Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, K01-OH-007956, 2007 Nov; :1-97
This method development study of the nail salon work environment assessed hazards and health effects in two pilot studies; explored access and contextual issues relevant to community-based approaches to occupational health research in immigrant communities; and developed an investigatory framework and recommendations for further study. There have been few investigations of this work environment, despite a vulnerable worker population of reproductive-age Asian immigrant women, long hours of work, and extensive potential for exposure to toxic chemical ingredients in nail products. Barriers have included the difficulty in investigating multiple small businesses, language differences and other access challenges, and the perception of a lack of potential hazard due to the limited volumes of chemical present in cosmetics. However, community concerns about the impact of this work on the mostly Vietnamese immigrant population occasioned the opportunity to collaborate with a community organization to evaluate nail salon hazards and health effects in the Boston area. As part of the work of this grant, a community-university collaborative partnership assessed self-reported work-related health effects and environmental factors in Boston's Vietnamese immigrant community via an interviewer-assisted survey. Seventy-one nail technicians responded. Musculoskeletal disorders, skin problems, respiratory irritation and headaches were commonly reported as work-related, as were poor air quality, dusts and offensive odors. The reporting of a work-related respiratory symptom was significantly associated with the reporting of exposure factors such as poorer air quality. Absence of skin disorders was associated with glove use and musculoskeletal symptoms were associated with years worked as a nail technician. Concern about chemical exposure in salons was expressed by three-quarters of the respondents and use of a surgical mask was almost universal. Nail technicians most often cited a (false) belief that these masks were protective from chemical vapors as the reason for their use. Additionally, twenty-two Boston area nail salons participated in a rapid assessment of basic air quality metrics. Sixteen of the 22 had no mechanical ventilation of any kind other than table fans and room air cleaners. Average carbon dioxide levels were 894 ppm, exceeding the reference level of 700 ppm (based upon the ASHRAE standard of 25 cfm fresh air per person in beauty salons). Temperatures and humidity levels were within reference guidelines. Potential offensive contaminants are plentiful in nail salons. These results suggest that a majority of nail salons may have inadequate fresh air and may not effectively exhaust contaminated air. Nail salon workers may be at risk of health effects such as headaches and respiratory irritation as a result of these conditions. Important lessons were gleaned from this community-based study with regard to collaborative research approaches. The most important of these included I) the mandate to tie assessments of hazards and health effects to education and outreach activities to help improve working conditions and 2) respect the voices and needs of the community representatives. Further research in this area will benefit from community collaborative approaches. An indoor air quality assessment (rather than a chemical-by-chemical) approach is recommended for further exposure assessment work. Health effects should be clinically evaluated in this population.
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