School of Public Health experts lead effort to improve conditions for nail salon workers

Nail salons in the United States are a $10 billion industry—and growing fast. Despite this, little is known about the estimated 400,000 workers behind this boom, including their precise number.

That’s because the large presence of undocumented individuals who work in nail salons likely means that the total is undercounted. To keep their jobs, these workers—most of whom are foreign-born women of Vietnamese ethnicity—tolerate exposure to hazardous chemicals and poor working conditions that often include workers’ rights violations and wage theft, according to Aurora Le, PhD, an occupational health expert with the Texas A&M University School of Public Health.

“Nail salon workers exemplify the experiences of low-wage, immigrant women in the service industry,” Le said. “They are found in nearly every community, but their health needs are often overlooked, even within their own communities.”

These workers routinely are exposed to toxic chemicals and volatile organic compounds that are largely unregulated.

“For example, toluene and formaldehyde are known carcinogens, and ammonia and phthalates are volatile organic compounds, and all of these and more are found in nail polishes and removers,” Le said.

Other health risks come from prolonged sitting, awkward postures and repetitive motions that can lead to musculoskeletal disorders and carpal tunnel syndrome.

Now, thanks to support from the Texas Higher Education Coordinating Board, Le and colleague Heather Clark, DrPH—who specializes in evaluating health programs in rural and underserved communities—are assessing the needs of nail salon workers in greater Houston, with plans to also identify ways to reduce the hazards they face.

Their study will be the first to focus on nail salon workers in Texas, which trails only California in the percentage of Vietnamese Americans and number of nail salon workers.

This location is significant, Le said, because Texas ranks 46th nationally in a major occupational safety and health ranking, and because workplace injuries and illnesses are thought to be underreported in border states such as Texas. In addition, the state’s continuing education requirements for license renewal focuses mainly on safety and sanitation for customers, not workers.

“Further complicating the issue is the fact that most nail salons operate as small businesses, meaning they have 10 or fewer employees and have far fewer record-keeping requirements than larger businesses,” Le said. “Furthermore, inspectors are less likely to prioritize nail salons over industries that are viewed as more dangerous, such as oil and gas and construction.”

She added that most workers are not proficient in English, affecting their ability to understand and implement training materials and safety data sheets for chemicals.

For their study, Le and Clark will first put together an advisory board of at least two nail salon owners and two nail salon workers who will provide input for the study.

They will then conduct English- and Vietnamese-language surveys of at least 95 nail salon owners and workers at 10 Houston-area salons about their current occupational safety and health needs.

Using what they learn from the survey, they will then use small focus groups of nail salon owners and workers, also in English and Vietnamese, to identify three of their biggest perceived hazards.

This study will build on and greatly extend Le’s extensive previous research on nail salon worker health and safety.

At its conclusion, she and Clark plan to launch a Texas chapter of the California Health Nail Salon Collaborative, a grassroots program focused on the issues faced by low-income, female, Vietnamese immigrant and refugee workers, as Le did in Michigan with the Michigan Healthy Nail Salon Cooperative.

They also will tie this new chapter to the Texas A&M Center for Worker Health, for which Le serves as a faculty director.

“Vietnamese American nail salon workers experience many barriers that result in poor health outcomes,” Le said. “Our work will give insight into a minority worker population that, until now, has been overlooked.”