Presentation on theme: "Beauty Salons are in the Eye of the Beholder ….."— Presentation transcript:
1 Beauty Salons are in the Eye of the Beholder ….. A Survey into the Environmental Health Standards Operating in Beauty Salons in Co. Donegal, March – April 2009Cora Murray, SEHO
2 This presentation…… Introduction Scope and Limitations Methodology ResultsConclusionsRecommendations.
3 IntroductionSummer beauty salons in Co. Donegal and 5 training collegesWhat do they offer?.....- skin treatmentse.g. make-up application,microdermabrasion- hair removal e.g. by laser,electrolysis or waxing- teeth whitening- removal of body toxinse.g. by platinum detox- manicures, pedicures- massage- ear candling- ….. and more.
4 Regulatory Background USA, Australia, UK .. Douze points- USA: licensing and inspection of nail salons- Australia: registration and inspection by EHOs where skin penetration procedures occur- UK: h & s enforcement by EHOsIrelande … zero points!- currently no public health legislation governing the operation of businesses such as beauty salons in the Republic of Ireland.
5 Potential cause / source So what are the risks?HazzardPotential cause / sourceSkin and other infectionRe-use of towels, tools, materials without proper cleaning and disinfection; Re-use of disposable tools, materialsHepatitis / HIVRe-use of crystals during medical microdermabrasionInadequate disinfection of body-piercing toolsBurning of skin / hair, ear damageImproper use of ear candlesBurns and scarringImproper laser treatmentNail infectionManicures / pedicures / application of acrylic nails / poor cleaning / poor trainingMouth and gum irritation / tooth damageTeeth whiteningAllergic reaction / skin irritationFailure to carry out patch testing prior to application of e.g. dye, bleachFungal infections of feetRecycling of water in or improper disinfection of foot spas
6 Case Incidence Country Details Source of Info USA 2006 An outbreak of infection from Mycobacterium fortuitum occurred as a result of clients receiving pedicures with whirlpool footbaths and / or shaving from failure to clean and disinfect the equipment used.The New England Journal of MedicineUSA 2006Fungal infection and nail bed damage at a nail salon‘Birmingham News’ newspaperThe Netherlands 2006MRSA transmission as a result of contact with an infected Beautician due to use of diluted alcohol used to disinfect skin after waxing and failure to wear glovesEmerging Infectious Diseases journal of the CDSCIrelandNone found.Some anecdotal evidence.
7 Scope and Limitations Included in the survey …. Commercial beauty salons onlyVoluntary participationInformation as reported by salon operator as observation was not possibleNo prior appointment (in 87% of cases) – time restrictionsNot Included in the survey …Services offered from private residencesSun-bed facilities, tattooing, ear piercing and hair dressing servicesHolistic services e.g. reflexology, acupuncture etc.Workplace health and safety assessmentEfficacy of treatments offered.
8 AimTo determine compliance levels with the EC (Cosmetic Products) Regs., among beauty salons in Co. Donegal andTo determine the degree to which such salons protect public health in the delivery of their service by way of the hygiene precautions implemented andTo make recommendations as to any improvements that could be made andTo instigate the formulation of national standards for health and hygiene within the commercial beauty salon industry in Ireland, working in partnership with relevant bodies such as the E.H.O.A., N.S.A.I., NABTET and / or IBPA
9 ObjectivesTo carry out a survey of approx. 25% (N = 30) of the salons operating within Co. Donegal during March – April 2009To assess the standard of hygiene by taking environmental swabs & / or samples for microbiological analysis.To sample cosmetic products used in beauty salons for analysis under the EC (Cosmetic Products) Regs.,To disseminate results of the survey.
10 Survey Development Two members of EH staff Database of beauty salons generatedPilot surveyLetter issued to salon ownersTwo-pronged approach i.e.1. Assessment of compliance with Cosmetic Products Regs. including a labelling assessment and sampling of cosmetic products in a number of salons.2. Assessment of hygiene standardsa) observed by the E.H.O. andb) as reported by the person in charge andc) by microbiological analysis of environmental swabs & or samples.
11 Results Three sections: Cosmetic Products Regs. Microbiological analysisHygiene standards observed and practices reported.
12 European Communities (Cosmetic Products) Regulations, 2004 - 2006 Laboratory analysis(N = 10) - 100% complianceLabelling assessment (N = 25 salons) – 20% non-compliance re. EU name and addressSample ofNo. of SamplesTested forEye lash and eye brow tint1P-phenylenediamineTeeth whitening foam stripsBleaching agentLotions8Lead and cadmiumTotal10-
13 Microbiological Analysis Parameters:Total Viable Count (TVC) at 30ºC.Staphylococcus aureusEnterobacteriaceae (not tested for regarding foot spas)Pseudomonas spp. (tested in swabs from foot spas only)N = 60 samples from 29 different salons( including 6 control samples)
14 Types of Swabs Taken Swab of: No. of Swabs: Foot spa 14 Make-up brush, Eye shadow / Make-up, Lip & eye pencil LipstickSinks / WHBs6Wax from wax pot4Toe separators / Manicure & Pedicure toolsHeads of facial machine / Interior of UV cabinet / Hot towel cabinet / Towels / Surface of trolley / Bowl / Plastic sheet for waxing / Hot stone in tank15‘Barbicide’ disinfectant1VaselineSun bed surfaceTotal60
15 Microbiological Standards There were no reference standards for microbiological levels within beauty salonsEquipment used to pierce skin must be sterileThe interpretation of the results based on a combination of factors including comparison with control samples and with results from other salons in the survey; experience within the Environmental Health Department and general research14% (N = 4) of the salons visited required a follow-up visit due to levels of contamination that were deemed unsatisfactory i.e.3 foot spas (1 higher TVC / 2 Pseud)1 toe spacers (S aureus ).
16 Summary of Results Swab of No. taken Summary of Result (in cfu per area swabbed / per g or per ml)Foot spa14Pseudomonas spp. identified in two samples and in one other case where TVC levels were comparatively high, adequate cleaning procedures were not in placeMake up and Make up applicators etc.Generally very good e.g. max TVC 282; < 10Staphylococcus aureus and < 10 EnterobacteriaceaeSinks/Wash hand basins6Generally very good e.g. max TVC 5,600; < 10Wax taken from wax pots4Generally very good e.g. max TVC 10; < 10Toe Separators & Manicure and Pedicure toolsGenerally good. Low levels of S aureus present on x1 swab from toe separators –no disinfectant step applied.General Equipment / Surfaces18Generally very good. In the interior of a UV cabinet, a TVC level of 673cfu was found
17 Hygiene Standards Assessed - cleaning facilities- hand washing facilities- laundry storage- storage of equipment- services (sanitary accommodation, heating, lighting, ventilation)- policies (hand washing, gloves, skin test)- personal hygiene- waste disposal- equipment for sterilisation and disinfection- cleaning of implements / tools- practices (e.g. ‘double dipping’, wax, use of disposables etc)- after care leaflets- client record cards- training- laser and intense pulsed light treatment- medical clinic- generalobservations.
18 Findings Cleaning Facilities Standard RequiredStandard FoundSeparate facilities for cleaning tools, equipment etc. should be provided in or within easy access to the treatment room(s) e.g. a sink with hot and cold water in a hallway from which the treatment room(s) are directly accessed.A sink in a toilet area is not suitable.7% (N=2) grossly inadequate i.e. had only a whb with only cold water in a toilet area for cleaning of tools, equipment and hand washing.Higher prevalence (75%) noted during pilot survey
19 Findings (contd.) Hand Washing Facilities Standard RequiredStandard FoundProvision of whb in toilet area and whb / sink in or adjacent to the treatment area(s).Hot and cold water, paper towels, soap17% (N = 5) inadequate i.e. 2 salons only had whb in toilet area, others without hot water or soap
20 Findings (contd.) Services – Ventilation Standard RequiredStandard FoundMechanical extract or air conditioning in appropriate areas and / or a suitable means of natural ventilation.Mechanical extract in spray tanning areas **Visual assessment37% (N = 11) inadequate ventilation in treatment areas20% ( N = 3) no mechanical extract ventilation in spray tanning areas50% (N= 15) satisfactory means of ventilation in all areas of salon
21 Findings (contd.) Policies Standard RequiredStandard FoundHand washing before and after treating a clientUse of disposable gloves where there is or may be contact with mucous membranes (e.g. during intimate waxing) or blood or serumVarious sensitivity tests available with varying time intervals between test and treatment27% (N = 8) reported washing hands only after treating a client87% ( N = 26) reported not using disposable gloves, as required for specific treatments (ref case in Holland)Further research required in this area
22 Findings (contd.) Waste Disposal Standard RequiredStandard FoundDouble-bagging prior to disposal by landfill of contaminated waste including waste cotton wool, tissues or cloths with any blood spots or human tissue100% (N = 12) contaminated waste not double baggedUse of a ‘sharps box’ labelled as ‘contaminated’ and ‘for incineration’ for used needles15 salons required a ‘sharps box’.13 % ( N = 2) did not have one.7 % ( N = 1) box inadequately labelled.Disposal of boxes of used needles by collection by permitted collectors.13 % ( N = 2) needed to dispose of ‘sharps box’ in past via Medical Practitioner. Knowledge on permitted disposal methods lacking.
23 Findings (contd.) Sterilising & Disinfection Standard RequiredStandard FoundProvision of sterilisation equipment e.g. glass-bead steriliser or an autoclave, for ‘hard’, reusable implements e.g. commodone extractors, metal scissors, tweezers, cuticle knives etc. used to cut or pierce the skin is considered essentialprovision of an adequate supply of suitable chemical disinfectantmaintenance of UV bulb where UV cabinet is provided100% (N = 30) did not have sterilisation equipment100% (N = 30) has a supply of suitable chemical disinfectant73% ( N = 22) had a UV cabinetof those, 50% ( N = 11) were unaware of when the bulb was last changed
24 Findings (contd.) Cleaning of Tools Standard RequiredStandard FoundThorough cleaning followed by suitable disinfectionInadequate cleaning procedures as reported re:66% (N = 19) foot spas63% ( N = 19) make-up brushes17% ( N = 5) manicure / pedicure tools6.6% ( N = 2) sponges
25 Findings (contd.) Practices Standard RequiredStandard FoundProvision of suitable floor cover or disposable foot covers required where client is bare-footed‘Double dipping’ to be avoidedTowels to be changed after every client10% (N = 3) reported inadequate procedures for protection for feet77% ( N = 23) reported ‘double dipping’ during waxing and 7%( N = 2) used same spatula for different areas of the body46 % ( N = 13) ‘double dipping’ of make-up applicators3.3 % ( N = 1) couch roll placed on towel on a couch with same towel changed after fourth client
26 Findings (contd.) Laser and Intense Pulsed Light Treatments 23% (N=7) offered laser treatmentH & S regulation protects employeesNo regulation to protect clients’ safetyMedical Clinics17% ( N = 5) offer medical clinic e.g. botox, injectables, anti-aging treatments Irish Medical Council
27 Findings (contd.) General Observation- Proprietors: Would welcome guidanceMany were in favour of some form of regulation
28 Conclusions Cosmetic Product Regs. – good compliance Microbiological Results – generally goodHygiene Standards Observed and Practices Reported- cleaning facilities generally good but grossly inadequate in a small number- hand washing facilities generally good but inadequate in nearly 1/5 of salons- improvements in policy on hand-washing and glove use needed
29 Conclusions (contd.)Hygiene Standards Observed and Practices Reported (contd.):- improvement needed in waste disposal- absence of sterilising equipment a concern- cleaning procedures inadequate for certain equipment / tools- practice of ‘double-dipping’ commonplace- regulation not in place- practitioners open to regulation and guidance
30 Recommendations Further research within EH Training for EHOs ‘Guide to Good Practice in Beauty Salons’ is developed by the EH in conjunction with relevant stakeholdersEH, in turn and in conjunction with relevant bodies, contribute to the training of Beauty Therapists by the development of a syllabus including Cosmetic Products Regs and P.H. AspectsEH staff, in conjunction with relevant, interested bodies develop an award system for salons proving to be operating to a defined standard, such as the guide referred to.
31 Recommendations (contd.) That information is provided to the public in relation to standards to expect in a beauty salonThat microbiological guideline standards applicable to beauty salons are developed by the E. H. serviceThat research is undertaken to determine the level of beauty salon acquired infection or injuryRegulation of beauty salons is introduced e.g. by licensing and enforcement of standards on an ongoing basis through regular inspections carried out by EHOs and any other profession deemed necessaryStaged implementation of above recommendations.
32 Acknowledgements Jenny Fortune, EHO, Letterkenny Salon owners Mary Ferry, Fás Course TutorIrish Beauty Professionals AssociationWendy Nixon in HABIATina Garrity, CIEHDr. Olive Smith, Irish Medicines BoardSuzanne Tinney, Waste Awareness Officer, Donegal County CouncilLouise Cullen, Public Health Dept., Letterkenny