Adverse birth outcomes and maternal complications in licensed cosmetologists and manicurists in California

Int Arch Occup Environ Health. 2015 Oct;88(7):823-33. doi: 10.1007/s00420-014-1011-0. Epub 2014 Dec 14.


Purpose: Due to concerns around occupational chemical exposures, this study sought to examine whether women working as cosmetologists (providing hair and nail care services) and manicurists (providing only nail care services) have an elevated risk for adverse pregnancy outcomes.

Methods: In this population-based retrospective study of cosmetologists and manicurists in California, we linked cosmetology licensee and birth registry files to identify births during 1996-2009. We compared outcomes among cosmetologists and manicurists to those of the general female population and to women from other industries. We also conducted restricted analyses for Vietnamese women, who comprise a significant proportion of the workforce.

Results: There was little evidence of increased risk for adverse birth outcomes, but we observed an association for small for gestational age (SGA) among Vietnamese manicurists (OR 1.39; 95 % CI 1.08-1.78) and cosmetologists (OR 1.40; 95 % CI 1.08-1.83) when compared to other working women. Some maternal complications were observed, notably an increased risk for gestational diabetes (OR 1.28; 95 % CI 1.10-1.50 for manicurists; OR 1.19; 95 % CI 1.07-1.33 for cosmetologists) compared with the general population, which further elevated when restricted to Vietnamese workers (OR 1.59; 95 % CI 1.20-2.11 for manicurists; OR 1.49; 95 % CI 1.04-2.11 for cosmetologists). Additionally, we observed an association for placentia previa among manicurists (OR 1.46; 95 % CI 1.08-1.97) and cosmetologists (OR 1.22; 95 % CI 1.02-1.46) compared with the general population.

Conclusions: Women in the nail and hair care industry may be potentially at increased risk for some maternal complications, although further research is warranted. Vietnamese workers may also have increased risk for SGA.

Keywords: Birth outcomes; Cosmetologists; Manicurists; Occupation; Women’s health.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Asian Continental Ancestry Group / statistics & numerical data
  • Beauty Culture / methods
  • Beauty Culture / statistics & numerical data*
  • California / epidemiology
  • Diabetes, Gestational / chemically induced
  • Diabetes, Gestational / epidemiology
  • Female
  • Humans
  • Infant, Newborn
  • Infant, Small for Gestational Age
  • Occupational Diseases / chemically induced
  • Occupational Diseases / epidemiology*
  • Occupational Exposure / adverse effects*
  • Placenta Previa / chemically induced
  • Placenta Previa / epidemiology
  • Pregnancy
  • Pregnancy Complications / chemically induced
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome*
  • Retrospective Studies
  • Risk Factors
  • Young Adult