During the pandemic, salon employees and customers alike wore masks. In the years to come, some workers might keep them — but not because of Covid-19. | Valentinrussanov/Getty Images

Cosmetology workers are reassessing their jobs, including the chemicals they’re exposed to.

Stylist Michele Ortiz has no plans to get rid of her personal protective equipment, even as Covid-19 protocols are rescinded in California and other states. “I would love to see hairdressers wearing their masks even after the pandemic, whenever all of this subsides,” Ortiz says.

For years, the California hairstylist experienced nosebleeds, lightheadedness, hot flashes, and rosacea as a result of the harsh chemicals used in hair color services. But now she refuses to use such chemicals, and after arriving for work at Phenix Salon Suites in Santa Barbara, she dons a mask, rubber gloves, and a face shield, and switches on an air purifier to counteract the chemicals used by a coworker. She feels safer this way, and not just from the virus.

Workers across the cosmetology industry, including spa, hair, and nail salon employees, have expressed workplace safety concerns before and during the Covid-19 pandemic. According to complaints filed by cosmetology workers to the Occupational Safety and Health Administration (OSHA) between January 2015 and July 2020 — obtained via Freedom of Information Act requests in partnership with the Economic Hardship Reporting Project and then shared with Vox — exposure to these chemicals, especially in salons with poor ventilation or whose owners failed to provide PPE, resulted in burning eyes, breathing problems, rashes, and more.

Now that salons have reopened and the CDC updated its guidelines to say fully vaccinated people can resume activities without practicing social distancing or wearing masks, cosmetology workers must navigate both the immediate threat of Covid-19 and the ongoing risks of cosmetic chemical exposures.

“Employees are exposed to the hair straightening products without proper ventilation, causing eye blisters and respiratory problems,” one OSHA complaint reads. “Employees are exposed to chemical fumes and are having trouble breathing,” reads another. “Employees are not provided with personal protective equipment.”

Potentially hazardous working conditions were already in place when the deadliest pandemic in a century landed in the US. Covid-19 left salon owners and workers facing the immediate health risks of a deadly airborne disease that required social distancing, forcing salons to upend their practices as shifting regulations left them open and shut. It also exacerbated the economic issues already confronting salon employees, often women of color, working without safety nets. As people in various industries assess the harsh working conditions of their employment, some salon workers are examining the risks that have been part of their jobs all along.

The health hazards associated with cosmetic chemicals are well-documented. Alexandra Flamm, assistant professor of dermatology at Penn State University, says her cosmetologist patients often suffer from contact dermatitis, “an itchy rash in the eczema family.”

Exposure to sprays and other personal care products make the eyes vulnerable to irritation or infection, adds Barbara Horn, immediate past president of the American Optometric Association Board of Trustees, and irritants landing directly on the eye can potentially cause keratitis, a condition the American Association of Ophthalmology defines as an “open sore on the cornea.”

Found in keratin treatments, formaldehyde is especially problematic, with the National Toxicology Program classifying it as a known carcinogen. What’s more, even short-term exposure to formaldehyde “is associated with eye, nose, and throat irritation, shortness of breath and wheezing,” per the Environmental Working Group (EWG), a health and environmental nonprofit, and the National Cancer Institute concurs.

Such risks are exacerbated by the lack of Food and Drug Administration (FDA) regulations. The FDA has been aware of the dangers of formaldehyde in cosmetic chemicals since 2016 but has yet to ban the chemical, according to documents obtained by the Environmental Working Group via FOIA and reporting from the New York Times. An FDA spokesperson said the agency continues to examine the safety of formaldehyde and will not discuss ongoing investigations or future plans.

Congress has repeatedly considered updating cosmetic chemical regulations, but so far the bills haven’t gotten very far. Rep. Frank Pallone (D-NJ) introduced the Cosmetic Safety Enhancement Act of 2019 in December of that year, while Sens. Dianne Feinstein (D-CA) and Susan Collins (R-ME) introduced the Personal Care Products Safety Act on Thursday for the third time, after doing so first in 2015 and again in 2019. But the industry has successfully lobbied in the past for the ability to self-regulate, said Melanie Benesh, the EWG’s legislative attorney. However, some companies now recognize the need for more regulation and are aware that consumers are beginning to care more about the ingredients in their products, Benesh added.

The cosmetics industry “did a very good job even back in 1938 [of] carving themselves out of the law and really limiting the FDA’s regulatory authority,” Benesh said. “Even the authority that’s written into the 1938 law is very limited.”

 Genaro Molina/Los Angeles Times via Getty Images
There are dangerous chemicals involved in some common salon treatments.

Dung Nguyen, program outreach coordinator of California Healthy Nail Salon Collaborative (CHNSC), said that she has heard concerns from workers who worry about their ability to recover from Covid-19 due to respiratory issues stemming from the products they use.

“We’re starting to see the disparities that Covid is affecting poor folks way more than it is affluent folks,” says Nguyen. “And it’s because of the poor folks who are working low-wage jobs where they have to work with all these chemicals. Just because I’m poor doesn’t mean I deserve to die and that my life is not worth as much as yours.”

Worker protections depend on whether a worker is classified as an independent contractor or an employee, notes ReNika Moore, director of the ACLU’s Racial Justice Program. As the pandemic unfolded, she says, federal agencies mostly introduced general recommendations and guidance for worker protections. Basically, the federal government has “dropped the ball,” Moore says.

She pointed to the National Employment Law Project’s warnings about the shortcomings of America’s safety net, during Covid-19, protections that previously excluded independent contractors from benefits like paid sick leave, family leave, and unemployment insurance, all of which have become acutely necessary as workers weather the economic uncertainty and health risk of working during the pandemic.

In April 2020, the US Department of Labor issued additional guidance regarding the Pandemic Unemployment Assistance Program that extended benefits to all independent contractors who have experienced “a significant diminution in work due to Covid-19.”

Another challenge for salon workers: Given the close-knit nature of the nail salon industry in particular, workers may fear retaliation for speaking out against unsafe working conditions, says Preeti Sharma, an assistant professor at California State University and co-lead author of the 2018 report “Nail Files: A Study of Nail Salon Workers and Industry in the United States.” Given that fear, it’s critical for worker organizations to inform salon workers of their available safeguards if they speak out against poor working conditions, she says.

But protections against such retribution only apply to employees, not independent contractors, Sharma adds. Regardless, as salons adjust to the changing regulations surrounding Covid-19, salon workers shouldn’t be solely responsible for enforcing mask-wearing or other precautions; strong health and safety guidelines, as well as diligent owners and compliant customers, keep everyone safe, she says.

Not surprisingly, a majority of those who responded to a June 2020 survey of nail salon workers and owners in California during Covid-19 were concerned about whether it was safe to return to work. The survey found that 61 percent of workers (and 43 percent of salon owners) were concerned about safely reopening. It also found that 43 percent of workers (and 63 percent of owners) were worried about their finances.

“Financially, it’s a lose-lose situation, and health-wise, it’s a lose-lose situation,” Sharma said. “You don’t have the resources to stay home, but to go back to the workplace is unhealthy.”

“There really isn’t an afterthought of ‘I don’t really want to do that. Is there something else I can do?’” added CHNSC’s Nguyen. “It comes from this survival nature: ‘What can I do here and now to provide for my family as quickly as possible?’”

On May 13, the CDC updated its guidelines to say that fully vaccinated individuals no longer need to wear masks or practice social distancing except where required by law, leaving states, municipalities, tribes, and territories to determine protocols. As a result, salon workers are weighing the risks of Covid-19 along with the long-term cosmetic chemical exposure.

Kimberly Bell, a hairstylist working in Fort Lauderdale, Florida, says that performing keratin straightening treatments caused her to experience nosebleeds, breathing problems, and rashes on her neck, chest, and forearms. These symptoms drove her to try wearing surgical and gas masks before the Covid-19 pandemic began. Once salons reopened, she continued to wear face masks.

Though the masks she wears can conceal the smell of hair coloring chemicals such as bleach, the gases released during keratin treatments still manage to creep in, she says.

“You get headaches a lot, because you have these masks on for hours upon hours throughout the day, and then you have all the chemicals that are around you,” Bell says. “It’s a combination of stress, chemicals, and breathing our own carbon dioxide.”

The CDC’s revised guidelines have left Bell conflicted. On one hand, keeping herself and her clients safe during the pandemic has been a priority. However, she is at greater risk for cosmetic chemical exposure during her workdays and is concerned about fumes getting into her mask. According to a 2019 CDC evaluation of four nail salons, surgical masks aren’t considered respiratory protection and don’t protect against gas, vapor exposures, or particulates in the air. And while N95 masks don’t protect against gases or vapors, they do protect against dust created while doing clients’ nails, per the CDC.

“I’ve given the mask question, ‘to wear or not’ many sleepless nights and have come to a decision that will minimize risk to myself and my clients,” Bell said. “Wearing a mask only exacerbates the health challenges as the fumes flow up and are trapped. You can imagine how debilitating breathing toxins all day is and creates irrefutable health risk and damage.”

Making sure clients are safe and comfortable was paramount for her before the coronavirus was a concern. Now that she’s fully vaccinated, she said she will wear a mask if clients are comfortable with her doing so. But if her clients are okay with her not wearing a mask, she will service them without one and continue her temperature checks, she said.

Ortiz said she’s fine with the CDC guidelines as long as people continue to get vaccinated, but she will continue wearing a mask, because she knows clients who aren’t getting vaccinated.

“I’m trying to feel things out with everything. It’s a little new to me [to go] from masks and shields to no masks,” Ortiz said.

Nguyen hopes that the health disparities the pandemic has revealed will lead to laws that will change what substances are allowed in beauty products. History has shown that this will more likely happen at the state level. Congress has not passed new legislation to regulate the cosmetics industry since the 1938 Food, Drug, and Cosmetic Act, but “states have been the leaders on chemical consumer policy changes in the law,” said the Environmental Working Group’s Benesh.

In September, for instance, California passed legislation requiring cosmetic product manufacturers to disclose fragrance ingredients or flavor ingredients starting in 2022, and banned the manufacturing and sale of products containing formaldehyde, quaternium-15, and other toxic cosmetic chemicals beginning in 2025.

“We think the California legislation really is important as sending a signal about what kinds of chemicals we won’t tolerate in our cosmetics. We certainly hope it inspires movement at the federal level,” Benesh said.

Other states, including Minnesota, Michigan, and Massachusetts, have enacted or introduced their own cosmetic chemical regulations, from banning toxic chemicals in children’s personal care products to requiring disclosures of ingredients in cosmetics.

As for Ortiz, after visits to multiple doctors failed to pinpoint the source of her nosebleeds, dizziness, and skin irritation, a holistic doctor finally advised her to stop working with chemicals and diagnosed her with lupus, an autoimmune disease in which the body’s immune system attacks the organs. (While studies published in Cutaneous and Ocular Toxicology in 2012 and Toxicology Reports in 2015 indicate that cosmetic exposures could exacerbate lupus symptoms, the studies concluded more research needs to be done to determine cosmetic chemicals’ effect.)

Though Ortiz has given up working with toxic chemicals, she’s concerned about her salon colleagues navigating both the risks of coronavirus and cosmetic chemicals. She adds: “I just think Covid and chemicals is a bad recipe.”

This article was supported by the Economic Hardship Reporting Project.

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