I am a 24-year-old woman and live in Georgia. I recently started working in a nail salon. The work with customers is fine and the pay isn’t bad, but another woman who works there told me she heard that such a job can be dangerous to health. I asked my boss, but she said it was “nonsense.” Is it really dangerous to do such work?  T.E., Atlanta, Georgia

Judy Siegel-Itzkovich replies:

Your concern about your health while working at a nail salon seems to be quite justified.

Researchers at the University of Colorado at Boulder who recently tested employees and ambient air at nail salons have found high levels of indoor airborne pollutants such as formaldehyde and benzene in nail salons. They even concluded that working in a salon is like working at an oil refinery or an auto garage!

The new study, which monitored volatile organic compound (VOC) levels in six Colorado nail salons, is among the first to illustrate the serious health risks prevalent in the industry, where technicians commonly work long hours and report symptoms such as headaches, respiratory difficulties and skin irritation.

The US Environmental Protection Agency (EPA) has determined that long-term exposure to carcinogenic compounds significantly raises the chances of developing cancers such as leukemia and Hodgkin’s lymphoma.

“The study provides some of the first hard evidence that these environments are dangerous for workers and that better policies need to be enacted to protect them,” said Lupita Montoya, lead author of the research and Research Associate in the university’s department of civil, environmental and architectural engineering.

Montoya has been interested in researching airborne hazards in nail salons for nearly a decade after visiting one for the first time and being being struck by the pungent smell of open chemicals used in gel and acrylic nail applications. The air quality couldn’t be very good in such a confined space with poor ventilation, she suspected, drawing on her background as a mechanical engineer.

But while many of the VOCs from nail products had already been identified, no scientific studies had looked at the long-term health impacts for workers exposed to them day in and day out. She wondered: Which compounds were in the air at what concentrations? And once released, how could they be removed?

Montoya tried on two separate occasions to get field tests started, but securing a location proved difficult. Over 90% of nail salons nationwide are small businesses, employing a predominantly minority workforce and lacking the resources to adequately address worker health and safety. Fearing consequences, many declined to participate. “This is an issue that requires tremendous sensitivity and a respectful approach to the communities being served,” Montoya said.

In 2017, four undergraduate students working with Montoya used personal connections to help secure access to six salons for a monitoring test over the course of 18 months. The salons agreed to participate on the condition of anonymity. The researchers set up equipment to monitor known VOCs such as benzene, toluene, ethylbenzene and xylenes (BTEX, collectively) along with formaldehyde. While formaldehyde levels were similar to those measured in other settings, the study turned up higher-than-expected concentrations of harmful benzene – which has been linked to leukemia – in all six salons.

The real concerns, the researchers say, is for workers in this industry. Montoya and her colleagues asked employees to fill out questionnaires about employment practices, safety practices and health symptoms. Technicians reported working an average of 52.5 hours per week, with some ranging as high as 80 hours per week. As many as 70% of workers reported experiencing at least one adverse symptom, with common responses including headaches, skin irritation and eye irritation. The study found that for workers in some salons, lifetime cancer risk was up to 100 times higher than baseline EPA-issued levels.

The researchers stressed that salon customers, however, face significantly fewer risks. The observed levels of air pollution observed are unlikely to have any negative health effects on all but the most vulnerable, such as those who are pregnant or have serious asthma.

“It really depends on how much time you spend in and around that environment,” Montoya said. “Customers spend a fraction of the time in salons that workers do. Unless they have pretty severe allergies or asthma, there’s not much for customers to be concerned about.”

With the hazards readily apparent, Montoya said, the biggest question is how to remove VOCs safely and without disrupting the salon business. In 2016, mechanical engineer and doctoral-degree candidate Aaron Lamplugh began working with Montoya on ways to reduce VOC concentrations passively using low-cost, absorbent materials like heat-treated coal or wood with strong affinity for organic molecules like BTEX compounds. These activated carbon materials can remove harmful VOCs through passive diffusion, but it takes a long time. Air jets that direct polluted air toward the absorbent material with greater flow provide far more efficient removal. “We’ve seen high rates of VOC removal with this method in controlled lab settings – nearly 100%,”  said Lamplugh. “We’re still optimizing it for the field, where conditions are more unpredictable.”

A master’s-degree student, Camila Friedman-Gerlicz, used activated carbon-based materials to create gallery-worthy artwork. The pieces could hang on the wall in a nail salon, pleasing to the eye while quietly cleaning the air, she said. In an ideal real-world setting, small jets would sit at the end of each table, fanning the chemical fumes directly toward the charcoal artwork, efficiently eliminating lingering VOCs.

So, based on this data, if you are very nervous about your health while working in your nail salon, you can quit; otherwise, insist that the workplace be well ventilated; and make sure that you don’t work too many hours at a time.  

My family doctor has prescribed that I take a pill called Tribemin, which is composed of various types of Vitamin B. He didn’t explain to me why I have to take it. I read on the Internet that Tribemin can be harmful. Should I keep taking it? V.R., Virginia

Howard Rice, a veteran Israeli pharmacist and pharmaceutical consultant, comments:

Tribemin consists of Vitamin B1 (thiamine hydrochloride), vitamin B12 (cyanocobalamin) and vitamin B6 (pyridoxine hydrochloride). It is prescribed to prevent vitamin deficiency and other conditions and, in rare cases, to treat an inherited disease marked by the excretion of sulfur in urine

With a believed half-life of 15 to 20 days and being mainly stored in muscle, the neurological effects of vitamin B6 (Pyridoxine) are well documented. The real problem arises from the individual kinetics varying so much. The US Food and Drug Administration gives 100 mg per day as the accepted dose. This accumulates in the body. Tribemin contains 200 mg.

Vitamin B1 has a short half- life and does little if any damage. Vitamin B12 can remain in the body (stored) for almost three years.

Since there is so much vitamin B 6 in Tribemin, ask your doctor whether you can ingest it from food or take a different pill. Good sources of vitamin B6 include chickpeas, beef liver, tuna, salmon, chicken breast, breakfast cereals fortified with the vitamin, potatoes, turkey meat and bananas.  There is no substitute for a well-balanced diet, and individuals, especially vegetarians, should seek a clinical dietitian’s advice.

I recently underwent a brain MRI scan. I was wondering about the difference between “white” and “gray” matter in the brain. M, U.S.

Prof. Natan Bornstein, head of the neurological institute at Jerusalem’s Shaare Zedek Medical Center, answers:

White matter means the nerve fibers in the central nervous system (brain and spinal cord) that are covered/wrapped by myelin. This appears to the naked eye as whitish/yellowish and therefore it is called the “white matter,” as opposed to the nerve cells (neurons) that are called “grey matter.”

If you want an Israeli expert to answer your medical questions, write to Breaking Israel News health and science senior reporter Judy Siegel-Itzkovich at judy@israel365.com with your initials, age, gender and place of residence and details of the medical condition, if any.