Breathing Nail Dust When Sanding

We're often asked how nail dust affects the health of foot care nurses over time. When using drills to help reduce pain or potential ulcerations due to thick nails, corns or calluses, dust invariably accumulates. Even drills using extractors aren't completely effective. One widely accepted publication found nail dust extractors to be between 25% - 92% effective in reducing airborne particles. Because dermatophyte fungi account for approximately 80–90% of all nail infections (onychomycosis), we're often asked how fungus affects lung health. In fact, one of the questions we're more consistently asked is, "Can toenail fungus infect my lungs?"

In short, no. Foot fungus evolved to colonize on skin and nails, not in the lungs.

The debate of how nail dust affects lung health has been ongoing since the 1970s, when people first began reporting symptoms such as coughing and itchy eyes when sanding. Until fairly recently, there wasn't much evidence to single out nail dust from any other kinds of dust as a cause for irritation. Dust was dust.

While it's important to understand that toenail fungus simply cannot and will not adapt to life in the lungs, it's equally important to address what it can do.

What Gets Inhaled when Sanding Toenails?

Studies have found that nail particles small enough to enter the lungs contain endotoxins, fungi, fungal arthrospores, and other microbial debris. These particles have been shown to trigger the release of IL-8, which is responsible for attracting neutrophils in inflammatory regions.

Below, nail dust illuminated with a Tyndall lamp

Effects of Toenail Dust Inhalation

IL-8 release can worsen asthma and exacerbate existing lung conditions such as chronic inflammation. This places toenail sanding dust in the same category of other well-documented dusts with adverse health effects.

Couple this with the fact that many podiatrists do not wear masks when sanding, and the risk for adverse health effects from nail care becomes clear.
According to one paper [1], once sensitized [to the dust], even the smallest amount of the substance can trigger asthma, rhinitis, or conjunctivitis that may exhibit the following symptoms: coughing, wheezing, chest tightness, runny or stuffy nose, and watery or prickly eyes."

These findings strongly suggest that nail drills used by podiatrists and foot care nurses can result in airway diseases such as asthma.

Prevention

• Always use protective face masks
• Wash hands and wear protective gloves; avoid touching face
• Use protective eye wear
• Clean drills properly and frequently
• Use an extractor to reduce particles
• Ensure adequate ventilation and filtration