OAKLAND — On one Tuesday afternoon in a downtown Berkeley nail salon, Lehn Tsan, Connie Nguyen, Helen Tieu and Cindy Duong were laughing and joking around like old friends.

But they havent known each other that long, and two are nail salon workers, while the other two work for a legal nonprofit.

Tsan demonstrated some easy stretches to the two workers, Tieu, 50, and Duong, 47. One included the cat stretch, where she extended her fingers and then curled her hands into cat claws.

Tieu mimicked her movements, then laughed self-consciously.

Tsan, community advocate and organizer, and Nguyen, peer-trainer, are from Asian Law Caucus, which launched a nail salon project in recent years as part of a worker health and safety program. The cat stretch is part of the ergonomics training the caucus offers workers.

This group were targeting has been silent for so long, said Tsan, 23. Our goal is to educate and empower workers, to let them know that they have a right not to work in poor conditions.

Tsan, who is fluent in Vietnamese, was hired out of college as an intern for the San Francisco-based Asian Law Caucus, and was retained full time to work on the nail salon project. In 2005, a group of health and environmental advocates, community-based groups, and nail salon owners and workers formed the California Healthy Nail Salon Collaborative out of a growing concern for the health and safety of workers in this industry, many whom are immigrants.

The nail salon worker population is estimated to be 80 percent Vietnamese in California, based on research by the leading industry magazine, NAILS. Since the mid-90s, California has given the manicurist test — required of all nail workers — in Vietnamese. The number of licensed manicurists tripled in the state in the last two decades, from 35,000 in 1985 to 105,000 today. California has the most licensed nail technicians in the country. If cosmetologists, who are licensed to cut hair, give facials and do manicures, are included, the number jumps to about 300,000.

But just as the industry has grown, so has the awareness of occupational health hazards. Workers use toxic chemicals such as acetone, formaldehyde, toluene and polishes that contain phthalates. Many of the chemicals are linked to cancer.

Like the Bay Area, other metropolitan areas with a high concentration of Vietnamese-owned nail salons, including Seattle and parts of Massachusetts, recently began focusing on the health of nail salon workers.

Tsan has visited more than 150 salons and contacted 350 salon workers and cosmetology students in Alameda County.

Through all my outreach, you never run out of salons to visit, she said. Alameda County alone is home to about 1,400 cosmetology establishments and 11,000 licensed manicurists and cosmetologists.

Santa Clara County has the most nail technicians in the greater Bay Area, with 16,000 licensed manicurists and cosmetologists. Contra Costa has 7,000. San Mateo has nearly 4,000. In the nine-county Bay Area, there are 58,000 licensed manicurists and cosmetologists and nearly 8,000 shops according to the state Board of Cosmetology and Barbering.

Many salons are like Tieus University Avenue shop — small, with one to two employees, where often the owner is also the manager and worker. In Tieus salon, Nail Image Complete Nail Care, the only other manicurist is her sister, Cindy Duong. Both have been there since the salons inception 11 years ago and work six days a week.

The salon has a reversible fan installed in the window, which circulates the air, a sign that the salon cares about ventilation and health. Tieu said she installed the fan when she opened the salon.

The main reason various groups took an interest in the population is that workers are exposed to health risks from the chemicals they work with.

But outreach workers face many challenges.

Getting workers to talk about their health problems is difficult.

A lot of times theyre in denial of the health risks, Tsan said.

Her co-outreach worker, Connie Nguyen, is a practicing cosmetologist Asian Law Caucus hired as a peer-trainer. She said some workers feel a sense of shame in talking about health problems.

Nguyen, who lives in San Mateo, suffered from breathing problems when she worked in salons for 13 years. She is trying to remove herself from nail work and now is a freelance makeup and hair artist.

Workers reticence to talk about health issues is a serious problem, Nguyen said.

They are afraid rumors and gossip will have a negative effect on making a living, she said. Thats a very, very tough and sensitive issue. What we really want to know is what they want to hide.

In one case, Tsan met a worker who had an extreme case of contact dermatitis — a serious rash that can be caused by exposure to chemicals — that didnt go away. But she continued to work and hid the skin problem under gloves. She eventually took a break from working and her hand healed a little.

If people are getting sick and theyre not going to speak about it, then whos going to know? Tsan asked.

Two Bay Area nonprofits are trying to do just that — find out more about nail salon workers and their health concerns.

Oakland-based Asian Health Services and the Fremont-based Northern California Cancer Center are expected to release results later this year from a community-based survey conducted with 200 Vietnamese nail salon workers in Alameda County. Oakland-based Asian Communities for Reproductive Justice also recently launched a survey project. Each organization is also a member of the Healthy Nail Salon Collaborative.

Tsan said there are other tricky situations, too.

Often, its even difficult to tell whos a worker, owner or manager. Someone may say they manage the store, but they may also own the shop.

Her four-part worker health training program is based on a bilingual English and Vietnamese curriculum developed by the University of California, San Francisco and Asian Law Caucus. It includes sessions on ergonomics, infectious diseases, chemicals and ventilation, and an introduction to the law called know your rights.

The latter, Tsan said, is a touchy subject. Talking about workers rights with employees while in the presence of the owner-manager is difficult, she said.

Despite some challenges, Tsan is confident that some progress is made just by reaching out to workers.

She also hopes to form an advisory group of nail salon workers and hone leadership and organizing skills amongst the workers. The larger goal, she said, is to influence state policy. Several recent bills were signed into law that affect nail salon workers and Tsan said shed like workers — who would be most affected by the laws — to have a voice in the process.

Some salons, though, are simply not interested.

Some of the salons are not receptive at all, she said. You say youre from Asian Law Caucus, they hear the word law. They think youre from some government institution that wants to punish them. They just turn you away and you dont get that opportunity to earn their trust.

Tsan is most concerned about the least receptive salons, such as some that line International Boulevard in East Oakland — some literally have locked doors and no windows, she said.

Unless they know you, they wont open the door, she said. She added shes had a difficult time working with some of the salons in areas that are poorer. In areas with high crime rates, trust is hard to come by — many owners are wary of opening doors to strangers.

Many nail salon workers stay in the industry. Even if they try to leave or retire, they still end up working part time on the weekends or to help out at a friends salon for extra money.

Nguyen said employees are typically paid by commission, usually splitting 50-50 with the owner. Workers can make anywhere from a few hundred dollars a month to a few thousand dollars, she said.

The average nail technician makes $18,500 a year with no benefits, according to the U.S. Bureau of Labor Statistics.

Tieu, the owner and manicurist of Berkeleys Nail Image Complete Nail Care, said that if her English were better, she would have gone to nursing school instead of cosmetology school.

She said her kids dont want her to work in the salon anymore.

I may retire, Tieu said. Shed like to spend time taking care of her grandkids.

Contact Momo Chang at mchang@angnewspapers.com or (510) 208-6483.