Developing an evidence-based intervention program for ... Salon 5.17.17.pdf · Developing an...
Transcript of Developing an evidence-based intervention program for ... Salon 5.17.17.pdf · Developing an...
Developing an evidence-based intervention
program for Vietnamese nail salon workers
in Philadelphia
Air Pollution Control Board Meeting5/17/2017
Tran Huynh, PhD, CIHDepartment of Environmental and Occupational Health
Dornsife School of Public HealthDrexel University
Some nail industry statistics
• 390,000+ nail technicians nationwide
• 56% are Vietnamese; 36% Caucasian; 8% Other
• 97% female and 3% male
• Age
12% 30 or younger
24% 31- 40
35% 41-50
29% 51 or older
• Highest level of completed school
28% finished high school
44% some college/AA degree
17% finished collegeSource: Nails Magazine: 2016-2017 The Big Book
In Pennsylvania
• 14,244 registered nail technicians – at least 46% are Vietnamese
• There are 396 out of 2386 nail salons in Philadelphia
Source: PA Board of Cosmetology
Exposure Studies
• Area and personal exposure for many solvents are below the permissible exposure limit
• Methyl methacrylate was detected in 58% of the establishments despite having been banned for use in nail products by the state of Utah (Aleves et al, 2012)
• Personal monitoring of solvents at Vietnamese salons in California: ethyl acetate (0.53 ppm), isopropyl acetate (0.4 ppm) and toluene (0.15 ppm) (Quach et al, 2011)
Indoor Air Quality Study
• IAQ conducted in Boston by Goldin et al (2011)
• CO2 in 15 out of 21 salons exceeded 800 ppm (25cfm/person)
• Median Total VOCs = 4,800 ppb (61 - 38,000 ppb)
(typical TVOCs for homes is about 337 ppb)
• Improving ventilation conditions in salons to meet minimum outdoor air delivery requirements can reduce exposures to TVOCs.
Reported Health Effects
• Mostly from cross-sectional studies
• Respiratory irritation (Roelofs et al 2008, Quach et al 2008, Quach et al 2011, NIOSH 1998)
• Dermatitis (Roelofs et al 2008, Quach et al 2011)
• Cognitive symptoms (LoSasso et al, 2001 and 2002)
• Musculoskeletal disorders (Roelofs et al 2008, NIOSH 1998)
• No cancer excess was found in cosmetologists and manicurists in California (Quach et al, 2010)
Tip of the iceberg
• A journalist investigating work conditions in NYC nail salons found:
- Allergy
- Asthma
- Wage issues
- Respiratory and skin irritations
The Price of Nice Nails by Sarah Maslin Nir, May 2015
Ventilation to Be Required in All New York Nail SalonsBy SARAH MASLIN NIRJULY 21, 2016
Health promotion planning tool:Intervention Mapping
Source: Kay Bartholomew Edredge et al. Intervention Mapping book
PUBLIC POLICY
•Self-efficacy
ORGANIZATIONAL
Salons’ practices, policies
COMMUNITY
INTERPERSONAL
INDIVIDUAL
Knowledge attitudes
Adapted from McLeroy KR, Bibeau D, Steckler A, Glanz K. An ecological perspective on health promotion
programs. Health Educ Q. 1988;15(4):351–377. [PubMed]
Social-Ecological Model
Needs assessment phase
• Literature review
• CAB meeting with representatives from the
Philadelphia Department of Public Health, regional
OSHA, nail salon worker.
• CAB meeting with Vietnamese nail salon workers
• Individual interviews and/or focus groups
Personal
determinants
(workers)
Determinants
(environment
al agents)
Behavioral
Risk
(workers)
HealthQuality-
of-Life
Environmen
tal Factors
Phase 1
Quality of life
Phase 2
Health problems
Phase 3
Behavioral and
Environmental Factors
Phase 4
Determinants
Modified Logic Model
Sex
Female 15
Male 2
Marital Status
Married 7
Single 10
Age
18-29 9
30-39 2
40-49 4
50-59 2
>60 0
Birthplace
Vietnam 15
US 2
Employment status
Owner/Manager 3
Worker 14
Years doing nails
0-4 8
5-9 3
>10 5
Years in US
0-4 5
5-9 1
10-19 6
>20 3
Average hours worked* 40+
Demographics of participants
Preliminary analysis – what we’ve learned -
• Most Vietnamese workers got into the business through family/relatives and friends connection.
• Most Vietnamese owners hire Vietnamese workers
• Social media, internet, you tube are major communication outlets for many workers.
• That said, our sample is skewed toward younger people
Preliminary analysis – what we’ve learned -
• Most workers and owners have some awareness
that the potential health effects from chemical
exposures but they don’t exactly know what
specific chemicals they work with. Most know
acetone and acrylic liquid because these
chemicals have strongest odor.
• Many reported wearing gloves and surgical masks
for both chemical protection.
• Barriers for PPE: discomfort and lack of availability of
PPE
• Most workers do not know about ventilation and its
role
• Muscularskeletal diseases (e.g., back pain, shoulder
pain, CTS, eye strain) are prevalent in this industry.
Behavioral outcomes (workers)
• Workers will consistently use gloves when providing nail
services.
• Workers will consistently use safety glasses when providing nail
services.
• Workers will do hand exercises more frequently.
• Workers will do whole body exercises more frequently.
Organizational environmental outcomes • Owners will make gloves available to workers.
• Owners will make safety glasses available to workers.
• Owners will maintain ventilation system annually to make sure
adequate air being circulated.
• Owners will replace methyl methacrylate with less allergic
chemical ethyl methacrylate for acrylic nails.
Selected behavioral and
environmental outcomes for the study
Current work and future directions
• Develop training materials for workers (K-award)
• Develop self-assessment tool to assist owners to
have a healthy salon and corresponding technical
assistance (multilevel interventions)
• Clarify ventilation requirements with engineers and
evaluate cost-benefits
• Work with local policy makers to develop
appropriate guidelines and outreach program
How can the Air Pollution Control Board help?
• Education and outreach • E.g., Boston Safe Shop, Healthy Salons Program in San
Francisco
• Focus on developing partnerships and engaging salon owners
• Work with PA Board of Cosmetology on health and safety training requirements for nail technicians and ventilation requirements for salons.