His skin rashes and asthma symptoms had gotten worse and disappeared on his days off, so he finally sought medical help.
Bassett sent him to an occupational dermatologist to pinpoint the substances that were provoking his skin problems.
"Patch testing is what we do," said Avram, who did not see this particular patient. Small amounts of allergens are placed on the person's back, then examined a couple of days later to see which substances produce a rash or skin reaction consistent with the patient's initial symptoms, he said.
"Sometimes, it's difficult to find out exactly what the culprit is," he admitted.
Once the salon owner's irritants were identified, he was advised to replace some of the products the shop used. In addition, he was told to wear a protective mask around the triggers. But sometimes, stylists and manicurists feel odd about wearing a mask at work for fear it might scare away their clients.
"An allergist is good at developing strategies to evaluate and investigate a case, but we also need a patient's help," said Bassett.
When possible, he suggested, bring along some of the products you suspect you might be sensitive to.
For 20 years, Kathy Sperrazza was a nurse in a Boston teaching hospital. During the early 1990s, many health care facilities, including the one where she worked, instituted universal precautions to protect medical personnel from infections such as HIV and hepatitis B when they came in contact with patients' blood and body fluids.
"We were using many more latex gloves, and there were lots of chemicals in those gloves," explained Sperrazza. And "we were also spraying more cleaning solutions that left a cloud of chemicals."
She recalled that "many of the nurses, especially the ones who worked in the operating rooms or in the intensive care units -- areas that required lots of regular cleaning and frequent glove use -- were developing rashes and their hands looked like raw meat."
Although she had reactions to wearing latex gloves, her test for latex allergy came back negative.
But all around Sperrazza, employees continued getting sick. Struggling to stay in this environment despite the toll it was taking on their health, many doctors and nurses were carrying around inhalers and popping antihistamines.
At first, she would just get headaches while at the hospital. If she worked several days in a row, though, her symptoms went far beyond headaches. She also had chest tightness, wheezing, difficulty breathing and nausea.
Many cleaning agents cause lots of irritation -- headaches, irritated eyes and nose -- and it's usually based on exposure, said Pacheco. "But they usually don't cause long-lasting problems."
Sperrazza eventually reached the point where "I didn't feel well in my own house," and she was getting worse and worse each day. So she took time off.
"I thought I would be back to work in a week, but I was never able to go back," she said.
She went from doctor to doctor -- an occupational medicine physician, a pulmonologist -- and they diagnosed her with occupational asthma as a result of her workplace exposure. But the chemicals seemed to do more than affect her lungs, they also affected her immune system and nervous system.
Only years later would she learn that she had developed multiple chemical sensitivity.