Improving Boston Nail Salon Indoor Air Quality Through Local Public Health Regulation, 2007-2019.

In 2011, following years of outreach and training, Boston, Massachusetts, enacted regulations to improve health and safety in nail salons. These were amended in 2013 to require mechanical ventilation, including dedicated exhaust for each manicure and pedicure station. As of June 2019, 185 of 190 salons have satisfied the regulatory requirements. Regulations can help ensure that environmental health benefits are widespread and that small businesses' investment in occupational health does not result in a competitive disadvantage.

Actions taken by the European commission to address the safety of sunbeds.

The safety of sunbed, especially when it comes to protecting young and vulnerable consumers, is a key concern that the Directorate-General for Health and Consumers has been trying to address in various ways. This document presents a brief overview of activities undertaken at European level to address the main concerns related to the use of this product.

Self-testing for contact allergy to hair dyes - a 5-year follow-up multicentre study.

BACKGROUND: In 2011, a multicentre study was conducted in order to determine how hair dye manufacturers instructed consumers to perform a self-test prior to dyeing their hair, in order to identify individuals who are likely to react upon subsequent hair dyeing. A number of concerns were raised concerning the variability in instructions between products and producers, and the safety and validity of this tool. OBJECTIVES: To perform a 5-year follow-up study in order to determine whether manufacturers still recommend a self-test, and if so, whether the procedures have been changed. METHODS: During March 2016, a total of 40 oxidative hair dye products from 21 different manufacturers were bought in retail stores in 8 European countries. RESULTS: The consumers were instructed to perform a self-test prior to hair dyeing for 39 of the products; however, the procedures varied greatly regarding the method of application, the amount of hair dye applied, the location and size of the application area, the number of applications, whether or not rinsing was performed after application, the reading times, and how a positive reaction was defined. CONCLUSIONS: Self-testing is still recommended by almost all manufacturers of permanent hair dyes. There are major variations in the instructions, even in products from the same manufacturer. The previously raised concerns regarding safety and validity still remain.

[Ultraviolet exposure from indoor tanning devices as a potential source of health risks: Basic knowledge of the proper use of these devices for practical users, physicians and solarium staff]. / Promieniowanie nadfioletowe solariów jako potencjalne zródlo zagrozen zdrowotnych ­ podstawowa wiedza dla uzytkowników, lekarzy i personelu solariów o prawidlowym korzystaniu z tych urzadzen.

Bearing in mind the adverse health effects of exposure to ultraviolet (UV) radiation in solarium, especially the risk of carcinogenesis, there is a need to adopt legal regulations by relevant Polish authorities. They should set out the principles for indoor tanning studios operation, supervision and service of the technical parameters of tanning devices and training programs to provide the staff with professional knowledge and other aspects of safety in these facilities. The mechanism of the harmful effects of ultraviolet radiation on the human body, scale of overexposure, resulting from excessive sunbathing are described. Methods for estimating UV exposure and possible actions aimed at reducing the overexposure and preventing from cancer development caused by UV are also presented in this paper. Med Pr 2017;68(5):653-665.

Evaluating a county-based healthy nail salon recognition program.

OBJECTIVES: The City of San Francisco, California established a recognition program for nail salons that use safer nail products and receive worker safety training. This pilot study examined whether participating salons had reduced levels of toluene, methyl methacrylate (MMA), and total volatile organic compounds (TVOC), and improved knowledge and behavior compared to control salons. METHODS: We conducted personal air monitoring and administered surveys assessing knowledge and behaviors of two workers from each of six intervention salons and five control salons. We conducted assessments before and after the worker training. RESULTS: Although non-significant, there was a reduction in toluene (-46% vs. 0%) and TVOC (-19% vs. +47%), but an increase in MMA (+113% and +72%) among intervention salons compared to control salons. Awareness of dibutyl phthalates in nail products increased (+55%) among intervention salons between surveys. CONCLUSIONS: A government-administered nail salon recognition program may reduce chemical exposures and increase work-related knowledge.

Characterizing workplace exposures in Vietnamese women working in California nail salons.

OBJECTIVES: We engaged Vietnamese nail salon workers in a community-based participatory research (CBPR) study to measure personal and area concentrations of solvents in their workplace. METHODS: We measured average work-shift concentrations of toluene, ethyl acetate, and isopropyl acetate among 80 workers from 20 salons using personal air monitors. We also collected area samples from 3 salons using summa canisters. RESULTS: For personal measurements, the arithmetic mean was 0.53 parts per million (range = 0.02-5.50) for ethyl acetate, 0.04 parts per million (range = 0.02-0.15) for isopropyl acetate, and 0.15 parts per million (range = 0.02-1.0) for toluene. Area measurements were lower in comparison, but we detected notable levels of methyl methacrylate, a compound long banned from nail products. Predictors of solvent levels included different forms of ventilation and whether the salon was located in an enclosed building. CONCLUSIONS: Using a CBPR approach that engaged community members in the research process contributed to the successful recruitment of salon workers. Measured levels of toluene, methyl methacrylate, and total volatile organic compounds were higher than recommended guidelines to prevent health symptoms such as headaches, irritations, and breathing problems, which were frequently reported in this workforce.

Compliance with age and skin type restrictions following the introduction of indoor tanning legislation in Melbourne, Australia.

BACKGROUND/PURPOSE: The study aimed to establish compliance of indoor tanning businesses with 2009 legislation, particularly with requirements to provide information on skin cancer and exclude people under 18 or with fair skin. METHODS: Compliance was tested through surveys and in-person visits to 30 businesses in Melbourne, Australia. Research assistants presented as potential customers with different profiles: young adults eligible to use a sunbed, young adults with fair skin, under age customers who prompted with their age and under age customers who concealed their age and claimed to be 18 if asked. RESULTS: Communicating the risks of skin cancer during the visit improved from 70% in 2003, prior to the introduction of legislation, to 97% in 2009. While there were improvements in restricting access to sunbeds among high-risk groups, compliance of indoor tanning businesses with age and skin type restrictions remained less than optimal. Almost half (47%) allowed access to fair-skinned research assistants, compared with 90% in 2003. Only one of the 30 operators allowed access to a teenager who prompted with her age; in 2003, 52% of under age teenagers were granted access without parental consent. However, when teenagers concealed their age or claimed to be 18, 80% of operators granted them access. CONCLUSIONS: The findings suggest that regulation of the indoor tanning industry is a better approach to this health issue than voluntary standards and/or education. Nonetheless, inadequate compliance with requirements to exclude high-risk groups lends weight to calls for stricter monitoring and enforcement, or an absolute ban.

[Comprehensive hygienic assessment of solaria].

The paper gives data on the positive and negative effects of human exposure to ultraviolet radiation (UVR). It provides the hygienic characteristics of solaria used to produce an artificial tan. This device has been found to present a high health risk to its users. There are considerable problems in the hygienic assessment of this type of exposure. The ways of solving the arising problems in developing the metrological monitoring of UVR and compiling a document regulating the sanitary-and-epidemiological surveillance of solaria are defined.

Public at risk: a survey of sunbed parlour operating practices in Northern Ireland.

BACKGROUND: The International Agency for Research on Cancer has identified artificial ultraviolet (UV) radiation as a class 1 carcinogen. The contribution of sunbeds to malignant melanoma has been estimated at 100 deaths per year in the U.K. The sunbed industry is growing and claims self-regulation. OBJECTIVES: To explore the standards of operation and client protection for sunbed users. METHODS: An observational study of tanning parlour practices was conducted by Environmental Health Practitioners who made unannounced visits to the majority of known commercial tanning parlours in Northern Ireland (population 1.77 million) during July/August 2007. Descriptive statistics were produced and comparisons between groups were made using chi(2) analysis. RESULTS: All 332 premises visited cooperated with the survey. The UV type in machines was unknown in 71.2% of premises while 15.6% reported using type 4, high-dose UV devices; 36.2% of premises did not regularly service sunbeds or were unsure. Unsupervised use of sunbeds was reported in 8.6% of parlours and 3.4% provided a home sunbed service. Eye protection was available in 97.6% of premises but 34.6% charged for the service and only 79.6% sanitized these between use. Of the responders 15.9% were members of the Sunbed Association. These were more likely to have maintenance records and operating manuals but were also more likely to provide a home sunbed service. CONCLUSIONS: This study highlights the need for improved standards of regulation of the sunbed industry to protect clients from excessive and dangerous levels of UV radiation in a population where the numbers of melanomas continue to rise.

Indoor tanning injuries: an evaluation of FDA adverse event reporting data.

BACKGROUND/AIMS: In 1979 the Food and Drug Administration (FDA) designated indoor tanning units would be regulated medical devices and that each must have an exposure timer. In 1985 FDA added a scheduled series of doses designed to allow tanning with little risk of concomitant sunburn. Subsequently FDA/CDRH maintained databases in which medical device associated injuries were reported. The databases, MAUDE and its predecessor MDR, are available online. While these records, in part, are not intended for evaluation of adverse event rates, analysis provides insight into the etiology of UV-related tanning injuries. METHODS/RESULTS: We compiled 142 records reported for 1985-2006 including 22% noninjury malfunctions. Of the reported injuries approximately 50% resulted from UV exposure, an average of <1/year resulted in hospitalization. At least 36% of the UV-related injuries were attributable to various (user/operator) noncompliance with FDA sunlamp guidance policies. During 1985-1995 there were six times more UV injuries than 1996-2006, presumably reflecting cessation of much mandatory reporting in 1996. Injury reports declined steady from 1997 to 2006. CONCLUSIONS: FDA guidance appears most efficacious in injury prevention and we encourage its incorporation into the enforceable performance standard. We also advise that tanning industry professional training programs seek standardization/accreditation of their personnel certifications through recognized accreditation bodies such as ANSI or ISO/IEC.

Images, femininity and cancer: an analysis of an international patient education programme.

This article is an analysis of a cancer patient education programme run by cosmetic companies. I focus on an analysis of imagery, arguing that there are particular discursive elements that the cosmetic companies use in order to make productive the relationship between femininity and cancer. I contextualize this education programme by presenting the controversies regarding cosmetics as they relate to the growth of breast tumours. In doing so, I conclude that conversations and questions about a link between chemicals and cancer are subverted by both ;horror' narratives of cancer and the provocative use of standards of beauty. Such discursive dominance in patient education programmes makes it difficult to engage in a more public understanding of cancer growth as affected by cosmetic chemicals.

Solaria compliance with the Australia/New Zealand Standard in Adelaide.

ISSUE ADDRESSED: To assess the compliance of solarium centres in metropolitan Adelaide with the Australia/ New Zealand Standard, specifically determining the access of different groups, skin cancer warnings and the use of consent forms. METHODS: Three groups of research assistants approached 30 solarium centres by telephone and in person. Centres were assessed on recommendations/claims made, warnings given and access to a solarium. RESULTS: There was an extremely low level of compliance with the standard. Sixty per cent of centres allowed access to under-aged clients, 93% of centres allowed access to fair-skinned clients, and only 53% consistently required clients to sign a consent form. Restriction of under-age and fair skin access was greatly over-reported over the telephone compared to actual access. CONCLUSIONS: The results highlight the need to increase adherence to the standard.

'Hidden' occupational allergens such as additives.

PURPOSE OF REVIEW: With the development of innovative technologies, new agents are continually introduced to the workplace. Some of these agents can act as hidden allergens whenever they are not declared in the product labels or whenever their health hazards are unknown. This review article focuses on the identification and description of unusual and/or hidden allergens recently incriminated in occupational diseases. RECENT FINDINGS: Occupational exposure is an important global health issue that can induce respiratory and cutaneous disorders, as well as life-threatening anaphylaxis. Apart from the classic forms of occupational exposure, reports have emerged from nonconventional or newly identified allergens or additives. These compounds are substances added to another in order to alter or improve the general quality or to counteract undesirable properties, and some of them may behave as potent and frequently hidden allergens. These highly uncommon and/or hidden allergens belong to several categories: foods, spices, cosmetics, insects, enzymes, chemicals, drugs, preservatives, and coloring agents, among others. SUMMARY: A high level of suspicion and awareness about the potential hidden allergens is necessary to ascertain the allergens implicated. It is of utmost importance to identify the specific eliciting agents of the occupational diseases in order to avoid strictly further exposure to them.

Inhalation exposure to formaldehyde and toluene in the same occupational and consumer setting.

Formaldehyde, a natural component of all mammalian cells, is metabolized to carbon dioxide. It is a colorless gas used as a preservative and a reactant in chemical processes in a wide variety of commercial and consumer products. Toluene is an organic solvent also used in a wide variety of commercial and consumer products. There is a growing concern that chemical exposure from consumer products including cosmetics adds to the overall toxic exposure bioburden. This study was designed to quantify the actual amount of formaldehyde and toluene exposure to professional nail technicians and their customers during the application of cosmetic nail products containing either formaldehyde or toluene. Formaldehyde concentrations were measured on workers and consumers using treated silica gel absorption tubes. Formaldehyde concentrations varied between 0.0012 and 0.0038 ppm. The results of this study clearly demonstrate that neither workers nor consumers are at any additional risk from exposure to formaldehyde or toluene in cosmetic nail products beyond daily exposure from commercial products in a work setting and in the home.

Pseudomonas aeruginosa necrotizing chondritis complicating high helical ear piercing case report: clinical and public health perspectives.

BACKGROUND: Auricular or high helical ear piercing is an increasingly widespread fashion trend that is associated with an increased risk of potentially serious post-piercing complications such as auricular perichondritis. CASE REPORT: An 11-year-old girl developed severe auricular perichondritis following piercing of the upper helical cartilage of her ear at a hairdressing salon. Four days post piercing, she returned to the same salon for a haircut during which the pierced site was manipulated. She presented to her family physician and was treated unsuccessfully with oral cephalexin. She was then referred to an infectious diseases consultant and received antipseudomonal intravenous antibiotics with subsequent resolution. She also required debridement and removal of necrotic cartilage. Public health investigation evaluated potential sources of infection including the piercing gun, disinfectant solutions, and hair cutting spray water bottles. Final culture results of the ear helical aspirate grew Pseudomonas aeruginosa. Pseudomonas aeruginosa was also cultured from one of the water bottles used to wet her hair during the haircut. DISCUSSION: Although the pseudomonal strains from the water bottle were different than the infecting one, this contamination presents a potential source of wound infection. Damage to the helical cartilage caused by the piercing gun may also have contributed to this infection. Initial empiric antibiotic therapy for these kinds of infection must include anti-pseudomonal coverage. Auricular or high helical ear piercing using a piercing gun is not recommended.

[Manicure and pedicure in the city of Ouagadougou (Burkina Faso): practices and risks]. / La manucure et la pédicure dans la ville de Ouagadougou (Burkina Faso): pratiques et risqué.

Pedicure-manicure represents the aesthetic care of hands, feet and nails. In Burkina Faso, the use of manicure-pedicure products, the techniques used and the level of risk remain unknown. The aim of our study was to evaluate the practice of manicure-pedicure in the city of Ouagadougou. We conducted a descriptive cross-sectional study of all practitioners with at least six months experience in aesthetic care and customers present at the time of the survey from December 2010 to November 2012. We interviewed a total of 313 practitioners and 313 clients. The average age of practitioners was 19 years and of customers was 32.2 years. Fixed location practitioners were mostly women (96.87%) while mobile practitioners were mostly men (68.37%); 64.53% of customers were women. The percentage of practitioners who did not receive professional training was 93.92%. 29.7% of practitioners soaked the instruments in javel water for at least ten minutes; 75.71% knew that the use of certain tools was dangerous and 26.51% had side effects. 40.25% of customers knew that the used equipment may pose some risks and 30.35% were victims of accidents. The manicure and pedicure is done in hair salons by untrained hairdressers to the professional practice. The origin and composition of the products is not known. Not recommended products are used (foot soak shampoo, razor blade and scissors for feet scraping). The use of manicure and/or pedicure is sometimes necessary but that should not obscure the risks to which it exposes customers. Customers education and practitioners training seem necessary to minimize risks.

Survey of UV Emissions from Sunbeds in the UK.

Increased use of indoor tanning for cosmetic purposes has led to concerns for its impact on the risk of cutaneous cancers. The effects on UVR on skin depend on radiant dose, i.e. combination of irradiance and exposure duration. While a number of studies surveyed accessible emission from sunbeds, majority did not include the information on doses received during tanning sessions. Spectral irradiance of 195 sunbeds in five areas of the United Kingdom was measured in order to assess the radiant doses for comparison with the SED. Erythema weighted irradiance of more than 85% of all tested solaria exceeded 0.3 W m(-2) , consistent with the findings of other studies. However, evaluation of radiant doses showed no evidence of increasing exposure per session in the United Kingdom in the last decade despite the increasing sunbed emission levels. Use of sunbeds for cosmetic purposes should be discouraged, with effective enforcement of the ban on under-18 use, strict control on tanning duration and promotion of information on health risks of sunbed use. Such an integrated approach on safe equipment, safe use, and information should reduce the risk of detrimental impact of sunbed use on public health.

Perspectives in melanoma prevention: the case of sunbeds.

The incidence of cutaneous malignant melanoma (melanoma) and of basal cell carcinoma is still increasing in most fair-skinned populations. The fashion of intermittent exposure to solar ultraviolet (UV) radiations is considered the main cause of this increase. In 20 years time, tan acquisition through exposure to artificial sources of UV radiations has become frequent among fair-skinned adolescents and young adults. Modern sunbeds are powerful sources of UV radiations that do not exist in the nature, and repeated exposures to high doses of UVA constitute a new phenomenon in humans. A large prospective cohort study on 106,379 Norwegian and Swedish women conducted between 1991 and 1999 has provided evidence for a significant, moderate increase in melanoma risk among regular sunbed users. Failure of past case-control studies to document with consistency the sunbed-melanoma association was probably due to a too short latency period between sunbed use and melanoma diagnosis, and to too few subjects with high total durations of sunbed use. Regulations of sunbed installation, operation and use should become standardised across the 25 European Union countries. Enforcement of regulations in tanning parlours remains inadequate. In contrast, the existence of regulations is presented by many tanning salon operators as a guarantee that sunbed use is safe. We stress the need for the control of information disseminated by the "tanning industry" on suppositions that sunbed use is safer than sun exposure, and on the hypothetical health benefits of tanning. New fluorescent UV lamps are proposed that have a spectrum similar to the midday sun. Given the known association between intermittent sun exposure and melanoma, public-health authorities should reconsider the soundness of the commercialisation of these lamps.