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Health Issues

Health Issues

We at Nine Mag are on a mission to help you guys find meaningful, reliable, clear information and links to useful guidance that complies with good practice frameworks. With this in mind we have established a working relationship with the very helpful health & safety people from Health England and the Environmental Health, with whom we will be working with long term each issue to support our readers and signpost the way to the information you guys need to know, without you having to trawl your way through endless health acts to get to it and giving up the will to live along the way.

Words – Sadie Hawson

Safety Guidance

To help tattooists, body modifiers and piercers comply with health and safety law there is relevant and helpful guidance out there produced by those who know both the health & safety laws and the body art businesses.

Check our links below to user-friendly documents and interesting contacts including who’s who when it comes to supporting tattooists and body artists. We highly recommend taking a look at these two links in particular; The Calderdale Documents Published in 2008, and The Dartford Document Published in 2009 – these local sources of definitive info have been specifically designed with artists and end users in mind to give clear, up to date and real information of what’s expected from you as providers covering all aspects from legal inspections and general good safe practice.

Web links
The Calderdale Documents, for PDF documents on Advice and Safe Practice for Permanent Tattooing Advice and Safe Practice for Body piercing.

“Advice and Safe Practice for Micropigmentation”

“Code of Practice for Hygienic Skin Piercing”

A significant amount of work and consultation with various regulatory bodies has gone into the production of these local documents, the aim being to ensure artists and studios have access to clear guidance & information so they can be proactive in making informed choices.

Check them out to find further access to more web links in the actual documents themselves, you’ll be happily surprised to find an abundance of interesting, practical, easy to deal with knowledge inside each one.

More nationally focused accepted guidelines and info has been expected to be published along similar lines as the two we link you to, but it’s been in the pipeline for over a year and it’s still not been approved, so in the meantime be ahead of the game and find the info you need here and now.

What key documents are out there?

Body Art, Cosmetic Therapies and Other Special Treatments
A booklet (published in 2001 by the technical indexes publisher Barbour and distributed by the Chartered Institute of Environmental Health).

This provided background information on popular body art techniques, the Health and Safety Executive guidance (LAC76/2 & 14/1 below) superseded it.

It dealt with best practice guidance on infection control and contained an overview of the applicable UK legislation at the time. Inclusive of tattooing and the other registered procedures it also covered chiropody, colon hydrotherapy, water treatments and massage therapies! There may be some copies still out there, it is generally useful but there are better more relevant documents, so if you still have one it is recommended that you upgrade your advice to the links above.

Health and Safety Executive guidance LAC 76/2 & 14/1
Initially, the main national guidance documents were produced by the Health and Safety Executive specifically for Local Authority enforcement officers. These are the inspectors who check studios and artists to ensure they are in compliance with local legislation.

Inspectors visit to check compliance with local by-laws (if registered) or specific licence conditions (if licensed) but they also check Health and Safety at Work legal compliance and some other key pieces of legislation. This means they may refer information on to other statutory enforcement bodies (e.g. the Fire Authority, Trading Standards and the Environment Agency).

Enforcement officers basically used these LAC documents as guides for their inspections. The full titles of the LACs (or Local Authority Circulars) are: 76/2 “Health and Safety issues related to body piercing, tattooing and scarification” (last revised in 2005); and Circular 14/1 “micro-pigmentation / semi-permanent tattooing / semi-permanent make-up” last revised in 2006.

The Health and Safety Executive controlled these documents and they have now been withdrawn from publication because both of them passed their revision dates without being reviewed – perhaps because of the newer guidance documents that have subsequently come out. The HSE may still re-issue these local authority circulars in the future, but until they do unfortunately they are no longer available on the web.

If you’re lucky you may still have the guidance note (LAC 76/2) because for many years it was the definitive guide and like other local authority circulars published by the HSE it was an open document, available to all. Some local authorities passed it on to their artists and studios for information. If you still have it, it is recommended that you keep it because LAC 76/2 covers areas not seen in the other documents and most of the information is still valid.

Many local authority inspectors probably still use these documents to guide their inspections because they go into the specifics of a wide range of applicable legislation and list clearly the enforcement expectation for specific breaches.

Enforcement expectations include; when guidance should be given and when prohibition notices should be served.

A prohibition notice is a legal notice requiring the stopping of a specific activity, a breach of a notice may result in possible major injury, and/or prosecution. Failures in the infection control procedure are highlighted in the LAC as being suitable for the service of a prohibition notice.

Enforcement officers in several councils (including Calderdale and Dartford) recognised that the LAC’s document was not user friendly for the artist. Requirements were listed in a monolithic way and several areas were described in deep technical detail. More straight forward advice specifically for studios and artists was needed.

The Calderdale Documents
Environmental Health at Calderdale District Council recognised the need for guidance documents for body art including micro-pigmentation and so they speculatively bid for funding from the Health and Safety Executive to do research into the requirements of such a document and won it.

This enabled them to work with other local authorities and the Health and Safety Laboratory (HSL) in Sheffield where they accessed good technical, PhD level knowledge and skills. The documents were developed over an 18 month period and individual documents on tattooing, body piercing and micro-pigmentation are available. Published in 2008 they reflect a very easy to read user friendly format.

The guidance includes information on the basic requirements for a safe, clean premises, good information on waste disposal, infection control, aftercare advice and at a glance checklists for compliance, that are easy to use. Appendices within each document also present excellent examples of how a medical history questionnaire, consent form and aftercare advice sheet might be prepared for each of the three treatment areas covered and offer answers to why they are needed in the body of the document.

The Dartford Document
Published by the Dartford Borough Council with reference to the Health Protection Agency (now part of Public Health England), the Chartered Institute of Environmental Health, the Health and Safety Executive and the Tattooing and Piercing Industry Union, The “code of practice for hygienic skin piercing” was formed from a local Kent Document and the other guidance documents available. It aims to be a gold standard of compliance for both enforcer and artist. It is recognised as a local document, not a national document. The current version available on the link above is version 3 and came out in 2009, however, an updated more rigorously referenced version is currently overdue for publication (please note it may be issued under a different title).

The Dartford document is the most recently published and although not specific for any one body piercing activity it covers the relevant topics > in a clear and systematic way. The producer of the document however recognises there is already a need for it to be updated. With the involvement, of what was Health Protection Agency guidance, in the production of the document, the emphasis on infection control is strong and is demonstrated by good guidance on the decontamination of equipment and on what to do for needle stick injuries. The Appendix provides guidance on the medical questionnaire, aftercare sheets, use of local anaesthetic agents, hand hygiene, maintenance record sheets, vaccinations and chemical cleaning and disinfection.

Your local environmental health or licensing inspectors are likely to be familiar with these documents. If you get to know them they will save you time by providing you with ready to use forms. The documents will reduce the stress levels you might feel about legal compliance because they will give you more of an idea of what the expected standard is and what an inspector might be looking for when they visit. Your local inspector will be able to talk to you about why things are needed, what is legally required and what is considered good practice. If you see them, don’t forget to ask them if the new document is out yet!

A brief who’s who
The following bodies have contributed to the information outlined and work to provide clear guidance to artists and studios:

Barbour (Barbour Index) – a technical referencing service providing documents and reference literature to health and safety and environment professionals.

Chartered Institute of Environmental Health (CIEH) – a registered charity and the professional body of environmental health officers. They provide information, evidence and policy advice to local and national government and environmental health officers / practitioners in order to protect and support the human race.

Environment Agency (EA) – an executive (like the HSE) non-departmental public body responsible to the secretary of state for environment, food and rural affairs. Along with other roles they enforce the law around waste.

Health Protection Agency (HPA) – provides an integrated approach to protecting the UK public health through provision of support and advice to other government bodies including local authorities. From April 2013 the HPA no longer exists because it has been incorporated into the larger organisation of Public Health England.

The Health and Safety Executive (HSE) – are a government inspecting body for the Health and Safety at Work (etc) Act 1974 along with local authorities. As well as undertaking enforcement duties they offer technical guidance and information to local authorities and create and publish excellent guidance available on their website.

Health and Safety Laboratory (HSL) – are a highly educated technical business set up to minimise risks to people’s health and safety at work through bespoke research and development. They support the work of the HSE and work with a wide range of other public and private-sector organisations.

Local Authorities – Environmental Health departments inspect premises under the Health and Safety Work (etc) Act 1974 and other legislation. They also have a protective role for public health providing information and education to prevent the spread of disease in their local communities.

Public Health England (PHE) – has now incorporated the Health Protection Agency into it and is part of the Department of Health. PHE has been established to protect and improve the nation’s health and wellbeing and to reduce inequalities. and

Tattoo and Piercing Industry Union (TPIU) – is affiliated to the GMB Union and aims to protect the people who work within the tattoo and piercing industry.