Presentation on theme: "Improving Health and Safety in Massachusetts Beauty Salons Training developed for the Massachusetts Division of Professional Licensure Board of Cosmetology."— Presentation transcript:
1 Improving Health and Safety in Massachusetts Beauty Salons Training developed for the Massachusetts Division of Professional Licensure Board of Cosmetology Inspectors Fall 2005By the Massachusetts Healthy Cosmetology Committee(Toxics Use Reduction Institute and the Department of Work Environment University of Massachusetts Lowell, MA Division of Occupational Safety, MA Department of Public Health, Pioneer Valley Project)
2 Improving Health and Safety in Massachusetts Beauty Salons Fall 2005 September 12 ~ Chemicals and Health, Toxics Use Reduction and RegulationsSeptember 26 ~ Proper Ventilation in Salons and OSHA RequirementsOctober 24th ~ Safe and Effective DisinfectionNovember TBA ~ Model Salon and Virtual Health and Safety Inspection
3 Overview Introduction Chemicals and Health Information and Protection Toxics Use ReductionRegulationsSummary and Questions
4 Discussion Why do you inspect salons? What do you inspect for?What two or three conditions are the mark of a clean and safe salon?Who is served by the BOC and its inspectors?How do you communicate with those you serve?How do you protect the public’s health?What do you think about the odors, chemicals and air quality in salons?
5 Chemicals and Health What’s an example of a chemical hazard in salons? Toxic vs. HazardousWho is potentially affected by chemicals in salons?Salon owners and workersFamily membersCustomersEmployees and residents near salonsInspectorsEnvironmental effects via water, waste and air
6 How chemicals affect us Types of effects:Contact: skin or eye or throat irritationSystemic: breathe in and chemicals go to “target organs” e.g. (solvents to brain)How they get in our bodiesSkin contact (relaxer burn)Skin adsorption (acrylics)Inhalation (nail polish remover vapor, nail dust)Injection (“needlesticks”)Ingestion (on food, hands, cigarettes, accident)
7 Forms of chemicals Aerosols: particles suspended in air Dusts and mists (ex. Nail dust, hair spray)Smaller particles go deeper and cause more diseaseVapors: gas over a liquid (ex. Ammonia)Commonly called “fumes”The more volatile (easily evaporated into the air) the greater the concentration of the vapor in the airThe higher the temperature, the more in the airGases (ex. Steri-Dry)Liquids (ex. Barbicide)Bulk products (ex. hair dye)
8 Concentrationppm = parts per millionExample: 1000 parts acetone per 1 million parts airmg/m3 = milligrams per cubic meterExample = 15 milligrams dust per cubic meter of airImportant: Odor doesn’t always tell you how much is there!
9 Chemical exposure Timing of Exposures Mixed exposures Acute exposures (high levels, infrequent) = spillChronic exposures (low levels, frequent) = cleaning with alcoholMixed exposuresInhalation exposures measured by sampling breathing zone concentrations over time
10 Timing of EffectsAcute effects happen immediately or soon after exposureExamples: burns, asthma attack, throat irritation, dizzinessChronic effects build up over timeExamples: cancer, asthma, allergies (sensitizers)Developmental/reproductive: exposed when pregnant, or trying (infertility, miscarriage, developmental defects)Effects may be irreversible or reversible when no longer exposed
11 Human Health Studies (Nails) Few human health studiesIncreased spontaneous abortions (John, 1994)Neurocognitive deficits (LoSasso, 2001; 2002)Respiratory irritation (Hiipakka, 1987)Many case reports on other exposed workers and clientssensitization from acrylics (both allergic contact dermatitis and asthma)nail damage (onycholysis)Specific to this pop.Neuro: greater frequency of reported neurological symptoms (reduced cognitive efficiency, memory loss and learning problems) and tests of 35 nail techs found deficits compared to controls in tests of attention, processing speed and olfaction.Other workers = dental assistants exposed to acrylic compounds used to make denturesNail damage – separation of nail from nail bed (onycholysis or the so-called “ring of fire”) led FDA to restrict MMA use
12 Human Health Studies (Hair) ReproductiveLower birth weight babiesRespiratorySensitization leading to asthmaUpper and lower respiratory irritation (cough, shortness of breath, bronchitis)SkinSensitization leading to allergic contact dermatitis and other skin problemsCancerBladder and lungOccupation as hairdresser = exposures that probably are carcinogenic
13 Chemicals of particular concern FormaldehydeFound in lots of salon productsSmall amounts in many nail polishes, esp. as TSF resinActive ingredient in Steri-Dry as “paraformaldehyde”Gas in air (respiratory) and skin contactUse of Steri-Dry can exceed short-term limitsHealth EffectsAcute: watery eyes; burning sensations of the eyes, nose, and throat; coughing; wheezing; nausea; and skin irritationChronic: Carcinogen (nasal and leukemia); sensitization (allergy)AVOID EXPOSURE!
14 Chemicals of particular concern Acids and basesAt either end of the pH scaleAcids pH < 7 (neutral), Bases pH >7Both cause burns and irritationAcids: nail primer, neutralizers, hydrogen peroxideBases: relaxer, perms, ammonia
15 Chemicals of particular concern AcrylicsMain ingredients in sculptured nailsStrong smell at low concentrationsPowder polymer and liquid monomerLiquids: ethyl methacrylate, methyl methacrylateSensitizers (asthma, dermatitis), irritation, miscarriages?Skin and nail damage
17 Chemicals of particular concern SolventsSo called because other stuff “dissolves” in themOrganic solvents used extensively in salon products: alcohol, acetone, toluene, xylene, butaneReadily vaporize into salon airMost solvents cause same short-term and long-term effects:CNS suppression (dizziness, nausea, spaciness)Skin defatting and irritationPossible reproductive effectsPossible liver and kidney damagePossible brain-damage (memory loss, decreased dexterity)
18 Other hazards in salons Emergencies and violenceBlood borne pathogens and infectious agentsSafety/FireMusculoskeletal
19 Chemical Hazard Mapping Draw a salon environment (hair or nails)Mark on the map where chemical hazards are foundBlue = dustsRed = vapors/gasesPurple = liquids/bulkMark hazards with dots with many dots to indicate higher concentrations
20 Protection from Hazards in the Salon Environment
21 Effective prevention strategy Prevention at the source(substitution, elimination)Prevention in the pathway(local exhaust ventilation)Prevention at the person(gloves and masks, training)
22 Prevention at the source Reduces or prevents exposureVia all routes (skin, breathing)All the time (regular use, bulk chemical handling, cleaning up spills, busy periods)Without relying on people to be able to follow directions, read in EnglishFor all people (including sensitive ones) and the environment (doesn’t shift risk)May be difficult to make happen
23 Prevention in the pathway Local exhaust ventilation
24 Prevention in the pathGeneral exhaust ventilation or dilution ventilationBrings in fresh air, exhausts bad air via HVAC, open doors and windowsDoes not prevent exposure, but may lower concentration levelsSome systems may have air cleanersCritical for healthy indoor environment
25 Prevention at the person Respiratory protectionDust masks may prevent some dust exposure, but don’t stop chemical vapors!Chemical cartridges with half-face respiratorsGood work practices include keeping containers closed; avoiding skin exposure, esp. during bulk chemical handlingTraining important, but challenging
26 How do we get information about chemicals? 1983 OSHA Hazard Communication Standard requiresEmployee Right to KnowTrainingMSDS, labelsChemical testing:animal studieshuman studies (workers)
27 MSDS Exercise MSDS stands for Material Safety Data Sheet Most important sections are:Ingredients/compositionHazard identification/health hazardsFire and explosion hazardsHandling and storage informationExposure control measuresEvery ingredient and product sold that will be used by someone at work has a MSDS available from the manufacturerSalons must have MSDSs for all products and labels on all products
32 What is TUR? Toxics Use Reduction Concept Minimization of pollution and hazards from chemical contamination through reduction, elimination, or substitution of the toxics substances at the point where they are produced or used.
33 Toxics Use Reduction TUR is NOT: treatment of toxic waste dilution of toxicstransfer of toxics from one medium to another (soil to water)
34 TUR in Practice TUR involves systems analysis and a planning process: Why is this chemical being used?Is there another method that will negate the need for the chemical?If the activity truly requires chemical use, is there a safer alternative?If no alternatives exist, is the chemical being used efficiently?
35 TUR Techniques Chemical Substitution Product Reformulation Process (Redesign) ChangeEquipment ModernizationImproved Operations & Maintenance (Housekeeping)Reusing (recycling) substances
38 COMMUNITY TURWhile TUR was developed for a manufacturing-facility focus, the TUR approach can be applied to other areas:Household chemical use.Municipal Operations: DPW garages/facilities, local water treatment plants, state or local building grounds-maintenance, etc.Small businesses: auto body, dry cleaning, food service, hair and nail salons.
39 TUR Techniques in “Cleaning” Use less toxic products (substitution)Use less product or proper dilution (process change)Pump instead of aerosol (product redesign)Proper mixing, covering containers (improved operations and maintenance)Training students in sanitation (improved operations and maintenance)
40 TUR in FOOD ESTABLISHMENT Lexington Health Department Purpose of ProjectExamine chemical usage in food establishmentsDetermine barriers and means of promoting TUR in this environmentExamine means of integrating TUR into establishment operation and inspection process
41 Why Is TUR Important in Food Establishments? High usage of chemicals: cleaners, degreasers, sanitizers and pesticides in environment, on food (e.g., Victory product)Limited training of workers on safety and handlingThreat to public health through food contaminationThreat to worker through occupational exposureEffect on environmentConflict between sanitation requirements and toxics usage
42 Practices Observed during inspections Overuse or inappropriate use of chemicalsUsage of unnecessary chemicalsFailure to dilute: higher exposureNo knowledge of product contents or safety issuesQuestionable application of pesticides (routine, use of foggers)Minimal safety equipment/trainingMSDS not availableNo knowledge of pesticides in use or IPM
43 Advantage of TUR for Food Establishments Greater worker safetyImproved food safetyBenefit to environmentDecreased costsImproved pest management, long termPublic perception of establishment
44 Key Messages for Food Establishments Non-Toxic AlternativesDegreaser-Borax on a damp clothFloor cleaner-1 cup vinegar in 2 gallons waterOven cleaner-2 tbsp liquid soap with 2 tsp of borax in warm waterWindow cleaner-2 tbsp vinegar in 1 quart warm waterOSHA RequirementsPromote safety and awarenessApplicable to restaurantsPersonal protective equipment (gloves, goggles, eye wash, storage, training)Hazard communication standardEmployee Training Program
45 Integrating TUR Into Food Establishments Provided literature/training-awarenessOngoing reinforcement through inspectionsDeveloped web-based training programDistributed mailing on subject of IPM and toxics controlIntegrated issues into inspection programCarry out extensive inspections with expert on IPMDeveloped model IPM program for food establishmentPassed regulation requiring IPM along model of Children and Families Protection Act
46 Why would Salons want TUR? Emerging Knowledge in Toxics and HealthLack of Product and Toxicity TestingKnown health risks associated with exposure to many chemicalsImpacts at Lower Exposure Levels and Timing of ExposureIncrease in environmentally-related diseasesDisruption of Hormone SystemsReproductive EffectsExposure is ubiquitous. All humans have been exposed, to varying amounts. Some have more exposure. Some have less. But no one has no exposure. No baby has been born for at least three decades without some exposure in the womb. Every person has several hundred novel chemicals in their body, chemicals not part of human body chemistry before the 20th century.Laboratory experiments show that exposures have impacts at levels far lower than had been considered possible in traditional toxicology. The exquisite sensitivity of natural hormonal control to interference by endocrine disruptors will force many changes in regulations, as the current system is inadequate.Many more hormone systems, perhaps all chemically-mediated message systems, are now known to be vulnerable to endocrine disruptors. The study of endocrine disruption began with a focus on compounds capable of mimicking or interfering with estrogen. Now science has revealed disruptors for almost every hormone system that has been studied. This includes other sex steroid hormones, like testosterone and progesterone, as well as thyroid and retinoids.Many more compounds are now known to be powerful endocrine disruptors. This includes contemporary use pesticides and a range of chemicals in widespread use in consumer products. The biggest surprise (except, perhaps, to the polymer chemists who invented them) is that certain plastics show endocrine-disrupting effects.Human health effects of concern now include adult impacts of fetal exposure. This means, for example, that studies attempting to prove an association between adult levels of exposure and adult risk to disease or dysfunction do not test the most important potential links between endocrine disruptors and human health. We need studies of developmental exposure (especially fetal) in relation to risk, examined for all relevant life stages. For example, one of the greatest gaps in breast cancer research is that while many studies examine adult exposure and adult risk, none examine fetal or pubertal exposure and adult risk.Human epidemiology is biased toward false negatives in the search for health effects of endocrine disruption. It will be exceedingly difficult, if not impossible, to establish scientific certainty of causation of many health problems in human, even though based on laboratory data it is likely that endocrine disruption is involved in a range of human diseases. Because the animal data demonstrate plausible, serious risks to human healths, this bias toward false negatives (a statistical term that means finding no association when in fact there is one) requires the application of the precautionary principle, using animal data as the guide.
47 Why would Salons want TUR? Reduce chemical exposure for the public and for workersImproved (safer) workplace environmentReduce liability (fire, spills, contamination, exposure)Public Image - “Green Operation,” care about environment and workersMarket advantage
48 TUR TechniquesChemical (Product) Substitution (Replace hazardous products with safer ones!)Product ReformulationProcess (Redesign) ChangeEquipment ModernizationImproved Operations & Maintenance(Housekeeping)Reusing (recycling) substances
49 TUR in CosmetologyUse less toxic hair dyes ~ non-permanent dyes (semi, demi)-(substitution and process change)Avoid Coal tar dyes, lead acetate (substitution)Use pump sprays instead of aerosols (substitution)Keep product containers and barbicide containers covered (improved Operations & Maintenance)
50 TUR in CosmetologyAvoid products with formaldehyde, toluene, phthalates (substitution)Physical straightening instead of chemical straightening (process change)Lower pH products (substitution)Natural nail care rather than artificial nails (process change)Establishing a separate chemicalstorage and mixing room(improved O & M)
51 Chemical (Product) Substitution Permanent Hair Dyes Chemicals of ConcernPara-PhenylediaminesDerivatives from coal tar.Darker dyes have more phenylediamine.Other names: 2, 4 - diaminoanisolepara-dyesHealth AffectsCan cause cancer.Can cause changes in geneticinformation in sperm and eggCan cause severe allergies anddermatitis.Try plant derived dyes:Henna (triggers asthma)Chamomile for lighteningSaffronBeet juiceUse semi-permanent dyes without:Para-PhenylediaminesAmmoniaResorcinolUrsol dyes containing phenylediamine also 4-methoxy-m- phenylediamine 4-MMPD – causes thyroid and lymph tumors, found in coal tar dyes also known as:2,4 – diaminoanisole cause skin allergy and sensitization,or 4-EMPD causes genectic mutations, used to replace 4-MMPD but now known to be carcinogenicor p-phenylediamineInformation from Healthy Hairstyling, by Waste Reduction Program, Alaska Health Project, 4/93Photo is from clipart on webQuestion – how hazardous are nitro and amino compounds?
52 Chemical (Product) Substitution Relaxers Chemicals of ConcernSodium Hydroxide (Lye)Problemhighly alkaline and corrosiveHealth Effectsburn skin and scalpcause blindnessirritant to skin, eyes,respiratory systemAlternative ProductBisulfatesThere are three types of hair relaxers:Sodium Hydroxide strongestvery hazardousAmmonium Thioglycolate fairly strongsignificant health riskAcid-Based with Bisulfates least strongleast health riskInformation from sources on page 1.Photo from web.Lye Based Product
53 Example of a No-Lye Product PromoDesigner Touch Sensitive Scalp No Lye Relaxer relaxes without the irritation that sometimes occurs with other relaxer products.Information from web
54 Example of a No-Lye Product PromoThis patented No Mix- No Lye lithium hydroxide relaxer with Vitamin E provides maximum silky straight results on all textures of hair.
55 Chemical (Product) Substitution Hair Bleaching/Lightening Chemicals of ConcernProtinator and activators containing oxidizers such as potassium persulfate and ammonium persulfate can cause respiratory irritation.When ammonium persulfate is heated to speed the bleaching process, it can produce toxic fumes.Hydrogen Peroxide can be a skin irritantHierarcy of Lighteners:Oil Bleaches (mildest)2. Cream Lighteners3. Powder Bleaches*Use bleach without the boosters.*When using boosters, try potassium persulfate boosters instead of ammonium persulfate boosters.Toxic fumes are the decomposition products including sulfur oxides, ammonia, and nitrous oxidesInformation from:Healthy Hairstyling, by Waste Reduction Assistance Program, Alaska Health Project, 4/93Health and Safety for Hair Care and Beauty Professionals, NIOSH draft 2000, written by the Labor Occupational Health Program, School of Public health, University of California with support from the California Sate Board of Barbering and CosmetologyPollution prevention Plan for a Hair Salon, Hawani Berhanu and Tania Mercado, 1997Oil Bleach Mildest, has the least amount of lightening action – for only one or two levels of color lift.Used for the entire head.Shampoo-based product containing hydrogen peroxide and ammonia solution to open the hair cuticle and gently diffuse the melanin. Contains sulfonated oils to slow down the bleaching process.Cream Bleach: Strong enough for pastel blonding but mild enough to be used on scalp.Used for all kinds of lightening services.Similar to Oil Bleaches as it is a shampoo-based product with sulfonated oils, a hydrogen peroxide solution (up to 6%) and ammonia.Uses a protinator or activator that contains an alkali or an oxidizer for extra lightening power.Have an average pH of 10.Powder: Strong enough to do pastel blonding.It is similar to Oil and Cream Bleaches as it contains ammonia and hydrogen peroxide.Here the ammonia is in dry form which begins the oxidation process when it is mixed with the liquid or cream hydrogen peroxide.
56 Chemical (Product) Substitution Nail Finishes Chemicals of ConcernToluene (solvent)Reproductive ToxinFormaldehyde (preservative, polymer)CarcinogenPhthalate (Plasticizer)Endocrine DisruptorPicture from clipart.Information from: Beauty Secrets, by the Environmental Working Group, 2001
57 Chemical (Product) Substitution Nail Finishes Some Products That Are Toluene, Formaldehyde, and Phthalate -FreeL’Oreal Paris Jet-Set Quick Dry Nail EnamelRevlon Nail EnamelGarden Botanika Natural Color Nail ColorKiss products, Kiss ColorPicture from clipart.Information from: Beauty Secrets, by the Environmental Working Group, 2001
58 Improved Operations (Work Practices) Application of Methacrylates Reducing Exposures From Vapors Use a small mouthed dispenserwith a pressure-sensitive stopperand a small opening just largeenough to fit the applicator brushinto and for the applicator tohold the nail liquid.Keep the container closed when not in use.Mix only the amount you need per application.Illustration and information from NIOSH.
59 Improved Operations and Maintenance Do not eat or drink in application area.Do not store food in chemical storage areas.Do not smoke in application or chemical storage area.Picture from TV Channel 2, CBSAll nails are flammable.
60 Improved Operations and Maintenance Prevent product contact on worker and clients’ skin.No living or sleeping in the salon.Keep all products covered.Keep table free of product residues and dusts.Label all containers.Wash hands between customers and before eating.Picture from TV Channel 2, CBSAll nails are flammable.
61 Improved Operations and Maintenance Managing Vapors from Waste Dispose of solution soaked gauze and other cleanup materials in a sealed container or bag.Keep a lid on the trash can and dispose of daily.Picture from clipart.Do no pour excess liquid on table and soak up with cotton gauze as that increases fumes in the air. Exposures were found to be higher when this practice was used and when the waste basket was opened that contained the wet gauze.Information from several NISH reports.
63 BOC Regs Compareda Manicuring is not regulated in Connecticut, though legislation is in legislative committees. No license required for manicure, but cosmetician license (1,500 hrs) for pedicures.b or an 8 month apprenticeshipc or 400 apprenticeship hours.d based on 3 inspectors, 1,206 salons*Continuing education credits are required in Florida (16 hours/per renewal period), Georgia (5), Illinois (10), Indiana (16), Iowa (8), Kentucky (6), Nebraska (8), Ohio (8) and South Carolina (6)e Rhode Island makes reference to state Building Code requirements which may require ventilationf New York says that only chemical mixing areas and eating areas must have ventilation.
64 Environmental Requirements RI: Section: 18.0 STRUCTURAL, AIR AND ENVIRONMENTAL REQUIREMENTS, EQUIPMENT AND SUPPLIES.1 A shop, place of business or establishment licensed to practice hairdressing and cosmetic therapy, manicuring or esthetics must meet the following structural requirements:.1 the Fire Safety requirements of the State Fire Code;.2 the State Building Code Commission requirements;.3 the local zoning laws; and.4 Federal Occupational Safety and Health Administration (OSHA) standards for air contaminants as published in the Federal Register CFR "Air Contaminants".
65 VT: shop area shall be sufficiently ventilated to exhaust hazardous or objectionable airborne chemicals, and allow the free flow of air;D. Chemical storage and emergency information:shops and facilities shall have, in the immediate working area, a binder with all Material Safety Data Sheets (MSDS) for chemical products used. These are provided by manufacturers;shops and facilities shall have a blood spill clean-up kit;flammable chemicals shall be stored in a flammable storage cabinet or a properly ventilated room; andchemicals which could interact in a hazardous manner (oxidizer, catalysts and solvents) shall be separated in storage.MA: Every salon shall be equipped with proper and adequate lighting and ventilation and kept in clean, orderly and sanitary condition.ME: C. The establishment must be adequately ventilated at all times.NH: (e) Mechanical ventilation shall be provided by a method of supply air and return or exhaust air in all schools and shops, with a minimum exchange rate of 35 cubic feet per minute.(m) The shop or school shall have Material Safety Data Sheets (MSDS) required by OSHA under 29 CFR (g) for products being used.
66 NYS: §160.25 Chemical storage and MSDS (a) Any chemicals used in the conduct of appearance enhancement shall be mixed only in a dispensing area which has adequate ventilation.(b) Flammable and combustible chemicals shall be stored in a metal cabinet remote from potential sources of ignition, such as an open flame or an electrical device.(c) All nail care chemicals must be stored in closed bottles.(d) An owner have on file all Material Safety Data Sheets (MSDS) for inspection. MSDS must be stored in a metal file accessible to all employees.§ Product labelingIn order to assure the safe provision of services to the public, all products used in the conduct of an appearance enhancement business must be maintained with the original manufacturer labeling intact. All bottles containing poisonous or corrosive substances shall be additionally and distinctly marked as such and shall be stored in an area not open or available to the public.
67 OSHA Regulations Regulated by OSHA. Governs DOS can provide compliance assistance, but cannot enforce OSHA.GovernsHazard Communication Standard – MSDSs, RTK training, Haz Com PlanFormaldehyde StandardEyewash StandardBlood Borne Pathogen
68 Hazardous Waste Regulations Regulated by the MA Department of Environmental ProtectionGoverns:The amount and length of time a waste can be stored.How the waste must be stored.Signage for the area and containers.Emergency response.Licensing and Paperwork.Criteria for designing and maintaining the storage area.How waste must be storedThe amount of waste that can be storedThe length of time that it can be storedRecord keeping
69 Federal Fire Regulations Written Emergency Action/Fire Prevention Plan – OSHARegulated by OSHA.Governs:Written plan required if 10 or more employees (otherwise oral).Emergency Response Equipment.Includes methods to prevent fires (including storage of flammables).Includes Emergency Escape Procedures, meeting place, etc.
70 State Fire Regulations Regulatory JurisdictionRegulated by the Office of the State Fire Marshal.Enforced locally by the Fire Department.Governs flammable dispensing and storage:Storage equipment.Storage permit and/or license requirements.Emergency response system.
71 Building Code Regulatory Jurisdiction Types of issues found in salons: Regulated by the State Building Inspector.Enforced locally by the Municipal Building Inspector.Types of issues found in salons:Shared wall construction.Shared ventilation systems.Use of locations not designed for business.Inadequate systems or systems not used correctly.Governs:Ventilation - mechanical and naturalIngress and EgressSmoke alarm and fire sprinkler systems
73 Noisome Trade Odor Complaints/Nuisance Regulatory JurisdictionBoard of HealthEnforced locally by local Health Department/AgentGoverns: (see Town of Sharon Regs.
74 Sanitary Code Regulatory Jurisdiction Governs: Regulated by the MA Department of Public HealthEnforced locally by local Health Department.Governs:Hot waterSanitation
75 Licensing Regulated by the MA Board of Cosmetology. Governs: The opening and licensing of salons.Occupancy PermitElectrical PermitBuilding PermitThe licensing of technicians.The operation of the salon.Equipment and Hygiene Procedures
76 Opportunities to Improve H & S in Salons Medical SurveillanceVocational TrainingFedStatePhysician TrainingLicensingPractitioner examSalon InspectionRegulatoryNon-regulatoryLocalConsumer Ed/DemandInspectionsContinuing Education(not required)Trade ShowsProduct Reformulation
77 DiscussionWhat are the barriers to improving salons, especially the air quality?What are the opportunities for improving salons?