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



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Appendix 9.7 Treatments offered by Beauty Salons

The following gives a breakdown of the number of salons offering various treatments:




Type of Treatment

No. of Salons Offering this treatment (N=30 in total)

%

Application of make-up

29*

97%

Manicure / Pedicure

29*

97%

Skin care and eye treatments

30

100%

Body electrical treatments

1*

3%

Electrolysis

14

47%

Facial electrical treatments

9

30%

Laser

7

23%

Nail art and technology

9

30%

Body & / or head massage

29

97%

Hot stone therapy

14

47%

Waxing

30

100%

Microdermabrasion

3

10%

Platinum detox

3

10%

Ear candling

4

13%

Spray tanning

20

66%

Teeth whitening

6

20%

Teeth jewellery

1

3%

* 29 out of the 30 salons were assessed for these criteria


END


Appendix 9.8. Implementation of Report Recommendations




The above is envisaged in the following stages:

Stage 1 Survey of Beauty Salons (completed in Co. Donegal)


Stage 2 Provision of training for specific Environmental Health personnel

Stage 3 Development of a ‘Guide to Good Practice’ for hygiene within beauty salons



Stage 4 Dissemination of Information to wider Environmental Health service

Stage 5 Development of training material to contribute to the training of Beauty Therapists



Stage 6 Contribution to the Development of an Awards System in conjunction with other bodies e.g. trade, beauty industry associations.

Stage 7 Dissemination of information to the public regarding expected standards



END

Appendix 9.9 Abbreviations

BABTAC - British Association of Beauty Therapy and Cosmetology


CIBTAC - Confederation of International Beauty Therapy & Cosmetology

CIDESCO- Comite International D'esthetique et de Cosmetologie

CIEH – Chartered Institute of Environmental Health
EHOA – Environmental Health Officers’ Association

FETACFurther Education and Training Awards Council

FHT – Federation of Holistic Therapies

HABIA - Hairdressing and Beauty Industry Authority

IBPA – Irish Beauty Professionals’ Association

ITEC – Irish Training & Educational Centre

NABTET – National Agency for Beauty Therapy Education and Training

NSAI – National Standards Authority of Ireland



NVQ – National Vocational Qualifications
END

Appendix 9.10 Draft Guide to Good Practice in Beauty Salons

Environmental Health Department


County Clinic

St. Conal’s Hospital


Letterkenny

Co. Donegal
( 074) 9123759

Fax: (074) 9122592


Nov 2009

DRAFT GUIDE TO GOOD PRACTICE IN BEAUTY SALONS



EC (Cosmetic Products) Regs., 2004 - 2006

All cosmetic products sold must comply with the above Regulations (see enclosed leaflet “HSE Environmental Health – Retail Sales of Cosmetic Product” for reference)


It is advisable to keep a record of suppliers of all cosmetic products to your premises and the product batch numbers.

Recommendations Regarding Practices within the Beauty Salon


Facilities for Cleaning:


  1. Separate facilities for cleaning tools, equipment etc. should be provided in or within easy access to the treatment room(s) e.g. a sink in a hallway from which the treatment room(s) are directly accessed. A sink in a toilet area is not suitable.

  2. A means of supplying constant and instant running hot as well as cold water at each sink / whb used within the salon should be provided e.g. by means of an under-sink immersion, connection to the central hot water heating system etc.

  3. A supply of hot water should be made available at all times during which the salon is in use.


Facilities for Hand washing:


  1. A wash hand basin for washing hands as required for the treatment of clients should ideally be provided and located in each treatment room or alternatively at an easily accessible location to the treatment room(s).

  2. Each wash hand basin should be provided with a constant and instant supply of running hot and cold water.

  3. A supply of liquid soap should be available at each wash hand facility at all times.

  4. Single use paper towels are preferred to fabric reusable towels for hand-drying.



Laundry:


  1. A covered container lined with a plastic bag should be provided for the storage of cloth items awaiting washing

  2. Reusable cloth items (e.g. towels / face cloths / headbands / blankets / duvets / foot or hand mittens / gowns / couch covers / sarongs / floor rugs) should be washed at a minimum temperature of 60 ºC in the washing machine.

  3. Re-usable cloth items with direct client contact should be used on one client only before being laundered. Reusable items with indirect client contact e.g. blankets on couches covered with couch roll or similar covering should be laundered once a week or more frequently, as required.


Storage of Equipment:
1. Equipment awaiting use should be stored in a manner so as to reduce the likelihood of contamination e.g. stored up off the floor on suitable shelving or other storage.
Services - Ventilation:
1. A suitable means of ventilation should be provided in each of the treatment rooms by (a), (b) or (c) below and the toilet area(s) by (a) or (b) below:

    1. natural means e.g. an openable window or a permanent vent in an outer wall or

    2. sufficient mechanical extract ventilation ducted directly to the outer air

    3. air conditioning to which air is supplied directly from the outer air

2. Mechanical extract ventilation ducted directly to the outer air should be provided in the spray tanning area. The extract fan should be of adequate strength and located so as to remove all traces of overspray.


Policies:
Disposable Gloves:
1. Disposable gloves should be worn where there is or may be contact with mucous membranes (e.g. during intimate waxing) or blood or serum (e.g. in case of blood spotting during waxing). The use of disposable gloves is recommended for each of the following treatments:


  • waxing

  • electrolysis

  • extractions

  • application of nail extensions

  • eyebrow tweezing

  • red vein treatment

  • application of tooth jewellery

Gloves should be discarded after each client. Wearing gloves is not a replacement for washing hands.


Patch Tests:


  1. A patch test should be carried out regularly on each client when attending for the following treatments:




  • waxing

  • tinting of eye brows or eyelashes

  • eyelash perming

  • application of false eyelashes

  • application of semi-permanent make-up

  • laser and intense pulsed light treatments

  • self tanning

  • hair bleaching

  • microdermabrasion

However, carrying out a patch test on each client each time a treatment is administered is recommended. The skin may become sensitive to a particular product even after many years of use and an allergic reaction may occur.




  1. For certain treatments e.g. eyebrow / eyelash tinting, eyelash perming, hair bleaching, a patch test should be carried out a minimum of 48 hours before treatment. Guidance should be taken from the instructions provided with the product or by the manufacturer of the equipment concerned.

  2. A patch test should be carried out on each client if a different brand or type of cosmetic product is used from the previous test.


Personal Hygiene:


  1. Fingernails should be kept short, clean and without enamel

  2. Hands should be washed before and after treating a client, involving any physical contact with the client or any possible blood or body fluid exposure.


Waste Disposal:
1. Lidded bins should be provided for the storage of general waste
2. Most waste material can be disposed of as general waste and placed into the normal refuse containers. However, some treatments can produce contaminated waste including waxing, electrolysis, microdermabrasion and extractions. Any cotton wool, tissues or cloths with any blood spots or human tissue should be double-bagged prior to disposal by landfill.
3. Boxes of used needles should be stored in a ‘sharps box’ labelled as ‘contaminated’ and ‘for incineration’ prior to disposal. Sharps boxes should not be filled to the top so as to avoid accidental injury
4. Boxes of used needles should only be disposed of by collection by permitted collectors. A list of permitted collectors can be obtained from your local authority.

Cleaning of Implements / Tools:
Sterilisation is the total removal or destruction of all living microorganisms. Equipment used to cut or pierce the skin must be sterile. Sterilisation may only be performed on ‘hard’ reusable implements e.g. metal scissors, tweezers.
Disinfection is the destruction of most microorganisms. Disinfectants do not kill all bacteria but they reduce them to an acceptable level.
Cleaning is the physical process that removes dirt, dust, soil and organic matter along with a large proportion of microorganisms from an object.
1. Disinfectant solutions used to steep tools should be changed regularly in line with manufacturers’ instructions. The preparation and use of a new solution of disinfectant daily is recommended as many disinfectants deteriorate when stored or are inactivated by contaminants.
2. Re-usable tools such as sponges, make-up brushes, some manicure / pedicure tools (e.g. foot files, toe separators etc) should be adequately cleaned, by washing in warm soapy water, rinsing followed by disinfection e.g.

a) using chemicals such as ‘Barbicide’ etc. or

b) by heat e.g. boiling water / steam / hot air, as appropriate.

Thorough cleaning is essential before disinfection so as to remove all organic matter such as skin tissue, dirt etc.


3. An effective disinfectant(s) suitable for use on tools, equipment, surfaces etc within a beauty salon should be used e.g. hand-sprays, tea tree oil or similar preparations used as skin disinfectants or anti-bacterial soap for hand-washing are not suitable for disinfecting tools or equipment.
4. An adequate supply of effective disinfectant(s) suitable for use on tools, equipment, surfaces etc. within the beauty salon should be available.
Equipment for Sterilisation and Disinfection:
1. ‘Hard’, reusable implements e.g. commodone extractors, metal scissors, tweezers, cuticle knives etc. used to cut or pierce the skin should be sterilised using suitable sterilisation equipment such as a glass-bead steriliser or an autoclave. The provision of equipment for sterilising such implements between use on clients is recommended.
Traditional benchtop steam autoclaves (non- vacuum) require training in correct use and maintenance. They are considered suitable for solid instruments. A vacuum autoclave is needed for hollow instruments or tubes. It is important that a vacuum autoclave has a vacuum drying cycle incorporated. It is essential that instruments are thoroughly cleaned before they are sterilised.
2. Please note that Ultraviolet (UV) cabinets do not sterilise and have limited disinfection properties – they are efficient in storing previously disinfected equipment. UV light inactivates microorganisms on the surface that it hits and is not suitable for the disinfection of tools such as make-up brushes, sponges or items with hidden surfaces.
3. UV light cabinets require maintenance e.g. bulbs in UV cabinets have a limited lamp life and bulbs should be changed according to manufacturers’ instructions. Although it may appear that bulbs are working efficiently, their output depletes over time. The life expectancy of the bulb in your UV cabinet should be checked with your supplier.
4. A note or record should be kept of the date each time the UV bulb(s) in the UV cabinet(s) is / are replaced.
Cleaning of Equipment:
1. Foot Spas (with aeration jets / drainage pipes / circulation pipes / removable rollers):-
The following cleaning and disinfection procedure is recommended:
After each client:


  1. drain the water from the foot spa basin or bowl and remove any visible debris.

  2. clean the surfaces of the foot spa with warm water and detergent

  3. rinse with clean water and drain

  4. after cleaning, disinfect the surfaces with a suitable disinfectant for 10 minutes or the minimum contact time required on the label of the disinfectant, turning the unit on circulate the disinfectant for the entire contact time.

  5. drain and rinse with clean water


Nightly:


  1. remove the filter screen, inlet jets and all other removable parts from the basin and clean out any debris trapped behind or in them.

  2. using a brush, scrub these parts with warm water and detergent

  3. rinse the removed parts with clean water and place them back into the basin apparatus

  4. fill the basin with clean water and disinfectant, following label directions. Turn the unit on and circulate the system with the liquid for 10 minutes or follow the minimum contact time required on the label of disinfectant.

  5. after disinfection, drain, rinse and allow to air dry or dry with disposable paper towel.

For Simple Basins:




  1. drain the basin and remove any visible debris

  2. scrub the bowl with a clean brush in warm water and detergent.

  3. rinse and drain

  4. disinfect the basin surface with a suitable disinfectant, preferably by steeping (i.e. rather than spraying) in a disinfectant solution for 10 minutes or the minimum contact time required on the label of disinfectant.

  5. drain the basin, rinse with clean water and allow to air dry or dry with disposable paper towel.

2. Other Equipment:


The following relates to equipment such as UV cabinets, hot towel cabinets, trolleys, wax pots, steamers, electrical equipment (e.g. microdermabrasion machines, laser machines, body electrical equipment), hot stone massage tank, platinum detox basin, spray tanning equipment, goggles etc:
Equipment should be adequately cleaned and disinfected, by washing all surfaces in soapy water (or wiping with a clean cloth in warm soapy water) followed by rinsing in clean water and, most importantly, disinfection e.g. by chemicals such as surgical spirits.
Practices:


  1. Suitable covering e.g. couch roll, should be placed on floor areas upon which clients walk barefooted. Alternatively, disposable foot covers should be provided for use by the client.

  2. The use of single use disposable tools / items, where possible, is recommended e.g. use of cotton wool in lieu of toe separators / wooden spatulas in lieu of metal ones

  3. The use of single client tools is recommended e.g. use of single client pots, cartridges and disposable applicator heads for waxing.

  1. In all cases, in order to reduce the risk of cross infection, applicators should not be put into a cosmetic product again once it has touched the clients skin, whether using either disposable or washable applicators i.e. double dipping must be avoided. This practice relates to the application of make-up (when using either disposable applicators or washable brushes) or waxing (using a new spatula for each dip into the wax pot or using a single spatula to take wax from the pot and then allowing the wax to drop onto another spatula for application on the client - sometimes referred to as the ‘spooning method’)

  2. Creams, lotions and sprays should be dispensed from pump or spray bottles where possible. Otherwise, products must be distributed with a disposable spatula.

  3. Wax remaining in the base of a wax pot should not be decanted into a fresh pot of wax.

  4. Towels should be changed after every client


After-Care Leaflets:
After care leaflets should be provided for first time clients having availed of the following treatments:


  • Microdermabrasion (after care & home care advice)

  • Semi-permanent make-up (after care advice)

  • Ultrasound (home care advice)

  • Waxing (home care advice)

  • Electrolysis (home care advice)

  • Laser and pulsed light treatment (home care advice)

  • Artificial nail systems (after care advice)

  • Self-Tanning Treatments (after care advice)

  • Red vein removal (after care & home care advice)

  • Body electrical treatments (home care advice)

  • Spa treatments (home care advice)


Client Record Cards:
Updated records outlining the treatments given to each client together with dates, patch / sensitivity tests and any contra-indications should be kept for the following treatments:


  • electrical epilation

  • laser and pulsed light treatments

  • eye lash and eye brow tinting

  • manicure and pedicure

  • waxing

  • nail art

  • body and facial electrical treatments

  • microdermabrasion


Training:
The qualifications of and documents relating to training received by all Therapists, whether whole-time or part-time, should be available on the premises for inspection by members of the public. This could be achieved by public display within the salon or by being available in a display folder.
First Aid Kit:
A first aid box should be provided for use in the salon. The minimum contents of a first aid box is:


    • guidance leaflet

    • 20 individually wrapped, sterile adhesive dressings of various sizes

    • 2 sterile eye pads

    • 4 individually wrapped triangular badges

    • 6 safety pins

    • 6 medium sized and 2 large individually wrapped, sterile, unmedicated wound dressings, and

    • disposable gloves

    • eye washing facilities


Laser and Intense Pulsed Light Treatment:
Salons with laser and / or intense pulsed light equipment are advised to follow manufacturers’ guidelines in carrying out specific risk assessment to highlight all safety risks and to put in place any remedial works or safeguards necessary to protect staff and clients.

Medical Clinic

To practice in the Republic of Ireland, a medical practicioner must be registered with the Irish Medical Council and is given a registration number. If you currently, or propose to, offer your salon as a medical clinic, you can check the qualifications of the medical practicioner concerned with the Medical Council of Ireland based at Lynn House, Portobello Court, Lower Rathmines Rd., Dublin 6 Tel. 01 4983100;

E mail: info@mcirl.ie.

You can also access their website at www.medicalcouncil.ie with the registation number of the person involved to assist in verifying qualifications.


These are draft recommendations only that have been identified as a result of a survey in Co. Donegal. They have been compiled from various sources and do not purport to be exhaustive. The HSE does not claim any responsibility for the consequences of acting upon the recommendations or from the omission of any recommendations.
END

References

Ref 1: http://www.emaxhealth.com/57/9116.html


Ref.2 http://www.sun-sentinel.com/business/custom/consumer/sfl-0121nailsalons,0,1515810.story)

Ref 3: http://www.sutherland.nsw.gov.au/ssc/home.nsf/Web+Pages/6A7DFA8856451040CA256DB800235CC0?OpenDocument#legislation)

Ref 4:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4009463

Ref. 5: http://www.nabtetgroup.ie/index.html

Ref. 6 ‘Nail Infection - Tool Kit for Raising Awareness of the Need to Prevent Spread of Infection through Nail Bars’ accessible on the CIEH website.
Ref. 7 Beauty Treatments ‘a health risk’, Environmental Health News, 1 June 2007
Ref. 8 http://beaut.ie/blog/?p=5730
Ref. 9 http://www.beautytech.info/articles/brminghamnews02132006.pdf
Ref. 10 Winthrop, K et al “An Outbreak of Mycobacterial Furunculosis Associated with Footbaths at a Nail Salon” The New England Journal of Medicine - Volume 346:1366-1371; May 2, 2002, Number 18
Ref 11: Huijsdens et al Methicillin-resistant Staphyloccus aureus in a Beauty Salon, the Netherlands, Emerging Infectious Diseases, www.cdc.gov/eid, Vol. 14, No. 11, November 2008, pp 1797-1799
Ref 12: Bove, JP & Conrad, J Nailing the Hazards EHP 31 March 2006 pp 12-14
Ref. 13, Environmental Health News, 7 Sept 2006
Ref. 14 Beauty Bars “are health risk’’, Environmental Health News, 24 Nov., 2006
Ref. 15 Hatton, Phillip, Hygiene for Hairdressers and Beauty Therapists, 3rd Ed., (1998), Addison Wesley Longman, UK
Ref. No 16 Management of Spa Pools: Controlling the Risks of Infection, Health Protection Agency, London. March 2006
Ref 17 http://www.dow.com/productsafety
Ref. 18 http://www.jtbaker.com/msds (material safety data sheet)
Ref 19 Habia – Hygiene in Beauty Therapy – 2006
Ref. 20 Cressy, Susan, Beauty Therapy Fact File 4th Edition, Heinemann Educational Publishers, 2004, page 144/ 5
Ref. 21 White, Maeve and Melia, Paul Unregulated beauty industry a time bomb, health experts warn in The Irish Independent, 21 June 2005
Ref 22 Treacy, Dr. Patrick, Condemnation of laser deregulation in the Irish Medical Times, posted in Letters on 14 June 2008
Ref. 23: Personal communication with the Irish Medicines Board, 2009

Bibliography

Ref 24: IBPA Standard of Excellence Award criteria received in personal communication


Ref 25. Antczak, Dr. Stephen and Gina Cosmetics Unmasked – your family guide to safe cosmetics and allergy-free toiletries (2001) HarperCollins Publishers, London
Ref. 26 Dunn, P.B. Worries over safety in Nail Salons’ from http://news.eltecolote.org/news
Ref. 27 Winters, Ruth A Consumer’s Dictionary of Cosmetic Ingredients (1999) 5th Ed. Three Rivers press, New York.
Ref. 25 NSAI I.S. 380:2007 Beauty and Holistic Therapy Management of Training Centres (2007) National Standards Authority of Ireland, Glasnevin, Dublin 9, Ireland.
Ref 28 Habia, Code of Practice for Waxing January 2007
END.

Disclaimer: This report is for information purposes only. While every effort has been made to ensure that all information is accurate, the HSE or its employees do not accept any responsibility or liability for direct, incidental or consequential damages as a result of the use of this information.


For further information, contact Cora Murray or Jenny Fortune, Environmental Health Dept., HSE, Co. Clinic, Letterkenny, Co. Donegal. Tel. 00 353 (0) 74 9123759

Email: cora.murray@hse.ie or jenny.fortune@hse.ie.


Produced by: Environmental Health Department, HSE West, Co. Donegal
Issue Date: December 2009
END OF REPORT


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