To: Dan Crowley, Principal Environmental Health Officer. From: Cora Murray, Senior Environmental Health Officer and Jenny Fortune, Environmental Health Officer

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Foot Spas

Levels of TVC

14 foot spa swabs were taken including 1 control sample. Swabs were taken of the interior surfaces and/or outlets of empty foot spas that may have been used on the day or held in storage. The result for the control sample taken was <10cfu which was deemed excellent with very low levels of micro-organisms detected. 1 foot spa had a TVC count of 360,000cfu. and it was noted that the method of cleaning this foot spa was inadequate due to a lack of a physical cleaning step prior to disinfection. 5 of the remaining foot spas matched the control sample result of <10cfu whilst the remaining 7 foot spas had TVC counts that were >10cfu ranging from 40cfu to 3,000cfu. Again the method of cleaning the foot spas varied but it can be noted from the surveys in all cases where the level of TVC was <10cfu a physical cleaning step was adopted by the salon along with a disinfection step.

Levels of Pseudomonas spp.
Out of the14 foot spas swabbed, 2 were found to have Pseudomonas present. In both cases it was noted that there had been no physical cleaning of the foot spas in conjunction with a disinfection step carried out between use on different clients. Both foot spas were only rinsed and sprayed using an antibacterial agent. In all cases where foot spas had Pseudomonas present, a follow up visit to the salons was organised to discuss the result with the Therapist. An information leaflet was given with regard to the recommended cleaning procedure of the foot spas. It should be stressed that Pseudomonas is ubiquitous and the levels found were interpreted as being more of a reflection of a lack of proper cleaning than being a source of infection. It should be noted that analysis was limited to the Pseudomonas species rather than a specific organism. There are guidelines available for the operation of spa pools and the presence of Pseudomonas aeruginosa. (Ref. No 16 “Management of Spa Pools: Controlling the Risks of Infection”, Health Protection Agency, London. March 2006). If >50 cfu/100ml the spa pool is to be taken out of operation and treated. However, it was felt that the operation of such pools and the use of a foot spa differs greatly.
Make up and Make up applicators etc.

Levels of TVC

8 swabs of make-up brushes, eyeliner applicators; lip liner applicators etc were taken including 1 control sample. The result of the control sample was <10cfu. which was deemed to be an excellent result with very low levels of micro-organisms present and 5 of the other swabs taken were comparable. 2 other samples indicated higher levels of micro-organisms with TVC counts of 282cfu and 55cfu. However, generally, the results were very good.

6 swabs or samples of make up were taken e.g. eye shadow powder, foundation lip stick etc. 5 of the samples taken were <10cfu and 1 sample of powdered eye shadow had a TVC of 80cfu. The reason samples and swabs were taken of these items was due to ‘double dipping’ of applicators whilst applying make up.
Sinks/Wash hand basins
6 swabs of sinks/wash hand basins were taken from salons including 1 control sample where a result of <10cfu TVC was found. A single sink in the WC was considered to be inadequate for the washing of tools and equipment. A swab of one such sinks had a TVC count of 464cfu. In general, the results indicated a high standard of cleanliness.
Wax taken from wax pots

4 samples of wax were taken from wax pots and all came back with TVC levels of

< 10cfu. which indicates very low levels of microorganism contamination. Although it was found that re-dipping of spatulas was being carried out in many salons, which is contrary to good practice, the 4 samples of wax taken from these pots were found to be satisfactory which may be indicative that wax may not be a suitable medium for microorganisms to grow or the temperature wax is held at is not conducive to microbial growth. “It should be noted that any viable microorganisms resident in wax would be unlikely to multiply, due to an absence of water availability or suitable nutrients” Ref. Identification of microbial contamination in body wax samples, Prepared by Health and Safety Laboratory for the Health and Safety Executive 2009, page 13.

Toe Spacers & Manicure and Pedicure tools

In the majority of salons toe spacers were not used. Therapists preferred the use of cotton wool instead. In cases where they were used the majority were disposable, however, a small number of salons re- used toe spacers, which required cleaning between clients. 2 swabs of 2 different toe spacers were taken. While both had relatively low levels of TVC present, one was found to have Staph aureus present. Both were washed in hot soapy water e.g. using fairy liquid. There was no disinfectant step applied. The swabs taken of manicure and pedicure tools indicated low levels of microrganisms present.

General Equipment used in salons

A number of swabs were taken of different pieces of equipment used in the salons as can be seen from the table above. It is interesting to note that from one swab of the interior of a UV cabinet, a TVC level of 673cfu was found, emphasising the point that UV cabinets do not sterilise and have limited disinfection properties – they are efficient in storing previously disinfected equipment. In general terms, the results indicate a standard of hygiene within salons to be very good.

The results found of TVC levels were not deemed significant. However where levels were deemed to be much higher than the norm it had been agreed to follow up on these results with the salons. It was decided that salons would be contacted in these cases to inform them of results. It was also agreed that if Pseudomonas spp. was present in any foot spa results, salons would be revisited and an information leaflet in relation to the microorganisms tested and a method of cleaning the foot spas would be given.
In conclusion 4 out of the 29 salons (14%) required a follow up visit where it was deemed that the results of analysis were unsatisfactory. Otherwise, results would indicate that the standard of hygiene were found to be very good.
5.3 Hygiene Standards Observed and Practices Reported
5.3.1. Facilities For Cleaning
The provision of a sink or basin, separate from any provided for in a toilet area, was considered essential to facilitate the proper cleaning and disinfection of tools and equipment used in the business. In some cases, a basin or sink located in a treatment room doubled up as a wash hand facility as well as a sink at which to clean tools and equipment. In addition, a means of providing a constant and instant supply of hot as well as cold water at the time of survey was required in order to be deemed adequate. In essence, if a salon has at least one sink or basin (other than one in a toilet) with hot and cold water at which to wash tools, equipment etc. which may also have been used for hand washing, the cleaning facilities were deemed to be satisfactory.
7% (N = 2) of the salons visited did not have adequate facilities for cleaning. This was evidenced in both cases by the use of a wash hand basin in a toilet cubicle as the only sink available for cleaning of tools and equipment. This is considered to be grossly inadequate. It is worth noting that during the pilot survey, 75% (N = 3) of the salons visited at that time also has inadequate facilities for cleaning for the same reason, hence, the incidence of deficient cleaning facilities may be more prevalent than the main survey indicates.
Of the 30 salons visited, 7% also did not have a suitable means of providing hot water at the sink or basin used for cleaning tools and equipment at the time of the survey. These were the same two salons that only had a basin in a toilet for cleaning purposes. In some cases, a means of providing hot water was provided but was not in operation at the time of the survey.
5.3.2. Facilities for Hand washing
Hand washing facilities were considered adequate if a wash hand basin(s) was provided in toilet areas and a basin /sink was provided in or adjacent to the working areas (see 5.3.1. above). All salons had a wash basin in toilet areas. In some salons, a wash hand basin was provided in each treatment room while in others, a basin was provided in one treatment area only. The latter was considered acceptable in circumstances such as salons operated by one person only as access to the basin was guaranteed when required. In addition, a means of providing a constant and instant supply of hot as well as cold water and soap at the time of survey was required in order to be deemed adequate
17 % (N = 5) of the salons did not have adequate hand washing facilities. This is broken down into 2 salons that had no wash hand basin other than one in a toilet area, 1 with no hot water at the wash hand basin in the toilet area, 1 with no hot water at basins in treatment rooms and 1 salon without soap at wash hand basins.
Clean cotton towels were considered adequate as a means of hand drying. However, single use paper towels are preferred to fabric reusable towels. 3 % (N= 1) of salons provided paper towels for hand drying.

5.3.3. Laundry Storage
The storage facilities for cloth items awaiting washing were assessed. Salons having laundry stored in a suitable covered container lined with a plastic bag were considered to be providing suitable facilities. This issue was not assessed in 10% of the salons visited. 66% ( N = 20) of the salons did not have suitable laundry storage. In many cases, laundry bins were not covered or lined and in some cases, a plastic bag was used. The risk posed by such means of storage is considered low.
5.3.4. Storage of Equipment
The storage of equipment was considered to be adequate if it was stored off the floor and in a manner so as to protect it from contamination. 27% (N = 8) were deemed to be storing equipment inadequately. It was found that some equipment, predominantly foot spas, was stored under treatment couches or on the floor in room corners. Again, the risk posed by such means of storage is considered low.
5.3.5. Services – Sanitary accommodation, Heating, Lighting and Ventilation

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