Viegas C, Coggins AM, Faria T, et al: Fungal burden exposure assessment in podiatry clinics from Ireland. Int J Environ Health Res 28: 167, 2018.
Abramson C, Wilton J: Nail dust aerosols from onychomycotic toenails: part I. Characterization of particles. JAPMA 82: 116, 1992.
Ward PE: Atopy and reaction to nail dust inhalation. Clin Podiatr Med Surg 12: 275, 1995.
Tinley PD, Eddy K, Collier P: Contaminants in human nail dust: an occupational hazard in podiatry? J Foot Ankle Res 7: 15, 2014.
Harris-Roberts J, Bowen J, Sumner J, et al: Work-related symptoms in nail salon technicians. Occup Med 61: 335, 2011.
Occupational Safety and Health Administration: Stay Healthy and Safe While Giving Manicures and Pedicures: A guide for Nail Salon Workers, US Department of Labor, Washington DC, 2012.
Park SA, Gwak S, Choi S: Assessment of occupational symptoms and chemical exposures for nail salon technicians in Daegu City, Korea. J Prev Med Public Health 47: 169, 2014.
Abramson C, Wilton J: Nail dust aerosols from onychomycotic toenails: part II. Clinical and serologic aspects. JAPMA 75: 631, 1985.
Coggins MA, Hogan VJ, Kelly M, et al: Workplace exposure to bioaerosols in podiatry clinics. Ann Occup Hyg 56: 746, 2012.
Davies RR: Human nail dust in chiropodial practice: irritant, allergen and source of antibodies to Trichophyton rubrum. J R Soc Health 104: 1, 1984.
Nowicka D, Nawrot U, Wlodarczyk K, et al: Detection of dermatophytes in human nail and skin dust produced during podiatric treatments in people without typical clinical signs of mycoses. Mycoses 59: 379, 2016.
Donaldson CL, Carline T, Brown DM, et al: Toenail dust particles: a potential inhalation hazard to podiatrists? Ann Occup Hygiene 46 (suppl): 365, 2002.
Purkiss R: An assessment of the airborne dust in podiatric treatment areas, and its relevance to the use of respiratory protective equipment. J Br Podiatr Med 52: 129, 1997.
Ackroyd R: What's the difference between a chiropodist and a podiatrist? Available at: https://21stcenturyclinic.co.uk/whats-difference-chiropodist-podiatrist/. Published March 3, 2015. Accessed March 13, 2020.
Background: Debridement of toenails is a common procedure that leads to the production of nail dust aerosols in the work environment. Previous studies indicate that inhaled nail dust can cause respiratory distress and eye irritation. This comprehensive review aimed to assess the available literature on the effect of nail dust exposure and to evaluate nail dust as a potential occupational hazard for podiatric physicians.
Methods: A comprehensive literature search was conducted via PubMed, Google Scholar, CINAHL, Cochrane Library, and ClinicalTrials.gov. Risks of bias of the collected studies were evaluated using various assessment tools to match the type of study design. A qualitative analysis of the included studies was performed, from which primary and secondary outcome measures were extracted: prevalence of symptoms and specific microorganisms in nail dust.
Results: Of 403 articles screened, eight met the inclusion criteria. The primary outcome measure resulted in a pooled prevalence of eye-related symptoms being the most consistent symptom reported (41%–48%). The secondary outcome measure resulted in a pooled prevalence of Trichophyton rubrum (9.52%–38%) and Aspergillus (11.11%–35.48%) as the most common microorganisms present in nail dust.
Conclusions: From the included eight articles, we found that nail dust is a potential occupational hazard, especially for those exposed more often. Aspergillus and T rubrum are most commonly associated with nail dust leading to development of respiratory illness. It is important to take preventive measures in podiatric medical clinics by using improved and efficient personal protective equipment for workers exposed to nail dust. Detailed health safety guidelines can be developed to decrease respiratory symptoms and diseases from nail dust exposure.