薇姬·甘 黃美蕓 陳秀

When Teni Adewumi surveyed African American salon workers in Inglewood， California， she kept seeing the same health concerns over and over. Asthma. Dermatitis. Hair loss. Uterine fibroids. Miscarriage. Veteran stylists told her they experienced symptoms when they applied relaxers and other chemical hair straighteners， and they now preferred working with natural styles. But many didn’t know that the products they used could be making them sick.

Adewumi， a graduate student at the University of California， Los Angeles， Fielding School of Public Health， works to close that knowledge gap as the environmental-justice program coordinator at the California nonprofit Black Women for Wellness. In salons across Inglewood and South Los Angeles， she helps train stylists in safe products and practices. But her work is also part of a nationwide effort to make beauty salons safer for the people—mostly women—who work in them.

That starts with research. Epidemiological studies dating back to the 1980s have found that hair stylists are at risk for a range of chronic occupational-health conditions， including skin and respiratory diseases and adverse reproductive outcomes. Certain toxic chemicals found in hair glues and straighteners， such as formaldehyde， styrene， and trichloroethylene， have been linked to cancer， liver damage， and dermatitis.

“When we held focus groups with salon workers， we found these stories of lack of education on chemical exposures and chemical-related health problems，” Adewumi says. “Even though they had all gone to beauty school， there was just really no training around what these products could do to your body and to your reproductive system.”

That’s partly because there’s precious little research on the long-term health effects of salon products. Alexandra Scranton， the director of science and research at the environmental organization Women’s Voices for the Earth， explains： “The weakness in the data is being able to connect [health impacts] to specific chemicals， because those connections are almost never studied.” And so far， research has failed to account for the combination of toxic chemicals found in hair salons.

In the absence of comprehensive longitudinal data， assessing the health risks of specific products is “an art as much as a science，” Scranton says. Her organization singles out chemicals of concern by drawing on watch lists created by governmental authorities—California and Washington state have them， along with the European Union—and recommends safer alternatives where available.

The case of Brazilian Blowout offers a window into federal regulation of the beauty industry. This professional hair-smoothing product contains formaldehyde， a known carcinogen， which is released into the air when hair treated with the solution is heated with a blow dryer and flat iron.

In 2011， the Occupational Safety and Health Administration issued a hazard alert about formaldehyde exposure from Brazilian Blowout， and the FDA issued a warning letter to the company， citing the product’s health risks and misleading “Formaldehyde Free” label. But the agency had no power to recall the product， even though it had been linked to “adverse events” including eye， respiratory， and nervous-system disorders. It was only after the state of California sued the makers of Brazilian Blowout that they modified its formula， reducing but not eliminating the formaldehyde content. Without mandatory-recall authority， the federal government could do little more than send strongly worded letters.

The FDA regulates cosmetics in the U.S.， but it doesn’t approve products before they hit the shelves. It also doesn’t require manufacturers to list the ingredients of professional salon products. That means that， on the label， the word “fragrance” may stand in for hundreds of unreported chemicals. “The burden is on us as consumers or us as researchers to test these products，” Adewumi says. That’s the reverse of the regulatory protocol in Europe， where cosmetic products must undergo scientific safety assessment before they can be sold. In the U.S.， companies can ask for forgiveness rather than permission， letting potentially hazardous products slip through the cracks.

The risks are particularly severe for salon workers， who have more exposure to these chemicals than consumers do. These women are “a tough lot，” says Scranton. “They really love their jobs， they really want to continue to work their jobs， so they tend not to complain as much， even though their health is definitely suffering.” And even when salon workers do report their health problems， public-health agencies are often unwilling or unable to help. They rely on federal “permissible-exposure limits” to determine whether a workplace is hazardous. But those limits are mostly based on studies of healthy adult men working in heavy industry—and even OSHA admits that they’re “outdated and inadequate for ensuring protection of worker health.”

These regulatory gaps are inseparable from historic gender and racial inequities in clinical research. Before the 1990s， women and minorities were consistently underrepresented in clinical studies， due in part to the assumption that research on male subjects could be extrapolated to these groups.

To protect salon workers across the board， federal cosmetic regulations will need to change. Scranton and Adewumi want to see legislation that requires manufacturers to list ingredients on all beauty-product labels; bans ingredients linked to cancer， birth defects， and developmental harm; empowers the FDA to recall unsafe products; and enforces stricter salon safety standards. With the powerful chemical lobby standing in the way， advocates have their work cut out for them.

But while they grind away at national policy， environmental and women’s health organizations are making significant progress at the state and local level. California， Boston， and King County， Washington， have certification programs for safe and healthy salons. New York state， in the wake of a widely-shared Times expose， enacted emergency regulations to improve workplace conditions for nail-salon employees. Adewumi is currently working with the city of Inglewood to create a pilot healthy-hair-salon recognition program.

And she’s still in salons， talking to workers about their health. On the whole， she says， stylists have been receptive and eager to learn more about greener products and practices. “We’re definitely very aware about economics，” she says. “This is what they do for a living， they are pillars in the black community， they are really strong women in terms of starting their own businesses. We just want to talk to them， to know how they’re doing … addressing [health] issues in a holistic sense， and then bringing up the conversation around product use.”

It’s a conversation Scranton encourages women to have with their own stylists. Women’s Voices for the Earth offers a number of informational materials about toxic salon exposures and products to avoid， which can kickstart the discussion about your stylist’s safety. “We often encourage people to take those with them when they go to the salon， and to have that conversation from the point of view of ‘I’m concerned about your health，’ and not， ‘You work a toxic job，’” Scranton says. “Com[e] from that standpoint of ‘I want to make sure that you’re healthy because I appreciate the service that you’re doing.’”

泰尼·阿德烏米對(duì)加州英格爾伍德的非裔美籍美發(fā)從業(yè)人員進(jìn)行了調(diào)查，在調(diào)查期間，她屢次注意到相同的健康問題：哮喘、皮炎、脫發(fā)、子宮肌瘤、流產(chǎn)。一些資深美發(fā)師告訴她，如果她們工作中使用直發(fā)膏等化學(xué)直發(fā)產(chǎn)品，就會(huì)出現(xiàn)一些癥狀，所以現(xiàn)在她們更愿意給顧客做自然發(fā)型。但是，很多美發(fā)師并不知道她們使用的產(chǎn)品會(huì)帶來疾病。

阿德烏米畢業(yè)于美國加州大學(xué)洛杉磯分校費(fèi)爾丁公共衛(wèi)生學(xué)院，現(xiàn)為加州非營利組織“黑人女性健康”環(huán)境正義項(xiàng)目的協(xié)調(diào)員，致力于在黑人女性中普及健康知識(shí)。阿德烏米在英格爾伍德和南洛杉磯的各家發(fā)廊幫助培訓(xùn)美發(fā)師使用安全產(chǎn)品及進(jìn)行安全操作。而她的工作還屬于全國范圍內(nèi)開展的一項(xiàng)行動(dòng)，該行動(dòng)旨在為美容院工作人員（其中大多為女性）提供更安全的工作環(huán)境。

行動(dòng)始于調(diào)研。早在20世紀(jì)80年代就開始進(jìn)行的流行病研究已經(jīng)發(fā)現(xiàn)，美發(fā)師正面臨一系列慢性職業(yè)病帶來的健康問題，包括皮膚病、呼吸系統(tǒng)疾病和不良生殖結(jié)局。發(fā)膠和直發(fā)劑中發(fā)現(xiàn)的某些有毒化學(xué)物——如甲醛、苯乙烯和三氯乙烯——和癌癥、肝損傷及皮炎等疾病相關(guān)。

阿德烏米說：“我們與美發(fā)師進(jìn)行焦點(diǎn)小組討論時(shí)發(fā)現(xiàn)，他們普遍缺乏關(guān)于化學(xué)輻射和化學(xué)物質(zhì)會(huì)引起健康問題的教育。盡管他們都上過美容學(xué)校，但是學(xué)校確實(shí)沒有告訴過他們這些產(chǎn)品可能對(duì)身體和生殖系統(tǒng)造成什么影響?！?/p>

部分原因在于，針對(duì)美發(fā)產(chǎn)品對(duì)健康長期影響的研究實(shí)在少之又少。環(huán)保組織“地球女性之聲”的科研負(fù)責(zé)人亞歷山德拉·斯克蘭頓解釋說：“目前缺乏能將特定化學(xué)物和健康影響聯(lián)系起來的數(shù)據(jù)，因?yàn)閹缀鯊奈催M(jìn)行過相關(guān)研究?！睂?duì)發(fā)廊里各種有毒化學(xué)物的混合狀況，科學(xué)研究迄今還無法解釋。

由于缺少全面縱向的數(shù)據(jù)，斯克蘭頓表示，對(duì)特定產(chǎn)品的健康風(fēng)險(xiǎn)評(píng)估“是科學(xué)，也是藝術(shù)”。她所在機(jī)構(gòu)會(huì)根據(jù)政府部門發(fā)布的觀察清單挑出值得關(guān)注的化學(xué)物質(zhì)，并推薦其他可獲取、更安全的替代品。加利福尼亞、華盛頓等州以及歐盟都制作了這樣的清單。

“巴西焗油護(hù)理劑”為人們提供了一個(gè)窗口了解聯(lián)邦政府對(duì)美容業(yè)的監(jiān)管。這款專業(yè)柔發(fā)產(chǎn)品含有甲醛，一種眾所周知的致癌物質(zhì)——經(jīng)這種液劑處理的頭發(fā)在用吹風(fēng)機(jī)和直板夾加熱時(shí)，其中的甲醛會(huì)散發(fā)到空氣中。

2011年，美國職業(yè)安全與健康管理局（OSHA）發(fā)布了有關(guān)“巴西焗油護(hù)理劑”釋放甲醛的危險(xiǎn)警告。隨后美國食品與藥物管理局（FDA）對(duì)該企業(yè)發(fā)出了警告信，指出其產(chǎn)品的健康風(fēng)險(xiǎn)及“無甲醛”標(biāo)簽的誤導(dǎo)性。但是，即便該產(chǎn)品已被證實(shí)與眼睛、呼吸系統(tǒng)和神經(jīng)系統(tǒng)紊亂等“不良反應(yīng)”有關(guān)，OSHA也沒有召回有關(guān)產(chǎn)品的權(quán)力。直到加州政府起訴“巴西焗油護(hù)理劑”的制造商，他們才改進(jìn)了產(chǎn)品配方，減少而非去除其中含有的甲醛。沒有強(qiáng)制召回權(quán)，聯(lián)邦政府最多只能發(fā)發(fā)措辭強(qiáng)硬的警告信。

FDA對(duì)美國化妝品進(jìn)行監(jiān)管，但并不負(fù)責(zé)化妝品上市審批，也不要求生產(chǎn)商列明專業(yè)美發(fā)產(chǎn)品的成分。這意味著，標(biāo)簽上所寫的“香味”一詞可能代表了上百種未報(bào)告的化學(xué)物質(zhì)。阿德烏米說：“檢驗(yàn)這些產(chǎn)品的責(zé)任落在了我們消費(fèi)者或我們這些研究人員身上。”這與歐洲的管理模式相反，在歐洲，化妝品上架前必須接受科學(xué)的安全評(píng)估。在美國，企業(yè)可以事后請(qǐng)求原諒，而非事先申請(qǐng)?jiān)S可，這就使?jié)撛诘挠卸井a(chǎn)品通過這些漏洞溜進(jìn)了市場。

美發(fā)師面臨的健康損害尤其嚴(yán)重，因?yàn)樗齻兘佑|這些化學(xué)物質(zhì)的機(jī)會(huì)遠(yuǎn)高于消費(fèi)者。斯克蘭頓說，這些女性“很堅(jiān)強(qiáng)，她們真的熱愛自己的工作，真的想繼續(xù)從事這份職業(yè)，所以即使健康確實(shí)遭受損害，也往往不太抱怨”。而且，就算美發(fā)師向公共衛(wèi)生機(jī)構(gòu)報(bào)告自己的健康問題，這些機(jī)構(gòu)常常也不愿或無法提供幫助。它們是依據(jù)聯(lián)邦政府頒布的“容許接觸限值”來判定工作場所是否安全，但這些限值絕大多數(shù)是基于從事重工業(yè)的健康成年男性的研究結(jié)果，甚至連OSHA都承認(rèn)，這些數(shù)據(jù)“不合時(shí)宜，不足以確保勞動(dòng)者的健康”。

這些管理漏洞的存在與臨床研究中由來已久的性別和種族不平等是分不開的。20世紀(jì)90年代之前，臨床研究中女性和少數(shù)族裔的數(shù)量一直很少，部分原因是對(duì)男性的研究被認(rèn)為可以推及上述群體。

為了保護(hù)所有美發(fā)從業(yè)人員，有必要修改聯(lián)邦化妝品管理機(jī)制。斯克蘭頓和阿德烏米希望政府立法，要求生產(chǎn)商在所有美容產(chǎn)品標(biāo)簽上列明成分，禁止含有會(huì)引起癌癥、先天畸形和發(fā)育不良的成分，授予FDA召回不安全產(chǎn)品的權(quán)力，并且執(zhí)行更嚴(yán)格的美發(fā)店安全標(biāo)準(zhǔn)。由于化學(xué)產(chǎn)品的游說團(tuán)體阻力巨大，環(huán)保倡導(dǎo)者們?nèi)沃囟肋h(yuǎn)。

不過，環(huán)保機(jī)構(gòu)與女性健康組織雖然推動(dòng)國家政策調(diào)整進(jìn)展緩慢，但在各州和各地區(qū)的工作正取得重要進(jìn)展。安全健康美發(fā)店的認(rèn)證項(xiàng)目已經(jīng)在加州、波士頓和華盛頓金縣等地開展。《紐約時(shí)報(bào)》對(duì)相關(guān)事件的曝光引發(fā)廣泛關(guān)注后，紐約州頒布了緊急管理?xiàng)l例，改善美甲店員工的工作環(huán)境。阿德烏米目前正與英格爾伍德市政府合作，創(chuàng)建一個(gè)美發(fā)店健康認(rèn)證試點(diǎn)項(xiàng)目。

阿德烏米仍然會(huì)去美發(fā)店，和員工們談?wù)撍齻兊慕】祮栴}?？偟膩碚f，她表示，美發(fā)師們已經(jīng)接受了我們的建議，也渴望了解更多更環(huán)保的產(chǎn)品與操作。她說：“對(duì)于經(jīng)濟(jì)狀況，我們當(dāng)然非常關(guān)注。她們就是靠美發(fā)為生，是黑人社會(huì)的中流砥柱，能自主創(chuàng)業(yè)說明她們確實(shí)是很堅(jiān)強(qiáng)的女性。我們就是想和她們聊聊，想知道她們過得怎么樣……先籠統(tǒng)地問問健康問題，然后將話題引到使用的產(chǎn)品上?！?/p>

斯克蘭頓鼓勵(lì)女性顧客與自己的美發(fā)師也能進(jìn)行這樣的談話。關(guān)于應(yīng)避免的有毒化學(xué)物質(zhì)和產(chǎn)品，“地球女性之聲”可提供大量材料，顧客可用以開啟與美發(fā)師的談話，聊聊美發(fā)師的安全問題。斯克蘭頓說：“我們常常希望人們?nèi)ッ腊l(fā)店時(shí)帶著這些信息，希望她們的談話是出于‘我關(guān)心你的健康’而非‘你的工作對(duì)身體有害’。之所以聊這個(gè)是‘我想確信你身體健康，因?yàn)槲腋兄x你提供的服務(wù)’?！? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? □

（譯者單位：浙江農(nóng)林大學(xué)）