Introduction
Head shaving is potentially major risk factor for transferring infections, especially bloodborne diseases. Hundreds of thousands of pilgrims to Makkah, Hajjees, shave their heads within hours in a well-defined area, Mina. We studied the head-shaving practices of barbers and Hajjees, to identify unsafe head-shaving practices necessary to prevent or reduce the transmission of bloodborne diseases among Hajjees.
Methodology
We observed 23 nationalities to determine the percentage who had completely shaved their heads. We used a two-stage cluster sampling, to select and interview 298 Hajjees who had their heads shaved with razor blades, and visually checked their scalps for visible cut wounds on scalp. We observed 196 barbers, without their knowledge, according to a standard checklist, asked them about infectious disease that could be transmitted by head shaving; and inspected their hands for visible cut wounds.
Results
The proportion of shaving Hajjees exceeded 90% among Hajjees from some countries such as Eritrea, Egypt, Mauritania and Pakistan, whereas the proportion of head-shaving Hajjees was quite low among Hajjees from in some other countries such as Tunisia and Syria. Some 20.8% (95% CI %%) Hajjees had cuts to the scalp, a mean of 2.6 per Hajjee, maximum of 18 cuts. Of all Hajjees, 1.3% indicated that they had past history hepatitis. Out of 196 barbers observed 23.0% (%%) had uncovered hand wounds, 21.4% (%%) used the same blade for more than one shave, and 81.6% (%%) threw at least one used blade on the floor. The mean (+ SD) time for a single head shave was 5 +1.8 minutes, rang 2-10 minutes. Hajjees (73.5%, 95% %%) and barbers (%%, 95% %%) alike were not aware of any health problems that could be caused by shaving with used razor blades. Head shaving practices of Hajjees did not vary with their educational level. About one fourth of Hajjees from western countries and sub-Saharan were relatively more aware of potential transmission of HIV/AIDS by barbers as compared with 4-12% of Hajjees from other nationalities. Hajjees, aged 50 years or younger, were relatively more concerned with transmission of HIV, whereas older Hajjees were more concerned about transmission of skin diseases.
Conclusion
There is an obvious increased potential risk for bloodborne diseases among Hajjees and between Hajjees and barbers. The detrimental impacts of faulty head shaving practices are probably overlooked and need to be given more attention. An appropriate intervention should be four-fold: availability of safe shaving blades, health education, presence of affordable head shaving services, and close supervision of barbers.