Development of health and safety training for Vietnamese American nail salon owners and workers

Background: Nail salon workers are an underserved worker population that faces multiple barriers to accessing occupational health training and services. We developed a series of occupational health training modules, which were culturally tailored to Vietnamese-speaking workers, covering topics on infection control, musculoskeletal disorder prevention, chemical safety, and labor practices. We delivered the training online (due to COVID-19) to a small group of Vietnamese owners and workers in the Philadelphia metro area to obtain feedback on the training content and potential implementation challenges. Methods: Seven participants (three owners and four workers) were recruited to attend the training. Qualitative feedback was obtained after each training session, followed by a more in-depth interviewer-assisted open-ended questionnaire to gain better understanding of the potential challenges of implementing the recommended changes. The Health Belief Model was used to guide the analysis of the participants's responses to identify the perceived benefits and barriers of the training. Results: Themes of perceived benefits of the training were bridging the gap of cosmetology school training, offering practical tips to protect their health at work, and inspiring conversations about work dignity and labor practices. Themes of perceived barriers were availability of affordable safer products and lack of resources, desire to please customers, lack of commitment from owners, and ubiquitous low wage that impacts employee's job satisfaction and motivation to change, and difficulty in obtaining a work license. Conclusions: Our study revealed the multitude of social and economic barriers facing immigrant nail salon owners and workers. Potential policies and strategies to overcome some of these structural barriers are discussed for the long-term health protection of nail salon workers.

Understanding Barriers and Knowledge Related to Hepatitis B for Vietnamese Nail Salon Workers in the United States

In the United States (U.S.), up to 2.2 million individuals have been chronically infected with hepatitis B virus (HBV). Many nail salon workers are at risk for HBV as they are coming from high-risk and traditionally underserved communities. To understand barriers and knowledge associated with HBV in the Vietnamese nail salon community, the Health Belief Model (HBM) was used to qualitatively assess the health needs for the prevention of HBV among Vietnamese nail salon workers through focus groups and interviews. Results revealed several themes that highlight barriers within the Vietnamese nail community. Major themes were the lack of knowledge related to hepatitis B, including significant misconceptions related to symptoms, and how hepatitis B is transmitted and prevented. There were also several barriers to health care access within the Vietnamese nail community including the cost of health care, long work hours, lack of insurance and lack of understanding of current community resources. Additionally, discrimination and stigma related to those infected with hepatitis B emerged as a theme from this data. Those interviewed also noted that the nail training and licensing they received did not highlight hepatitis B and other infectious diseases that can be spread within the nail salon.

A Pilot Biomonitoring Study of Cumulative Phthalates Exposure among Vietnamese American Nail Salon Workers

Many California nail salon workers are low-income Vietnamese women of reproductive age who use nail products daily that contain androgen-disrupting phthalates, which may increase risk of male reproductive tract abnormalities during pregnancy. Yet, few studies have characterized phthalate exposures among this workforce. To characterize individual metabolites and cumulative phthalates exposure among a potentially vulnerable occupational group of nail salon workers, we collected 17 post-shift urine samples from Vietnamese workers at six San Francisco Bay Area nail salons in 2011, which were analyzed for four primary phthalate metabolites: mono-n-butyl-, mono-isobutyl-, mono(2-Ethylhexyl)-, and monoethyl phthalates (MnBP, MiBP, MEHP, and MEP, respectively; μg/L). Phthalate metabolite concentrations and a potency-weighted sum of parent compound daily intake (Σandrogen-disruptor, μg/kg/day) were compared to 203 Asian Americans from the 2011–2012 National Health and Nutritional Examination Survey (NHANES) using Student’s t-test and Wilcoxin signed rank test. Creatinine-corrected MnBP, MiBP, MEHP (μg/g), and cumulative phthalates exposure (Σandrogen-disruptor, μg/kg/day) levels were 2.9 (p < 0.0001), 1.6 (p = 0.015), 2.6 (p < 0.0001), and 2.0 (p < 0.0001) times higher, respectively, in our nail salon worker population compared to NHANES Asian Americans. Levels exceeded the NHANES 95th or 75th percentiles among some workers. This pilot study suggests that nail salon workers are disproportionately exposed to multiple phthalates, a finding that warrants further investigation to assess their potential health significance.