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

Perceived Benefits and Barriers to Implementing Occupational Health Recommendations Among Immigrant-Owned Nail Salons in the Greater Philadelphia Region

Introduction. Immigrant nail salon owners and employees face multiple barriers to accessing occupational health training and services. We formed an academic-community-based organization-business owner partnership-unique in that all partners were culturally congruent-to develop a pilot intervention program for the nail salon community. Methods. Eighteen individuals (nine salon owners and nine employees) from the Greater Philadelphia region received the training in their native language and provided feedback through in-depth qualitative interviews. Interview guide was developed using the Consolidated Framework for Implementation Research (CFIR). Themes of perceived benefits and barriers were identified and aligned with relevant CFIR constructs to gain better understanding of the implementation challenges. Results. Reported benefits of program were improved knowledge of the workplace hazards and safety practices, and the potential to attract more customers and retain employees. Perceived barriers to implementing recommended practices were limited availability of safer products and high cost, challenges communicating with customers, lack of engagement from some owners, organizational management practices affecting employees' motivation, and limited partnership with local government to assist small immigrant-owned businesses. Conclusions. Our study revealed multiple factors that pit long-term health protection of nail salon workers against the economic viability of the businesses that employ them. Our research highlights the need to (1) advocate for federal policies making safer products to be more accessible to the masses, (2) establish local policy and culturally appropriate technical support programs that engage community-based organizations, and (3) develop economic opportunities and mentorship for immigrant entrepreneurs to operate profitable healthy salons.

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.

Exposure assessment to BTEX in the air of nail salons in Tehran city, Iran

The nail salon industry has grown considerably, but there are serious concerns about the health risks associated with working in this field. Therefore, the purpose of this study was to investigate the exposure of nail technicians to BTEX. A cross-sectional study was conducted on 49 salons, and NIOSH Method 1501 was used to measure the concentration of BTEX in the breathing zone of technicians. The EPA method was used to assess health risks. Statistical analysis was conducted using SPSS software. The mean concentrations of toluene were (82.65 ± 198.84µg/m³)µg/m³, followed by benzene (10.58 ± 9.62µg/m³), p-xylenes (20.77 ± 37.79µg/m³), o-xylene (13.79 ± 25.70µg/m³), and ethylbenzene (29.35 ± 58.26µg/m³) , that lower than the permissible exposure limits suggested by NIOSH. Among the BTEX, toluene (82.65 ± 198.84µg/m³) has the most concentration in the nail salons. It was also discovered through multiple linear regression analysis that humidity had a significant effect on increasing the concentration of toluene (Beta = 0.50, P-value = 0.001) and ethylbenzene (Beta = 0.16, P = 0.049), while there was a considerable association between the number of services performed and benzene concentration (Beta = 0.34, P = 0.010). The average inhalation lifetime cancer risk for benzene (4.9 × 10 ^-5±4.5 × 10^-5) was higher than the recommended value set by the US EPA. Although the concentrations of BTEX were lower than the maximum permissible limits, the results of the cancer risk assessment for benzene showed that working in nail salons with poor ventilation is hazardous. Therefore, exposure can be minimized by ensuring appropriate ventilation in the workplace and using safe products.

Stakeholders' Perspectives on the Feasibility of Adopting a Healthy Nail Salon Recognition Program in Philadelphia: A Qualitative Study

OBJECTIVES

The California Healthy Nail Salon Recognition Program is a statewide initiative to incentivize nail salons to adopt occupational health and safety best practices such as the use of safer nail products without certain harmful chemicals, ventilation systems upgrade, proper personal protective equipment use, and staff training. This public policy intervention is in response to the call to protect nail care workers, mostly women of color, who bear a disproportionate burden of chemical exposure at work. Because there is an interest to adopt a similar program in the Greater Philadelphia region, we conducted this formative research to document stakeholders' perspectives on the feasibility of adopting a Healthy Nail Salon Recognition Program in Philadelphia.

METHODS

We conducted semi-structured interviews with a purposive sample of 31 stakeholders in Philadelphia in 2021. Using the Consolidated Framework for Implementation Science as our theoretical framework, we developed the interview guide and analysed the data using qualitative research methods to identify key facilitators and barriers.

RESULTS

Key facilitating themes were perceived need and benefits of program to improve workers' health and working conditions, and willingness of stakeholders to leverage their organizational resources. Barriers included perceived high cost and time commitment from salon owners and employees, lack of funding and implementation leaders at the city government, community members' willingness to be visible and advocate for the program affected by the stigmas of being immigrant workers, and fear of interacting with authorities, as well as the impact of COVID-19 pandemic.

CONCLUSIONS

Our results suggest successful adoption of a Healthy Nail Salon Recognition Program in Philadelphia will require outreach within the community to raise awareness of the benefits of the program and close partnership with community-based organizations to facilitate mutual understanding between the authorities and the ethnically diverse nail salon communities.

Exposure of formal and informal nail technicians to organic solvents found in nail products

Nail technicians are exposed to volatile organic compounds (VOCs) emitted from nail products used in their daily work, which may cause adverse health effects. This study aimed to assess VOC exposure of nail technicians in the South African formal and informal sectors and to provide a task-based exposure assessment of different nail applications. Personal passive sampling was conducted on 10 formal and 10 informal nail technicians located in the northern suburbs of Johannesburg and the Braamfontein area, over 3 days. Real-time measurements were taken to determine task-based peak exposures. The number of clients serviced, working hours, type of nail application, type of ventilation, room volume, and carbon dioxide (CO₂) concentrations, were also recorded. There were differences in the nail products used, the types of nail applications performed, the number of clients serviced, and breathing zones VOC concentrations of the formal and informal nail technicians. Some formal nail salons were equipped with mechanical ventilation while the informal nail salons relied on natural ventilation. CO₂ concentrations were higher in the informal than the formal nail salons and increased during the course of the working day. Formal nail technicians were exposed to higher total volatile organic compounds (TVOC) concentrations than informal nail technicians, which may be due to the different nail application procedures as well as 'background' emissions from their co-workers-the bystander effect. Acetone was the predominantly detected VOC: the formal nail technicians were exposed to significantly higher TWA (8 h) concentrations [geometric mean (GM) 43.8 ppm, geometric standard deviation (GSD) 2.49] than were the informal nail technicians (GM 9.87 ppm, GSD 5.13). Methyl methacrylate among the informal nail technicians was measured at 89.7% detection frequency, far higher than that among the formal nail technicians (3.4%). This may be attributed to the observed popularity of acrylic nail applications in this sector. Nail applications involving soak-off gave rise to high TVOC peaks at the start of the nail application process. This is the first study to compare organic solvent exposures among formal and informal nail technicians and determine task-based peak exposures. It also brings attention to the often-overlooked informal sector of this industry.

Licensure and citations among nail salons in Michigan from 2017 to 2021: A cross‐sectional study of an overlooked and vulnerable industry

Background

Nail salon workers (NSW) in the United States (U.S.) are predominantly immigrant women who face a number of occupational hazards, such as biological, ergonomic, and chronic chemical exposures. Additionally, there are challenges to keeping up with the latest practices in this evolving small business industry. Licensure requirements are intended to keep not only consumers but also workers safe, however licensure requirements vary between states creating little skill, education, and occupational health and safety knowledge and practice consistency among the nail salon workforce. The current state of nail salons and licensure of workers in the State of Michigan—an overlooked state and region (Midwest) in NSW research—was determined to better characterize this workforce.

Methods

A Freedom of Information Act request was submitted to the Michigan Department of Licensing and Regulatory Affairs regarding nail salon establishments and their workers, formally termed manicurists, and citation data for breaches. Data were provided on the number of licensed cosmetologists and cosmetology businesses from January 2017 to March 2021. From there, the total number of licensed manicurists was determined, and the cosmetology establishment list was analyzed to see if the businesses exclusively or predominantly provided nail services.

Results

As of Mach 2021, there were 1372 nail salons that exclusively provided nail services and over 12,000 licensed manicurists. Over half of the disciplinary actions cited were for salons not officially licensed. Michigan has reduced licensure requirements compared to other states and no continuing education (CE) requirements for license renewals.

Conclusion

There is a need for industry educational and training standardization, across the nation, as well as heightened licensure requirements for these vulnerable workers. CE not only keeps workers abreast of the latest practices in the industry, but also provides them the skills and knowledge to enhance their worker health, safety, and wellbeing.