What Will It Take to Clean Up Nail Salons?

Despite the efforts of activists, nail salon workers, and some politicians, the movement to make East Bay nail salons safer continues to lag.


Illustration by Gillian Dreher

More than two decades ago, Phuong An Doan-Billings noticed something alarming while working as a medical interpreter at Asian Health Services in Oakland: Many of the nail salon workers in her community were sick. Almost entirely Vietnamese immigrants, the women came in to the community health center complaining of headaches, skin irritations, trouble breathing, and, although they were sometimes embarrassed to admit it, cancers and miscarriages.

“In a group of seven or eight women, you would have four or five of them with cancer, and three of [those] were nail salon workers,” Doan-Billings said. “I was taken aback when I found out how many of them had cancer.”

Doan-Billings told Julia Liou stories about the health epidemic she was witnessing. At the time, Liou was writing grants and doing community outreach at Asian Health Services, and was a policy fellow at the Women’s Foundation of California working to ban certain phthalates from personal care products. She began to dig into existing research on the health impacts of repeated exposure to nail care products in workers. She found very little.

“The workers are basically the canaries in a coal mine,” said Liou, who’s now chief deputy of administration of Asian Health Services. “They are the ones working with these products day in and day out, seven days a week.”

Surprised by the lack of research on chemical exposure in nail salons, and frustrated by the defeat of a California bill that would have banned a toxic chemical in cosmetics, Liou cofounded the California Healthy Nail Salon Collaborative in 2005 to improve the health, safety, and rights of nail salon workers. With input from community members and the San Francisco Department of the Environment, the collaborative developed the Healthy Nail Salon Recognition program, which included voluntary guidelines for improving worker safety, such as using safer nail products, wearing nitrile gloves, and having proper ventilation. Her goal was to protect workers without penalizing salons.

“We decided that a stick approach was not the way to go,” she said. “We chose a carrot approach.”

What began in San Francisco soon expanded to Alameda, San Mateo, and Santa Clara counties and the city of Santa Monica. Using the Healthy Nail Salon guidelines, the counties established certification and training programs to incentivize safety improvements in nail salons.

In 2016, a bill passed to make the Healthy Nail Salon Recognition Project statewide; in April, California’s Department of Toxic Substances Control issued guidelines to help counties establish their own voluntary programs. On the federal level, U.S. Sen. Kamala Harris introduced the Environmental Justice Right to Know Act, which would, among other things, expand the healthy nail salon recognition program nationwide and fund research on the impact of “toxic cosmetics” on women.

However, despite the hard work of activists, nail salon workers, and some politicians, the movement to make nail salons safer has stalled repeatedly, with a shortage of funding at the local level, a lack of regulations by the federal government, and a powerful beauty industry worth $62 billion annually fighting every step of the way.

Over the last six years, Alameda County’s Healthy Nail Salon Recognition Project has certified only 15 out of 350 nail salons. And statewide, roughly 200 salons are certified healthy.

Meanwhile, a record number of women are getting their nails done. According to Nails Magazine, California has more than 7,800 nail salons and 100,000 nail techs — by far the most in the country. For many, getting a mani-pedi is a fast, affordable way to pamper oneself, but awareness of the health risks, especially among nail salons workers, seems to be low.

Part of the problem in Alameda County can be attributed to a lack of resources. The coordinator of Alameda County’s Healthy Nail Salon program retired in 2016, and the Alameda County Department of Environmental Health has failed to fill the position. Ronald Browder, the director of the DEH, said they are working to establish a new position that will oversee the Healthy Nail Salon program and other, similar non-regulatory programs within the department, and hopes to do so within the next few months. He said funding to cover the program’s activities is in the development stages as well. Outreach has effectively stopped.

And while many nail polishes are now free of the “toxic trio” of chemicals — dibutyl phthalate, toluene, and formaldehyde — that doesn’t mean other chemicals used by nail salons don’t pose health risks. The FDA doesn’t evaluate the safety of cosmetic products and ingredients before they hit the market. Instead, the cosmetic industry researches the safety of its own products, leaving state agencies like the California Department of Toxic Substances Control to test the veracity of the cosmetic industry’s science after the product is already lining the shelves of nail salons.

“You shouldn’t be putting these things out unless you’re sure that they’re safe. We do it with food, we do it with drugs, why does the cosmetics industry get away with this?” said Thu Quach, chief deputy of administration at Asian Health Services. “We are constantly trying to catch up with the manufacturers as they play switcheroo with chemicals.”

Quach, who has a Ph.D. in epidemiology, has conducted some of the few studies about the environmental health of nail salon workers. And although she admits that she hasn’t found a smoking gun — an initial study did not directly link cancer with nail salon work — she said the public should be concerned. A 2008 survey of Vietnamese nail salon workers in Alameda County shows that 47 percent report health symptoms that can be linked to nail salon products. For another study, she deployed personal air monitors on 80 Vietnamese nail salon workers. The monitors tested the air throughout the day and showed airborne toxins that surpassed the California EPA’s recommended indoor levels, but not federal occupational levels.

“Research is like a puzzle,” Quach said. “You get little pieces at a time and those pieces are still coming forth. But we know this is a huge problem from talking to workers.”

Anna Bui got her Oakland salon, Diva Nails, certified as a Healthy Nail Salon in 2012. She showed off the mechanical ventilator and filter attached to her artificial nail station, which prevents her from inhaling toxic acrylic dust. She said she has fewer headaches and more energy after switching to safer products, and she’s engaged in local politics in a way she never expected to be. As part of the certification process, she has trained all of her employees and even educated her customers about which products are safer. Now her regulars are happy to pay $2 more a set, and business has increased since getting the certification.

“I feel proud that I was smart enough to join the collaborative,” Bui said through a translator. “We didn’t pay attention that we suffered the side effects of chemicals. We were suffering but we didn’t know.”

Even salon owners who are aware of the health concerns have a hard time making their businesses safer. Lawrence Tran of Simply Green Day Spa in Oakland said his sister worked in conventional nail salons and had to quit due to nosebleeds, coughs, and rashes. He decided to surpass the Healthy Nail Salon guidelines by using mostly organic products. But doing so was a challenge. Simply finding a nail polish remover without acetone was “ridiculous.”

“I went through six companies to find one I actually felt comfortable with,” he said. “They all add alcohol. They all have fumes.”

He finally found something citrus-based. Instead of cuticle oil, his nail technicians use olive oil. And he only stocks nail polishes that are free of many of the industry’s most concerning chemicals. Tran likes to point out that his employees aren’t wearing facemasks because there’s no acrylic powder in the air and no chemical fumes.

But it doesn’t come cheap. A gallon of normal nail polish remover is $12, while the organic one Tran uses is $50 — and that’s if it’s on sale. His price are higher as a result.

For many customers, it’s worth it. On a Tuesday afternoon in June, the spa was full of mothers and daughters getting their nails done. Davina Vick said she brought her daughter from Alameda because of the products and the cleanliness.

It’s clear that the demand for beautiful nails isn’t going away, but hopefully the risks to the women workers who create them — and the customers who enjoy them — will.

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