A ‘Q and A’ with Linor David about the environmental health equity issues of nail salon workers in Toronto

There are over 1150 nail salons in Toronto with approximately 10,000 workers who are routinely exposed to chemicals that are known to be harmful to health1, yet related occupational health and safety policies and regulations are limited. This is a health equity issue; many nail salon workers are female immigrants from China and Vietnam who may be unable to access information or to report exposures and working conditions due to language barriers or power imbalances related to immigration status.

Linor David, a CEHE Knowledge Leader, spoke to us about The Healthy Nail Technicians Project, which she was involved with during her time at the Central Toronto Community Health Centres. Through this project, nail salon workers in Toronto were able to share their concerns, learn how to protect themselves, and identify next steps, such as creating a Nail Technician Association and making resources accessible by translating them into Chinese and Vietnamese.

Q. Could you tell me a little bit about the rationale behind the Healthy Nail Technicians Project, and how this issue relates to environmental health equity?

A. This project was initially started over a concern for the reproductive health of nail technicians. Nail technicians are exposed to a whole host of chemicals that have the potential to impact on reproduction and Central Toronto Community Health Centres, where I worked at the time, are deeply involved in women’s health issues and in early years programs. In Toronto, nail technicians working at discount nail stores are mainly newcomers, either from Vietnam or China. We quickly realized that this was an environmental health equity issue, as this group had increased vulnerabilities because of language barriers and employment conditions. We felt like more research and an intervention in this area could have an impact on the environmental health of the nail technicians.

Q. How did you get involved with this work?

A. I come to this work from a few different angles. Firstly I came as a health promoter working within a Community Health Centre whose focus was on addressing the social determinants of health of priority populations, which for our centre included newcomer Chinese women and children. My own experiences with environmental exposures and reproductive effects also sensitized me to the long lasting repercussions that in-utero exposures can have on the life of both the child and family. As a woman and customer at nail salons my own relationships with the women working at salons and my own environmental sensitivities to the chemicals that I experienced while in nail salons, heightened my awareness of this as a potential issue. Through theKnowledge Leaders experience at CEHE many of these links were made and helped me better understand how it all fit together in the schema of environmental health equity.

Q. The project began with outreach to nail technicians and a focus group, followed by resources and workshops tailored to the needs and concerns expressed by the participants. What were their primary concerns, and what kinds of resources and workshops did they receive?

A. The project lasted over six months and so we addressed a range of issues over time. The primary concerns that the nail technicians had was a lack of information about how to protect themselves at work and a lack of knowledge about what potential effects the exposures could have on them and their pregnancies. Women reported a lot of skin conditions as a result of the materials they worked with and so for our first workshop we had CREOD [Centre for Research Expertise in Occupational Disease] come in and give a workshop on how to protect your hands at work. The workshop was very practical and experiential and gave the workers easy ways to protect their skin and avoid dermatitis while working in a nail salon.

Nail technicians were also concerned about the potential effects their exposures were having on pregnancy and children and so we focused one of our workshops on this issue – and on how to reduce exposures in general, as women also reported respiratory and neurological effects from the chemicals. We were also lucky enough that Anne Rochon Ford, from the National Network on Environments and Women’s Health was able to bring in Dr. Thu Quach, a San Francisco researcher who has done extensive work in this area, to present about the types of research and initiatives that have been carried out in California.

Q. The last step was a multi-stakeholder roundtable with nail technicians and other key players to share findings and identify potential opportunities for collaboration. What were the main findings, and what are the next steps that should be or are being taken to improve awareness and working conditions?

A. The multi-stakeholder roundtable revealed areas where nail technicians and other key players overlap. Nail technicians expressed how learning about the regulatory structures has been helpful to them but that they have to organize themselves so that they can have a voice when it comes to policy decisions around the laws regulating cosmetics and workplaces. Representatives from the Labour Committee of the Chinese Interagency Network were extremely supportive of the development of a Nail Technician Association and offered to help with its set up.

Nail technicians shared that the lack of formal training they receive is a barrier to protecting themselves at work. Another need identified was to produce resources in Chinese and Vietnamese so that they are accessible to nail technicians. The need for continued research and long-term data was also discussed. Lastly, the need to involve and educate other allies, like customers at salons, was also identified as an important piece of work. The roundtable became the starting point for the development of a collaborative including many of the key players that will further the issue of nail technician health past the point where the projects funding ends.

Thank you Linor!

For more information please visit http://www.cwhn.ca/en/node/46338/

Central Toronto Community Health Centres

1Balkissoon, D. (2012). Your manicure looks beautiful. But the health effects are ugly. The Globe and Mail online. 14 July 2012.http://www.theglobeandmail.com/life/health-and-fitness/health/your-manicure-looks-beautiful-but-the-health-effects-are-ugly/article4416784/