The New York Times Says Working in Nail Salons Causes Cancer and Miscarriages. The Evidence Says Otherwise. (Part 3)

The final in a three-part series on how Sarah Maslin Nir's investigative series violated the standards of responsible journalism.

New York Times reporter Sarah Maslin Nir's provocatively titled May 12 article, "Perfect Nails, Poisoned Workers," opens at a salon in Ridgewood, Queens. One manicurist has had a miscarriage, readers are told, and another has had five. A third woman has a disabled child.

Reproductive problems are only part of Nir's story. Later in the piece, we meet nail salon workers suffering from sarcoidosis, thyroid problems, and breast cancer.

The clear implication from all of this is that working with nail polish and other substances common in salons caused these problems.

The available evidence, however, strongly suggests the opposite of what Nir's story implies. Rather than dispassionately examining and presenting what we know on the subject, Nir commits the cardinal sin of science journalism: recounting alarmist anecdotes and suggesting that they are indicators of trends that aren't backed up by research.

About halfway through, careful readers will catch a grudging admission: A study looking for higher rates of cancer among nail technicians "found no correlation." The study, which was published in the American Journal of Epidemiology in 2010, "Cancer Incidence in Female Cosmetologists and Manicurists in California, 1988-2005," considered 9,044 cancer cases out of 325,228 licensed workers.

It actually found that manicurists were less likely to get cancer than members of the general population.

"Perfect Nails, Poisoned Workers" was the second in a two-part series in the Times all about the nail salon industry. Over the past several weeks, I've been re-reporting aspects of Nir's coverage, and have found errors, misquotes, and broad misconceptions about the industry. This article is the final installment in my own three-part series scrutinizing the Times' reporting on this topic. (Click here to read the first installment, and here to read the second.)

The implication that chemicals in nail salons cause cancer is just one of many journalistic transgressions Nir committed. She also doesn't mention another study that looked at higher rates of "adverse birth outcomes and maternal complications" in cosmetologists and manicurists. It found no correlation. (The study received $131,248 in NIH funding.)

A different 2009 study published in the American Journal of Perinatology looked at the prevalence of conditions like postpartum hemorrhage and newborn intubation among cosmetologists. It also found a rate similar to that of the general population.

That doesn't mean that there aren't plenty of nail salon workers who have had multiple miscarriages or complicated pregnancies. There are about 79,000 manicurists in the U.S., according to the Bureau of Labor Statistics, and the profession skews heavily female. By some estimates, 15 percent of all pregnancies end in a miscarriage, so there are likely thousands of manicurists who have miscarriages every year—plenty of good anecdotal subjects for Nir's brand of journalism.

The "Toxic Trio"

Nir also spends several paragraphs discussing the dangers of three chemicals found in nail products, noting that worker advocates call them "the toxic trio": dibutyl phthalate, toluene, and formaldehyde.

The first problem here is that two out of three of those chemicals aren't in nail products anymore. The second problem is that all three were only ever present in such a low concentration that they were never harmful in the first place.

Though dibutyl phthalate isn't used in nail polish anymore, it never had any negative health consequences on manicurists or their clients. Dibutyl phthalate has been shown to cause fertility problems in lab rodents in high doses, but as an EPA fact sheet makes clear, "[n]o studies are available regarding the reproductive or developmental effects of dibutyl phthalate in humans from inhalation or oral exposure."

The initial concerns by regulators over dibutyl phthalate had to do with its use in spray paint, according to Doug Schoon, a chemist and the co-chair of the Professional Beauty Association's Nail Manufacturers Council on Safety.

"Phthalates aren't very volatile, so they don't easily evaporate," says Schoon. "Car spray paints are mists, so they can be inhaled, and the differences are enormous."

Toluene also isn't used in nail polish anymore because of scare stories. "When you pump gas once, you expose yourself to more toluene than you would if you sat in a room for the rest of your life filled with open nail polish bottles that contain the substance," says David Steinberg of the consulting firm Steinberg & Associates. (Steinberg is also a retired chemistry professor at Fairleigh Dickinson's graduate school, where he created the Master's program in cosmetic science, and has 45 years of experience in the industry.)

Formaldehyde is present at about 1,000 to 2,000 parts per million in nail hardener, says Steinberg. But the instant the hardener touches the nail the formaldehyde is no longer present.

There are, however, trace amounts of formaldehyde present in nail polish. Nir stokes fear over this fact, noting, "some of the chemicals found in nail polish are known to cause cancer." That's technically true, but it's misleading. There are carcinogenic chemicals all around us; it's the dose that matters. Formaldehyde is also present in every cell in our bodies and in our breath every time we exhale.

"If you tested many of the USDA's organic vegetables," says Schoon, "you would find higher concentrations of formaldehyde than is present in nail polish in a salon."

Formaldehyde causes one form of rare nasal cancer, and when it happens, it's because people are exposed to "levels of formaldehyde hundreds or thousands of times higher than you'd ever be exposed to from using nail polish," says Schoon. "To my knowledge, nobody has ever gotten cancer from nail polish."

Nir interviewed Schoon on two occasions for a total of two hours. She included a two-sentence quote from him in her coverage, which he says was included out of context. After the article appeared, Schoon sent Nir a blistering email complaining that she ignored everything he had told her. She didn't respond.

After spending multiple paragraphs on the dangers of the "toxic trio," Nir offers a vague disclaimer: "In recent years, in the face of growing health concerns, some polish companies have said that they have removed certain controversial chemicals from their products." She continues: "But random testing of some of these products by government agencies showed the chemicals were still present."

This vague sentence is meant to dramatize a single embarrassing episode for the industry. In 2012, California's Department of Toxic Substances Control (DTSC) took a random sample of 25 products off the shelves of Bay Area stores. They found that many products that claimed to be free of toluene and dibutyl phthalate weren't.

According to Schoon, the majority of the products tested by the DTSC were made by independent manufacturers—not the "major players" that dominate the industry and have much more to lose. Most had simply neglected to wash toluene and dibutyl phthalate completely out of their manufacturing chains, says Schoon. But the DTSC study did expose a few bad actors purposely mislabeling their products.

There's no basis for Nir's implication that dibutyl phthalate and toluene are still omnipresent in nail products. And it was never a health issue since both substances are safe. Rather, Schoon says, it was "a problem with misleading advertising."

Scientists like Schoon and Steinberg have spent their careers trying to refute the sort of unsubstantiated claims that Nir gives credence to. Because of all the attention it drew, Nir's reporting in the Times was a setback to their efforts.

There are some valid health concerns related to nail salons, but they're fairly banal. "There's no dust that's good to breathe large amounts for long periods of time," says Schoon, referring to the tiny particles that can get into the air when nails are filed. "Out of an abundance of caution, manicurists should wear a mask," he says.

In other words, health safety in nail salons isn't the kind of topic journalists can expect to earn Pulitzers covering. As long as they get the story right.

And that's the big takeaway from the Times' nail salon series.

Nir's story was too good to be true. Could it really be that you can "[s]tep into the prim confines of almost any salon and workers paid astonishingly low wages can be readily found?" Or that a public health crisis in nail salons is happening right under our noses—to the point that if you go down the line in one shop, worker to worker, you'll see the effects? Is it also possible that nail polish industry executives could be so cunning and immoral as to keep this public health crisis under wraps—an evil conspiracy just waiting to be uncovered by an enterprising young reporter?

Stories like that happen in movies and fairytales, but rarely in the real world. Reporters who think they've come across such a one-sided story should look harder at the evidence. And when they come across something that "at first glance appear[s] to be a typo," they should assume they're probably misreading it.

The Times' coverage is filled with internal contradictions and other red flags that should jump out at even those with no prior knowledge of the topic. Otherwise discerning readers suspended their better judgment, I think, because many believe the Times has such high editorial standards that if the paper's editors were willing to print such an outlandish story, it must be true.

I don't think Nir is the main culprit here. Every impassioned reporter needs to be reined in and challenged by a good editor. Why did editors Michael Luo, Wendell Jamieson, and Dean Baquet allow the nail salon series to be published in The New York Times?