Assessing Acute Symptoms Related to Occupational Exposures Among Nail Salon Technicians

Fungal Lung

Foot and nail care specialists spend a great portion of their day using nail drills to reduce nail thickness and smooth foot calluses. This process generates a large amount of dust, some of which is small enough to breathe in and deposit into the deepest regions of the respiratory tract, potentially causing health problems. Foot and nail dust often contains fungi, from both fungus-infected and healthy-appearing nails. Although the majority of healthy individuals can tolerate inhaled fungi, the immune systems of older, immunocompromised, and allergy-prone individuals often react using the inflammatory T helper cell type 2 pathway, leading to mucus overproduction, bronchoconstriction, and, in severe cases, lung tissue damage. To protect vulnerable podiatry professionals, wearing a surgical mask, using a water spray suppression system on nail drills, installing air filtration systems, and considering drilling technique can help reduce exposure to nail dust.

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.

Health and Safety in Nail Salons: A Cross-Sectional Survey

OBJECTIVES

In recent years, nail salons have become more abundant than ever. The majority are small businesses, often employing immigrant women. Nail technicians have many exposures at work including chemical, biological, physical, and ergonomic hazards but few data exist on their symptoms or occupational health and safety practices, particularly in the Canadian context. The aim of this study was to learn about nail technicians, their work, and their health and safety practices.

METHODS

Nail technicians were recruited from nail salons in Toronto, Ontario. Participants completed an anonymous survey with questions about demographics, work tasks, workplace health and safety practices, and symptoms (skin, respiratory, and musculoskeletal).

RESULTS

A total of 155 nail technicians (95% female) participated in the survey. The majority of nail technicians performed manicures (99%) and pedicures (96%) and applied shellac polishes (86%). Only a third (34%) applied acrylic artificial nails. The reported use of personal protective equipment (PPE) was very high; 88% reported using a mask at work and 96% reporting using gloves. The most common symptoms reported by technicians were neck (44%) and back pain (38%). Skin and respiratory symptoms were less common with 6% of technicians reporting cough, 8% wheeze, and 5% a current rash. Technicians working over 30 h per week reported more neck pain (52 vs. 32%, P = 0.02). Technicians who reported using shellac polishes were more likely to report a runny nose (25 vs. 0%, P = 0.01).

CONCLUSIONS

Nail technicians in Toronto, Canada are experiencing work-related symptoms. Musculoskeletal symptoms were the most common symptoms reported. Much of the focus on nail salons and health has been on chemical exposures, but ergonomic hazards should not be overlooked. Efforts to increase knowledge and improve occupational health in nail salons should include information on multiple possible workplace hazards and how to reduce impacts of exposure.

Assessment of work-related symptoms, perceived knowledge, and attitude among nail salon technicians

OBJECTIVES

Beauty is a Lebanese stereotype, as Lebanese women often feel urged to decorate themselves. Recent studies have raised concerns about nail salon technicians' (NSTs) health and safety issues. The aim of our study was to evaluate the occupational symptoms reported by NSTs, to assess their knowledge and document their awareness regarding hazardous chemicals found in nail cosmetics.

METHODS

NSTs completed a researcher-administered questionnaire. Data were gathered on sociodemographic characteristics, perceived knowledge, and safety issues. Work-related symptoms reported by NSTs were evaluated, and their responses were compared to those of the office employees.

RESULTS

A total of 120 NSTs and 120 office employees were interviewed. Compared to the control group, NSTs reported a higher prevalence of work-related respiratory, dermal, and irritative symptoms, all significantly associated with smoking and a poor ventilation system. In addition, musculoskeletal complaints were common among NSTs and significantly linked to a poor ventilation system, an increased number of customers per day, and a longer service duration. Furthermore, a longer career duration was significantly associated with an increased prevalence of irritative symptoms. When a binary logistic regression was carried out, it demonstrated a 25 times higher prevalence of work-related symptoms among NSTs compared to the office employees. Interestingly, 84% of the respondents had an inaccurate knowledge of nail cosmetics' risks with their educational level acting as key factor.

CONCLUSIONS

Based on these findings, it is warranted to perform a clinical assessment, implement a stringent regulatory framework, and improve knowledge toward nail cosmetics' risk.

"Worrying About Getting Sick in the Future": Lived Experience of Health Seeking and Healthcare Utilization Among Korean Immigrant Nail Salon Workers

To understand the health and safety concerns of Korean immigrant women nail salon workers in the Greater New York City area and their experiences of health seeking and health service utilization, 20 semi-structured interviews were conducted and analyzed using interpretive hermeneutic phenomenology. Most worried about working in nail salons and experienced work-related health symptoms. However, they were disinclined toward personal protective device use because of discomfort and inconvenience. Major barriers to healthcare utilization limited their healthcare use to times when they had intolerable symptoms, preventing opportunities for regular screening tests. To overcome these limitations, workers actively sought available resources and health-related information online and through personal networks, the latter facilitated by living in a Korean community. Despite efforts to maintain their health and manage their symptoms, Korean nail salon workers worried about getting sick as they got older due to prolonged occupational chemical exposure and limited healthcare access. Appropriate education and intervention should aim to resolve current barriers to personal protective device use and healthcare use and provide a source of care for uninsured workers.

Determinants of Exposures to Hazardous Materials among Nail Cosmeticians in the Kampala City, Uganda

Globally, nail salons represent a fast expanding industry and often with low-income cosmeticians. In general, cosmeticians have limited access to safety information about the hazardous materials they handle, which would potentially enable them to minimize workplace exposures. The problem is much pronounced in low- and middle-income countries due to weaknesses in regulation of the industry. We investigated determinants of exposures to hazardous materials among nail cosmeticians in Kampala District, Uganda. We employed a cross-sectional study design among a random sample of 243 participants. The sociodemographic characteristics, education and training status, knowledge about routes of exposure to hazardous chemicals, and personal protective material use of cosmeticians were assessed through face-to-face interviews. Most cosmeticians were aged 18–34 years, and more males were engaged in this work than females. Also, 82.7% believed inhalation was the major exposure route for the chemicals they handled. Participants who had attained secondary-level education and above were over three times more likely to wear masks (AOR = 3.19, 95% CI 1.58–6.41) and gloves (AOR = 3.48, 95% CI 1.55–7.81) and over two times more likely to use aprons (AOR = 2.50, 95% CI 1.18–5.32). Participants who had ever received safety training on hazardous chemicals were more likely to wear all four personal protective equipment: masks (AOR = 3.21, 95% CI 1.61–6.42), gloves (AOR = 4.23, 95% CI 2.05–8.75), goggles (AOR = 4.14, 95% CI 1.25–13.65), and aprons (AOR = 2.73, 95% CI 1.25–5.96). Participants who had spent more than two years in the nail cosmetics business were more likely to wear masks (AOR = 3.37, 95% CI 1.64–6.95). With the increasing demand for nail cosmetics, and many people in urban areas of low-income countries engaging in this industry, there is need for training and better workplace policies to promote a healthier urban workforce dealing in cosmetics.

Work-Related Symptoms, Safety Concerns, and Health Service Utilization Among Korean and Chinese Nail Salon Workers in the Greater New York City Area

The purpose of this study was to determine similarities and differences in health effects, safety concerns, and health service utilization among Korean and Chinese immigrant women working in nail salons in the Greater New York City area. In this cross-sectional study, analyses involved descriptive statistics, t tests, and χ2 tests. Koreans had longer work experience and more work-related health effects and concerns, but were less likely to use personal protective equipment than Chinese workers. Although Koreans reported better socioeconomic status than Chinese workers, they were less likely to have health care access and utilized less health services. To prevent prolonged exposure to toxic chemicals, nail salon employees need education regarding the importance of personal protective equipment use. Reducing structural barriers and increasing health care access for all nail salon workers are especially important in improving their health service utilization.