The Price Of Nice Hair

In the wake of the viral New York Times report exposing the deplorable working conditions of nail salon workers in New York City, Gov. Andrew Cuomo (D-NY) immediately introduced two emergency measures in the New York State Legislature that would make it more difficult to mistreat nail technicians. In particular, one measure would require workers to wear respirators, protective goggles, and special gloves in nail salons, in response to the serious health problems that many workers face. But while the New York Times series focused on the health risks of extended exposure to nail products, hair salons pose their own share of similar health risks.

From head to toe, hair salon workers are at risk for adverse health outcomes. Constant handling of chemicals during the hair shampooing process — classified as “wet work” because the hands remain wet or moist for a long period of time — can reduce the skin’s natural barrier and allow greater absorption of chemicals. A 1998 study found that hairdressers have skin conditions like dermatitis, eczema, and rashes, at two to three times the rate of people in other occupations. Other chemicals used to dye, bleach, and treat also can cause skin conditions. A 2000 American Journal of Epidemiology study found that hairdressers are four times more likely to be diagnosed with a chronic lung disease known as idiopathic pulmonary fibrosis, while a 1997 Finnish Institute of Occupational Health study found that they were four times more likely to suffer from chronic bronchitis when compared with supermarket saleswomen.

In 2010, the International Agency for Research on Cancer (IARC) found that “occupational exposures as a hairdresser or barber are probably carcinogenic to humans.” That followed a 2001 study, which found that permanent hair dye was linked to an increased risk for bladder cancer in U.S. women. And from the present into the future, hair salon workers are at greater risk of miscarriage or giving birth to babies with cleft palates. They are also more at risk of dying from the three neurological conditions: Alzheimers’s disease, presenile dementia, and motor neuron disease.

But even with all the potential health effects, both clients and hair stylists are complicit in this industry because it pays off for both participants. Sometimes, it’s the only job they can get. As Charlene Obernauer, the Executive Director at NY Committee for Occupational Safety and Health, told ThinkProgress, “low-income people of color are going to take the job that they can get. When you’re looking at the service industries, you’re looking at new immigrants looking for employment opportunities. Because of the fact that they’re new immigrants, they enter into an industry that’s not the safest to work in.”

‘Society won’t want my hair to look like this.’

The risks of hair salons are exacerbated among women of color, both because of a chemical industry geared at women with “ethnic hair” and because of the importance of hair in African American culture. A forthcoming report by the advocacy group Black Women for Wellness found that African American women spend more than $9 billion on hair care, in part due to a culture “that is layered with stereotypes, personal expression and history that influences how, where, and what we style our hair with.”

Because hair styles and braids can take hours, stylists often find themselves with ergonomics problems. But the type of treatment that clients ask for can also affect a hair stylist’s health. The American Journal of Epidemiology found that the use of hair relaxers is linked to uterine fibroids, while other hair products contain estrogen-altering chemicals that could cause premature puberty in girls and can also be linked to breast cancer.

“For the black community, if we’re looking at hair relaxers, even knowing that these are linked to uterine fibroids, when it comes to culture and economics, black women are told by society that their hair has to be a certain way, and we see this especially in workplaces where they are not allowed to wear their hair in a natural state,” Teni Adewumi, the Environmental Justice Research Coordinator at Black Women for Wellness, explained to ThinkProgress. “When you talk to women, they’ll say that ‘society won’t want my hair to look like this.’ Women go to work and hear their bosses say, ‘you have braids,’ or ‘your hair is in its natural state.’ It’s that we encounter these situations where it’s uncomfortable.”

The physical manifestation of such treatments results in a wide variety of ailments. During focus group sessions held in 2014, the Black Women for Wellness reported that one participant said, “My friends 20 years in the industry, girl, my friends don’t have fingerprints anymore… my friends can’t go to the DMV and put the hand down and have fingerprints anymore.”

Other hair stylists working on various kinds of hair told ThinkProgress that they can also attest to the negative health effects that they believe could be attributed to the salon products they used. Safiyyah Edley, the owner of the Luv Mi Kinks salon in Los Angeles, CA, grew up helping in her aunt’s hair salon as a small child. She’s been in the hair salon business for more than 20 years and began operating a “natural” salon that doesn’t use chemicals, for more than a decade. “Last year, I was diagnosed with uterine fibroid tumors,” Edley said. “I was diagnosed at the same time that they told me that I had miscarried. The thing that was very striking is that I’ve been a natural hair stylist for ten years. I haven’t done major relaxer treatments in ten years, and I do deal with some coloring, but the effects last for years.”

An unnamed Korean-American hair salon owner in Seattle, WA, used hair colors, dyes, and treatments for 20 years before she went the “natural” route without chemicals five years ago. She said that she rarely, and only on special occasions, does hair straightening treatments because “the perm solutions on my clothing affects my eyes. I have no idea why I have my eye problems [and an eye hemorrhage], but I think it’s from the perm. The client’s hair is right by my eye sightline. When you do it for one or two years, you don’t see the effects, but when you do it for 30 years, it shows a lot. It’s hard to prove and I still don’t know if it’s chemicals or old age, but my eyes are so burning [sic] whenever I do a chemical treatment on the hair. … It’s a lot of ammonia right in front of our faces.”

“My fingernails are kind of crazy, it’s almost dark,” the Korean-American woman said. “It’s turning a blue-black color and a lot of doctors say that it’ll go away. But all the things we use like shampoos, all those chemicals, they foam… but it’s hard to prove.”

Rosie Espriu, a Latino-American hair salon owner based in Tucson, Arizona, has been working at a hair salon for 20 years and owned her own salon for the past 12 years. Through her son Jesus who acted as translator, Espriu said that she has bad allergies “due to the chemicals from dying the hair, bleaching the hair, so my hands tend to hurt. It’s likely that I will develop arthritis — it’s very common among people cutting hair. … every once in a while, I’ll feel numbness in the hand. I feel burning.”

‘We get to sell the product forever without reformulation.’

Under the Food, Drug, and Cosmetic Act, which hasn’t been updated since 1938, federal law doesn’t require premarket safety approval of products, nor does it require cosmetic companies to disclose the “chemicals or gain approval for the 2,000 products that go on the market every year. And removing a cosmetic from sale takes a battle in federal court,” Scientific American reported in 2012.

When the Occupational Safety and Health Administration (OSHA) issued a hazard alert in 2011 on the hair straightener treatment product known as the Brazilian Blowout, it helped to elevate the dangers of formaldehyde gas, a known carcinogen linked to nose and throat cancers, leukemia, and other respiratory problems. Stylists in Oregon and California complained to the Food and Drug Administration (FDA) over symptoms like difficulty breathing and nose bleeding, but hair straightening products that contain formaldehyde are still on the shelves and the agency cannot issue a mandatory recall.

Though the Brazilian Blowout company can’t market its product as “formaldehyde-free” after they agreed to shell out $4.5 million to settle a class-action lawsuit, the company’s chief executive Michael Brady considered the lawsuit a win because “we get to sell the product forever without reformulation. … In my eyes, that’s the acquittal we’ve been waiting for,” the New York Times reported in 2012.

Since then, the FDA has issued only a warning letter in 2011 stating that Brazilian Blowout products were mislabeled as formaldehyde-free even though they emitted formaldehyde gas.

Even now, OSHA, the agency responsible for establishing and enforcing the maximum exposure limit for chemicals, has yet to update its Permissible Exposure Limits (PELs) for chemicals used in salon products that have adverse health effects “to protect against chronic health hazards, including cancer, reproductive and developmental toxicity, and asthma,” the 2014 Women’s Voices Beauty and Its Beast report found. The current maximum formaldehyde exposure level is set at 0.75 parts formaldehyde per million parts of air (ppm) for an 8-hour work shift or the Short Term Exposure Limit (STEL) of 2 ppm during a 15-minute period, the OSHA website stated.

Jamie McConnell, Director of Programs and Policy at Women’s Voices for the Earth stated that while “OSHA has done a lot of work using whatever authority they can, like issuing hazard alerts, highlighting certain areas of concern like lack of ventilation, and done some site inspections. But there’s also a lack of enforcement and funding to do so.”

‘No one knows what are in these products.’

But much of this is, as the Korean-American hair stylist rationalized, “my own problems.” According to the Beauty and Its Beast report that looked at the beauty industry at large, “many salon workers are contractors renting booths in a salon, or mis-classifieds as contractors (when they should be classified as employees) and thus do not have many of the same benefits or rights of being an employee, such as health care, sick leave, or job security.”

It is thus sometimes up to the individual hair salon workers to decide what products their clients want them to use, and consequently to what risks they are exposed, even when they don’t have enough knowledge to make those determinations. “When I’m using certain colors, I’ve noticed some skin itchiness even when I’m covered up to my forearms,” Edley said. “I have to pay attention to the brand — one of the main ones is Wella that causes the allergic reaction. I use it because I have a lot of elderly ladies who want to cover their grays.”

Adewumi said, “There are laws on personal care products and beauty salon products, but no one knows what are in these products. In terms of being able to go into these salons and do testing, that’s really at the discretion of salon owners. The difficulty of getting OSHA or another federal agency is that … each booth can be considered an independent contractor.”

“When you look at OSHA — the agency that sets out to regulate safety and health for workers — the only way that standards can be higher is if it’s more of a public health provision,” Obernauer told ThinkProgress. “Individual cities have the power to regulate public health, but not worker safety. … No one is testing the exposure level of formaldehyde. OSHA regulates formaldehyde, but they’re not going into every hair salon. … it’s up to the salons themselves. Workers are innocent people just trying to work in a hair salon. It’s the responsibility of any business to take responsibility to follow the laws.”

On a practical level, there just aren’t enough federal agency personnel to enforce the safety and health regulations in every hair salon in the United States, so it’s generally up to the state cosmetology boards. But while regulations differ from state to state, the Beauty and Its Beast report found that the regulations are “rarely specific enough to address toxic chemical exposures in salons. For example, there are very few regulations establishing minimum ventilation requirements in salons. And often, the capacity to enforce regulations is also limited, given the large number of individual establishments.”

“By law, all the products have to be on the label,” McConnell told ThinkProgress. “The nail polish and blush need to have an ingredients list — that’s what you see on the pull-out packaging list … but [hair] salon products have a loophole where they don’t have to have the full product ingredients in their label. … We need more regulations over these products.”

Even when there are labels, they aren’t always well understood in English. As a 2009 California Healthy Nail Salon Collaborative report found, “information on chemicals in the workplace is generally not easily understood by lay people.” California law requires chemical manufacturers and distributors to provide a Material Safety Data Sheet (MSDS) for products that they produce or include a hazardous chemical. But the MSDS contains “highly technical information” and is generally only in English.

Miriam Yeung, the Executive Director at National Asian Pacific American Women’s Forum, said “there are a couple of compounding issues. One is language access: hair products are supposed to come with manufacturer descriptors, called Material Safety Data Sheet, but they only publish these sheets in English, so if you’re an immigrant worker with limited language capacity, there’s no way of knowing what’s written on the sheet.”

Despite the health effects, all three hair stylists conceded that they’re willingly putting their health at risk because they’re able to charge more to carry out the hair treatments that have longer-lasting effects.

“Some of these can cost hundreds of dollars so for hair stylists, that’s a lot of money to them,” Adewumi said, explaining that despite some hair stylists knowing of the damage that hair relaxing treatments can do, “that’s like an extra $150 into their pockets.”

Espriu has allergies that “flare out the most from the powder used to bleach hair,” but compared to charging $20 for a female haircut (or $15 for a male’s haircut), Espriu is able to charge upwards of $100 to bleach and dye hair.

“I obviously do it to survive,” Espriu said.

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