In nearly every United States community, a nail salon can be found tucked away in the local shopping center. We all know someone who regularly gets manicures and pedicures; it might be yourself, a family member, or a friend. However, the workers who provide these services are often invisible to the communities they serve. According to the Bureau of Labor Statistics, in 2021 there were approximately 163,000 nail salon workers (manicurists and pedicurists) in the U.S. But other sources, such as NAILS Magazine, estimate that count to be as many as 400,000 due to the number of undocumented and unlicensed individuals who work in this small business industry.

The U.S. nail salon industry is predominantly owned and staffed by foreign-born individuals (immigrants or refugees) who run small “mom-and-pop” businesses with 10 or fewer employees, making them subject to fewer OSHA regulations and recordkeeping requirements. As explained in a report published in 2018 by the UCLA Labor Center and the California Healthy Nail Salon Collaborative, nail salons mostly staff women of child-bearing age with limited English proficiency who work for low wages and few employment-related benefits. The study on which the 2018 report is based found that nearly eight in 10 nail salon workers earn low wages, defined as two-thirds of the median full-time wage, and most work overtime, or more than eight hours per day. According to the UCLA report, approximately 80 percent of nail salon workers are female; about 75 percent are of Asian descent, with Vietnam as the most common place of birth; 65 percent of the workforce is between 16 and 44 years old; and nearly 50 percent do not speak English or have limited English proficiency.

Nail salon workers in the U.S. are licensed through their respective state cosmetology or licensing boards, which have requirements that vary by state. Workers can be trained through a formal cosmetology program or through an apprenticeship; many workers opt for the latter given the lower cost and lower barriers. When it comes to occupational health and safety in the nail salon industry, the differences in state licensure requirements contribute to a lack of uniformity and baseline expectations regarding training and educational requirements, as explained in a study published in Health Science Reports in 2022. Thus, challenging working conditions and labor enforcement and rights issues are pervasive within this industry. Nail salon workers also experience occupational health disparities, which are described in a previous Synergist article. The often precarious work arrangements, combined with complex OHS regulations and product warning labels that are frequently only available in English, make it challenging for owners and workers to understand the long-term implications of their exposures and ways to protect their health.

Many nail salon workers feel that this work is the only way to earn their livelihood in the U.S., and many understand that they are regularly exposed to a number of occupational hazards—though they do not receive adequate training and education to fully understand what those hazards are and how to mitigate them, as discussed in a paper published in 2021 in the International Archives of Occupational and Environmental Health. For example, a more recent study published in January 2023 in Nature Communications found that radiation emitted by nail polish dryers used to cure gel manicures can damage DNA and cause somatic mutations in mammalian cells. The study attracted much media attention regarding potential cancer risk to nail salon customers. This instance is representative of how most of the discussion surrounding nail salons tends to focus on protecting customers’ health and safety, rather than that of the workers. This article is intended to shift that focus toward common occupational hazards encountered by nail salon workers.

CHEMICAL HAZARDS Numerous chemical ingredients are found in nail care products, and overexposure to them can cause short- and long-term health effects. However, many beauty products used in nail salons are not regulated by the Food and Drug Administration. For instance, acetone, typically used to remove nail polish and acrylic nails, may cause headache, dizziness, and irritation to the skin, eyes, throat, and central nervous system. Many nail polishes may contain what is known as the “toxic trio”: formaldehyde (or formalin), toluene, and dibutyl phthalate. Formaldehyde is a known human carcinogen, and short-term health effects of formaldehyde exposure may include irritation of the respiratory system and wheezing. Toluene, another known respiratory irritant, may also cause liver and kidney damage. Dibutyl phthalates and other phthalates found in nail salons are endocrine disruptors and have been linked to reproductive health issues, as described in studies published in 2022 in the International Journal of Environmental Research and Public Health and in 2008 in the Journal of Immigrant and Minority Health. And methyl methacrylate (MMA), a type of liquid monomer used in acrylic nail application, is a dermal sensitizer. The use of MMA in nail care has been banned since the 1970s, but the chemical continues to be found in nail salon products, resulting in exposures to some unsuspecting workers and customers.

Exposure studies of the nail salon environment have typically found chemical levels below relevant occupational exposure limits. However, multiple health studies of nail salon workers report short-term symptoms that are consistent with known health effects related to exposure to volatile organic compounds (VOCs) such as those mentioned previously as well as others. These studies—which are listed below as resources from the Journal of Community Health, the Journal of Immigrant and Minority Health, and the Annals of Work Exposures and Health—confirm adverse health outcomes resulting from low-level exposures to VOCs in nail salon settings.