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1167: EFFECT OF NAIL POLISH ON OXYGEN SATURATION READINGS

Introduction/Hypothesis: Nail polish continues to be perceived to influence pulse oximetry accuracy despite studies showing no significant effects. The aim of this study was to explore the effect of current popular nail polishes on oxygen saturation (SpO2) readings with a current, popular pulse oximetry device. Methods: A prospective, double–blinded study on four colors of nail polish (red, blue, pink, purple) were tested with two different finishing types (sheer, matte), along with a metallic dark purple, to a total of nine different samples in addition to a clear nail polish as control. All samples and control were applied and analyzed at the same time per individual. A power analysis indicated a minimum sample size of 28 to detect a difference of 3% oxygen saturation with a significance level (alpha) of 0.005 using a two–sided Wilcoxon test. SpO2 of the sample nail polishes were measured (Masimo, Irvine, CA) at control SpO2 levels of 97% and 94%. Nitrogen gas was blended with air in a closed system to achieve control SpO2 levels, at which point pulse oximetry readings were obtained. Paired t test model was used to analyze the results. Results: A total of 33 healthy volunteers were tested. None of the colors and finishes had an SpO2 significantly different compared to the control SpO2, except for matte blue. At the SpO2 of 94% testing level, matte blue resulted in a higher SpO2 than control (95.76 ± 2.63, p = 0.0005). At SpO2 of 97%, matte blue also trended towards a higher SpO2 than control (97.55 ± 1.60, p = 0.0075). Conclusions: Although most of the nail polish colors and finishes did not interfere with SpO2 accuracy, blue nail polish with a matte finish did produce a falsely higher oxygen saturation reading.