Improving Health and Safety in Massachusetts Beauty SalonsTraining developed for the Massachusetts Division of Professional LicensureBoard of Cosmetology InspectorsFall 2005

By the Massachusetts Healthy Cosmetology Committee(Toxics Use Reduction Institute and the Department of Work Environment University of Massachusetts Lowell, MA Division of Occupational Safety, MA Department of Public Health, Pioneer Valley Project)

Improving Health and Safety in Massachusetts Beauty SalonsFall 2005

September 12 ~ Chemicals and Health, Toxics Use Reduction and

Regulations

September 26 ~ Proper Ventilation in Salons and OSHA Requirements

October 24th ~ Safe and Effective Disinfection

November TBA ~ Model Salon and Virtual Health and Safety Inspection

Overview

• Introduction

• Chemicals and Health

• Information and Protection

• Toxics Use Reduction

• Regulations

• Summary and Questions

Discussion

• Why do you inspect salons?– What do you inspect for? – What two or three conditions are the mark of a

clean and safe salon?

• Who is served by the BOC and its inspectors? – How do you communicate with those you serve?

• How do you protect the public’s health?• What do you think about the odors, chemicals

and air quality in salons?

Chemicals and Health

• What’s an example of a chemical hazard in salons?

• Toxic vs. Hazardous• Who is potentially affected by chemicals in

salons?– Salon owners and workers– Family members– Customers– Employees and residents near salons– Inspectors– Environmental effects via water, waste and air

How chemicals affect us

• Types of effects:– Contact: skin or eye or throat irritation– Systemic: breathe in and chemicals go to “target

organs” e.g. (solvents to brain)

• How they get in our bodies– Skin contact (relaxer burn)– Skin adsorption (acrylics)– Inhalation (nail polish remover vapor, nail dust) – Injection (“needlesticks”)– Ingestion (on food, hands, cigarettes, accident)

Forms of chemicals

• Aerosols: particles suspended in air– Dusts and mists (ex. Nail dust, hair spray)– Smaller particles go deeper and cause more disease

• Vapors: gas over a liquid (ex. Ammonia)– Commonly called “fumes”– The more volatile (easily evaporated into the air) the

greater the concentration of the vapor in the air– The higher the temperature, the more in the air

• Gases (ex. Steri-Dry)• Liquids (ex. Barbicide)• Bulk products (ex. hair dye)

Concentrationppm = parts per millionExample: 1000 parts acetone per 1 million parts airmg/m3 = milligrams per cubic meterExample = 15 milligrams dust per cubic meter of air

Important: Odor doesn’t always tell you how much is there!

Chemical exposure

• Timing of Exposures– Acute exposures (high levels, infrequent) =

spill– Chronic exposures (low levels, frequent) =

cleaning with alcohol

• Mixed exposures• Inhalation exposures measured by

sampling breathing zone concentrations over time

Timing of Effects

• Acute effects happen immediately or soon after exposure– Examples: burns, asthma attack, throat irritation,

dizziness

• Chronic effects build up over time– Examples: cancer, asthma, allergies (sensitizers)

• Developmental/reproductive: exposed when pregnant, or trying (infertility, miscarriage, developmental defects)

• Effects may be irreversible or reversible when no longer exposed

Human Health Studies (Nails)

• Few human health studies– Increased spontaneous abortions (John, 1994)– Neurocognitive deficits (LoSasso, 2001; 2002)– Respiratory irritation (Hiipakka, 1987)

• Many case reports on other exposed workers and clients– sensitization from acrylics (both allergic contact

dermatitis and asthma)– nail damage (onycholysis)

Human Health Studies (Hair)

• Reproductive– Lower birth weight babies

• Respiratory– Sensitization leading to asthma– Upper and lower respiratory irritation (cough, shortness of

breath, bronchitis)

• Skin– Sensitization leading to allergic contact dermatitis and other skin

problems

• Cancer– Bladder and lung– Occupation as hairdresser = exposures that probably are

carcinogenic

Chemicals of particular concern

• Formaldehyde– Found in lots of salon products

• Small amounts in many nail polishes, esp. as TSF resin• Active ingredient in Steri-Dry as “paraformaldehyde”

– Gas in air (respiratory) and skin contact– Use of Steri-Dry can exceed short-term limits– Health Effects

• Acute: watery eyes; burning sensations of the eyes, nose, and throat; coughing; wheezing; nausea; and skin irritation

• Chronic: Carcinogen (nasal and leukemia); sensitization (allergy)

– AVOID EXPOSURE!

Chemicals of particular concern

• Acids and bases– At either end of the pH scale

• Acids pH < 7 (neutral), Bases pH >7

– Both cause burns and irritation– Acids: nail primer, neutralizers, hydrogen

peroxide– Bases: relaxer, perms, ammonia

Chemicals of particular concern

• Acrylics– Main ingredients in sculptured nails– Strong smell at low concentrations– Powder polymer and liquid monomer

• Liquids: ethyl methacrylate, methyl methacrylate

– Sensitizers (asthma, dermatitis), irritation, miscarriages?

– Skin and nail damage

Chemicals of particular concern

• Solvents– So called because other stuff “dissolves” in them– Organic solvents used extensively in salon products:

alcohol, acetone, toluene, xylene, butane– Readily vaporize into salon air– Most solvents cause same short-term and long-term

effects: • CNS suppression (dizziness, nausea, spaciness)• Skin defatting and irritation• Possible reproductive effects• Possible liver and kidney damage• Possible brain-damage (memory loss, decreased dexterity)

Other hazards in salons

• Emergencies and violence

• Blood borne pathogens and infectious agents

• Safety/Fire

• Musculoskeletal

Chemical Hazard Mapping

• Draw a salon environment (hair or nails)

• Mark on the map where chemical hazards are found– Blue = dusts– Red = vapors/gases– Purple = liquids/bulk

• Mark hazards with dots with many dots to indicate higher concentrations

Protection from Hazards in the Salon Environment

Effective prevention strategy

Prevention at the source(substitution, elimination)

Prevention in the pathway(local exhaust ventilation)

Prevention at the person(gloves and masks, training)

Prevention at the source

• Reduces or prevents exposure – Via all routes (skin, breathing)– All the time (regular use, bulk chemical

handling, cleaning up spills, busy periods)– Without relying on people to be able to follow

directions, read in English– For all people (including sensitive ones) and

the environment (doesn’t shift risk)

• May be difficult to make happen

Prevention in the pathwayLocal exhaust ventilation

Prevention in the path

• General exhaust ventilation or dilution ventilation– Brings in fresh air, exhausts bad air via

HVAC, open doors and windows– Does not prevent exposure, but may lower

concentration levels– Some systems may have air cleaners– Critical for healthy indoor environment

Prevention at the person

• Respiratory protection– Dust masks may prevent some dust

exposure, but don’t stop chemical vapors!– Chemical cartridges with half-face respirators

• Good work practices include keeping containers closed; avoiding skin exposure, esp. during bulk chemical handling

• Training important, but challenging

How do we get information about chemicals?

• 1983 OSHA Hazard Communication Standard requires– Employee Right to Know

• Training• MSDS, labels

• Chemical testing: – animal studies– human studies (workers)

MSDS Exercise• MSDS stands for Material Safety Data Sheet• Most important sections are:

– Ingredients/composition – Hazard identification/health hazards– Fire and explosion hazards– Handling and storage information– Exposure control measures

• Every ingredient and product sold that will be used by someone at work has a MSDS available from the manufacturer

• Salons must have MSDSs for all products and labels on all products

Toxics Use Reduction and Best Practices

What is Toxics Use Reduction (TUR)?

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Planning Process

Concept

State Pollution Prevention Program

Techniques

Waste Management Tool

I. Massachusetts Toxics Use Reduction Program

Executive Office of Environmental Affairs

TURA Program

Department of Environmental

Protection

Office of Technical Assistance

Toxics Use Reduction

Institute, UMASS Lowell

What is TUR?

• Toxics Use Reduction Concept– Minimization of pollution and hazards from

chemical contamination through reduction, elimination, or substitution of the toxics substances at the point where they are produced or used.

Toxics Use ReductionToxics Use Reduction

• TUR is NOT:– treatment of toxic waste– dilution of toxics– transfer of toxics from one medium to another

(soil to water)

TUR in Practice

TUR involves systems analysis and a planning process:

Why is this chemical being used? Is there another method that will negate the

need for the chemical? If the activity truly requires chemical use, is

there a safer alternative? If no alternatives exist, is the chemical

being used efficiently?

TUR Techniques

1. Chemical Substitution

2. Product Reformulation

3. Process (Redesign) Change

4. Equipment Modernization

5. Improved Operations & Maintenance (Housekeeping)

6. Reusing (recycling) substances

Chemical Use

Chemical Releases to the Environment

COMMUNITY TUR• While TUR was developed for a

manufacturing-facility focus, the TUR approach can be applied to other areas:– Household chemical use.– Municipal Operations: DPW garages/facilities,

local water treatment plants, state or local building grounds-maintenance, etc.

– Small businesses: auto body, dry cleaning, food service, hair and nail salons.

TUR Techniques in “Cleaning”

• Use less toxic products (substitution)

• Use less product or proper dilution (process change)

• Pump instead of aerosol (product redesign)

• Proper mixing, covering containers (improved operations and maintenance)

• Training students in sanitation (improved operations and maintenance)

TUR in FOOD ESTABLISHMENT Lexington Health Department

Purpose of Project

•Examine chemical usage in food establishments

•Determine barriers and means of promoting TUR in this environment

•Examine means of integrating TUR into establishment operation and inspection process

High usage of chemicals: cleaners, degreasers, sanitizers and pesticides in environment, on food (e.g., Victory product)

Limited training of workers on safety and handling

Threat to public health through food contamination

Threat to worker through occupational exposure

Effect on environment

Conflict between sanitation requirements and toxics usage

Why Is TUR Important in Food Establishments?

Practices Observed during inspections

Overuse or inappropriate use of chemicals

Usage of unnecessary chemicals

Failure to dilute: higher exposure

No knowledge of product contents or safety issues

Questionable application of pesticides (routine, use of foggers)

Minimal safety equipment/training

MSDS not available

No knowledge of pesticides in use or IPM

Advantage of TUR for Food Establishments

Greater worker safety

Improved food safety

Benefit to environment

Decreased costs

Improved pest management, long term

Public perception of establishment

Key Messages for Food Establishments

Non-Toxic AlternativesDegreaser-Borax on a damp clothFloor cleaner-1 cup vinegar in 2 gallons waterOven cleaner-2 tbsp liquid soap with 2 tsp of borax in warm waterWindow cleaner-2 tbsp vinegar in 1 quart warm water

OSHA Requirements•Promote safety and awareness•Applicable to restaurants•Personal protective equipment (gloves, goggles, eye wash, storage, training)•Hazard communication standard

Employee Training Program

Integrating TUR Into Food Establishments•Provided literature/training-awareness•Ongoing reinforcement through inspections•Developed web-based training program•Distributed mailing on subject of IPM and toxics control •Integrated issues into inspection program •Carry out extensive inspections with expert on IPM •Developed model IPM program for food establishment•Passed regulation requiring IPM along model of Children and Families Protection Act

Why would Salons want TUR?

1. Lack of Product and Toxicity Testing

2. Known health risks associated with exposure to many chemicals

3. Impacts at Lower Exposure Levels and Timing of Exposure

4. Increase in environmentally-related diseases

5. Disruption of Hormone Systems

6. Reproductive Effects

Emerging Knowledge in Toxics and Health

Why would Salons want TUR?

• Reduce chemical exposure for the public and for workers

• Improved (safer) workplace environment • Reduce liability (fire, spills, contamination,

exposure)• Public Image - “Green Operation,” care

about environment and workers• Market advantage

TUR Techniques

1. Chemical (Product) Substitution (Replace hazardous products with safer ones!)

2. Product Reformulation

3. Process (Redesign) Change

4. Equipment Modernization

5. Improved Operations & Maintenance (Housekeeping)

6. Reusing (recycling) substances

TUR in Cosmetology

• Use less toxic hair dyes ~ non-permanent dyes (semi, demi)-(substitution and process change)

• Avoid Coal tar dyes, lead acetate (substitution)

• Use pump sprays instead of aerosols (substitution)

• Keep product containers and barbicide containers covered (improved Operations & Maintenance)

TUR in Cosmetology

• Avoid products with formaldehyde, toluene, phthalates (substitution)

• Physical straightening instead of chemical straightening (process change)

• Lower pH products (substitution)• Natural nail care rather than artificial

nails (process change)• Establishing a separate chemical storage and mixing room (improved O & M)

Chemical (Product) Substitution Permanent Hair Dyes

Chemicals of Concern• Para-Phenylediamines

– Derivatives from coal tar. – Darker dyes have more

phenylediamine. – Other names: 2, 4 -

diaminoanisolepara-dyes

• Health Affects – Can cause cancer.– Can cause changes in genetic

information in sperm and egg– Can cause severe allergies

and dermatitis.

Try plant derived dyes: Henna (triggers asthma)Chamomile for lighteningSaffronBeet juice

Use semi-permanent dyes without:Para-Phenylediamines

AmmoniaResorcinol

Chemical (Product) Substitution Relaxers

Chemicals of Concern Sodium Hydroxide (Lye) • Problem

– highly alkaline and corrosive

• Health Effects– burn skin and scalp– cause blindness– irritant to skin, eyes,

respiratory system

• Alternative Product– Bisulfates Lye Based Product

Example of a No-Lye Product

Promo

Designer Touch Sensitive Scalp No Lye Relaxer relaxes without the irritation that sometimes occurs with other relaxer products.

Example of a No-Lye Product

PromoThis patented No Mix- No Lye lithium hydroxide relaxer with Vitamin E provides maximum silky straight results on all textures of hair.

Chemical (Product) Substitution Hair Bleaching/Lightening

Chemicals of Concern• Protinator and activators

containing oxidizers such as potassium persulfate and ammonium persulfate can cause respiratory irritation.

• When ammonium persulfate is heated to speed the bleaching process, it can produce toxic fumes.

• Hydrogen Peroxide can be a skin irritant

Hierarcy of Lighteners: 1. Oil Bleaches (mildest)

2. Cream Lighteners3. Powder Bleaches

*Use bleach without the boosters.

*When using boosters, try potassium persulfate boosters instead of ammonium persulfate boosters.

Chemical (Product) SubstitutionNail Finishes

Chemicals of ConcernToluene (solvent)

Reproductive ToxinFormaldehyde

(preservative, polymer)

CarcinogenPhthalate (Plasticizer)

Endocrine Disruptor

Chemical (Product) SubstitutionNail Finishes

Some Products That AreToluene, Formaldehyde, and Phthalate -Free

• L’Oreal Paris Jet-Set Quick Dry Nail Enamel

• Revlon Nail Enamel

• Garden Botanika Natural Color Nail Color

• Kiss products, Kiss Color

Improved Operations (Work Practices) Application of Methacrylates

Reducing Exposures From Vapors

• Use a small mouthed dispenser

with a pressure-sensitive stopper

and a small opening just large

enough to fit the applicator brush

into and for the applicator to

hold the nail liquid.

• Keep the container closed when not in use.

• Mix only the amount you need per application.

Improved Operations and Maintenance

• Do not eat or drink in application area.

• Do not store food in chemical storage areas.

• Do not smoke in application or chemical storage area.

Improved Operations and Maintenance

• Prevent product contact on worker and clients’ skin.

• No living or sleeping in the salon.

• Keep all products covered.• Keep table free of product

residues and dusts.• Label all containers.• Wash hands between

customers and before eating.

Improved Operations and Maintenance Managing Vapors from Waste

• Dispose of solution soaked gauze and other cleanup materials in a sealed container or bag.

• Keep a lid on the trash can and dispose of daily.

Regulations

MA RI CT NH VT ME NY School Hrs 100 300 Nonea 300 400b 200c 250 CEU* None None N/A None None None None Salons/inspector 402d 167 N/A 94 10 60 85 Vent. Req in salon licensing

Yes Noe N/A Yes Yes Yes Yesf

MMA restricted Yes No NO Yes Yes Yes Yes

a Manicuring is not regulated in Connecticut, though legislation is in legislative committees. No license required for manicure, but cosmetician license (1,500 hrs) for pedicures.b or an 8 month apprenticeshipc or 400 apprenticeship hours.d based on 3 inspectors, 1,206 salons*Continuing education credits are required in Florida (16 hours/per renewal period), Georgia (5), Illinois (10), Indiana (16), Iowa (8), Kentucky (6), Nebraska (8), Ohio (8) and South Carolina (6)e Rhode Island makes reference to state Building Code requirements which may require ventilationf New York says that only chemical mixing areas and eating areas must have ventilation.

BOC Regs Compared

Environmental Requirements• RI: Section: 18.0 STRUCTURAL, AIR AND ENVIRONMENTAL

REQUIREMENTS, EQUIPMENT AND SUPPLIES • .1 A shop, place of business or establishment licensed to practice

hairdressing and cosmetic therapy, manicuring or esthetics must meet the following structural requirements:

• .1 the Fire Safety requirements of the State Fire Code; • .2 the State Building Code Commission requirements; • .3 the local zoning laws; and • .4 Federal Occupational Safety and Health Administration (OSHA)

standards for air contaminants as published in the Federal Register CFR 1910.1000 "Air Contaminants".

VT: 8. shop area shall be sufficiently ventilated to exhaust hazardous or objectionable airborne chemicals, and allow the free flow of air;D. Chemical storage and emergency information:1. shops and facilities shall have, in the immediate working area, a binder with all Material Safety Data Sheets (MSDS) for chemical products used. These are provided by manufacturers;2. shops and facilities shall have a blood spill clean-up kit;3. flammable chemicals shall be stored in a flammable storage cabinet or a properly ventilated room; and4. chemicals which could interact in a hazardous manner (oxidizer, catalysts and solvents) shall be separated in storage.

MA: Every salon shall be equipped with proper and adequate lighting and ventilation and kept in clean, orderly and sanitary condition.

ME: C. The establishment must be adequately ventilated at all times.

NH: (e) Mechanical ventilation shall be provided by a method of supply air and return or exhaust air in all schools and shops, with a minimum exchange rate of 35 cubic feet per minute.(m) The shop or school shall have Material Safety Data Sheets (MSDS) required by OSHA under 29 CFR 1910.1200 (g) for products being used.

NYS: §160.25 Chemical storage and MSDS (a) Any chemicals used in the conduct of appearance enhancement shall be mixed only in a dispensing area which has adequate ventilation. (b) Flammable and combustible chemicals shall be stored in a metal cabinet remote from potential sources of ignition, such as an open flame or an electrical device. (c) All nail care chemicals must be stored in closed bottles. (d) An owner have on file all Material Safety Data Sheets (MSDS) for inspection. MSDS must be stored in a metal file accessible to all employees.§160.26 Product labelingIn order to assure the safe provision of services to the public, all products used in the conduct of an appearance enhancement business must be maintained with the original manufacturer labeling intact. All bottles containing poisonous or corrosive substances shall be additionally and distinctly marked as such and shall be stored in an area not open or available to the public.

OSHA Regulations

• Regulated by OSHA. – DOS can provide compliance assistance, but

cannot enforce OSHA.

• Governs– Hazard Communication Standard – MSDSs,

RTK training, Haz Com Plan– Formaldehyde Standard – Eyewash Standard– Blood Borne Pathogen

Hazardous Waste Regulations• Regulated by the MA Department

of Environmental Protection• Governs:

– The amount and length of time a waste can be stored.

– How the waste must be stored.– Signage for the area and containers.– Emergency response.– Licensing and Paperwork.– Criteria for designing and

maintaining the storage area.

Federal Fire Regulations

• Regulated by OSHA.

• Governs:• Written plan required if 10 or more employees

(otherwise oral).• Emergency Response Equipment.• Includes methods to prevent fires (including storage

of flammables).• Includes Emergency Escape Procedures, meeting

place, etc.

Written Emergency Action/Fire Prevention Plan – OSHA 1910.38

State Fire Regulations

• Regulatory Jurisdiction• Regulated by the Office of the State

Fire Marshal. • Enforced locally by the Fire

Department.

• Governs flammable dispensing and storage:

• Storage equipment.• Storage permit and/or license

requirements.• Emergency response system.

Building Code• Regulatory Jurisdiction

– Regulated by the State Building Inspector.– Enforced locally by the Municipal Building Inspector.

• Types of issues found in salons:– Shared wall construction.– Shared ventilation systems. – Use of locations not designed for business.– Inadequate systems or systems not used correctly.

• Governs:– Ventilation - mechanical and natural– Ingress and Egress– Smoke alarm and fire sprinkler systems

Noisome Trade Odor Complaints/Nuisance

Noisome Trade Odor Complaints/Nuisance

• Regulatory Jurisdiction– Board of Health– Enforced locally by local Health

Department/Agent

• Governs: (see Town of Sharon Regs.

Sanitary Code

• Regulatory Jurisdiction– Regulated by the MA Department of Public

Health– Enforced locally by local Health Department.

• Governs:– Hot water– Sanitation

Licensing

• Regulated by the MA Board of Cosmetology.

• Governs:– The opening and licensing of salons.

• Occupancy Permit• Electrical Permit• Building Permit

– The licensing of technicians.– The operation of the salon.– Equipment and Hygiene Procedures

Vocational Training

Licensing

• Practitioner exam

• Salon Inspection

Continuing Education

(not required)

Trade Shows

Inspections

Opportunities to Improve H & S in Salons

Medical Surveillance

Physician Training

Consumer Ed/Demand

Product Reformulation

Discussion

• What are the barriers to improving salons, especially the air quality?

• What are the opportunities for improving salons?