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Do nail salon workers have a higher incidence of cancer?

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These days, it might seem like there's a nail salon in every shopping center and on every street corner.

It's not your imagination -- nail salons are one of the fastest growing industries in the United States [source: Quach et al.]. For customers, getting a manicure is an easy, relatively inexpensive way to feel pampered, and for nail technicians, working at a nail salon only requires a short training period and offers a flexible work schedule. Additionally, the job doesn't require perfect English proficiency, an advantage for the Asian immigrants who make up more than 40 percent of the growing salon workforce [source: NAPAWF].

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Every now and then, a story will appear in a magazine or on the local news about the threats posed by salons. These stories usually focus on potential threats to customers -- a dirty footbath might harbor untold bacteria, while poorly sterilized instruments put customers at risk of staph infections or hepatitis. While salon patrons may keep an eye out for their own safety, we're much less likely to pause and consider the safety of our manicurists. In recent years, however, anecdotes have started trickling out about these professionals' health problems; manicurists have reported skin rashes, respiratory problems, headaches and reproductive problems such as miscarriages or stillbirths [sources: Fernandez; Sole-Smith].

Many environmental watchdog groups link these health problems to the chemicals that are in the salon's products. It's possible that products that may be safe for the average consumer are unsafe for workers who are exposed to them day in and day out. Cosmetics and salons are currently in something of a gray area as far as regulatory oversight goes, which we'll examine on the next page. Further complicating matters, the people most affected by these issues speak little English, and may be suspicious of outside agencies that would take away their livelihood by shutting down a salon for improper ventilation or using certain chemicals.

These circumstances present a unique public health situation. More research is required to ascertain what health problems exist and why, but these health issues exist within a community that may be wary of the people asking these sorts of questions. The nail technicians require outreach from organizations and people they can trust and understand. Enter the California Healthy Nail Salon Collaborative, which was formed in 2005. It's leading the way on research and outreach to manicurists that may provide a useful model to salons around the country. On the next page, we'll examine the challenges ahead and the studies underway that could create a safer salon for everyone.

Asian Health Services and the Northern California Cancer Center are currently working with the California Healthy Nail Salon Collaborative on studies investigating the possible link between workers' health, the products they use and their workplace. Part of the study involves volunteers wearing air quality sensors to determine if a salon has adequate ventilation, while another part will compare nail technicians' health records to those of the general public's. Full results are expected in 2010.

Even if these studies determine that there is a link between these working conditions and cancer, it may be an uphill climb to enact change. Even though people are more concerned about what they put in and on their bodies, there's still little regulatory oversight in the beauty field. The Campaign for Safe Cosmetics estimates that 89 percent of ingredients in personal care products have never been assessed for safety [source: Sole-Smith]. It's a particular problem in the United States: In the European Union, more than 1,100 chemicals have been banned for use in cosmetics because they may cause cancer or reproductive problems, but in the U.S., only nine such ingredients have been banned [source: Warbanski]. The Cosmetic Ingredient Review, which evaluates the safety of ingredients in the U.S., has no authority to actually ban a product.

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And it may not be just one product, it may be how the chemicals in different products interact with each other in a nail salon. The Food and Drug Administration can't ban products based on the hazardous work environment they create; that duty falls to the Environmental Protection Agency (EPA) and the Occupational Safety and Health Administration (OSHA), which set and enforce the limits of how long employees can be exposed to certain chemicals [source: Sole-Smith].

The OSHA guidelines, however, were created with industrial settings in mind, not nail salons, where employees face low-dose but long-term exposure, which means there may not be proper ventilation in the salons [source: Sole-Smith]. Some of the settings still in use were created when women weren't a large presence in the workplace, but women now make up the majority of salon employees, so the standards may not issues such as reproductive health into consideration. Plus, women may be more at risk of cancerous tissue finding a home in their bodies. Women have a higher percentage of body fat than men do, and that body fat is an ideal resting place for fat-soluble chemicals that could cause cancer [source: Warbanski]. Breast tissue is particularly at risk for these chemicals, and breast cancer is the leading cause of cancer death in Vietnamese women in the U.S. Is that due to the salons, or something else? That's what the agencies working with the California Healthy Nail Salons Collaborative hope to definitively determine.

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Sources

  • Adams, Amy. "Survey takes health snapshot of nail salon workers." Stanford StoryBank. May 28, 2008. (Dec. 7, 2009)http://storybank.stanford.edu/stories/survey-takes-health-snapshot-nail-salon-workers
  • Chang, Momo. "Hearing focuses on health, safety of nail salons." McClatchy-Tribune Business News. Nov. 17, 2007.
  • Fernandez, Elizabeth. "Nail salon workers exposed to toxic chemicals, say experts in S.F." San Francisco Chronicle. Nov. 16, 2007. (Dec. 7, 2009)http://www.sfgate.com/cgi-bin/article.cgi?f=/c/a/2007/11/16/BAFPTDA11.DTL
  • Graves, Ginny. "Danger at Your Local Salon." Health. January/February 2009.
  • Greenhouse, Steven. "Studies Highlight Hazards of Manicurists' Chemicals." New York Times. Aug. 19, 2007. (Dec. 7, 2009)http://www.nytimes.com/2007/08/19/nyregion/19nailside.html
  • "Nail Salon Workers - Repeated and Prolonged Exposure to Variety of Chemicals Could Put Workers at Risk." Medical News Today. May 23, 2008. (Dec. 7, 2009)http://www.medicalnewstoday.com/articles/108581.php
  • Quach, Thu, Kim-Dung Nguyen, Phuon-An Doan-Billings, Linda Okahara, Cathryn Fan, Peggy Reynolds. "A Preliminary Survey of Vietnamese Nail Salon Workers in Alameda County, California." Community Health. May 14, 2008.
  • Quach, Thu, Peggy Reynolds, Bob Gunier. "Breast Cancer Risk in California Nail Salon Workers. Environmental Chemistry Laboratory Seminar Series. Jan. 14, 2009. (Dec. 7, 2009)http://www.dtsc.ca.gov/AssessingRisk/ECL/upload/ECL_Presentation_Nail-Salon-Cancer.pdf
  • Sole-Smith, Virginia. "The High Price of Beauty." The Nation. Sept. 20, 2007. (Dec. 7, 2009)http://www.thenation.com/doc/20071008/sole-smith
  • "The Nail Salon Industry and the Impact of Cosmetic Toxins on API Women's Reproductive Health." National Asian Pacific American Women's Forum. February 2008. (Dec. 7, 2009) http://napawf.org/wp-content/uploads/2009/working/pdfs/issuebrief_nailsalon_updated.pdf
  • Warbanski, Misha. "The Ugly Side of the Beauty Industry." Herizons. Summer 2007. (Dec. 7, 2009)http://www.herizons.ca/node/227

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