In 1986, nail technician Mary Vo began to suffer severe daily headaches accompanied by occasional nausea. A painful, persistent dryness in her nose propelled her into a round of fruitless visits to nose specialists. Finally, one of the many doctors who examined Vo diagnosed her problem as an allergy to an acrylic liquid and powder used in the manufacture of artificial nails. He advised her to give up her job immediately at the Encino, California, nail salon where she had been working for two years. But Vo had a family to support, so for the next 13 years she accepted the headaches as part of her life. Even when she changed salons, the nagging symptoms persisted.
"Every time I came back to the acrylics, I got sicker," she says. In October 1999, she was hired at a Beverly Hills salon that doesn't offer services in acrylics, and within a month her headaches disappeared.
Manicurists routinely handle solvents, chemicals, solutions, and glues. Many of these chemicals are irritants and can cause allergic reactions or affect the central nervous system. Like some other employees who work with chemicals or around dust for a living, many manicurists report nagging problems such as headaches, asthma, chronic cough, dermatitis, runny or dry nose, and fatigue or depression.
Two chemicals are believed to be the principal culprits behind many of the health problems: methyl methacrylate liquid monomers (MMA) and ethyl methacrylate (EMA). Both chemicals can trigger asthma, contact dermatitis, and allergies of the eyes and nose, according to the National Institute for Occupational Safety and Health (NIOSH).
In 1974, the Food and Drug Administration banned the use of all products composed of 100 percent MMA, and it is rarely used at all in nail salons today. EMA, however, is still commonly used in artificial fingernail products. Other chemicals used in nail salons -- acetate, toluene, and formaldehyde -- are also linked to headaches and skin and respiratory disorders; formaldehyde is also a suspected cancer-causing agent. Another chemical, dibutyl phthalate, which is used in nail polish and nail hardener, is linked to reproductive health and development problems in cases of prolonged exposure, according to the Environmental Protection Agency.
But hazardous chemicals aren't the only problem. Many nail salons are not only poorly ventilated, but fail to adhere to basic sanitation standards, according to the Nail Manufacturers Council (NMC). Julie Serquinia, owner of the Paint Shop in Los Angeles, where Vo is now employed, agrees that the conditions in many salons leave a lot to be desired. "I was kind of appalled by the things people could get away with," she says. In her own experience, she's observed that many nail technicians fail to wash or disinfect their instruments after using them on a client. "There's one place that would use paper towels in place of regular towels under your feet and hands," she says. "When they got done with them, they would just turn them over and use them again."
Paper masks aren't enough
Nail technicians can protect themselves and their customers by making sure their workplace adopts the following guidelines, most of which have been endorsed by NIOSH and the NMC:
- Make sure your workplace is well-ventilated. Since nail filings and fumes circulate in the air of nail salons, proper ventilation is crucial. Open doors and windows can be effective, but NIOSH also recommends that salons install an exhaust fan or ventilation system to filter tiny particles and fumes from the air. To remain effective, the system needs to be cleaned and filters changed periodically as recommended by the manufacturer. (The agency warns against using charcoal filters to recycle the air, however, because it's hard to tell when they're full.) Another good safety device, says NIOSH, is a table made of perforated wood that is coated with veneer (to avoid absorbing the toxins) and equipped with an exhaust fan that draws off chemical fumes while the work is being performed.
Many nail technicians wear disposable masks to filter the air they breathe. While this measure guards them from dust filings, it will not protect them from toxic chemical fumes, say experts, who emphasize that exhaust fans and ventilation are of paramount importance. "The fan is for the safety and well-being of the nail technician as well as the client," says Gerri Cevetillo, president of the Nail Manufacturers Council. She and other manufacturers recommend that before accepting a job, a nail technician should take a whiff of her new salon.
"See if there's clean air in there," says salon shop owner Serquinia. If there isn't, she says, "it hits you like a ton of bricks." If you walk in and smell the chemicals, the ventilation is inadequate, she says. With continued exposure, the nerves for the sensation of smell may become desensitized to the noxious fumes and you may no longer be able to detect them. That's why, Serquinia says, at the first overpowering whiff of chemicals "you should turn around and walk out. You can get used to it, but that doesn't mean that it's not there doing the damage."
- Set sanitation guidelines. Place EMA-soaked gauze or tissue into a sealed plastic bag before throwing it in the trash, and change the trash liners daily. To comply with its blood-borne pathogen standard, the Occupational Safety and Health Administration (OSHA) requires cleaning instruments after use on each client and then submerging the implements fully in a disinfectant that is proven effective against HIV, hepatitis B, and hepatitis C. You should also spray workstations and pedicure tubs with a disinfectant between appointments and throw away anything that isn't washable after one use.
If a nail technician cuts a client (or herself), the tool she was using should be immediately disinfected or discarded. (Alcohol is inadequate as a disinfectant; certain disinfectants that contain bleach are effective.) You should also immediately wash the area with soap and water and consult with your physician.
- Keep dispenser bottles closed. NIOSH recommends always using bottles with narrow throats (for the application brush) and a pressure-sensitive bottle stopper. These will cut down on evaporation and exposure to harmful chemicals. To cut down on fumes and accidental misuse, keep all chemicals in closed, marked containers, and store all disinfected implements in a clean, covered container or in a closed drawer to prevent contamination, Cevetillo suggests.
- Wear protective clothing and glasses. Since material from artificial nails can chip into the air when they're removed, nail technicians should protect their eyes with safety glasses. To protect skin from acrylic dust, NIOSH recommends wearing long sleeves and gloves and washing hands, arms, and face several times a day with mild soap and water. (Unlike latex, vinyl gloves will protect you from both chemical contact and blood-borne pathogens.)
- Don't eat, drink, or smoke on the job. Methacrylates in nail dust and other chemicals can be harmful if swallowed, or even if they come into contact with your mouth or face. Drinks and food sitting on workstations can absorb chemicals and dusts that will then be ingested. (Also, be sure to wash your hands before eating because the chemicals and dusts on your fingers can be transferred to hand-held food and ingested as well.) Because salons are full of flammable chemicals, smoking on the premises should be strictly forbidden.
- Use professional products. To avoid MMA and check for other chemicals that have been flagged as hazards (including toluene, ethyl methacrylate, formaldehyde, and dibutyl pthalate), be sure to read the ingredient list. In addition, make sure your salon buys reputable products labeled "for professional use" and "intended for the nails only." All trustworthy products come with directions, and these should be read and heeded.
Besides learning how to handle chemicals, manicurists must also cope with the routine stresses of their job. For most nail technicians, one of the greatest perks of the job is the opportunity to interact with a wide variety of people, but occasionally this becomes a liability, Serquinia says. Customers are often difficult to please, causing undue stress for employees. She has even seen customers bully new technicians into providing additional services at no extra cost. Serquinia advises unseasoned manicurists to maintain good relationships with their bosses and co-workers so that they can consult with them about problem customers, if necessary.
Serquinia adds that loquacious customers tend to be more problematic than rude ones. "Remember that as a nail technician, you're not a psychiatrist," she says. "That's not really your role. Doing nails is like being a bartender or a hairdresser. Customers sometimes need a shoulder to cry on. Just remember that you're only human and that you can't solve the problems of the world."
Nail Manufacturers Council (NMC)
A division of the Professional Beauty Association, the NMC works to elevate safety standards in the nail industry. For salon owners, the NMC has created a list of professional guidelines for the health and safety of nail technicians.
Occupational Safety and Health Administration (OSHA)
Part of the Department of Labor, OSHA develops and enforces safety and health regulations in the workplace.
National Institute for Occupational Safety and Health (NIOSH)
Established in 1970, NIOSH is a federal research agency which makes recommendations to help employers prevent job-related injuries and illnesses.
Controlling Chemical Hazards During the Application of Artificial Fingernails. National Institute for Occupational Safety and Health.
Spencer AB, Estill CF, McCammon JB, Johnston OE . NIOSH studies EMA. Nails (November):5054.
Prohibited Ingredients and Related Safety Issues. USFDA, Center for Food Safety and Applied Nutrition. Office of Cosmetics Fact Sheet. March 30, 2000.
Fingernails: Looking Good While Playing Safe, U.S. Food and Drug Administration. Dec 1995.
Protecting the health of nail salon workers, United States Environmental Protection Agency, EPA no. 74-f-07-001 March 2007
Phasing out the toxic trio: a review of popular nail polish brands, A report by the National Healthy Salon Alliance, May 2009