Beauty Salons are in the Eye of the Beholder ….. A Survey into the Environmental Health Standards...

Beauty Salons are in the EyeBeauty Salons are in the Eye

of the Beholder …..of the Beholder …..

A Survey into the Environmental Health A Survey into the Environmental Health Standards Operating in Beauty Salons in Co. Standards Operating in Beauty Salons in Co.

Donegal, March – April 2009Donegal, March – April 2009

Cora Murray, SEHOCora Murray, SEHO

This presentation……This presentation……

IntroductionIntroduction Scope and LimitationsScope and Limitations MethodologyMethodology ResultsResults Conclusions Conclusions Recommendations.Recommendations.

IntroductionIntroduction Summer 2009 - 130 beauty salons in Co. Donegal Summer 2009 - 130 beauty salons in Co. Donegal

and 5 training collegesand 5 training colleges What do they offer?.....What do they offer?.....

- - skin treatments skin treatments e.g. make-up application, e.g. make-up application, microdermabrasionmicrodermabrasion- hair removal e.g. by laser, - hair removal e.g. by laser, electrolysis or waxingelectrolysis or waxing- teeth whiteningteeth whitening- removal of body toxins - removal of body toxins e.g. by platinum detoxe.g. by platinum detox- manicures, pedicures- manicures, pedicures- massage- massage- ear candling- ear candling- ….. and more. - ….. and more.

Regulatory BackgroundRegulatory Background

USA, Australia, UK .. Douze points USA, Australia, UK .. Douze points - USA: licensing and inspection of nail salons- USA: licensing and inspection of nail salons

- Australia: registration and inspection by EHOs - Australia: registration and inspection by EHOs where skin penetration procedures occurwhere skin penetration procedures occur

- UK: h & s enforcement by EHOs- UK: h & s enforcement by EHOs Irelande … zero points! Irelande … zero points!

- - currently no public health legislation governing currently no public health legislation governing the operation of businesses such as beauty salons the operation of businesses such as beauty salons in the Republic of Ireland. in the Republic of Ireland.

So what are the risks?So what are the risks?

HazzardHazzard Potential cause / sourcePotential cause / source

Skin and other infectionSkin and other infection Re-use of towels, tools, materials without Re-use of towels, tools, materials without proper cleaning and disinfection; Re-use of proper cleaning and disinfection; Re-use of disposable tools, materialsdisposable tools, materials

Hepatitis / HIVHepatitis / HIV Re-use of crystals during medical Re-use of crystals during medical microdermabrasionmicrodermabrasion

Inadequate disinfection of body-piercing tools Inadequate disinfection of body-piercing tools

Burning of skin / hair, ear damage Burning of skin / hair, ear damage Improper use of ear candles Improper use of ear candles

Burns and scarring Burns and scarring Improper laser treatment Improper laser treatment

Nail infection Nail infection Manicures / pedicures / application of acrylic nails / Manicures / pedicures / application of acrylic nails / poor cleaning / poor training poor cleaning / poor training

Mouth and gum irritation / tooth damage Mouth and gum irritation / tooth damage Teeth whiteningTeeth whitening

Allergic reaction / skin irritationAllergic reaction / skin irritation Failure to carry out patch testing prior to Failure to carry out patch testing prior to application of e.g. dye, bleach application of e.g. dye, bleach

Fungal infections of feet Fungal infections of feet Recycling of water in or improper disinfection of Recycling of water in or improper disinfection of foot spas foot spas

Case Incidence Case Incidence CountryCountry DetailsDetails Source of InfoSource of InfoUSA 2002USA 2002 An outbreak of infection from An outbreak of infection from

Mycobacterium fortuitumMycobacterium fortuitum occurred as a result of clients occurred as a result of clients receiving pedicures with receiving pedicures with whirlpool footbaths and / or whirlpool footbaths and / or shaving from failure to clean shaving from failure to clean and disinfect the equipment and disinfect the equipment used.used.

The New England Journal of The New England Journal of Medicine Medicine

USA 2006USA 2006 Fungal Fungal infectioninfection and nail bed and nail bed damage at a nail salondamage at a nail salon

‘‘Birmingham News’ Birmingham News’ newspapernewspaper

The Netherlands 2006The Netherlands 2006 MRSA transmission as a result MRSA transmission as a result of contact with an infected of contact with an infected Beautician due to use of diluted Beautician due to use of diluted alcohol used to disinfect skin alcohol used to disinfect skin after waxing and failure to wear after waxing and failure to wear glovesgloves

Emerging Infectious Emerging Infectious Diseases journal of the Diseases journal of the CDSCCDSC

IrelandIreland None found. None found.

Some anecdotal evidence.Some anecdotal evidence.

Scope and LimitationsScope and Limitations

Included in the survey ….Included in the survey …. Commercial beauty salons onlyCommercial beauty salons only

Voluntary participationVoluntary participation

Information as reported by salon Information as reported by salon operator as observation was not operator as observation was not possiblepossible

No prior appointment (in 87% of No prior appointment (in 87% of cases) – time restrictionscases) – time restrictions

Not Included in the survey …Not Included in the survey … Services offered from private Services offered from private

residencesresidences

Sun-bed facilities, tattooing, ear Sun-bed facilities, tattooing, ear piercing and hair dressing piercing and hair dressing servicesservices

Holistic services e.g. reflexology, Holistic services e.g. reflexology, acupuncture etc.acupuncture etc.

Workplace health and safety Workplace health and safety assessmentassessment

Efficacy of treatments offered.Efficacy of treatments offered.

AimAim

To determine compliance levels with the EC To determine compliance levels with the EC (Cosmetic Products) Regs., 2004 - 2006 among (Cosmetic Products) Regs., 2004 - 2006 among beauty salons in Co. Donegal and beauty salons in Co. Donegal and

To determine the degree to which such salons To determine the degree to which such salons protect public health in the delivery of their protect public health in the delivery of their service by way of the hygiene precautions service by way of the hygiene precautions implemented andimplemented and

To make recommendations as to any To make recommendations as to any improvements that could be made andimprovements that could be made and

To instigate the formulation of national To instigate the formulation of national standards for health and hygiene within the standards for health and hygiene within the commercial beauty salon industry in Ireland, commercial beauty salon industry in Ireland, working in partnership with relevant bodies working in partnership with relevant bodies such as the E.H.O.A., N.S.A.I., NABTET and / or such as the E.H.O.A., N.S.A.I., NABTET and / or IBPA IBPA

Objectives Objectives To carry out a survey of approx. 25% (N = 30) To carry out a survey of approx. 25% (N = 30)

of the salons operating within Co. Donegal of the salons operating within Co. Donegal during March – April 2009during March – April 2009

To assess the standard of hygiene by taking To assess the standard of hygiene by taking environmental swabs & / or samples for environmental swabs & / or samples for microbiological analysis.microbiological analysis.

To sample cosmetic products used in beauty To sample cosmetic products used in beauty salons for analysis under the EC (Cosmetic salons for analysis under the EC (Cosmetic Products) Regs., 2004 - 2006 Products) Regs., 2004 - 2006

ToTo disseminate results of the survey.disseminate results of the survey.

Survey DevelopmentSurvey Development Two members of EH staffTwo members of EH staff Database of beauty salons generatedDatabase of beauty salons generated Pilot surveyPilot survey Letter issued to salon ownersLetter issued to salon owners Two-pronged approach i.e.Two-pronged approach i.e.

1. 1. Assessment of compliance with Assessment of compliance with Cosmetic Products Regs. including a labelling Cosmetic Products Regs. including a labelling assessment and sampling of cosmetic products assessment and sampling of cosmetic products in a number of salons.in a number of salons.

2. Assessment of hygiene standards 2. Assessment of hygiene standards a) observed by the E.H.O. and a) observed by the E.H.O. and b) as reported by the person in charge and b) as reported by the person in charge and c) by microbiological analysis of environmental swabs & c) by microbiological analysis of environmental swabs & or samples.or samples.

ResultsResults

Three sections: Three sections:

1.1. Cosmetic Products Regs.Cosmetic Products Regs.

2.2. Microbiological analysisMicrobiological analysis

3.3. Hygiene standards observed and Hygiene standards observed and practices reported.practices reported.

European Communities (Cosmetic Products) European Communities (Cosmetic Products)

Regulations, 2004 - 2006Regulations, 2004 - 2006

Laboratory analysis Laboratory analysis (N = 10) - 100% (N = 10) - 100% compliancecompliance

Labelling assessment Labelling assessment (N = 25 salons) – 20% (N = 25 salons) – 20% non-compliance re. EU non-compliance re. EU name and addressname and address

Sample Sample ofof

No. of No. of Samples Samples

Tested Tested forfor

Eye lash Eye lash and eye and eye brow tintbrow tint

11 P-P-phenylenphenylenediamine ediamine

Teeth Teeth whitening whitening foam foam stripsstrips

11 Bleaching Bleaching agent agent

LotionsLotions 88 Lead and Lead and cadmiumcadmium

TotalTotal 1010 --

Microbiological AnalysisMicrobiological Analysis

Parameters:Parameters: Total Viable Count (TVC) at 30ºC.Total Viable Count (TVC) at 30ºC. Staphylococcus aureusStaphylococcus aureus EnterobacteriaceaeEnterobacteriaceae (not tested for (not tested for

regarding foot spas)regarding foot spas) Pseudomonas spp. (tested in swabs from Pseudomonas spp. (tested in swabs from

foot spas only)foot spas only)

N = 60 samples from 29N = 60 samples from 29 differentdifferent salons salons

( including 6 control samples)( including 6 control samples)

Types of Swabs Taken Types of Swabs Taken Swab of:Swab of: No. of No. of

Swabs:Swabs:Foot spaFoot spa 1414

Make-up brush, Eye shadow / Make-up, Lip & eye pencil Make-up brush, Eye shadow / Make-up, Lip & eye pencil LipstickLipstick

1414

Sinks / WHBs Sinks / WHBs 66

Wax from wax pot Wax from wax pot 44

Toe separators / Manicure & Pedicure tools Toe separators / Manicure & Pedicure tools 44

Heads of facial machine / Interior of UV cabinet / Hot Heads of facial machine / Interior of UV cabinet / Hot towel cabinet / Towels / Surface of trolley / Bowl / Plastic towel cabinet / Towels / Surface of trolley / Bowl / Plastic sheet for waxing / Hot stone in tanksheet for waxing / Hot stone in tank

1515

‘‘Barbicide’ disinfectantBarbicide’ disinfectant 11

Vaseline Vaseline 11

Sun bed surface Sun bed surface 11

TotalTotal 6060

Microbiological StandardsMicrobiological Standards There were no reference standards for There were no reference standards for

microbiological levels within beauty salonsmicrobiological levels within beauty salons Equipment used to pierce skin must be sterileEquipment used to pierce skin must be sterile The interpretation of the results based on a The interpretation of the results based on a

combination of factors including comparison with combination of factors including comparison with control samples and with resultscontrol samples and with results from other from other salons in the survey; experience within the salons in the survey; experience within the Environmental Health Department and general Environmental Health Department and general researchresearch

14% (N = 4) of the salons visited required a 14% (N = 4) of the salons visited required a follow-up visit due to levels of contamination that follow-up visit due to levels of contamination that were deemed unsatisfactory i.e.were deemed unsatisfactory i.e.3 foot spas (1 higher TVC / 2 Pseud)3 foot spas (1 higher TVC / 2 Pseud)1 toe spacers (S aureus ).1 toe spacers (S aureus ).

Summary of ResultsSummary of ResultsSwab ofSwab of No. No.

takentakenSummary of ResultSummary of Result

(in cfu per area swabbed / per g or per ml)(in cfu per area swabbed / per g or per ml)

Foot spaFoot spa 1414 Pseudomonas spp. identified in two samples and Pseudomonas spp. identified in two samples and in one other case where TVC levels were in one other case where TVC levels were comparatively high, adequate cleaning comparatively high, adequate cleaning procedures were not in placeprocedures were not in place

Make up and Make up Make up and Make up applicators etc.applicators etc.

1414 Generally very good e.g. max TVC 282; < 10Generally very good e.g. max TVC 282; < 10

Staphylococcus aureus and < 10 Staphylococcus aureus and < 10 EnterobacteriaceaeEnterobacteriaceae

Sinks/Wash hand basinsSinks/Wash hand basins 66 Generally very good e.g. max TVC 5,600; < 10Generally very good e.g. max TVC 5,600; < 10


Wax taken from wax potsWax taken from wax pots 44 Generally very good e.g. max TVC 10; < 10Generally very good e.g. max TVC 10; < 10


Toe Separators & Toe Separators & Manicure and Pedicure Manicure and Pedicure toolstools

44 Generally good. Low levels of S aureus present Generally good. Low levels of S aureus present on x1 swab from toe separators –no disinfectant on x1 swab from toe separators –no disinfectant step applied.step applied.

General Equipment / General Equipment / SurfacesSurfaces

1818 Generally very good. In the Generally very good. In the interior of a UV interior of a UV cabinet, a TVC level of 673cfu was foundcabinet, a TVC level of 673cfu was found

Hygiene Standards AssessedHygiene Standards Assessed

- - cleaning facilitiescleaning facilities- - hand washing facilitieshand washing facilities- laundry storage- laundry storage- storage of equipment- storage of equipment- services (sanitary - services (sanitary accommodation, heating, accommodation, heating, lighting, lighting, ventilationventilation))- - policiespolicies (hand washing, (hand washing, gloves, skin test)gloves, skin test)- personal hygiene- personal hygiene- - waste disposalwaste disposal- - equipment for equipment for sterilisation and sterilisation and disinfectiondisinfection

- - cleaning of cleaning of implements / toolsimplements / tools- - practicespractices (e.g. (e.g. ‘double dipping’, wax, ‘double dipping’, wax, use of disposables etc)use of disposables etc)- after care leaflets- after care leaflets- client record cards- client record cards- training- training- - laser and intense laser and intense pulsed light treatmentpulsed light treatment- medical clinic- medical clinic- - generalgeneral observations.observations.

FindingsFindingsCleaning FacilitiesCleaning Facilities

Standard RequiredStandard Required Standard FoundStandard FoundSeparate facilities for Separate facilities for cleaning tools, equipment cleaning tools, equipment etc. should be provided in etc. should be provided in or within easy access to the or within easy access to the treatment room(s) e.g. a treatment room(s) e.g. a sink with hot and cold water sink with hot and cold water in a hallway from which the in a hallway from which the treatment room(s) are treatment room(s) are directly accessed. directly accessed.

A sink in a toilet area is not A sink in a toilet area is not suitable. suitable.

7% (N=2) grossly 7% (N=2) grossly inadequate i.e. had only inadequate i.e. had only a whb with only cold a whb with only cold water in a toilet area for water in a toilet area for cleaning of tools, cleaning of tools, equipment and hand equipment and hand washing.washing.

Higher prevalence (75%) Higher prevalence (75%) noted during pilot noted during pilot surveysurvey

Findings Findings (contd.)(contd.)

Hand Washing FacilitiesHand Washing Facilities

Standard RequiredStandard Required Standard FoundStandard FoundProvision of whb in toilet Provision of whb in toilet area area andand whb / sink in or whb / sink in or adjacent to the treatment adjacent to the treatment area(s).area(s).

Hot and cold water, paper Hot and cold water, paper towels, soaptowels, soap

17% (N = 5) inadequate i.e. 17% (N = 5) inadequate i.e. 2 salons only had whb in 2 salons only had whb in toilet area, others without toilet area, others without hot water or soaphot water or soap


Services – VentilationServices – Ventilation

Standard RequiredStandard Required Standard FoundStandard Found

Mechanical extract or air Mechanical extract or air conditioning in appropriate areas conditioning in appropriate areas and / or a suitable means of and / or a suitable means of natural ventilation.natural ventilation.

Mechanical extract in spray Mechanical extract in spray tanning areas **tanning areas **

Visual assessment Visual assessment

37% (N = 11) inadequate 37% (N = 11) inadequate ventilation in treatment areasventilation in treatment areas

20% ( N = 3) no mechanical 20% ( N = 3) no mechanical extract ventilation in spray extract ventilation in spray tanning areastanning areas

50% (N= 15) satisfactory means 50% (N= 15) satisfactory means of ventilation in all areas of of ventilation in all areas of salonsalon


PoliciesPolicies


-Hand washing before and after Hand washing before and after treating a clienttreating a client- Use of disposable gloves Use of disposable gloves where where there is or may be contact with there is or may be contact with mucous membranes (e.g. during mucous membranes (e.g. during intimate waxing) or blood or serumintimate waxing) or blood or serum

- Various sensitivity tests available Various sensitivity tests available with varying time intervals between with varying time intervals between test and treatment test and treatment

27% (N = 8) reported 27% (N = 8) reported washing hands only washing hands only afterafter treating a clienttreating a client- 87% ( N = 26) reported not using 87% ( N = 26) reported not using disposable gloves, as required for disposable gloves, as required for specific treatments (ref case in specific treatments (ref case in Holland)Holland)

- Further research required in this Further research required in this areaarea


Waste DisposalWaste Disposal


Double-bagging prior to disposal by landfill of contaminated waste including waste cotton wool, tissues or cloths with any blood spots or human tissue

100% (N = 12) contaminated waste not double bagged

Use of a ‘sharps box’ labelled as ‘contaminated’ and ‘for incineration’ for used needles

15 salons required a ‘sharps box’. 13 % ( N = 2) did not have one.7 % ( N = 1) box inadequately labelled.

Disposal of boxes of used needles by collection by permitted collectors.

13 % ( N = 2) needed to dispose of ‘sharps box’ in past via Medical Practitioner. Knowledge on permitted disposal methods lacking.


Sterilising Sterilising & Disinfection& Disinfection


-Provision of sterilisation equipment Provision of sterilisation equipment e.g. e.g. glass-bead steriliser or an glass-bead steriliser or an autoclave, autoclave, for ‘hard’, reusable for ‘hard’, reusable implements e.g. commodone implements e.g. commodone extractors, metal scissors, extractors, metal scissors, tweezers, cuticle knives etc. used to tweezers, cuticle knives etc. used to cut or pierce the skin cut or pierce the skin is considered is considered essentialessential - provision of an adequate supply of provision of an adequate supply of suitable chemical disinfectantsuitable chemical disinfectant- maintenance of UV bulb where UV maintenance of UV bulb where UV cabinet is providedcabinet is provided

-100% (N = 30) did not have 100% (N = 30) did not have sterilisation equipmentsterilisation equipment

- 100% (N = 30) has a supply of 100% (N = 30) has a supply of suitable chemical disinfectantsuitable chemical disinfectant- 73% ( N = 22) had a UV cabinet73% ( N = 22) had a UV cabinet- of those, 50% ( N = 11) were of those, 50% ( N = 11) were unaware of when the bulb was last unaware of when the bulb was last changedchanged


Cleaning of ToolsCleaning of Tools


Thorough cleaning Thorough cleaning followed by suitable followed by suitable disinfectiondisinfection

Inadequate cleaning Inadequate cleaning procedures as reported re:procedures as reported re:

66% (N = 19) foot spas66% (N = 19) foot spas

63% ( N = 19) make-up 63% ( N = 19) make-up brushesbrushes

17% ( N = 5) manicure / 17% ( N = 5) manicure / pedicure toolspedicure tools

6.6% ( N = 2) sponges6.6% ( N = 2) sponges


PracticesPractices

Standard RequiredStandard Required Standard FoundStandard Found- Provision of suitable floor cover Provision of suitable floor cover or disposable foot covers or disposable foot covers required where client is bare-required where client is bare-footedfooted- ‘ ‘Double dipping’ to be avoidedDouble dipping’ to be avoided

- Towels to be changed after Towels to be changed after every clientevery client

-10% (N = 3) reported inadequate 10% (N = 3) reported inadequate procedures for protection for feetprocedures for protection for feet

- 77% ( N = 23) reported ‘double 77% ( N = 23) reported ‘double dipping’ during waxing and 7% dipping’ during waxing and 7%

( N = 2) used same spatula for ( N = 2) used same spatula for different areas of the bodydifferent areas of the body- 46 % ( N = 13) ‘double dipping’ 46 % ( N = 13) ‘double dipping’ of make-up applicatorsof make-up applicators- 3.3 % ( N = 1) couch roll placed 3.3 % ( N = 1) couch roll placed on towel on a couch with same on towel on a couch with same towel changed after fourth clienttowel changed after fourth client


Laser and Intense Pulsed Light Laser and Intense Pulsed Light TreatmentsTreatments

23% (N=7) offered laser treatment23% (N=7) offered laser treatment H & S regulation protects employeesH & S regulation protects employees No regulation to protect clients’ safetyNo regulation to protect clients’ safety

Medical ClinicsMedical Clinics 17% ( N = 5) offer medical clinic e.g. botox, 17% ( N = 5) offer medical clinic e.g. botox,

injectables, anti-aging treatments injectables, anti-aging treatments Irish Medical CouncilIrish Medical Council

FindingsFindings (contd.)(contd.)

General Observation-General Observation-

Proprietors: Proprietors: - Would welcome guidanceWould welcome guidance- Many were in favour of some form of Many were in favour of some form of

regulationregulation

ConclusionsConclusions

Cosmetic Product Regs. – Cosmetic Product Regs. – good compliancegood compliance Microbiological Results – Microbiological Results – generally goodgenerally good Hygiene Standards Observed and Hygiene Standards Observed and

Practices Reported Practices Reported - cleaning facilities generally good but - cleaning facilities generally good but grossly inadequate in a small numbergrossly inadequate in a small number- hand washing facilities generally good - hand washing facilities generally good but inadequate in nearly 1/5 of salonsbut inadequate in nearly 1/5 of salons- improvements in policy on hand-washing - improvements in policy on hand-washing and glove use neededand glove use needed

Conclusions Conclusions (contd.)(contd.)

Hygiene Standards Observed and Practices Hygiene Standards Observed and Practices Reported (contd.):Reported (contd.):

- - improvement needed in waste disposal improvement needed in waste disposal

- absence of sterilising equipment a concern- absence of sterilising equipment a concern

- cleaning procedures inadequate for certain - cleaning procedures inadequate for certain equipment / toolsequipment / tools

- practice of ‘double-dipping’ commonplace- practice of ‘double-dipping’ commonplace

- regulation not in place- regulation not in place

- practitioners open to regulation and guidance- practitioners open to regulation and guidance

RecommendationsRecommendations

Further research within EHFurther research within EH Training for EHOsTraining for EHOs ‘‘Guide to Good Practice in Beauty Salons’ is Guide to Good Practice in Beauty Salons’ is

developed by the EH in conjunction with developed by the EH in conjunction with relevant stakeholdersrelevant stakeholders

EH, in turn and in conjunction with relevant EH, in turn and in conjunction with relevant bodies, contribute to the training of Beauty bodies, contribute to the training of Beauty Therapists by the development of a syllabus Therapists by the development of a syllabus including Cosmetic Products Regs and P.H. including Cosmetic Products Regs and P.H. AspectsAspects

EH staff, in conjunction with relevant, interested EH staff, in conjunction with relevant, interested bodies develop an award system for salons bodies develop an award system for salons proving to be operating to a defined standard, proving to be operating to a defined standard, such as the guide referred to.such as the guide referred to.

Recommendations (contd.)Recommendations (contd.)

That information is provided to the public in That information is provided to the public in relation to standards to expect in a beauty salonrelation to standards to expect in a beauty salon

That microbiological guideline standards That microbiological guideline standards applicable to beauty salons are developed by applicable to beauty salons are developed by the E. H. servicethe E. H. service

That research is undertaken to determine the That research is undertaken to determine the level of beauty salon acquired infection or injurylevel of beauty salon acquired infection or injury

Regulation of beauty salons is introduced e.g. by Regulation of beauty salons is introduced e.g. by licensing and enforcement of standards on an licensing and enforcement of standards on an ongoing basis through regular inspections ongoing basis through regular inspections carried out by EHOs and any other profession carried out by EHOs and any other profession deemed necessarydeemed necessary

Staged implementation of above Staged implementation of above recommendations.recommendations.

AcknowledgementsAcknowledgements Jenny Fortune, EHO, LetterkennyJenny Fortune, EHO, Letterkenny Salon ownersSalon owners Mary Ferry, Fás Course TutorMary Ferry, Fás Course Tutor Irish Beauty Professionals AssociationIrish Beauty Professionals Association Wendy Nixon in HABIAWendy Nixon in HABIA Tina Garrity, CIEHTina Garrity, CIEH Dr. Olive Smith, Irish Medicines BoardDr. Olive Smith, Irish Medicines Board Suzanne Tinney, Waste Awareness Officer, Suzanne Tinney, Waste Awareness Officer,

Donegal County CouncilDonegal County Council Louise Cullen, Public Health Dept., Louise Cullen, Public Health Dept.,

LetterkennyLetterkenny

New Developments …New Developments …

Fish pedicure ….Fish pedicure ….

That’s it!That’s it!

Thank you for your attention.Thank you for your attention. Contact details:Contact details: Cora Murray, Senior EHO,Cora Murray, Senior EHO, Co. Clinic,Co. Clinic,Letterkenny,Letterkenny,Co. DonegalCo. DonegalTel. 074-9123759Tel. 074-9123759Email: Email: [email protected] EHOA Yearbook 2010See EHOA Yearbook 2010

Beauty Salons are in the Eye of the Beholder ….. A Survey into the Environmental Health Standards...

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