Improving the knowledge and behavior of workplace chemical exposures in Vietnamese-American nail salon workers: a randomized controlled trial

The cost of beauty: Perspectives of salon workers in Kisumu City, Kenya

Despite occupational exposure to hazardous chemicals in cosmetics and personal care products (PCPs), salon workers receive minimal formal protections. Consequently, most salon workers rely on personal safeguards. However, the nature of such individual-level safeguards remains unknown. Knowledge of risks associated with occupational use of cosmetics and PCPs and information needs of salon workers were investigated in Kisumu City, Kenya. Responses from 302 respondents showed that 84% were women and 30% had post-secondary education. Seventy percent reported knowing that ingestion, inhalation, dermal absorption, and injection are the pathways through which harmful products in cosmetics and PCPs may enter the body. Salon workers who had been employed for more than 5 years were at least twice more likely to report that it is not the case that cosmetics and PCPs only cause harm to children (5-10 years vs 1 year: OR = 2.440, 95% CI, 1.160-5.239; >10 years vs 1 year: OR = 8.857, 95% CI, 3.163-29.377); they were about three times more likely to either agree with the statement that cosmetics and PCPs only cause harm under prolonged exposure or to say that they did not know compared to their counterparts who had worked in the industry for 1 year (5-10 years vs 1 year: OR = 2.750, 95% CI, 1.144-7.179; >10 years vs 1 year: 3.179, 95% CI, 1.173-9.096). Over 50% of the respondents reported that they need information on how to protect themselves and others; on available protective measures; and on cosmetic products and PCPs that are safe. Sixty percent reported that they would prefer to get such information from the Ministry of Health at the county or national level and on product inserts. Overall, salon workers in Kisumu City are knowledgeable about the risks associated with their occupation but also appreciate gaps in their knowledge, which can be filled by government-mandated interventions.

The need for a multi-level approach to occupational safety and health among Asian and Asian American beauty service workers

Asian and Asian Americans (A/AA) are a group overlooked in general health outcomes but especially occupational safety and health outcomes. In the United States, the beauty service microbusiness industry (e.g., nail salons) predominantly employs immigrant Asian women who regularly encounter a plethora of occupational hazards (e.g., harmful chemical exposures -toluene, formaldehyde, bloodborne pathogens, fungi. However, due to the precariousness of beauty service jobs, cultural and linguistic barriers, and social determinants of health, A/AA beauty service workers face complex occupational safety and health challenges that require interdisciplinary collaboration and cultural competency to address. This commentary will discuss a multi-level approach including specific outreach partners that will offer the required diverse skillsets necessary for improving the occupational safety and health for this worker population in this microbusiness industry. Implications and suggestions for interventions and policy changes are also recommended utilizing the National Institute on Minority Health and Health Disparities' Research Framework.

A participatory approach to designing and implementing an occupational health intervention for the nail salon community in the Greater Philadelphia region

BACKGROUND

The nail salon industry in the US comprises mostly immigrant-owned, small mom-and-pop salons that employ primarily first-generation immigrant workers from Asia. Because of the cultural and language barriers, both owners and workers may not avail themselves of the occupational safety resources. We formed an academic-community partnership to co-design a feasibility study and multi-level occupational health intervention for Vietnamese-speaking salon owners, workers, and community-based organization.

METHODS

The intervention for each salon included (i) 2-h in-person training covering chemical safety, infection control, musculoskeletal prevention, and workers' rights for both the owners and their employees, (ii) a tailored recommendation report for the owner, and (iii) check-ins with the owner during the 3-month follow-up. Community partner was trained to deliver the in-language training with technical assistance from the research team. Baseline and post-intervention individual data about health symptoms and behaviors, as well as personal chemical exposures were collected and analyzed.

RESULTS

A total of 44 participants from 12 consented salons enrolled in the study. One salon dropped out at follow-up due to change of ownership. Analysis of the differences between post-and pre-intervention showed a tendency toward reduction in some self-reported symptoms in the respiratory system, skin, and eyes, neurotoxicity score, as well as chemical exposures. We could not rule out seasonality as an explanation for these trends. Increase in self-efficacy in some areas was observed post-intervention.

CONCLUSIONS

Our study demonstrated a successful academic-community partnership to engage community members in the intervention study. While the intervention effects from this feasibility study should be interpreted with caution, our preliminary results indicated that our community-based intervention is a promising approach to reduce work-related exposures among Asian American nail salon workers.

Nail job and women’s health: Assessment of ergonomics and occupational hazards

BACKGROUND: The nail job is a new occupation in which the number of people who choose this job is rising. Therefore, the harmful hazards affecting the health of the practitioners should be taken into account. OBJECTIVE: The purpose of this study is to evaluate the ergonomics and occupational health hazards among nail technicians in Iranian society. METHODS: The self-administered questionnaire, the Nordic Musculoskeletal Questionnaire and Novel Ergonomic Postural Assessment (NERPA) method were used to gather data from 80 female nail technicians who participated in this study. RESULTS: More than half of the participants (67.6%) complained of coughing and eye irritation (70%) which was the most frequently reported irritation. The final score of the NERPA was at a high-risk level and the neck pain (63.8%) was the highest in comparison with other parts of the body. There was a significant relationship between activity type with disorder in the neck, elbow, hip, knee, and ankle. Lighting intensity was not significantly associated with musculoskeletal disorders. CONCLUSIONS: Concerning the low work experience, the prevalence of musculoskeletal disorders and, respiratory complaints is high. Hence, the attention of policy-makers to the safety and hygiene issues of women in this occupation is necessary by setting guidelines and considering inspections of occupational health and safety professionals.

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

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.

Perceived work exposures and expressed intervention needs among Michigan nail salon workers

Background

Nail salon workers are an underserved population exposed to various occupational hazards. Comprised primarily of women and immigrants, these workers face challenges that further increase their workplace exposures and adverse health outcomes. Though previous studies have noted nail salon workers’ exposures, these studies have yet to explore the workers’ insights on intervention needs. This study among Michigan nail salon workers addresses this gap.

Methods

This qualitative study was informed by the phenomenology methodological framework anchored within critical social theory. Participants were recruited from nail salons in Southeast Michigan to partake in focus groups. Interviews were recorded, transcribed, and analyzed using content analysis.

Results

Three focus groups were conducted with 13 participants. Three major categories emerged. The first category, workers’ perceived work-related stressors, included six themes: lack of standardized policies, regulations, education/training; disconnect between education/training and real-world practice; inadequate knowledge on exposures and safety protocols; unsafe nail products; customer pressure; and immigrant-related pressures. The second category, health issues perceived to be directly related to workplace exposures, included two themes: symptoms experienced due to contact with nail products and symptoms due to poor ergonomics. The third category, participants’ perceived intervention needs, included four themes: continuing education; updates with new products; communication with key stakeholders; and partnership building and resource access.

Conclusions

To our knowledge, this is the first qualitative study among U.S. nail salon workers focused in Midwest. In addition to the noted individual and organizational-level interventions, policy level implications are discussed given discrepancies in training and practices across states.

Occupational symptoms due to exposure to volatile organic compounds among female Vietnamese nail salon workers in Danang city

OBJECTIVES

Nail workers are exposed to many hazardous chemicals. Despite many warnings about health problems among nail workers in other countries, data concerning exposure to chemical hazards among nail workers is still limited in Vietnam. In this study, we aimed to identify exposure to volatile organic compounds and their relationship with occupational symptoms among Vietnamese female nail salon workers.

METHODS

A cross-sectional study was conducted in Danang, Vietnam, from January 2019 to September 2019. Total 42 personal passive samplers were collected to evaluate 12 substances from 21 nail workers (15 salons) twice a week. We chose one representative worker from each of the nine salons with less than six workers and two representative workers from each of the six salons with over five workers for personal sampling based on the principle of similar exposure groups. We interviewed a total of 100 nail workers in 15 salons and 100 office workers in offices adjacent to the salons to compare occupational symptoms among them.

RESULTS

The commonly detected compounds in nail salons were acetone (97.6%), butyl acetate (83.3%), and ethyl acetate and ethyl methacrylate (78%). The concentration of total target VOCs was related to the number of serviced customers, the concentration of CO₂ , and general ventilation used. The subjective symptoms were significantly higher for the nail workers than for the comparison subjects, that is, headache, nausea, nose irritation, skin irritation, shortness of breath, and confusion. Among 100 nail workers, nose irritation was significantly higher for nail workers who were exposed to acetone at levels exceeding the Vietnam occupational exposure limit (VOEL) adjusted with the Brief-Scala model.

CONCLUSIONS

Exposure to VOCs such as acetone in nail salons results in occupational symptoms among workers.

Nail health in women

Healthy nails are functionally and cosmetically important to the daily work of women. The globally increasing market for nail cosmetics reflects the importance of the appearance of nails. This article details the composition of a healthy nail, diagnosis and treatment of nail disorders, use of nail cosmetics and their risks, the impact of the aging process on nails, and the relative risks to nail salon workers. Knowledge of these issues will prepare health care providers and patients to maintain healthy nails throughout their lives.

Biological and environmental exposure monitoring of volatile organic compounds among nail technicians in the Greater Boston area

Nail technicians are exposed to volatile organic compounds (VOCs) from nail products, but no studies have previously measured VOC biomarkers for these workers. This study of 10 nail technicians aimed to identify VOCs in nail salons and explore relationships between air concentrations and biomarkers. Personal and area air samples were collected using thermal desorption tubes during a work shift and analyzed using gas chromatography/mass spectrometry (GC/MS) for 71 VOCs. Whole blood samples were collected pre-shift and post-shift, and analyzed using GC/MS for 43 VOCs. Ventilation rates were determined using continuous CO₂ measurements. Predominant air VOC levels were ethyl methacrylate (median 240 µg/m³ ), methyl methacrylate (median 205 µg/m³ ), toluene (median 100 µg/m³ ), and ethyl acetate (median 639 µg/m³ ). Blood levels were significantly higher post-shift than pre-shift for toluene (median pre-shift 0.158 µg/L and post-shift 0.360 µg/L) and ethyl acetate (median pre-shift <0.158 µg/L and post-shift 0.510 µg/L); methacrylates were not measured in blood because of their instability. Based on VOCs measured in these seven nail salons, we estimated that emissions from Greater Boston area nail salons may contribute to ambient VOCs. Ventilation rates did not always meet the ASHRAE guideline for nail salons. There is a need for changes in nail product formulation and better ventilation to reduce VOC occupational exposures.

Evaluating an owner-to-worker training intervention in California nail salons using personal air monitoring

BACKGROUND

Chemicals in nail products have been linked to numerous health concerns.

METHODS

We recruited Vietnamese-American nail salon owners and workers in California and randomized salons into an intervention or control group. Owners in the intervention group received training and then provided education to workers in their salons on best practices to reduce workplace chemical exposures. Methyl methacrylate (MMA), toluene, and total volatile organic compounds (TVOCs) were measured using personal air monitors worn by workers during the work-shift.

RESULTS

We enrolled 77 salons (37 intervention and 40 control) and 200 workers. There was no significant intervention effect between the two groups. However, MMA and TVOCs were higher for workers who used gel polish and acrylic nails as well as in busy salons.

CONCLUSIONS

Although the intervention did not show reductions in chemical levels, identifying worker tasks and salon characteristics that predict chemical levels can inform future interventions to reduce exposures.