Chemicals commonly found in nail polish and related products are linked to cancer and other health risks.

Thu Quach and Alisha Tran are of different generations and educational backgrounds, but they are well-matched research partners.

Quach, 35, has a doctorate in epidemiology from UC Berkeley and is a researcher on the rise. Tran, at 59, is a relative rookie in the health care field whose wisdom comes from some long, tough years in a job that made her sick.

The two women joined forces to study the potential hazards of the nail salon industry where the workers — the majority of whom are Vietnamese women — are overly exposed to chemicals in the polish and products that they breathe and touch.

"Nail salon workers routinely handle products containing many potentially harmful compounds, some of which are carcinogens or have endocrine disrupting effects, yet are virtually unregulated," said Quach, a research scientist at the Cancer Prevention Institute of California in Fremont. "Many of these women work in small shops with poor ventilation for up to 12 hours a day."

Quach heads an ongoing study, funded by the UC-administered California Breast Cancer Research Program to understand possible links between Vietnamese nail salon workers' exposure to chemicals and health risks, including breast cancer.

Created by the state Legislature in 1993, the UC-based program is the largest state-funded breast cancer research program in the nation. It is funded through the voluntary tax check-off program on California income tax form 540, a portion of the state tobacco tax and individual contributions. The program awards grants to jump-start new areas of investigation to push the boundaries of research.

"Our goal is to focus on closing the critical gaps in the breast cancer research field," said Mhel Kavanaugh-Lynch, the program's director. "One way we've accomplished this is by making sure that our research is guided by the knowledge and experience of the people who deal with breast cancer firsthand. We provide opportunities for community members and researchers to partner together to answer their urgent questions in a scientifically rigorous way."

Chemicals linked to cancer

A major concern for the research program are the commonplace chemicals — in everything from pesticides to cosmetics — that may damage breast cells, particularly in young women. A widespread misunderstanding is that only women who have cancer in their family tree are at risk. Quach's research is one of many projects the program funds that are looking at environmental causes of breast cancer and why some ethnic groups are more affected by the disease.

Cancer researcher Thu Quach (left) and health advocate Alisha Tran work in tandem on studying environmental risks faced by nail salon workers.

The true burden of environmentally-induced breast cancer is grossly underestimated. Some 80,000 chemicals on the market in the United States are largely unregulated and understudied for safety, and more than 74 billion pounds of chemical products are produced or imported into the country each day, said Megan Schwarzman, research scientist at the Center for Occupational and Environmental Health in UC Berkeley's School of Public Health. Schwarzman spoke at a recent statewide symposium sponsored by the UC research program.

For Quach, the research is personal. Her mother, an immigrant from Vietnam, worked as a cosmetologist for more than 15 years. She remembers her mother's complaints of skin irritation and headaches, which she believes were clearly rooted to her work. When her mother died of leukemia in 2005, Quach decided to devote her career to research. And while she was a doctoral student at UC Berkeley, she began focusing on the health and safety of nail salon workers.

That industry is one of the fastest-growing in the United States, with more than 300,000 licensed nail salon workers in California alone. Almost all these workers are women, and an estimated 60 to 80 percent are immigrants from Vietnam.

"Worries about chemicals in the nail products were at first driven by consumer concerns, but no one was looking at the workers" said Quach. "When you walk into one of these salons you can smell it and know that being around the chemicals for so long can't be healthy."

Among the toxic chemicals commonly found in nail salons are formaldehyde — a classified carcinogen — toluene and dibutyl phthalate, which have been linked to miscarriages and birth defects. More than half of the women who work in nail salons are of childbearing age, said Quach.

Recruiting research subjects

Quach and co-researchers at the Cancer Prevention Institute of California designed a series of studies to learn the effects of the chemicals on nail salon workers, but she needed a good number of willing research subjects. She approached the Asian Health Services, a community health center in Oakland, where she met her eventual research partner, Alisha Tran.

Tran, a health advocate in the Vietnamese community, had worked in the nail salon industry for 16 years, owning four different shops in the East Bay. Tran, a Vietnamese refugee who came to the United States in 1981, became a manicurist because it was quick and easy to obtain a license, and she needed to help support a family with three children. But while business was good, her health was not. "Two times, I got dizzy and my face became numb," said Tran. "It was so bad that they had to call an ambulance to take me from work to the emergency room."

Two weeks after the second emergency, she quit the manicuring business. After a few other jobs and after her husband died of heart disease in 2006, Tran found a job with Asian Health Services. She works in the Vietnamese community educating people about the importance of preventive health care.

For the breast cancer research project, Tran had the task of convincing wary and suspicious nail salon workers to participate in Quach's studies. One project called for workers to wear a small air monitor badge to measure their exposure to benzene and toluene, two chemicals associated with cancer, and total hydrocarbons, which reflect a mix of other solvents.

Tran was able to recruit 80 Vietnamese salon workers from 20 salons throughout the East Bay. As a former nail salon owner and worker, Tran was able to break down language and cultural barriers and help Quach gather valuable research data.

"Many of the workers are really happy they are part of this research," said Tran. "They want to follow its progress. They know that something's going on and it's not all healthy. But they can't afford to quit their jobs."

It will take a long time to find or prove any connection between the chemicals and cancer, said Quach. In the meantime, researchers have observed health complaints such as headaches, respiratory problems and skin irritation. More important, they are able to pass on suggestions to workers, such as wearing gloves and masks, opening windows to increase ventilation and keeping nail polish bottles closed when not in use.

"If not for Alisha and her charisma, we couldn't do this research and involve so many people in the community," said Quach, who hopes that her studies will lead to policies that will protect nail salon workers from harmful chemicals.

Andy Evangelista is the research coordinator for the UC Office of the President Strategic Communications Department.  For more news, visit the UC Newsroom or follow us on Twitter.