Sanitation and Cleanliness
Renu is the only “D” Spa in the northern suburbs of Chicago, and one of the few in the state of Illinois. “D” stands for disinfection and disposing of the tools used in services. Tools that are not disposable are thoroughly sanitized. We constantly update our inventory of FDA approved disinfectants. Our place is cleaned daily by a team of two housekeepers. We use environment friendly cleaning supplies. We care for our clients and our goal is to create a healthy and pleasant environment for them.
Othres versus Us
Sanitation Marsa Hepatitis C and sexually transmitted diseases spread quickly through the U.S. Would you ever expect coloration between those diseases and spa services? Yes, you can catch those diseases in most American spas, nail salons and beauty shops because typically those places ignore basic sanitation rules and put profit ahead of client safety. Have you experienced waxing as a way of hair removal? If yes, recall how it was done or watch your technician while she applies wax to your skin. In the entire country, “double dipping” which is touching your skin with the spatula and then putting the same spatula back in the wax, is illegal and dangerous. Dangerous because the spatula which touched your skin is coated with your body’s bacteria and fluids since bleeding occurs frequently during waxing; those elements are placed in the wax during repeated use of the same spatula, contaminating the wax. Wax contains water and is warm, therefore is a great breeding ground for bacteria to multiply. The bacteria’s that left the body of the client before you are now placed on your skin and since the hair is just being removed the pores are wide open to welcome dangerous diseases and bacteria. Even bacteria’s that were living on your skin but had no way to enter your body have a ball when the technician performs “double dipping” pushing them into open pores of your body. Pamela Anderson claims that she contracted Hepatitis C from her ex-husband during a tattooing session when they shared the same needle. He denies it. Hey, maybe she contracted it in a dirty spa during waxing, or a manicure or pedicure. Those services are her religion. Watch your technician when she does your nails. She completed the treatment of the client before you, now she goes to the sink, pours the water out, rinses the manicure bowl, rinses the brush, fills the bowl with clean soap and water and starts working on you. If you are lucky, she will spread a drop of sanitizer on her hands and yours, but did it work? There is no sanitizer that kills bacteria in an instant. The most effective take 15 minutes to do the job. Your dentist instructs you to change your toothbrush constantly, because they are loaded with bacteria’s. Can you imagine the “wildlife” living on the manicure brush and the walls of your manicure dish? Then pay attention to your technician’s files and buffers. How long did they scrub, rinse and spray them with sanitizer after the client they treated before you? Those are tools with pores, very difficult to eliminate the residue left on them from the previous client. Watch how your technician treats your cuticles and note that cutting them is illegal in the state of Illinois and most of the states in the country. In addition, it is illegal to use a razor blade during a pedicure. It is illegal, because the more aggressively you treat the skin, the faster it grows back. It is also dangerous because you can get cut and develop infections from dirty toes. Also, cuticles in particular, are a protective barrier making it impossible for the millions of bacteria’s living on your skin to enter your body. Furthermore, the nippers of an aggressive technician can be contaminated with the blood of the person treated before you and that blood can contaminate yours.Did you ever go to a fancy pedicure spa which offers a whirlpool pedicure? Even if they offer the pipeless whirlpool which is the safest, how certain are you that they really are pipeless and how clean and sanitized is the actual bath you soak your feet in it? Picture your own bath and shower after a week. How clean will it be if only you and your husband use it? In a busy salon, at least 10 people a day soak their feet in the same tub. Try to come to your spa a few minutes before your pedicure and watch what had happened to the tub between the last client came and the tub was filled with the water for you. I can bet you that they didn’t take time to brush, scrub, rinse, then spray with disinfectant, let it sit on walls for at least 15 minutes, then rinse it again before they filled it with water for you. Only that action would provide you with a safe environment for a pedicure. Some might tell you that they put in your water sanitizers. First of all, the most powerful sanitizers kill only 90% of the bacteria’s in water. Second of all, ask them to provide you with proof that they are FDA approved. At RENU we dispose of the tools which have pores and cannot be 100% sanitized. Those are waxing spatulas, spatulas used to distribute lotions and creams during facials, manicures and massages. We provide disposable dishes for all manicures. We also have liners in all our pedicure dishes which are disposed of after each use, therefore your water is always clean. We treat all brushes used for facials manicures or body treatments to 3 steps of sanitation. They are washed, bleached, rinsed and then distributed to the technicians who keep them in ultra-violet sanitizers. The only tools which are reused are metal implements. Each technician has at least 2 nippers, 2 metal pushers and 2 tweezers. Those are kept constantly in an FDA approved sanitizer which is made daily as required by the FDA. You can trust us on safety and cleanliness as well as being EXPERTS in all the services we provide.
HEALTH WISE
By Inga Hansen
Dangerous Waters
Protect clients and employees from the hidden risks in water-based treatments.
WATER TREATMENTS ARE AN INTEGRAL PART OF THE spa experience - they allow clients to close their eyes and relax as jets of warm water wash away the day’s stress. But careless attention to disinfection can turn these treatments from healing to hostile in a matter of days.
“Wherever there’s warm water, there’s the potential for waterborne bacteria and other organ-isms that cause disease, referred to as pathogens, to thrive,” says Matthew R. Freije, president of HC Information Resources, a water-treatment consulting company.
Equipment, when not properly maintained, is an ideal environment for tiny pathogens to hide and multiply. Once released, they have the ability to wreak havoc on clients’ skin and lungs, and inflict irreparable damage on your spa’s reputation.
It’s important to guard your spa against these dangerous bacteria by understanding which ones present a problem, what to do to avoid hazards and how to reduce risks without too much downtime.
Hidden Dangers
Pathogens take two routes to enter your spa. One is through clients’ bodies when they soak in your tubs, and the other is through water that fills the tubs. “Water comes into buildings from natural sources like lakes and rivers,” says Janet Stout, Ph.D., laboratory director at Special Pathogens Laboratory. “Certain organisms and bacteria are natural inhabitants of these bodies of water. Once inside your spa, they can find nutrients and continue to grow, particularly in warm water.”
Some of the waterborne pathogens that cause the greatest concern among healthcare professionals are mycobacteria, pseudomonas and legionella.
Mycobacterium is one of the most common bacteria. The Mayo Clinic has linked hot tub lung, a respiratory illness that causes wheezing and shortness of breath, to a strain of it. “Mycobacterium avium belongs to the same class of bacteria that causes tuberculosis,” says Edward Rosenow, M.D., a pulmonologist at Mayo Clinic. “Unlike tuberculosis, hot tub lung isn’t contagious.”
Mycobacterium fortuitum was identified as the culprit in a 2000 outbreak in Watsonville, California, where 110 pedicure clients experienced oozing sores and ulcers on their legs. The State of Colorado Department of Barber and Cosmetology Licensure changed its disinfection regulations to help prevent a similar occurrence in its state.
The Environmental Protection Agency (EPA) and the Centers for Disease Control cites that mycobacteria is a major problem in pedicure spas. A study of 30 foot baths conducted by the California Department of Health Services in Berkeley, California, in 2000 found that mycobacteria were isolated in virtually all pedicure spas surveyed,” said author Due J. Vugia, et al. “The sole exception was a foot spa that had been in service 11 days.”
“Pseudomonas is another organism commonly found in improperly treated hot tubs,” Stout says. “It can cause wound infections and a rash known as hot tub folliculitis, an infection in the skin follicles. Pseudomonas has also been associated with urinary tract infections.”
Named for its most famous outbreak among American Legion delegates in 1976, legionella is the bacterium responsible for Legionnaires’ disease, a potentially deadly illness that causes flu-like symptoms and pneumonia.
“The good news is most of us are well enough that, even if we’re exposed to these bacteria, illness doesn’t occur,” Stout says. But a weakened immune system or an unclean environment that enables significant overgrowth of bacteria can put clients at risk.
In addition to entering open wounds or hair follicles, bacteria can lead to a host of respiratory problems if inhaled. “When bubbles in the tubs burst, tiny droplets of water can enter the lungs and cause infection,” Freije says. “Clients and employees are even at risk of inhaling bacteria-laden water droplets if they stand too close to a decorative fountain that’s not kept clean.”
Reducing the Risk
Steam rooms are unlikely to cause pathogen concerns because “the bacteria can’t survive at the temperature needed to convert water to steam,” Freije says. Your primary area of concern is soaking tubs. Disinfection standards are dictated by the EPA, and state and county Departments of Health.
Bacterial -growth prevention in tubs and foot spas begins with effective cleaning and water treatment protocols based on the type of tubs your spa offers. “There are two types of equipment - fill - and - drain tubs, where water is drained after each use, and larger whirlpool spas, where water is kept in the tub for a length of time,” Freije says.
Following are some basic disinfection protocols to keep equipment safe, but be aware that your state may have more stringent requirements.
Jetted tubs require the use of biocides such as chlorine or bromine to destroy dangerous pathogens, and the chemical levels must be monitored regularly. “Depending on your state, the requirements for testing may be as often as every hour, which can be a challenge,” Stout says. “One way to make sure the appropriate amount of biocides is present is to use an automated feeding system.” These systems read the chlorine or bromine levels then inject chemicals into the water as needed.
“You’ll still need to do a manual check with a water-testing kit once or twice a day, depending on your state’s regulations,” Freije says.
Most states offer, and in some cases require, water-treatment training where owners and managers learn to perform and document water tests. It’s important, Stout cautions, to have more than one member of your staff trained in water treatment. “We had a situation where the employee responsible for water testing went on vacation, and the next person in line didn’t really understand what she was doing,” Stout says. “She diligently tested the water and recorded her results but didn’t understand what she was measuring. When we saw the logs, the bromine levels had been at zero for two weeks, which means there was no biocide in the water.”
In addition to chemical treatments, hot tubs need to be drained regularly, and the inside must be scrubbed and disinfected thoroughly before refilling. “I’d recommend completely draining and cleaning your hot tub every week or two. The frequency required varies from state to state, so contact your Department of Health to make sure you’re in compliance,” Stout says.
Drain-and-fill tubs, including hydrotherapy and foot spas, are emptied after every use, so there’s no need to use chlorine or bromine, or monitor chemical levels. However, this doesn’t mean they don’t need to be monitored. “If you’re system has circulation piping, 8 to 10 ounces of water will remain in the pipes even when you drain the tub,” Freije says. This sitting water offers an ideal environment for bacterial growth. Once the tub is refilled, the bacteria will circulate into the water and onto your clients’ skin. The EPA requires you to drain the tub, wipe away all debris, and refill with fresh water and hospital-grade disinfecting solution after every use. The solution must be circulated for a minimum of 10 minutes.
Some states, particularly those that have experienced outbreaks, have enacted more stringent requirements. Amanda Gorecki, owner of Healing Waters Med Spa (healingwatersmedspa.com) with locations in Wichita, Kansas, and Raleigh-Durham, North Carolina, uses Barbicide Plus and bleach to clean her circulation-pipe pedicure and hydrotherapy tubs, per new state regulations in Kansas. She also cleans out filters and drains weekly. "There was a bad outbreak of pseudomo-nas in our community," she says. "As a result, our regulations changed this year. We have to use more powerful disinfecting solutions, and we had to add bleach to the process."
New pipeless units feature jets that "screw onto the outside of the tub to agitate the water," Freije says, "so there's no worry about bacteria associated with circulation piping. The jets can be removed and cleaned with a bleaching solution, but there's no need to circulate the disinfecting chemicals." Some states, including Colorado, err on the side of safety and require owners to circulate disinfecting solutions even in portable or pipeless units.
Dealing with Downtime
One of the biggest challenges of new disinfection standards is determining how to integrate the protocols needed to keep everyone safe without cutting too deep into your bottom line. "We get so booked that 1
can't afford to have a station empty for 10 minutes between each client," says Roula Nassar, owner of Roula's Nail Spa (mom-consulting. com/rns_index) in Houston. "To maintain our sanitation standards without losing money, we disinfect while the client is there."
Nassar's employees are trained to drain, scrub and refill the pedicure foot spa between soaking and polishing, so the disinfecting solution can circulate while the technician polishes the client's nails. "By the time the tech is done, the station has been disinfected, and we've circulated the jets," Nassar says. "And the client has seen it all, which gives her peace of mind." With eight pedicure stations and a nine-hour workday, Nassar saves 90 minutes of downtime per station for a total of 12 hours each day by incorporating disinfection into the service.
Gorecki has designated one spa assistant to hydrotherapy tub disinfection. "We have an assistant come to the hydrotherapy room and disinfect the tub while the therapist is closing out the service and showing the client her recommended retail products," she says. By the time the therapist is done, the tub is ready for the next client. This system provides the dual benefit of reducing downtime and "allowing the therapist to spend more one-on-one time with the client," Gorecki says.
"It's crucial to maintain your water therapy equipment and treatment rooms," she adds. "You put so much money into branding your spa and building your reputation, you can destroy all that by skimping on disinfection compliance."
Inga Hansen is a Los Angeles-based freelance writer. Email her at ihansen@ socal.rr.com.
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