2013-07-08 16:12:22
Immersion of all or part of the body in water containing fish (generally of the species Garra rufa) removing scales from the skin, has been a practice that has existed for many years in Turkey, Asia and the Middle East. In many countries, including France, a growing number of establishments offer this type of treatment – notably a so-called “fish pedicure” offer – promoting aesthetic or well-being effects, but also sometimes therapeutic effects.
In this context, the Ministry of Health requested the Agency to assess the risks linked to this type of aesthetic practice of immersing the feet in a pool populated with Garra rufa.
To carry out this work, the Agency relied on the collective expertise of a multidisciplinary working group bringing together scientists specializing in water-related risks, microbiology, fish health, dermatology and involving two of its specialized expert committees.
Status report on health risks
Since 2010, the offer of pedicure treatments known as “fish pedicures” has been developing very significantly in Europe, in aesthetic or “well-being” establishments where it is implemented, most often in addition to other services. Although it is not possible to precisely determine the extent of this practice in France, it seems that several hundred establishments offer “fish pedicure” treatments. However, only a few dozen of them would respect the legal conditions (in particular the holding of captive wildlife) necessary for opening.
Indeed, it appears from the work carried out by ANSES that the practice of “fish pedicure” is not currently regulated by any specific health regulations. At present, data on the quality of water in tanks within establishments practicing “fish pedicure” are rare and there is no specific study on the presence and survival of pathogenic microorganisms in the populations of Garra rufa marketed in France.
However, due to the presence of fish in the pedicure tanks, it is not not possible to maintain disinfectant water there, which greatly complicates the control of microbial risks. Furthermore, several cases of bacterial infections linked to aquarium and pedicure practices have already been recorded previously.
In addition, the Agency’s work also highlights the fact that certain clients constitute a population plus sensible to infections: diabeticsthe people immunocompromised (under treatment or illness) or even presenting skin lesions on the feet.
Finally, this practice seems to particularly attract people with a thickening of the skin (hyperkeratosis)likely to bemycotic origin. They thus increase the risk of water contamination and present at the same time increased susceptibility to infections.
ANSES conclusions and recommendations
On the basis of these different elements, the Agency considers thatthere is a potential risk of transmission of pathogens (of human or animal origin) through water or fish, during the practice of “fish pedicure”. This risk is probably weakexcept for more sensitive user populations. However, due to the lack of data linked to this practice, the Agency favors the collection of data on water quality and its evolution within establishments offering this type of pedicure treatment, in order to be able to quantify the health risks. .
Furthermore, ANSES considers it necessary to regulate practices of “fish pedicure” by a adapted regulations including in particular:
- procedures for admission and hygiene of users, hygiene of the establishment under the responsibility of qualified personnel;
- control and self-monitoring of the operation of the installations, the quality of the water in the tanks and the general hygiene of the establishment;
- the obligation of batch traceability and fish health control;
- objective information of the public on the dangers incurred during this practice;
- informing staff, including temporary workers, interns and staff of external companies working within the establishment, regarding the risks of infection, in particular by bacteria that are multi-resistant to antibiotics.
- the need to respect occupational hygiene rules and the training of staff in these establishments to guarantee their safety and that of users.
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