Be Spa Safe Your guide to PROTECTING yourself at the spa

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Be Spa Safe Your guide to PROTECTING yourself at the spa Spa health risks What you need to know Tips to reduce your risk of infection Does your SPA pass the test? Know what to look for with six easy checklists www.ahs.ca/eph

Spa health risks: What you need to know Many of us go to the spa* to relax and get pampered. Most spas work hard to make sure their clients enjoy a safe service. However, there are many ways that serious infections can be spread at the spa if proper steps to prevent infections are not taken. These infections include Mycobacterium, Pseudomonas, Hepatitis B, Hepatitis C, and skin and nail fungus. Some of these infections can be very difficult to treat. About this guide The Be Spa Safe guide was developed to explain how infections can spread during spa services and what you can do to reduce your risk. It reviews Alberta Health Services role to inspect spas and explains how you can choose spa services wisely. It also includes six easy checklists of things to look for before you receive a manicure, pedicure, facial, waxing, hairstyling or ear piercing. Be sure to review the checklists before your next visit to the spa. *In this guide, the term spa includes businesses that offer services such as manicures, pedicures, waxing, facials, ear piercing, make-up and hair and barbering services. 2018 Alberta Health Services Safe Healthy Environments Adapted with the permission of York Region Community and Health Services. This copyright work is licensed under the Creative Commons Attribution-Noncommercial- NoDerivative 4.0 International. You are free to copy and distribute the work including in other media and formats for non-commercial purposes, as long as you attribute the work to Alberta Health Services Safe Healthy Environments do not adapt the work and abide by the other license terms. To view a copy of this license, see: https://creativecommons.org/licenses/bync-nd/4.0/. The license does not apply to content for which the Alberta Health Services Safe Healthy Environments is not the copyright owner.

What you need to know about... The spa industry pas in Alberta have been regulated to meet minimum health S standards for over 90 years. Spa owners and operators are required to comply with the Alberta Personal Services Regulation. As an educated consumer, you can also play an important role in ensuring that your health and safety is protected. Alberta Health Services role In Alberta, Alberta health Services Environmental Public Health Team can inspect spas to: Ensure compliance with Alberta s Personal Services Regulation, which will reduce the risk of infection, cuts, scalding, or chemical burns. In this role, the team may educate and support operators in offering safe spa services, and can also take enforcement action Investigate client concerns and complaints Roles of other agencies Other government agencies also regulate aspects of the spa industry. For instance, Health Canada regulates consumer product safety, such as cosmetics and labelling. Disinfectants that are approved for use in Canada, will have a Drug Identification Number assigned by Health Canada. pas may operate out of private homes, mobile vehicles, or at S festivals and events. These spas must also comply with Alberta s Personal Services Regulation.

! What you need to know about... How infections can spread Spas serve many clients every day, some of whom carry germs into the spa. Germs that cause infections can be spread when an infected client s skin, blood or body fluid comes into contact with a spa worker s hands, tools or work surfaces during service. If a spa worker does not practice proper hand hygiene, and if tools and work surfaces are not properly cleaned and disinfected after each client, germs that cause infection can spread. Germs spread by touching: the client s skin directly a cut, tear or open wound on the client s skin When to avoid spa services Your skin is your first defence against infection. When it is broken, irritated or infected, your risk of getting an infection increases. For this reason, we recommend that you avoid getting a spa service on the parts of your body where you have: a cut, tear or open wound a rash or skin infection irritated or severely dry, chapped skin Avoid getting a pedicure if you have just shaved your legs within the last 24 hours. Spa tools Not all spa tools should be treated the same way. Some tools are to be used on one client only and then thrown away. This is because these tools cannot be properly cleaned and disinfected after each use. Other tools can be used more than once, but must be cleaned and disinfected between each client. Review the checklists in this guide to see which tools need to be thrown away and which can be re-used. Cleaning and disinfection Proper cleaning and disinfection is important to kill germs that cause infections. For tools and work surfaces to be properly cleaned and disinfected, they must first be cleaned with water and detergent to remove dirt and debris. Next, they must be treated with a chemical solution called a disinfectant to kill germs. If you see a disinfectant at a work station, such as Barbicide, be aware that the operator must thoroughly clean tools before the tools are disinfected. Tools that may break the skin and come into contact with blood or body fluids must be treated with a high level disinfectant or be sterilized.

Five steps to protect yourself! Look around and see how tools and work spaces are cleaned and disinfected. Don t be afraid to refuse services or report a complaint. 1. Ask for a recent inspection report Ask the operator if they have a copy of their most recent inspection report. Call your AHS Environmental Public Health office if you have any concerns or questions about the latest inspection report. 2. Know what to look for Read the Be Spa Safe checklists before you book or receive a spa service. They list what you should look for at the spa to reduce your risk of infection. 3. Look around and ask questions While at the spa, take time to observe spa practices and ask the staff any questions you may have. You can do this when you go to make an in-person appointment, while you wait for your service and even during the service itself. This can also help to build trust with your spa, making your experience more enjoyable. 4. Make an informed decision If you are uncomfortable with what you see or what you hear, don t be afraid to refuse the service. If you are unsure about the conditions, ask the operator questions about their cleaning and hand hygiene practices. You have the right to make sure you receive a safe service that is given with clean equipment and clean hands. Proper hand washing means scrubbing all parts of the hands with soap for 20 seconds before rinsing, and drying with a disposable towel. It is sometimes acceptable to use hand sanitizer on visibly clean hands. However, hand sanitizer does not replace proper hand washing after using the toilet or after handling blood-contaminated items. 5. Report concerns or complaints You can help to prevent the spread of serious infections at the spa. If you are concerned about a spa s cleaning and disinfection practices, you can contact Alberta Health Services at the numbers at the back of this booklet. Alberta Health Services public health inspectors will investigate. All concerns and complaints are kept confidential.

Be Spa Safe Checklist General Checklist for ALL Spa Services Tools and supplies are stored in a clean area (for example: in covered containers) All Services The spa operates in a location inspected by Alberta Health Services All work areas are well lit, clean and organized Tools, work surfaces and equipment are in good repair (for example: no rust, cracks, etc.) Tools, equipment and surfaces are cleaned and disinfected between each client Single-use items are thrown away between each client No double dipping! Creams and lotions are used in a way that does not contaminate the original product (for example: use a pump, no fingers in jars) Clean sheets, towels, robes etc. are used for each client. Paper liners are thrown out after each use Spa workers practice proper hand hygiene before and after each client The checklists that follow outline more things to look for before and during specific spa services.!remember Serious infections can be spread during service if these safety practices are not followed.

Be Spa Safe Checklist for Manicure, Pedicure and Nail Treatment Services The spa worker practices proper hand hygiene before and after each service The client s hands and feet are washed prior to receiving the service The client s nails are checked for signs of nail mould/ fungus. If found, service is refused These items are used on one client only, then thrown away: Emery boards These items are cleaned and disinfected between each client: Nail clippers Non-wood Foot paddles Nippers Acrylic nail brushes Metal nail drill bits Glass and diamond nail files Nails Wooden cuticle pushers Sanding bands Nail buffers Pedicure razor blades Pumice stones Hand baths Foot baths!foam slippers Don t be afraid to ask for new ones before your service REMEMBER Foam toe separators Serious infections can be spread during Don t be afraid to ask if and how these items are cleaned and disinfected before your service service if these safety practices are not followed.

Be Spa Safe Checklist for Waxing Services The spa worker practices proper hand hygiene before and after service The client s skin is checked for open cuts or wounds and signs of infection. If found, service is refused The spa worker wears disposable gloves on both hands during service Pots of wax The temperature of heated wax is not hot enough to kill germs on the skin. Applicators (e.g., wooden sticks) used for waxing that touch the skin should never be dipped back into the original pot of wax. No double dipping! Roll-on wax When wax is rolled directly onto the skin, germs from the skin can contaminate the wax left over in the cartridge. In this case, a new wax cartridge must be used between each client to prevent the spread of germs. Waxing These items are used on one client only, then thrown away: These items are cleaned and disinfected between each client: Cotton pads to apply cream and lotion Roll-on wax Tweezers Scissors Wooden applicators Cloth waxing strips Eyebrow brushes Contact with blood and body fluid is common during waxing service. It is important that your spa worker wears gloves. Don t be afraid to ask for new ones before your service Don t be afraid to ask if and how these items are cleaned and disinfected before your service!remember Serious infections can be spread during service if these safety practices are not followed.

Be Spa Safe Checklist for Make-up and Facial Services The spa worker practices proper hand hygiene before and after service The client s skin is checked for open cuts or wounds and signs of infection. If found, service is refused The spa worker wears disposable gloves on both hands during removal of pimples, black heads and in grown hair Water in the facial steamer is changed daily These items are used on one client only, then thrown away: Wooden applicators Face pads Applicator brush Tweezers These items are cleaned and disinfected or sterilized between each client: Glass tubes Bowls Spatulas Brushes Contact with blood and body fluid is common during facial service. It is important that your spa worker wears gloves. Double-loop comodone extractors Facial Needles and lancets for extractions* *Needles and lancets used for extractions must be sterile for safe use, because they break the skin. Sponges!Don t be afraid to ask for new ones before your service REMEMBER Serious infections can be spread during Don t be afraid to ask if and how these items are cleaned and disinfected before your service service if these safety practices are not followed.

Be Spa Safe Checklist for Barbering and Hairstyling Services These items are cleaned and disinfected between each client: Hairdressing Foil strips The spa worker practices proper hand hygiene before and after service Capes and gowns are clean New neck strips or clean towels are used on each client These items are used on one client only, then thrown away: Disposable razor blades Scissors Electric razors Combs and brushes Straight blade razor handle Clippers Crochet hooks Single-use razor blades Single-use razors and blades are thrown away immediately after each use.!don t be afraid to ask for new ones before your service REMEMBER Serious infections can be spread during Cap Don t be afraid to ask if and how these items are cleaned and disinfected before your service service if these safety practices are not followed.

Be Spa Safe Checklist for Ear Piercing Services These items are cleaned and disinfected or sterilized between clients: Ear Piercing The spa worker practices proper hand hygiene before and after service The spa worker wears disposable gloves on both hands during service The client s ear lobes are cleaned with a skin antiseptic Jewelry is pre-packaged and sterile, and is opened in front of the client The client is given verbal and written aftercare instructions These items are used on one client only, then thrown away: Disposable cartridges with sterile jewelry Disposable adaptors with sterile jewelry Ear piercing equipment Ear piercing guns should only be used to pierce the ear lobe. They should not be used to pierce other areas of the body because this may cause tissue damage and increase your risk of infection. Hand clasp device Contact with blood and body fluid is common during ear piercing services. It is important that your spa worker wears gloves.!don t be afraid to ask for new ones before your service REMEMBER Serious infections can be spread during Don t be afraid to ask if and how these items are cleaned and disinfected before your service service if these safety practices are not followed.

Be Spa Safe. For more information or to report a concern or complaint please contact your nearest Environmental Public Health office. Edmonton 780-735-1800 Calgary 403-943-2288 Lethbridge 403-388-6689 Grande Prairie 780-513-7517 Red Deer 1-877-360-6366 www.ahs.ca/eph This material is intended for general information only and is provided on an as is, where is basis. Although reasonable efforts were made to confirm the accuracy of the information, Alberta Health Services Safe Healthy Environments does not make any representation or warranty, express, implied or statutory, as to the accuracy, reliability, completeness, applicability or fitness for a particular purpose of such information. This material is not a substitute for the advice of a qualified health professional. Alberta Health Services Safe Healthy Environments expressly disclaims all liability for the use of these materials, and for any claims, actions, demands or suits arising from such use. CC BY-NC-SA-4.0 2018 Alberta Health Services Safe Healthy Environments PUB-0001-201804