• 1.

    Johnson IL, Dwyer JJ, Rusen ID, et al: Survey of infection control procedures at manicure and pedicure establishments in North York. Can J Public Health 92: 134, 2001.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Stout JE, Gadkowski LB, Rath S, et al: Pedicure-associated rapidly growing mycobacterium infection: an endemic disease. Clin Infect Dis 53: 787, 2011.

  • 3.

    Winthrop KL, Abrams M, Yakrus M, et al: An outbreak of mycobacterial furunculosis associated with footbaths at a nail salon. N Engl J Med 346: 1366, 2002.

    • Crossref
    • Search Google Scholar
    • Export Citation

Do Educational Interventions Targeted to Nail Salon Workers and Customers Improve Infection Control Practices in These Salons?

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  • 1 Department of Communicable Disease, Tacoma–Pierce County Health Department, Tacoma, WA.
  • | 2 Office of Assessment, Planning, and Improvement, Tacoma–Pierce County Health Department, Tacoma, WA.
  • | 3 Business and Professional Division, Washington State Department of Licensing, Olympia, WA.
  • | 4 Pacific Podiatry Group, MultiCare Health System, Tacoma, WA.
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The Tacoma–Pierce County Department of Health, the Pierce County Antibiotic Resistance Task Force, and the Washington State Department of Licensing (DOL) designed an intervention to determine whether nail salon infection control practices could be improved by educating salon employees and their customers about good infection control practices.


Twenty intervention salons and 26 control salons completed the 3-month study. The intervention group received a letter asking them to “join our campaign to promote healthy people in healthy communities … .” Two DOL pamphlets on cleaning and disinfecting and a tent card with important infection control reminders—targeted to clients on one side and to salon workers on the other side—were also included. Outreach workers from the health department visited 25 (of the original 27) intervention salons once and talked about the materials included in the mailing. Inspection infractions were used to measure compliance with infection control practices. Each salon was inspected by the DOL at baseline, within 1 month after the educational mailing, and within 1 month after an outreach visit from the local health department.


Both groups exhibited statistically significant decreases in infractions; however, the intervention group exhibited a higher and more significant decrease in infractions than the control group.


The intervention and control groups underwent three DOL inspections, which may have resulted in a Hawthorne Effect, with both groups seeing a statistically significant decline in infractions after inspection visits. The more significant decrease in the number of infractions cited in the intervention salons may be due to the educational materials and the health education site visit they received.

Corresponding author: Lois Lux, MSN, RN, Tacoma–Pierce County Health Department, 3629 S D St, Tacoma, WA 98418. (E-mail: llux@tpchd.org)