Orange County is home to hundreds of nail salons, which for three decades have served as a crucial gateway to employment for newly arrived Vietnamese immigrants.

But the trade-off for economic security is often a toxic work environment that can lead to workers suffering from serious illnesses, according to experts and advocates.

Headaches, dizziness, respiratory problems and skin irritations are common adverse effects plaguing salon workers, who inhale daily the fumes from nail polish, acetone and acrylic nail powder.

While some are more sensitive to chemicals than others, nearly all employees will suffer a headache now and then. It’s simply part of the job description, said Mary, an employee at an airy east Anaheim salon who did not want to give her full name for publication.

“Some people start working, and they’re gone after just a couple of weeks,” said Mary, speaking in Vietnamese. A rickety plastic fan blows over her workstation and the salon keeps its front and back doors open for ventilation.

“If you don’t take precautions, you might start to feel dizzy, and that’s when you should get up and get some fresh air. You have to take breaks. Otherwise, of course, you’ll get a headache.”

The long-term effects of such exposure go far beyond headaches, according to health experts.

Chief hazards in the salons are a group of chemicals dubbed the “toxic trio” — dibutyl phthalate (DBP), formaldehyde, and toluene. Toluene, for example, can cause permanent brain damage when inhaled in large amounts, such as when sniffing glue or paint, according to the Environmental Protection Agency. Formaldehyde has been labeled a carcinogen by the agency. Disinfectants that fill the tubs where customers receive foot baths also are a concern.

“Many of these workers talk about these chemicals, and they know it can’t be good for them,” said Thu Quach, an epidemiologist with the Cancer Prevention Institute of California whose mother was a manicurist.

Her mother’s death from cancer helped spark Quach’s scientific inquiry. “We know that these chemicals have been linked to harm and are used in nail polishes,” Quach said.

Additionally, those who work in the salons while pregnant might have a greater risk of miscarriage and developmental delays in their children, according a survey by the California Healthy Nail Salon Collaborative. This is an especially important consideration, because up to half of the state’s 97,100 manicurists and 241,700 cosmetologists are of child-bearing age, according to the Nail Salon Collaborative.

The survey showed that 10 percent of manicurists have worked while pregnant, with 8 percent knowing another worker who has experienced complications such as difficulty conceiving, miscarriages, still births and birth defects.

But making a direct link from salon exposure to birth defects, miscarriage and cancer is difficult, Quach said. She participated in a recent study that did not show higher cancer rates among manicurists, but Quach said it may take 20 to 30 years after exposure for a cancer to be diagnosed.

The Vietnam Connection

Getting a manicure or pedicure used to be a rare luxury, but that changed in the 1970s when actress Tippi Hedron wanted to help Vietnamese “boat people” find employment and asked her manicurist to train a group of women.

From there the nail trade took off in the Vietnamese immigrant community, and a manicuring license became a path to a middle-class income without the need for a college education or strong English skills. On average, a beauty college program for a manicurist license takes about three months.

For many employees, the benefits of economic stability outweigh the known health risks.

Health effects “have been written about in many newspapers, but what other job is there to do? said the manager of the Anaheim salon in Vietnamese. “Many people don’t have good English, and this job is a livelihood. … Can you name a job that doesn’t have its risks?”

He worked as a manicurist for more than two decades until dimming vision forced him to stop.

Statewide, Vietnamese workers continue to dominate the industry, constituting 80 percent of the workforce, according to common estimates. There are more than 20,700 licensed manicurists in Orange County alone.

In Westminster, there are at least three beauty schools with bilingual courses, including Hang Nga Beauty College, Elite Beauty School and the Asian American International Beauty College. The state’s Board of Barbering and Cosmetology offers exams in Spanish, Vietnamese and Korean.

Working to Create a Better Work Environment

Researchers and activists are working on a number of fronts to improve conditions, including outreach to local beauty schools and community nonprofits to inform new students and current workers about developing research and legislation.

Tam Nguyen, owner of Advance Beauty College in Garden Grove, said research about the personal health risks is still developing and knowledge among new students is minimal.

“Quite frankly, [toxicity] information is not in the textbooks that are being taught nationwide. So we’re partnering with local organizations and acting as a platform to educate students,” said Nguyen, whose school has trained more than 30,000 students since his parents founded it in 1985.

The school hosts educational speakers from both the nail industry and local nonprofits. Last month, the school hosted the Healthy Nail Salon Town Hall sponsored by state Sen. Lou Correa’s office.

The work of the Healthy Nails Collaborative has had an impact on at least one local salon owner. Phuoc Dam, who owns and operates Queen Nails in Brea, spent several thousand dollars on two exhaust systems and two air conditioning systems.

The result is an airy salon where the chemical smell is not immediately noticeable.

Dam, who came to the U.S. in his twenties, decided to join the Healthy Nails Collaborative because “I wanted to give something back to the industry.” Dam doesn’t use products containing the toxic trio, and he provides gloves and masks, which most workers put on when using the machines that file acrylic nails and generate a puff of powder.

Conceding that his views wouldn’t make him popular among fellow salon owners, he said he favors more government oversight of the industry. He would like to see initiatives like Santa Monica’s recently announced effort to certify salons as eco-friendly.

“Hopefully, the next project will be in Orange County,” he said.

Amy DePaul is a Voice of OC contributing writer and lecturer in the UC Irvine literary journalism program. You can reach her directly at

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