Walrath J: Cancer incidence among cosmetologists (Yale University dissertation), 1977 5. Hammond EC: Some negative findings and evaluation of risks. Presented at the nineteenth Science Writers Seminar, Sarasota, Florida, April 1-6, 1977 6. Hennekens CH, Speizer FE, Rosner B, et al: Hair dyes and human cancer. Presented at the eleventh annual meeting of the Society for Epidemiologic Research, Iowa City, Iowa, June 16, 1978 7. Clayson DB, Garner RC: Carcinogenic aromatic amines and related compounds, Chemical Carcinogens (American Chemical Society Monograph No. 173). Edited by CE Searle. Washington, DC, American Chemical Society, 1976, pp 366-461 8. Weisburger J: Chemical carcinogenicists, Toxicology: The basic science of poisons. Edited by LJ Casarett, J Doull. New York, Macmillan, 1975, pp 333-378 9. Tomatis L, Agthe C, Bartsch H, et al: Evaluation of the carcinogenicity of chemicals: a review of the Monograph Program of the International Agency for Research on Cancer (1971-1977). Cancer Res 38:877-885, 1978 10. Bioassay of 2,4-dinitrotoluene for possible carcinogenicity. Natl Cancer Inst Carcinogenesis Tech Rep Ser 54:1-48, 1978 11. Bioassay of 1,2-dichloroethane for possible carcinogenicity. Natl Cancer Inst Carcinogenesis Tech Rep Ser 55:1-62, 1978

CORRELATION OF THE HEPATITIS B SURFACE AND E ANTIGENS To the Editor: Hepatitis B virus infections are identified by presence of specific markers, such as surface antigen/antibody (HBsAg/anti-HBs), core antigen/antibody (HBcAg/anti-HBc) and particularly e antigen/antibody (HBeAg/anti-HBe) and DNApolymerase. HBeAg, a high Dane-particle count and high DNApolymerase activity tend to be associated with high infectivity.' However, the clinical utility of analyses of HBeAg and anti-HBe has been limited by the lack of standardized reagents or better assay systems than immunodiffusion. The notion that the quantity of HBsAg and HBeAg in serum may

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reflect virulence of hepatitis B virus infection2 has gained support from recent data of Stevens et al.3 Recently, radioimmunoassays for HBeAg and anti-HBe were clinically evaluated.' We used a group of serum specimens originally collected from chronic carriers of HBsAg, and sequential specimens from patients who had acute hepatitis B. Serum specimens from the chronic HBsAg carriers found to be HBeAg positive by immunodiffusion were designated strong HBeAg, and those positive only in the radioimmunoassay test were designated weak HBeAg. Of 17 specimens positive for HBsAg and HBeAg but negative for anti-HBe, six were strong, and 11 were weak, HBeAg. Of 30 HBeAg-negative specimens, 14 were anti-HBe positive, and 16 anti-HBe negative (normal human serum negative for all markers of hepatitis B virus infection was used as a diluent in titration of the specimens). Each dilution was tested for HBsAg by the commercially available radioimmunoassay (Ausria, Abbott Laboratories). A highly significant quantitative correlation of HBsAg titers with HBeAg was observed (P

Hair dyes and breast cancer.

Vol. 299 No. 22 CORRESPONDENCE HAIR DYES AND BREAST CANCER To the Editor: The possible association of breast-cancer incidence with hair-dye use has...
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