Professionals working in nail care and decoration: exposure to multiple chemical substances

In 2009, at the request of the Directorate General for Health (DGS), the French Health Products Safety Agency (ANSM) assessed the risk for consumers associated with the use of toluene in cosmetics, particularly in nail varnish, without however taking into account the potential risks for the health of professionals. Moreover, these professionals are required to handle products containing other hazardous chemicals besides toluene. The ANSM therefore made a formal request to ANSES to assess the risks to professionals associated with exposure to the products used in nail care and decoration.

Nail care and decoration activities, and the professionals concerned

Nail care and decoration are carried out by nail prosthetists and beauticians. These professionals are required to perform various types of nail care and decoration, including application of classic or semi-permanent varnish, manicures, application of prosthetic nails using different techniques (gel, resin, etc.), and nail styling.
This predominantly female population encompasses every age group, but particularly those between 18 and 35 years of age. These professionals may be employees or self-employed, working in dedicated premises or at their clients' homes. Nail care and decoration establishments tend to be small in size, often employing no more than five people.

Substances identified, pathologies diagnosed and means of prevention

The analysis of the available data helped identify around 700 substances found in the composition of the products used or in the workplace air. Sixty of these 700 substances were found to be of very high concern as they were in the highest hazard class (carcinogenic, mutagenic and toxic to reproduction – CMR, sensitising and/or included on a list of potential endocrine disruptors).

The data from the occupational disease surveillance networks are consistent with those in the literature, and indicate that the groups of pathologies most frequently diagnosed in these workers are:

• skin disorders, mainly including allergic contact dermatitis;
• disorders of the respiratory tract and ENT, mainly including asthma;
• headaches;
• musculo-skeletal disorders, mainly including those linked to prolonged and frequent sitting postures and repetitive movements of the hand, wrist or forearm.

In more than half of the cases, the diagnosed pathology was attributed to exposure to the class of (meth)acrylates, whose presence in workplace air was confirmed by a measurement campaign carried out among professionals in the Ile-de-France and Hauts-de-France regions between July 2015 and October 2016. Indeed, the products used in nail cosmetics and mainly implicated in the diagnosed pathologies are products for shaping artificial nails (gel, resin) containing (meth)acrylic monomers that are sensitising, irritant or even neurotoxic. These are the compounds mainly responsible for the allergic contact dermatitis identified in these professionals. The (meth)acrylates may also be implicated in certain respiratory problems identified in these professionals, such as asthma.

The measurement campaign also highlighted the presence in the air of (semi) volatile organic compounds, or (s)VOCs, some of which are neurotoxic and CMR agents. Up to 42 (s)VOCs were identified on a single work premises. However, the (s)VOC concentrations taken individually are low compared to those generally measured on industrial sites. In contrast, the concentrations of total VOCs and toluene are high when compared to those measured in housing and in outdoor air.
 
Professionals in this sector are also exposed to particles from the sanding of nails and resins. This dust has not been characterised in detail, particularly in terms of its chemical content and particle size.

Lastly, the results of the measurement campaign also show that protective measures for preventing chemical risk, including general ventilation, localised ventilation such as suction tables, and the wearing of gloves and masks for protection against dust, are little used by these professionals.

The Agency’s recommendations

In light of the conclusions of its expert appraisal, the Agency is recommending:

• for professionals working in nail care and decoration activities, strengthening the implementation of chemical risk prevention measures in order to minimise exposure to hazardous chemical agents: search for substitute products, use suction tables and suitable personal protective equipment;
• for companies marketing cosmetics intended for nail care and decoration activities, implementing the development and/or replacement of products in the short and medium term in order to eliminate exposure to the sources of various hazardous chemical agents, in particular polymeriserable (meth)acrylic monomers, toluene, acetaldehyde, etc.; secondly, developing "no-touch" products/techniques with which the professional does not come into contact, in cases where substitution of the hazardous agent may not be technically possible;
• for the public authorities, ensuring that assessment of the risks to professionals is:
  • carried out by the companies marketing the products;
  • systematically taken into account in the framework of the chemical safety assessments for cosmetic ingredients carried out by the European Scientific Committee on Consumer Safety (SCCS).

The Agency also recommends that harmonised diploma courses, including a module on occupational risk prevention and good working practices, be made mandatory for any person required to apply prosthetic nails.

In terms of research, it seems necessary to improve knowledge on effects and exposure, especially to inhaled particles during sanding and filing, and in particular on the toxicity of these particles when these operations are performed on artificial nails made from (meth)acrylates. The Agency also recommends improving knowledge on this working population's state of health and how it evolves, regarding among other things the risks of sensitisation, allergic contact dermatitis, asthma, adverse outcomes in terms of reproduction and development, neurological pathologies, autoimmune pathologies and even cancer..