Dissertations and Theses

Date of Degree


Document Type


Degree Name

Doctor of Philosophy (Ph.D.)


Environmental, Occupational, and Geospatial Health Sciences


Brian Pavilonis

Committee Members

Jean Grassman

Andrew Maroko

Meredith Manze

Subject Categories

Environmental Health | Environmental Studies | Public Health


COVID-19 transmission risk, Wells-Riley, ventilation, indoor air quality, nail salons, systematic review


Background: Currently, there are 156,000 people employed as manicurists or pedicurists in the United States. Employment in this sector is expected to grow by 10% over the next decade. Exposure assessments have revealed that salon workers are chronically exposed to a variety of substances that cause respiratory sensitization, developmental problems, contact dermatitis, blood, liver, and kidney issues, as well as nervous system impacts. Most recently, the SARS-Cov-2 pandemic has raised the issue of the vulnerability of nail salon workers to airborne infectious diseases as well. This dissertation aims to characterize and assess the chemical exposures that nail salon workers face and the transmission potential of the highly infectious SARS-Cov-2 in nail salons in New York City.

Methods: The first study in this dissertation is a systematic review of the literature to characterize airborne chemical exposures in nail salons in the United States using the Office for Health Assessment and Translation (OHAT) framework. The systematic review included studies that conducted environmental monitoring and those that explored health effects related to occupational exposure in nail salons. The second aim involved environmental monitoring in 12 nail salons in New York City to measure pollutant concentrations and estimate ventilation rates using carbon dioxide concentrations as a proxy measurement. Aim 3 focused on modeling the transmission potential of SARS-Cov-2 in nail salons in New York City using five realistic scenarios. The nail salons that participated in aims 2 and 3 were chosen using convenience sampling.

Results: In the first study, the evidence in the included studies showed that nail salon workers are exposed to a variety of volatile organic compounds (VOCs) and particulate matter. Generally, the concentrations for most chemicals have declined over the past 30 years. Few studies investigated health outcomes and found that nail salon workers often experience acute symptoms such as headaches and dizziness, coughing, nausea, and irritation of mucosal membranes. Chronic symptoms included nervous system damage. In the second study, we found that most (XX%) New York City nail salons tested were not in compliance with New York State regulations to have exhaust ventilation systems installed. Toluene, methyl methacrylate (MMA), and ethyl acetate were detected in salons but only a quarter of samples of toluene and MMA were above the limit of detection (LOD). In salons that did have general exhaust ventilation, indoor pollutant concentrations were lower. We also found that carbon dioxide (CO2) concentrations were a significant good predictor of indoor air quality in the nail salons. In study 3, we found the risk of SARS-CoV-2 airborne infection transmission across all salons and all exposure scenarios when not wearing face masks ranged from

Conclusions: These studies highlight some of the indoor air pollution hazards that nail salon workers face. Exposure to low concentrations of chemicals can cause acute symptoms, but repeated long-term exposures may cause lasting health problems and should be explored further. Additionally, the synergistic or additive effects of low-level exposures is unknown. There is a need for more epidemiological studies to explore the associations between exposure to nail salon products and specific health outcomes. Reducing exposures to vapors, particulates, and pathogens requires installing or improving ventilation systems, using personal protective equipment (PPE) such as gloves and appropriate masks/respirators and, eliminating products with harmful chemicals. The results of aims 2 and 3 showed that salons with appropriate ventilation rates had lower levels of airborne chemicals and a lower risk of transmissions of SARS-CoV-2 infectious particles. These measures will serve to benefit both workers and patrons of nail salons.



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