Respiratory hazards of “nail sculpture”
BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7422.1050-a (Published 30 October 2003) Cite this as: BMJ 2003;327:1050All rapid responses
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What was not mentioned in the letter by Gallagher et al (1) is the
exposure to those having their nails sculptured. We have noticed while
waiting and having nails sculptured that there are horrendous odors of
acrylic and organic solvents in these salons. The common acrylic resin
used is methyl methacrylate, which can cause contact dermatitis (2).
Another agent used for removing artificial nails is acetonitrile, which
can cause nausea at high concentrations and release of metabolic cyanide
(2). One study (3) suggested that women who used formaldehyde and worked
more than 35 hours in salons experienced an increased risk of spontaneous
abortions. These reports clearly identify this industry as having
occupational hazards. From our experiences, chemical odors are often so
high that upon entering a salon there is immediate respiratory irritation,
burning in the nose and lacramation of the eyes. Besides the occupational
hazard identified by Gallagher and others, there are also health concerns
for those who frequent these establishments for nail sculpturing. The
mechanism for preventing these exposures is improvement in ventilation, in
some cases installing ventilation, and establishment of exposure standards
for this industry. Certainly, this will be difficult since there are
neither exposure studies for the salon industry nor mixture studies on
these chemicals.
1. Gallagher F, Gaubert D, Hale M. 2003. Respiratory hazards of “nail
sculpture”. Brit Med J 2003; 327; 1050
2. Hathaway GJ, Proctor NH, Hughes JP, Fischman ML. Proctor and
Hughes’ chemical hazards of the workplace. Van Nostrand Reinhold, New
York, 1991, ages 62-63 and 406-407.
3. John EM, Savitz DA, Shy CM. Spontaneous abortions among
cosmetologists. Epidemiology 1994; 5: 147-155.
Competing interests:
None declared
Competing interests: No competing interests
Respiratory and Infectious hazards of nail sculpture
I read with interest the letter by Gallagher et al1 regarding
respiratory hazards of "nail sculpture". Apart from respiratory hazards,
we in Plastic Surgery have seen nasty cases of nail bed infections.
The problem is related to the type of acrylate glue used to make up the
acrylic nail. Acrylic nails can be made with EMM (Ethyl Methacrylate) or
MMA (Methyl Metacrylate). MMA is highly irritant to skin, eyes and mucous
membranes and is known to cause respiratory problems2 MMA bonds well and
remains attached to the surface nail for longer. However, it creates nail
extensions which are too rigid for the natural nail plate. MMA extensions
also resist breaking if accidentally caught or jammed. This often leads to
painful breakage of the nail plate near the cuticle and predisposes to
infection.
In the application of acrylic nails it is necessary to file the nail, or
rough it up. Some technicians use a drill on the nail for this purpose.
Using a drill on the nail raises the moisture level of the nail and
increases the risk of infection. I have seen three cases of nail bed
infections related to acrylic nail application or acrylic nails using MMA
as a product. They all required minor surgery and antibiotics.
References
1. Gallagher F., Gaubert D. & Hale M. Respiratory hazards of
"nail sculpture". BMJ 2003;327:1050-a.
2. Piirila P., Hodgson U., Estlander T., Keskinen H., Saalo A.,
Voutlainen R., Kanerva L. Occupational respiratory hypersensitivity in
dental personnel. Int Arch Occup Environ Health. 2002;75:209-216
Competing interests:
None declared
Competing interests: No competing interests