In 2011, the Zero Waste Alliance (ZWA) initiated a Social Determinants of Health project aimed at understanding the health concerns of an estimated 2,500 Vietnamese Nail Salon workers in the Portland metropolitan area. Vietnamese workers, primarily women, have been recognized as a majority in this service sector and experience health disparities associated with work1. This project has been supported by the Kaiser Permanente Community Fund at the Northwest Health Foundation.
ZWA partnered with the Immigrant and Refugee Community Organization (IRCO) to reach out to nail salon workers about health related concerns at work and at home. From our survey, we established that Nail Techs in the Portland metropolitan area are disadvantaged by low educational accomplishment and a highly competitive work environment that disrupts social cohesion, drives down prices for services, and imposes unrelenting financial pressure to cover expenses.
From our survey, we have also learned that poor air quality, associated with volatile organic compounds (VOCs) – e.g., acetone, ethyl acetate, toluene, etc., is a primary health concern in nail salons. VOCs are considered to be the cause for headaches, burning sensations in the eyes, and the strong smells that affect the respiratory system adversely and can lead to persistent morbidity (e.g., asthma, chronic obstructive pulmonary disease or COPD). In 2012, following recognition of this concern by nail salon technicians, we surveyed the public on this issue. We learned that clients also react strongly to the presence of these VOCs (i.e., smells) in salons. The results of our work can be found at
https://www.slideshare.net/Melethil/zwa-nail-salon-project-2012-nw-env-health-conference.
Recent research, using functional magnetic resonance imaging (f MRI) indicates that chronic exposure to VOCs can cause irreversible changes in brain structure and function2. Emerging data also suggests that both pathogens and pollutants appear to share a common cellular signaling system, suggesting that airpollutants, like pathogens, might alter innate immunity3. Susceptible populations, in communities exposed to higher levels of pollutants, both gaseous and particulate (e.g., nail salons, those who live or work near highways, communities using woodstoves), are at higher risk for respiratory tract infections. This article provides insights into the larger picture (i.e., hormesis) of how our immune system can be activated by exposure to multiple “low-level” triggers that can lead to chronic states of low level inflammation in the affected communities or sensitive populations. By “triggers” we mean chronic exposures to low levels of organic compounds (e.g., VOCs), particulate matter (e.g., aerosols, dusts, mold spores), or infectious pathogens (e.g., viruses, bacteria).
We intend to use education as the primary mechanism to protect Vietnamese Nail Techs from continued exposure to harmful VOCs. To provide economic incentives (i.e., market strategies) to salons that voluntarily commit to meeting the clean air standards defined by our Oregon Collaborative for Healthy Nail salons (OCHNS) partners, we intend to develop a certification process. e.g., certifying committed salons as Portland area Clean Air Nail Salon (CANS) members. A similar program has been developed and is being evaluated in San Francisco4.
The Oregon Collaborative for Healthy Nail Salons (OCHNS), was formed in August 2007, following a workshop coordinated by the Oregon Department of Environmental Quality (DEQ) and funded by the U.S. Environmental ProtectionAgency (EPA). The current members of the collaborative are DEQ, Multnomah County Health Department- Environmental Health, Oregon Health Licensing Agency (OHLA), Oregon Health & Science University- CROET, Oregon OSHA, and ZWA. For additional information about OCHNS, visit www.oregonhealthynailsalons.org.
Organizations such as the Campaign for Safe Cosmetics (www.safecosmetics.org) and Women’s Voices for the Earth(www.womensvoices.org) are campaigning for reductions in the use of toxic compounds in cosmetics. We recognize this important work as contributing to solutions at a higher and upstream level but believe that it will take many years of lobbying for reformulation of nail salon products. For this reason, we need more immediate solutions to mitigate the hazards associated with poor air quality found in nail salons.
Please support our continued work in this area and help us develop a program to demonstrate cost effective air purification technologies that will mitigate health hazards associated with VOCs in the workplace and improve the quality of life for Nail Salon workers.
References
1. A Preliminary Survey of Vietnamese Nail Salon Workers in Alameda County, California, J Community Health (2008) 33:336–343; Results from a Community-based Occupational Health Survey of Vietnamese-American Nail Salon Workers, J Immigrant Minority Health (2008) 10:353–361. Exposure Assessment in Nail Salons: An Indoor Air Approach. ISRN Public Health, Volume 2012, Article ID 962014.
2. Occupational Solvent Exposure and Brain Function: an fMRI study. ENVIRONMENTAL HEALTH PERSPECTIVES (2011) doi: 10.1289/ehp. 1002529.
3. Effects of air pollutants on innate immunity: The role of Toll-like receptors and nucleotide-binding oligomerization domain–like receptors. J Allergy Clin Immunol 2012; 129:14-24.
4. Regulation to adopt standards and process for nail salons to qualify for San Francisco’s Healthy Nail Salon Recognition Program. Ordinance No. 269-10, Adopted November 5, 2010. Regulation Effective Date: February 7, 2012. ttp://www.sfenvironment.org/downloads/library/
sfe_env_reg_12-01-HNSRO.pdf