Beauty Salons are in the Eye of the Beholder …..

1. Beauty Salons are in the Eyeof the Beholder ….. A Survey into the Environmental Health Standards Operating in Beauty Salons in Co. Donegal, March – April 2009 Cora Murray, SEHO

2. This presentation…… • Introduction • Scope and Limitations • Methodology • Results • Conclusions • Recommendations.

3. Introduction • Summer 2009 - 130 beauty salons in Co. Donegal and 5 training colleges • What do they offer?..... - skin treatments e.g. make-up application, microdermabrasion - hair removal e.g. by laser, electrolysis or waxing - teeth whitening - removal of body toxins e.g. by platinum detox - manicures, pedicures - massage - ear candling - ….. and more.

4. 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 EHOs Irelande … zero points! - currently no public health legislation governing the operation of businesses such as beauty salons in the Republic of Ireland. Regulatory Background

5. So what are the risks?

6. Case Incidence

7. Included in the survey …. Commercial beauty salons only Voluntary participation Information as reported by salon operator as observation was not possible No prior appointment (in 87% of cases) – time restrictions Not Included in the survey … Services offered from private residences Sun-bed facilities, tattooing, ear piercing and hair dressing services Holistic services e.g. reflexology, acupuncture etc. Workplace health and safety assessment Efficacy of treatments offered. Scope and Limitations

8. Aim • To determine compliance levels with the EC (Cosmetic Products) Regs., 2004 - 2006 among beauty salons in Co. Donegal and • To determine the degree to which such salons protect public health in the delivery of their service by way of the hygiene precautions implemented and • To make recommendations as to any improvements that could be made and • To 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. Objectives • To carry out a survey of approx. 25% (N = 30) of the salons operating within Co. Donegal during March – April 2009 • To 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., 2004 - 2006 • Todisseminate results of the survey.

10. Survey Development • Two members of EH staff • Database of beauty salons generated • Pilot survey • Letter issued to salon owners • Two-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 standards a) observed by the E.H.O. and b) as reported by the person in charge and c) by microbiological analysis of environmental swabs & or samples.

11. Results Three sections: • Cosmetic Products Regs. • Microbiological analysis • Hygiene standards observed and practices reported.

12. European Communities (Cosmetic Products) Regulations, 2004 - 2006 • Laboratory analysis (N = 10) - 100% compliance • Labelling assessment (N = 25 salons) – 20% non-compliance re. EU name and address

13. Microbiological Analysis Parameters: • Total Viable Count (TVC) at 30ºC. • Staphylococcus aureus • Enterobacteriaceae (not tested for regarding foot spas) • Pseudomonas spp. (tested in swabs from foot spas only) N = 60 samples from 29differentsalons ( including 6 control samples)

14. Types of Swabs Taken

15. Microbiological Standards • There were no reference standards for microbiological levels within beauty salons • Equipment used to pierce skin must be sterile • The interpretation of the results based on a combination of factors including comparison with control samples and with resultsfrom other salons in the survey; experience within the Environmental Health Department and general research • 14% (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

17. - 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 - general observations. Hygiene Standards Assessed

18. FindingsCleaning Facilities

19. Findings (contd.)Hand Washing Facilities

20. Findings (contd.)Services – Ventilation

21. Findings (contd.)Policies

22. Findings (contd.)Waste Disposal

23. Findings (contd.)Sterilising & Disinfection

24. Findings (contd.)Cleaning of Tools

25. Findings (contd.)Practices

26. Findings (contd.) Laser and Intense Pulsed Light Treatments • 23% (N=7) offered laser treatment • H & S regulation protects employees • No regulation to protect clients’ safety Medical Clinics • 17% ( N = 5) offer medical clinic e.g. botox, injectables, anti-aging treatments  Irish Medical Council

27. Findings(contd.) General Observation- Proprietors: • Would welcome guidance • Many were in favour of some form of regulation

28. Conclusions • Cosmetic Product Regs. – good compliance • Microbiological Results – generally good • Hygiene 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 stakeholders • EH, 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. Aspects • EH 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 salon • That microbiological guideline standards applicable to beauty salons are developed by the E. H. service • That research is undertaken to determine the level of beauty salon acquired infection or injury • Regulation 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 necessary • Staged implementation of above recommendations.

32. Acknowledgements • Jenny Fortune, EHO, Letterkenny • Salon owners • Mary Ferry, Fás Course Tutor • Irish Beauty Professionals Association • Wendy Nixon in HABIA • Tina Garrity, CIEH • Dr. Olive Smith, Irish Medicines Board • Suzanne Tinney, Waste Awareness Officer, Donegal County Council • Louise Cullen, Public Health Dept., Letterkenny

33. New Developments … • Fish pedicure ….

34. That’s it! Thank you for your attention. Contact details: Cora Murray, Senior EHO, Co. Clinic, Letterkenny, Co. Donegal Tel. 074-9123759 Email: cora.murray@hse.ie See EHOA Yearbook 2010