Researchers develop the first free online training program on workplace chemical exposure and safety for nail salon workers

One occupation is expected to grow faster than all others—a whopping 12 percent per year—through 2033: nail salon work.

This surge began in 2023, bringing the current number of nail salon workers in the United States to more than 365,000.

This popularity comes at a cost, however. Their work with nail polishes and polish removers, artificial nails, adhesives, glues, hardeners, sanitizers and other tools of the trade exposes them to a wide range of chemicals and airborne volatile organic compounds (VOCs).

“These include known carcinogens such as formaldehyde and other harmful VOCs such as acetone, ethyl acetate, butyl acetate, isopropanol, toluene, methyl methacrylate, and ethyl methacrylate—and the list goes on,” said Aurora Le, PhD, with the Texas A&M University School of Public Health. “These compounds are known to irritate the eyes, skin and respiratory system, to damage the liver and kidneys and to cause neurological deficits and adverse reproductive outcomes.”

Although Le is encouraged by recent efforts to increase awareness of these hazards, notably by the federal Occupational Safety and Health Administration (OSHA) and California Healthy Nail Salon Collaborative, she said much work remains to help nail salon workers mitigate the potential dangers they face.

“In addition to the huge number of workers, two other factors play a significant role in worker awareness and training,” she said.

One is a lack of comprehensive regulation of the compounds nail salon workers use. OSHA regulates some—but not all—and lacks the capacity to enforce existing regulations. In addition, the U.S. Food and Drug Administration does not rigorously regulate the ingredients in most beauty products, especially nail products.

The other factor is a lack of training tools on chemical exposure and safety that are language-appropriate and easy to use by those in an occupation primarily comprised of women of Vietnamese descent.

“With limited English proficiency, these workers struggle to comprehend warning labels, existing training materials or Safety Data Sheets,” Le said. “In one of our focus groups, for example, we learned that most nail salon workers quickly throw away any English educational pamphlets and brochures they are given.”

To address these issues, Le and colleagues from the University of Michigan School of Nursing assessed the needs of nail salon workers in Michigan and developed what they believe is the first free, online training module to increase nail technicians’ knowledge of chemical exposure and safety. Their study, published in the Journal of Occupational and Environmental Medicine, was initiated by the Michigan Healthy Nail Salon Cooperative.

The researchers used a three-phase Analysis, Design, Development, Implementation and Evaluation (ADDIE) model for the study. For the first phase, they developed a needs assessment through focus group sessions with nail salon workers in Michigan and reviewed scholarly studies and federal and state policies on chemical exposure and safety measures for nail salon work. From this, they developed content for the online training module.

The self-paced module focused on the use of chemicals in the five major tasks that a nail technician typically performs (cleaning nails, applying and removing nail polish, applying and removing artificial nails, sanitizing and sterilizing equipment and handling and storing equipment) and the OSHA Hazard Communication Standard (Labels and Safety Data Sheets).

“We engaged participants through interactive questions and used a pretest and posttest to capture the knowledge gained, with a score of 70 percent or greater leading to certification,” Le said.

In the second phase, the researchers revised the module through a three-month collaboration with a community advisory board composed of salon workers and owners who also would disseminate and implement the module. In the third phase, they translated the module into Vietnamese with assistance from native speakers and conducted a pilot test. Based on committee feedback, they also increased the final required module training score to 80 percent or greater for the posttest in either English or Vietnamese.

A pilot test of the Phase 1 module with four nail salon workers, eight industrial hygiene students, and two occupational health nursing students found that the training increased their knowledge of chemical exposure and safety practices. Based on their feedback, the researchers also added more interactive activities and made the module easier to use on mobile devices.

In the Phase 2 evaluation of the English language module, the team, with feedback from the committee, repackaged the module using a new learning management system for the storyboard platform and made it public. Seven individuals completed the final English version, and their mean pretest score was 81.43 percent and mean posttest score was 98.57 percent, indicating that their knowledge of chemical exposures increased.

For Phase 3, which focused on the Vietnamese translation, 24 nail salon workers who went through the module scored 58.33 percent on the pretest and 91.67 on the posttest, demonstrating a significant increase in knowledge of the topic.

The average pretest scores for seven people who completed the English version and 24 who completed the Vietnamese version were 81.43 percent and 58.33 percent, respectively. The average posttest score was 98.57 percent for English and 91.67 percent for Vietnamese. In addition, those who responded to a voluntary survey about the module content reported satisfaction with its content, length and knowledge application, as well as increased confidence in their knowledge of workplace chemical exposure and their ability to protect themselves against exposure.

“This module, in English and Vietnamese, is free, self-paced and available to anyone around the world with internet access,” Le said. “Salon workers in Vietnam have taken the training, and we plan to promote it in Texas and other states as a valuable tool for promoting health and well-being among licensed and unlicensed nail salon workers alike.”