Protecting the Health of Yourself and Your Clients

INTRODUCTION

Everyone working in, or clients of, the tattoo industry run the risk of contracting a range of diseases which can lead to serious illness or even death if proper infection control procedures are not followed. Blood transmitted infections such as hepatitis C, hepatitis B, HIV (the virus that leads to AIDS) and a whole range of bacterial infections, can be transmitted by unclean equipment and unhygienic premises and procedures. This Policy & Procedure highlights some of the basic precautions you should take to protect yourself and your clients against disease.

HOW INFECTIONS HAPPEN

Needles and other sharp instruments that are used to penetrate the skin can become contaminated by infected blood if they are not thoroughly cleaned and sterilized, and diseases can be passed on from client to client, or to workers who prick themselves with needles carrying infected blood. Transmission of viruses such as hepatitis C, hepatitis B and HIV, and common bacteria such as Staphylococcus can cause infections when infected instruments penetrate the skin or come into contact with mucous membranes.

Infections can also occur:

Where materials which clients come into contact with are not clean or are not handled and used hygienically. Where the operator does not keep his/her premises or themselves clean and hygienic, and where the premises, including furnishings and fittings are not kept clean and in good repair, and where disinfecting, and sterilization practices and equipment are inadequate.

THE MOST COMMON INFECTIONS

Hepatitis C

This is a blood borne virus and is easily transmitted via blood such as that found on needles used in tattooing procedures. Hepatitis C can result in long-term illness and can result in liver damage, and cancer of the liver. There is no known cure for hepatitis C nor is there a preventive vaccine.

Hepatitis B

Hepatitis B can also result in long term illness including liver damage and liver cancer. Hepatitis B can also be transmitted via blood such as that found on needles used for tattooing procedures and through poor hygiene. A safe effective vaccine is available and a course of three injections will provide full protection to most people. A blood test will show whether a person is protected. HIV (Human Immunodeficiency Virus) is the virus that results in AIDS. HIV can be transmitted via blood through used needles for tattooing (as well as through unprotected sex with an infected person). At present there is no vaccine against HIV/AIDS and no cure. Safe and hygienic practices are the best prevention.

Bacterial Infections

Common bacteria such as Staphylococcus can cause infections from unhygienic practices and result in nasty skin infections, wound breakdown and in the long run ruin the tattoo site.

THE BASIC STEPS TO HYGIENIC AND HEALTHY TATTOOING

Hygienic procedures for tattooist

Preparation of work area:

• Ensure the work area is clean and tidy.
• Set up work area making sure all items required for skin preparation, tattooing, skin dressing and waste disposal are within easy reach.
• Cover any work surfaces in the immediate area with disposable coverings - one per client
• Cover surfaces, which may need to be touched, e.g. spray bottles, power controls, and telephones, with a dust cloth.
• Place a container labeled "contaminated instruments for sterilizing" in each area where tattooing takes place.
• Always wear clean clothing including shirt/T-shirt and pants.
• Dispense the required pigment, lubricating jelly, therapeutic cream and any other lotion required into single-use disposal containers using single-use spatulas. Single-use spatulas should always be used when handling the petroleum jelly or any cream or lotion.
• Place water to be used for rinsing between colors into a single-use disposable cup.
• Place sufficient single-use wipes for one client in the area.
• Remove rings and thoroughly wash hands using soap or detergent under running water. Dry hands using a single-use paper towel or air dryer.
• Wear clean, new disposable gloves for each client.

Skin preparation

• Ensure client's skin is clean and free from infection, sores or wounds on or around the tattoo site.
• If area needs to be shaved, use a new disposable safety razor for each client.
• Disinfect the skin around the tattoo site using either a single-use alcohol swab or a single-use wipe with skin disinfectant which (a) has been decanted into a single-use container or (b) is applied with a spray bottle - this bottle must be emptied, cleaned and refilled daily and must NEVER be "topped-up."
• Leave the disinfectant or alcohol swab on the skin for at least two minutes before starting skin penetration.
• Prior to the placement of a stencil, a detergent based lotion may be applied to the tattoo site using the methods outlined above. Multi-use deodorants should never be used.
• Because of the high risk of cross-contamination with blood, only single-use stencils should be used to mark the skin.
• Apply a lubricating jelly to the tattoo site. Use a clean, new single-use spatula for each client. Never use gloves or bare fingers to apply lubricating jelly, always apply with a spatula and discard spatula after each application.

Before tattooing

• Open autoclave bags containing tubes and needles attached to needle bars and check indicator color. If satisfactory, then assemble hand piece. Note: Proper validation of steam sterilization is a complex issue outside the scope of this document.
• Inspect all needles for defects. Never test them for sharpness on an operator's skin.

Tattooing

• Wash hands before putting on gloves.
• Always wear new disposable gloves on both hands for each client and wear throughout the tattooing procedure.
• Tattoo outline of design.
• Change needle assembly or hand piece.
• Tattoo the color or shade of the outline.
• As far as possible, avoid contamination of work area with the client's blood.
• Avoid cross-contamination between surfaces e.g. while tattooing, do not eat, drink or smoke. When leaving clients during tattoo procedure, tattooists should remove and dispose of their gloves, and thoroughly wash their hands. If the client takes a break during the tattooing process, then cover the skin being tattooed with a dry clean dressing.
• After any break during a tattoo (e.g. answering the phone, toilet break), wash hands and put on new disposable gloves before resuming tattooing.
• During tattooing, use a cleaning solution from a spray bottle and a disposable wipe to remove excess pigment and blood from the tattoo site.
• Control any excess bleeding by applying pressure to the wound with a dry sterile dressing.
• During and after bleeding, handle contaminated instruments and dressings carefully to avoid contact with blood or serum.
• Dismantle, rinse in warm water, scrub crevices and grooves and autoclave any contaminated instruments.
• Wash contaminated surfaces such as benches, chairs and floors with warm water and detergent.
• Thoroughly wash hands after removing gloves.
• Dispose of contaminated materials in an appropriate waste container or sharps safe container ready for disposal.
• Put on new disposable gloves before starting a new tattoo.

After tattooing:

• Remove therapeutic cream from a single-use container and apply to the treated area by means of a single-use spatula, and cover with sterile dressing.
• Take time to tell, and show the client how to care for the tattoo, this will prevent infection and provide the client the same advice in writing.
• Dismantle needle assembly and place disposable needles into a "sharps safe" container for disposal.
• Remove and discard disposable gloves.
• Wash hands after tattooing and cleaning the work site.
• Clear the work area by cleaning, disinfecting and sterilization (in separate cleaning area and wearing heavy duty gloves).

Electrical hand piece

Benches, chairs and other work surfaces.

Instruments including needles, needle bars, tubes and nozzles

• Rinse in warm water taking care to prevent any needle stick injury or splashing.
• In a sink, immerse instruments in warm water and detergent, and then hold the instruments under the water and scrub with a clean brush.
• Rinse clean instruments in warm water and dry using a lint-free disposable towel.
• Place cleaned instruments in an autoclave bag and sterilize in a bench top autoclave, which complies with local government legislation.
• Store sealed autoclave bags of sterilized equipment in a clean dry area. Do not open bags until instruments are required for use.

Garments and other washable fabrics

• Wash with soap or detergent in water.
• Rinse and dry (alternatively have commercially laundered).
• Store in a clean, appropriate area, like a closed cupboard.

At the end of the day

• Clean the hand basins, sinks and floors with a detergent and warm water.
• Dispose of all contaminated materials in a "contaminated waste container" or "sharps safe" container for disposal as per your State's health requirements.
• Ensure that the autoclave is maintained according to manufacturers' instructions.
• Wash hands after cleaning is complete.

You and your staff

• Consider and discuss Hepatitis B immunization for you and your staff.
• Ensure that any break in your skin or your staff's skin is covered with a waterproof bandage that will completely protect the wound.
• Assume that everyone's blood is potentially infectious and treat everyone in the same way by practicing infection control procedures.
• Consult your medical practitioner if you or your staff sustains a needle-stick injury.

PREVENTION IS BEST FOR EVERYONE

It is in your best interests as a tattooist, in the best interest of your staff, and in the best interest of your clients, that your artistry does not lead to the transmission of any infections. Under Occupational Health and Safety legislation, as a proprietor, you have a legal obligation to ensure that your workplace is safe and hygienic for employees and that they are given every opportunity to learn and practice proper infection control procedures. Tattooists may pierce or injure their own skin while operating on a client. The transfer of even invisible amounts of your blood into a tattoo presents a risk of infecting the client if you are infected with HIV, hepatitis B or hepatitis C. Tattooists who are HIV or hepatitis C antibody positive or are hepatitis B carriers are advised to consider seriously whether they should continue to practice tattooing. They must discuss their infection with their medical adviser and seek clarification as their potential to continue practicing. If your clients contract a disease after a tattoo, you could be liable for civil damages and prosecution under government legislation. More importantly, for the viability of your business, it is essential that no one comes away from your studio with a health problem.

TATTOO AFTER CARE

1. Leave the bandage on 1 to 2 hours. Do not remove and re-bandage the tattoo no matter how badly you want to show your friends right after you've finished. This is an important step to start the healing process right and help prevent infection when the skin is at it's most sensitive. Your tattoo will be there forever so you can surely wait one day to show it off.
2. Remove the bandage and wash the tattoo with mild soap and water. Gently pat the tattoo dry with a clean towel or paper towel.
3. Apply non-medicated, non-fragrant lotion sparingly, rub it in briefly and then wipe off any excess. Just enough should be used so that the skin is soft, not shiny. In order to heal quickly, your skin must be able to breathe.
4. Continue to wash the tattoo and apply the lotion twice a day until the tattoo has healed. A dry flaky layer of skin will form on the tattoo. When it has peeled off completely on it's own then the lotion need not be used any longer.
5. Do not ever pick or scratch at the tattoo. It is natural for a new tattoo to itch somewhat while it is healing, however, scratching at a fresh tattoo could remove a scab or flaking skin prematurely. Doing this could seriously affect the look of your tattoo when it heals.
6. Do not get any direct sunlight on the tattoo for a period of two weeks or until it is healed completely. This point can not be stressed enough. Whenever in the sun for the first two weeks, the tattoo must always be covered by your clothing.
7. Do not swim or use Jacuzzis for at least one week. While it is necessary to shower and clean the tattoo regularly, it should not be soaked in water for long periods of time as this could remove a scab prematurely and negatively affect the look of your tattoo.
8. After your tattoo has healed, be aware of the sun's effects on it. Excessive exposure to sunlight will fade and damage a tattoo's appearance. To keep a tattoo looking it's best for a lifetime, it is recommended to use a strong sunblock (spf 36 or spf 50) on the tattoo itself to prevent it from being harmed.
9. Failure to follow the care directions properly can extend the healing time or prevent your tattoo from looking it's best. If you have any questions please do not hesitate to contact us.
10. And last but not least DO NOT listen to any so-called tattoo artists for 6 months.