Nancy Otavalo, a healthy 39-year-old, had a miscarriage in 2014. Monica Rocano, had a son, who at 3 years old, was still struggling with speaking and walking. Van Hoang, a Vietnamese immigrant, has had two miscarriages since moving to the US in 2001. All three women seemed to be healthy before and during pregnancy. What was found to be common between the three women? Each was a manicurist, working long hours in nail salons. 

According to the CDC, roughly 350,000 people, 96% of which are women, work in nail salons and suffer the consequences of exposure to a variety of chemicals. Studies have shown that long-term exposure to toxic fumes and other hazardous chemicals in nail salons and other businesses in the cosmetic industry can result in harmful long-term effects not only in individuals, but also in the many generations following them. 

The top three most common ingredients in nail salons and manicure supplies, also known as the “toxic trio”, are formaldehyde, toluene and dibutyl phthalate (DBP). They’re also found in everyday items such as food packaging, shampoos, perfumes, detergents, toys and other fragrance products.  Formaldehyde has been shown to increase risk for various types of cancer due to high levels or long-durations of exposure, while toluene causes reproduction irregularities, headaches, skin and eye irritation, asthma, and damage in the central nervous system, the kidney, and the liver. DBP has been associated with various side effects in female workers, such as menstrual disorders, miscarriages and reproductive issues.

According to a 2019 NIH study on Asian nail salon workers on the East coast, of the 81% that had been pregnant, 15.6% of them had at least one miscarriage. Consequences of long-term exposure to the toxic trio, however, do not end with the individuals directly exposed. Recent studies have shown that long-term exposure to toxic chemicals could result in changes to gene expression, and could then be passed down transgenerationally. 

Epigenetics is the study of modifications of gene expression due to environmental exposures. These modification “tags” could be through DNA methylation (which causes certain genes to be repressed), histone acetylation (where some genes may be triggered when they shouldn’t be), or alternating non-coding RNA, which could prevent translation of certain genes into proteins. Inheriting these modifications could result in abnormal development in future generations.

The FDA has stated that phthalates and toluene in nail products are “minimal to negligible in most cases” but does not recognize the difference between an individual consumer using nail polish versus the 81% of nail salon workers who work year-round, or the 72% who work 35 hours a week, in an environment where the exposure to these chemicals are 1200 times greater in intensity in unventilated environments.  A buildup of toxic compounds like the phthalates found in nail polish could persist in the body and bleed into the germ lines from the exposed individual.

Most of these toxic chemicals, especially the toxic trio’s DBP, are endocrine-disrupting chemicals, or EDCs, that have the ability to interfere with hormone functions that are necessary in gene expression and protein creation. Under normal circumstances, reproductive systems in the early stages of producing germ lines erase and reset most epigenetic marks made on the parent throughout their lifetime, leaving only the DNA. However, EDCs have the ability to disrupt this “reset” process and pass down abnormal development changes to offspring. Prenatal and fetal stages are also particularly vulnerable to EDC exposure and can disrupt crucial stages of development, such as stem cell differentiation, which is when pluripotent cells decide what specific types of cells they will become in the developing embryos. If the EDCs interrupt the germline’s own epigenetic marks, phenotypic consequences could persist transgenerationally.

Although there has been some advocacy for better regulation of toxic working environments in nail salons, many of the current protections have not been well enforced. Awareness about the toxic trio has been on the rise and many brands have begun to declare and label their products as “n-free”, meaning they have excluded a certain number of toxic ingredients in the polish. Despite the decrease in use of the original toxic trio, many substitutes that are just as toxic have been used yet remain undisclosed on labels. Examples of these substitutes include plasticizers such as TPHP and DEHP, which just like DBP, act as endocrine disrupting chemicals.

The FDA still has not banned the use of the toxic trio and other EDCs in nail products despite the striking long-term, multigenerational effects on nail salon workers. Female POC in working-class communities, who make up more than 80% of the nail salon industry in the US, are disproportionately affected by the lack of regulation and public reprimand of the government’s complacency with manufacturers continuing the use of toxic ingredients. Although there are some “non-toxic” alternatives entering the market, most nail salon businesses are in working-class communities, and can’t afford to raise prices of their services for the sake of healthier products. Additionally, the validity of the safety of a product labelled as “non-toxic” is not always credible. 

Until a consistent criteria is established for all labels to prevent different definitions of n-free labels by different bands and real third party validation of ingredient exclusion and decreased toxicity, nail salon workers continue to be in danger of both direct and epigenetic consequences.

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