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Improving Health and Safety in Massachusetts Beauty Salons Training developed for the Massachusetts Division of Professional Licensure Board of Cosmetology.

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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 2005 By 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 Regulations September 26 ~ Proper Ventilation in Salons and OSHA Requirements October 24th ~ Safe and Effective Disinfection November TBA ~ Model Salon and Virtual Health and Safety Inspection

3 Overview Introduction Chemicals and Health Information and Protection
Toxics Use Reduction Regulations Summary 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. Hazardous Who is potentially affected by chemicals in salons? Salon owners and workers Family members Customers Employees and residents near salons Inspectors Environmental effects via water, waste and air

6 How chemicals affect us
Types of effects: Contact: skin or eye or throat irritation Systemic: breathe in and chemicals go to “target organs” e.g. (solvents to brain) How they get in our bodies Skin 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 disease Vapors: 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 air The higher the temperature, the more in the air Gases (ex. Steri-Dry) Liquids (ex. Barbicide) Bulk products (ex. hair dye)

8 Concentration ppm = parts per million Example: 1000 parts acetone per 1 million parts air mg/m3 = milligrams per cubic meter Example = 15 milligrams dust per cubic meter of air Important: Odor doesn’t always tell you how much is there!

9 Chemical exposure Timing of Exposures Mixed exposures
Acute exposures (high levels, infrequent) = spill Chronic exposures (low levels, frequent) = cleaning with alcohol Mixed exposures Inhalation exposures measured by sampling breathing zone concentrations over time

10 Timing of Effects Acute effects happen immediately or soon after exposure Examples: burns, asthma attack, throat irritation, dizziness Chronic effects build up over time Examples: 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 studies Increased spontaneous abortions (John, 1994) Neurocognitive deficits (LoSasso, 2001; 2002) Respiratory irritation (Hiipakka, 1987) Many case reports on other exposed workers and clients sensitization 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 dentures Nail 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)
Reproductive Lower birth weight babies Respiratory Sensitization leading to asthma Upper and lower respiratory irritation (cough, shortness of breath, bronchitis) Skin Sensitization leading to allergic contact dermatitis and other skin problems Cancer Bladder and lung Occupation as hairdresser = exposures that probably are carcinogenic

13 Chemicals of particular concern
Formaldehyde Found in lots of salon products Small amounts in many nail polishes, esp. as TSF resin Active ingredient in Steri-Dry as “paraformaldehyde” Gas in air (respiratory) and skin contact Use of Steri-Dry can exceed short-term limits Health Effects Acute: watery eyes; burning sensations of the eyes, nose, and throat; coughing; wheezing; nausea; and skin irritation Chronic: Carcinogen (nasal and leukemia); sensitization (allergy) AVOID EXPOSURE!

14 Chemicals of particular concern
Acids and bases At either end of the pH scale Acids pH < 7 (neutral), Bases pH >7 Both cause burns and irritation Acids: nail primer, neutralizers, hydrogen peroxide Bases: relaxer, perms, ammonia

15 Chemicals of particular concern
Acrylics Main ingredients in sculptured nails Strong smell at low concentrations Powder polymer and liquid monomer Liquids: ethyl methacrylate, methyl methacrylate Sensitizers (asthma, dermatitis), irritation, miscarriages? Skin and nail damage


17 Chemicals of particular concern
Solvents So called because other stuff “dissolves” in them Organic solvents used extensively in salon products: alcohol, acetone, toluene, xylene, butane Readily vaporize into salon air Most solvents cause same short-term and long-term effects: CNS suppression (dizziness, nausea, spaciness) Skin defatting and irritation Possible reproductive effects Possible liver and kidney damage Possible brain-damage (memory loss, decreased dexterity)

18 Other hazards in salons
Emergencies and violence Blood borne pathogens and infectious agents Safety/Fire Musculoskeletal

19 Chemical Hazard Mapping
Draw a salon environment (hair or nails) Mark on the map where chemical hazards are found Blue = dusts Red = vapors/gases Purple = liquids/bulk Mark 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 exposure Via 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 English For 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 path General exhaust ventilation or dilution ventilation Brings in fresh air, exhausts bad air via HVAC, open doors and windows Does not prevent exposure, but may lower concentration levels Some systems may have air cleaners Critical for healthy indoor environment

25 Prevention at the person
Respiratory protection Dust masks may prevent some dust exposure, but don’t stop chemical vapors! Chemical cartridges with half-face respirators Good work practices include keeping containers closed; avoiding skin exposure, esp. during bulk chemical handling Training important, but challenging

26 How do we get information about chemicals?
1983 OSHA Hazard Communication Standard requires Employee Right to Know Training MSDS, labels Chemical testing: animal studies human studies (workers)

27 MSDS Exercise MSDS stands for Material Safety Data Sheet
Most important sections are: Ingredients/composition Hazard identification/health hazards Fire and explosion hazards Handling and storage information Exposure control measures Every ingredient and product sold that will be used by someone at work has a MSDS available from the manufacturer Salons must have MSDSs for all products and labels on all products


29 Toxics Use Reduction and Best Practices

30 What is Toxics Use Reduction (TUR)?
Planning Process Concept Waste Management Tool Techniques State Pollution Prevention Program

31 I. Massachusetts Toxics Use Reduction Program

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 toxics transfer 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) Change Equipment Modernization Improved Operations & Maintenance (Housekeeping) Reusing (recycling) substances

36 Chemical Use

37 Chemical Releases to the Environment

38 COMMUNITY TUR While 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 Project Examine chemical usage in food establishments Determine barriers and means of promoting TUR in this environment Examine 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 handling Threat to public health through food contamination Threat to worker through occupational exposure Effect on environment Conflict between sanitation requirements and toxics usage

42 Practices Observed during inspections
Overuse or inappropriate use of chemicals Usage of unnecessary chemicals Failure to dilute: higher exposure No knowledge of product contents or safety issues Questionable application of pesticides (routine, use of foggers) Minimal safety equipment/training MSDS not available No knowledge of pesticides in use or IPM

43 Advantage of TUR for Food Establishments
Greater worker safety Improved food safety Benefit to environment Decreased costs Improved pest management, long term Public perception of establishment

44 Key Messages for Food Establishments
Non-Toxic Alternatives Degreaser-Borax on a damp cloth Floor cleaner-1 cup vinegar in 2 gallons water Oven cleaner-2 tbsp liquid soap with 2 tsp of borax in warm water Window cleaner-2 tbsp vinegar in 1 quart warm water OSHA Requirements Promote safety and awareness Applicable to restaurants Personal protective equipment (gloves, goggles, eye wash, storage, training) Hazard communication standard Employee Training Program

45 Integrating TUR Into Food Establishments
Provided literature/training-awareness Ongoing reinforcement through inspections Developed web-based training program Distributed mailing on subject of IPM and toxics control Integrated issues into inspection program Carry out extensive inspections with expert on IPM Developed model IPM program for food establishment Passed regulation requiring IPM along model of Children and Families Protection Act

46 Why would Salons want TUR?
Emerging Knowledge in Toxics and Health Lack of Product and Toxicity Testing Known health risks associated with exposure to many chemicals Impacts at Lower Exposure Levels and Timing of Exposure Increase in environmentally-related diseases Disruption of Hormone Systems Reproductive Effects Exposure 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 workers Improved (safer) workplace environment Reduce liability (fire, spills, contamination, exposure) Public Image - “Green Operation,” care about environment and workers Market advantage

48 TUR Techniques Chemical (Product) Substitution (Replace hazardous products with safer ones!) Product Reformulation Process (Redesign) Change Equipment Modernization Improved Operations & Maintenance (Housekeeping) Reusing (recycling) substances

49 TUR in Cosmetology Use 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 Cosmetology Avoid 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 chemical storage and mixing room (improved O & M)

51 Chemical (Product) Substitution Permanent Hair Dyes
Chemicals of Concern Para-Phenylediamines Derivatives from coal tar. Darker dyes have more phenylediamine. Other names: 2, 4 - diaminoanisole para-dyes Health Affects Can cause cancer. Can cause changes in genetic information in sperm and egg Can cause severe allergies and dermatitis. Try plant derived dyes: Henna (triggers asthma) Chamomile for lightening Saffron Beet juice Use semi-permanent dyes without: Para-Phenylediamines Ammonia Resorcinol Ursol 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 carcinogenic or p-phenylediamine Information from Healthy Hairstyling, by Waste Reduction Program, Alaska Health Project, 4/93 Photo is from clipart on web Question – how hazardous are nitro and amino compounds?

52 Chemical (Product) Substitution Relaxers
Chemicals of Concern Sodium Hydroxide (Lye) Problem highly alkaline and corrosive Health Effects burn skin and scalp cause blindness irritant to skin, eyes, respiratory system Alternative Product Bisulfates There are three types of hair relaxers: Sodium Hydroxide strongest very hazardous Ammonium Thioglycolate fairly strong significant health risk Acid-Based with Bisulfates least strong least health risk Information from sources on page 1. Photo from web. Lye Based Product

53 Example of a No-Lye Product
Promo Designer 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
Promo This 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 Concern Protinator 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 irritant Hierarcy of Lighteners: Oil Bleaches (mildest) 2. Cream Lighteners 3. 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 oxides Information from: Healthy Hairstyling, by Waste Reduction Assistance Program, Alaska Health Project, 4/93 Health 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 Cosmetology Pollution prevention Plan for a Hair Salon, Hawani Berhanu and Tania Mercado, 1997 Oil 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 Concern Toluene (solvent) Reproductive Toxin Formaldehyde (preservative, polymer) Carcinogen Phthalate (Plasticizer) Endocrine Disruptor Picture 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 -Free L’Oreal Paris Jet-Set Quick Dry Nail Enamel Revlon Nail Enamel Garden Botanika Natural Color Nail Color Kiss products, Kiss Color Picture 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 dispenser with a pressure-sensitive stopper and a small opening just large enough to fit the applicator brush into and for the applicator to hold 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, CBS All 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, CBS All 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.

62 Regulations

63 BOC Regs Compared a 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 apprenticeship c 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 ventilation f 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; and chemicals 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 labeling In 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. Governs Hazard Communication Standard – MSDSs, RTK training, Haz Com Plan Formaldehyde Standard Eyewash Standard Blood Borne Pathogen

68 Hazardous Waste Regulations
Regulated by the MA Department of Environmental Protection Governs: 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 stored The amount of waste that can be stored The length of time that it can be stored Record keeping

69 Federal Fire Regulations
Written Emergency Action/Fire Prevention Plan – OSHA Regulated 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 Jurisdiction Regulated 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 natural Ingress and Egress Smoke alarm and fire sprinkler systems

72 Noisome Trade Odor Complaints/Nuisance

73 Noisome Trade Odor Complaints/Nuisance
Regulatory Jurisdiction Board of Health Enforced locally by local Health Department/Agent Governs: (see Town of Sharon Regs.

74 Sanitary Code Regulatory Jurisdiction Governs:
Regulated by the MA Department of Public Health Enforced locally by local Health Department. Governs: Hot water Sanitation

75 Licensing Regulated by the MA Board of Cosmetology. Governs:
The opening and licensing of salons. Occupancy Permit Electrical Permit Building Permit The licensing of technicians. The operation of the salon. Equipment and Hygiene Procedures

76 Opportunities to Improve H & S in Salons
Medical Surveillance Vocational Training Fed State Physician Training Licensing Practitioner exam Salon Inspection Regulatory Non-regulatory Local Consumer Ed/Demand Inspections Continuing Education (not required) Trade Shows Product Reformulation

77 Discussion What are the barriers to improving salons, especially the air quality? What are the opportunities for improving salons?

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