Hepatitis C: What Are the Odds?

In spring 2002, the San Mateo County Health Services Agency in California investigated a case of acute hepatitis C in a patient whose only identified risk factor was receiving regular pedicures.

Bu t this patient’s pedicures hardly followed textbook procedures. “The [patient] reported that her foot calluses were routinely shaved with a razor-type device and that tissue around her nail beds was cut with nail nippers, sometimes causing bleeding during monthly pedicure treatments,” wrote Beth Schulz, communicable disease control officer, in the agency’s Winter 2002 Health Bulletin.

During a joint investigation, the California Bureau of Barbering and Cosmetology, Health Services, and the local district attorney confiscated several Credo blades. “In addition, no disinfectant was found on the premises [and] implements were not being disinfected,” Schulz wrote. Despite these findings — or perhaps because of them — the isolated case doesn’t budge the state’s view that salons are a low-risk setting for transmission of hepatitis, reassures Dean Peterson, director of the San Mateo County Environmental Health Department.

The Centers for Disease Control and Prevention (CDC) agrees: “Salons are not considered a risk area for infection,” emphasizes Dolly Sinha, health communications specialist. Statistics provide additional assurances: While the CDC says 79% of drug users test positive for hepatitis C, only 1.6% of the general population does.

While the salon risk may be low, cases of hepatitis C are on the rise. If unchecked, it may account for as many U .S. deaths in 2010 as did AIDS in 1996. As with any communicable disease — including the common cold — arming yourself with knowledge of the disease and its symptoms (not to mention the ways to minimize its spread) is one of the most effective preventive measures you can take.

ABCs (and Ds and Es) of Hepatitis

The spread of hepatitis causes such concern because of its potential to damage the liver, a critical organ. The liver fights infections and stops bleeding; it filters drugs and other poisons from the blood, and it stores energy reserves for times when you need it.

Hepatitis is a viral infection of the liver that inflames the liver and prevents it from functioning properly. Ultimately, viral hepatitis can result in liver failure or liver cancer.

Ac co rd ing to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health, several distinctly different viruses result in hepatitis, hence the designations of hepatitis A, B, C, D, or E. All the hepatitis viruses can cause acute, or short-term, viral hepatitis.

Hepatitis B and C particularly worry medical professionals because they can result in chronic hepatitis, a prolonged (sometimes lifelong) infection. With the 1994 introduction of a hepatitis B vaccine, most infants automatically receive the series of vaccinating shots with their other immunizations. The vaccine also is available to at-risk adults.

Researchers have yet to develop a vaccine against hepatitis C, however. The CDC estimates that more than 4.5 million Americans have hepatitis C, but 80% of them show no symptoms (which include jaundice, fatigue, abdominal pain, loss of appetite, nausea and vomiting, and joint pain) until liver damage is advanced and irreversible.

By the same token, most Americans have little risk of contracting hepatitis C, which is spread by direct blood contact, most commonly via shared drug needles, unprotected sex, and tattoos or body piercing done with unsterile tools. Also at risk are people who received blood transfusions prior to 1990 — when blood banks began to screen for the virus.

Hepatitis in the Salon: An Unlikely Scenario

Rather than waste your time screening clients for hepatitis (which anyway could be considered an invasion of privacy, not to mention offensive), invest y our energies wisely in the same practices that help to minimize the most commonly transmitted diseases in salons: colds and flu.

Perform services in a manner that does not draw blood, sanitize work surfaces between each client, and sanitize and disinfect all implements between each client. Implements that can’t be disinfected, such as orangewood sticks and some nail files, should be given to the client or thrown away. Just as importantly, sanitize other high-touch surfaces — such as door knobs, light switches, and faucet handles — throughout the day to minimize the spread of bacteria and viruses.

Just don’t go overboard, or implement extreme practices for the wrong reasons. For example, the CDC’s Sinha views sterilization of nail implements as completely unnecessary in nail salons.

Even in instances when a nicked cuticle bleeds, Sinha recommends nail techs simply avoid skin contact with the blood. Follow basic first-aid rules by immediately applying a pressure bandage to stop the bleeding, then cover the cut with a fresh, loosely wrapped bandage. Additionally, she adds that nail techs should always cover any cuts or other open wounds on their own body with a bandage to prevent accidental blood-to-blood exposure.

“Any time blood gets on an instrument, that instrument needs to be cleaned,” Sinha says. Specifically, the CDC advises handling implements exposed to blood with gloved hands to minimize your exposure, then immediately sanitizing the instrument with soap and water. Finally, the implement must be effectively disinfected before its next use. According to Sinha, the CDC routinely recommends a solution comprised of one part bleach to 10 parts water. However, she cautions nail techs that bleach can corrode some metal implements.

For that reason, industry chemist Doug Schoon, VP of science and technology for Creative Nail Design, advises nail techs to soak implements in a low-level disinfectant per the manufacturer’s directions.

But, again experts urge nail techs to take these steps not to prevent the transmission of hepatitis in salons, but to minimize clients’ and their own exposure to everyday, “inconvenient” infections like the common cold and paronychia.