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760-1409, Personnel, Health, and Disease Control, Suffolk County, New York
Wes Wood
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These are personal views and opinions of Wes Wood and do not necessarily represent the views and opinions of Unimax Supply Co Inc.
Copyright 2006

760-1409, Personnel, Health, and Disease Control, Update Nov 23, 2006

Section 1. Section 1 needs study to determine the practicality, legality and accuracy of this requirement. Having “any” communicable disease is not a likely justification to prohibit body art activities. In hospitals, the actual disease and the workers likelihood of transmitting that disease are considered on an individual case by case basis. The issue of communicability and scenarios is not addressed by supplying a list of items that can become contaminated by a worker. Basing the prohibition on a list is not sufficient reasoning to prohibit workers their livelihood.  If this were legal and appropriate, it would be clearer to require that no person with a contagious disease engage in activities that would pose a likelihood of causing the transmission of disease to others.
The Article would also seemingly include runny noses and seasonal viruses.  Shop owners might face legal challenge based on employee rights or other unintended ramifications and cause workers financial hardships. It is doubtful that this section is properly evaluated.

Section 2 can be used to illustrate a weakness throughout the Article: specifically, the intent should be to write standards that can be applied to situations. Instead, it is written as a shopping list of allowable and prohibited actions without establishing the standards or the responsibilities needed to help body artists determine the proper responses to daily challenges.

2. The following requirements shall be applicable to all employees engaged in the practice of Body Art Procedures:

a. During all body art procedures,
-the body artist must wear clean outer garments,
-observe a high degree of personal cleanliness,
-conform to hygienic practices, and
-employ the practice of Universal Precautions as defined herein.
While engaged in doing a body art procedure, the body artist's
-shirt or blouse must have sleeves that do not extend below the elbow.

The language creates loopholes and even endangers the safety of body artists.
1. The first oversight is applying the requirements only to "employees" and not the self-employed or proprietors. This lapse is uncharacteristic because the tenor of the Article is to try and out-think loopholes.
2. As written, the dress code and Universal Precautions (as written) are meant to apply only during the procedure, not before or after. This is not mere semantics. Language must be as unambiguous as possible.
3. Outer garments but not undergarments?
4. Not just clean but a "high degree of personal cleanliness."  Personal cleanliness is not sufficient? Spotless? Fastidious? Obsessive?
5. Listing hygienic practices and mixing in Universal Precautions diminishes the importance of Universal Precautions.
6. Universal Precautions “as defined herein" means that the authors have altered OSHA and CDC definitions.

7. "Sleeves" (short sleeves) are made mandatory,
shirt or blouse must have sleeves that do not extend below the elbow,

long sleeves are prohibited. For unspecified reasons tank tops and sleeveless shirts are prohibited.  Because long sleeves can become contaminated in some tattooing by leaning on the client or dragging the long sleeve across a tattoo we can understand the thinking but it is not an accurate assessment of the extent of the problem nor the proper solution. Personal Protective Equipment is the last step of defense against blood exposure to prevent contamination of the worker. When the tattooist is leaning on a tattoo the arm and any clothes must be protected with PPE. This prohibition exposes the arm to contamination. This is a serious. More than half of all tattoos do not have a likelihood of blood exposure to the artist's arm, and no piercing procedures exposes the piercer to exposure. The issue has nothing to do with sleeve length. The principle is that when any body part or a worker's clothes are likely to become exposed to blood they must be protected. 


b. The body artists shall perform proper hand washing in an acceptable hand washing facility before starting work and as often thereafter as may be necessary.

Hands are known to be the major source of spreading disease in hospitals by cross contamination from patient to HCW then to a second patient. Other than when hands are contaminated by exposure, hands can be washed or an alcohol hand preparation (without washing) can be used. The phrase and as often thereafter as may be necessary implies when contaminated. OSHA requires after gloves are removed and before leaving the area.


The next section deals with gloves.
Instead of reading something like: "Body Artists shall use new single-use disposable gloves for each client."
We read:

c. Both of the Body Artist's Hands shall be covered with disposable, Single Use, examination gloves approved by the Department when a body art procedure is performed. These gloves must be changed if they rip or tear, touch any other person, or touch any object or thing that might be a source of contamination during a body art procedure, and for each new customer.


You can see the "add-ons" as they occur to the authors.
-1) An easy one is the "approved by the Department" insertion. OSHA does not undertake this task because there are no industry standards to approve or disapprove makes or types of gloves. This is a good example of bad regulations.

-2) It would have been sufficient to write "Single Use examination gloves shall be worn when contamination is likely." or "Personal protective equipment (for example, gloves) shall be used when exposure to blood or body fluids is anticipated."
-3) The word "Hands" (plural) should be enough of an explanation, but why "Both" hands; but we know why: the writers think body artists are likely to seek loop-holes and use only one glove unless they are specifically prohibited
-4) An awkward expression like "both hands shall be covered with” is almost as bad as stipulating that the hands must be "inside” the gloves.
This is not an isolated example out of context.

The paragraph continues with a list of the conditions that explain when gloves should be changed.

These gloves must be changed if they rip or tear, touch any other person, or touch any object or thing that might be a source of contamination during a body art procedure, and for each new customer.


First, anything “might” be a source of contamination, so that is not helpful.
Second, the language may include the client as a source of contamination. Does “other person” mean other than the worker or other than the client?  We know this confusion is not intended, but it is created. And the appended: “and for each new customer”?
It should read something like “gloves must be changed if their function as a barrier is compromised.” This is a performance-based prescription that can be applied to any new or unexpected situation.
1) Notice: not just gloves, but "These" gloves –

2) Rip and tear mean the same but holes are forgotten.

It should be something like "maintain the protective performance of the glove."
3) The "obsession" with detailing leads to greater error.  For example, "objects" does not seem to be enough. Included are "things" which somehow are different than "objects". Specifying conditions creates a boundary which leads to more additions as each new condition is added.

There's more in every sentence.
4) The same paragraph adds a condition: "...that might be a source of contamination." "Might" be a source of contamination is incorrect.  The instruction is not “might,” but when they become contaminated.

The condition as written confuses the issue. a) Might means also might not. How to judge might is a problem? b) What about things we think might not be contaminated but are?  Should they be included? c) "During" a body art procedure leads to the question: not before or after? and d) what about contamination from touching the client-person, where does that fit in? e) For each "new" customer. (not old customers?).  The clarifications create new exceptions which cause more clarifications to be written and results in leaving things out that should be included. The attempt to be exhaustively inclusive is self-defeating. This is everywhere and not isolated.

c. The body artist shall keep fingernails clean and neatly trimmed.
d. The body artist shall not wear cosmetics or jewelry that is deemed to interfere with prescribed personal hygiene and grooming practices put forth by the department and would subsequently interfere with effective hand washing or the performance of any body art procedures.

The problem here is the tortured stream of thinking. What does "shall not wear" anything "deemed" to interfere with "grooming practices." Grooming practices? How do cosmetics "subsequently interfere with effective hand washing"? Is hand washing a grooming practice or "performance" of any body art?  Do cosmetics (usually confined to the face) interfere "with prescribed personal hygiene and grooming practices put forth by the department" What practices? Where are these “prescribed grooming practices” to be found?

Yes, jewelry and long nails can produce challenges to gloves that we would like to avoid by keeping nails short and limiting the amount and types of jewelry worn. But this is not surgery. Tattoo and piercing do not create the same dangers as creating open exposed wounds. This is piercing and tattooing not surgical procedures.  The rigors of surgery are not \appropriately applied to tattooing and piercing.  This is a characteristic error of the Article: it includes ancillary good ideas (that would not be discouraged), such as fingernail brushes and files at every hand washing facility for every artist, as if they are crucial and thus must be compulsory.


Here's another example

760-1409 2:e (this entire section can easily be replaced with a simple sentence)

e) "The use of tobacco in any form or any other substance (as if non-tobacco smoking items are not prohibited – so the writer adds more) used in the form of a cigarette or pipe for smoking purposes (The felt need is to spell out that a cigarette or pipe is used for smoking. Then it says) "The use of tobacco will be conformance with New York State Public Health Law."

Instead of saying "Body Art Shops are not exempt from the NYS Clean Air Act" and leaving it at that we get a barrage of obsessive-compulsive writing. Even this statement is not necessary because the law already exists and is known.

The next paragraph:

"f. The consumption of food and drink by employees shall be restricted to designated areas acceptable to the commissioner. There shall be no consumption of food or drink in the workstation areas of the body art establishment."

This prohibition is copied from Food Preparation regulations and reasonable in that situation. It is obvious that eating a sandwich when packaging food or making pizza is not a good idea. OSHA's  position is that food and drink must be stored and used in areas where cross-contamination is unlikely, primarily addressing laboratories that have beakers and dishes of contaminated items on benches and places that have refrigerators for medical purposes. Here, the Department usurps the role of the employer and micro-manage. Not only is eating prohibited in the work area but a special designated area within the approved area must get approval.  You would not be allowed to drink a soda at the counter.

Understanding the issues, the reasons could be written something like: "food and drink shall only be stored and consumed in areas where and in a manner that contamination is unlikely." – that takes care of everything.

There is an issue here that needs consideration.

It is common in tattoo and piercing for clients to need food or drink energy to continue. Working efficiently and in one session is Best Practice and often requires refreshment without leaving the chair, for good reason. Aren’t patients continuously fed intravenously during operations?  Delays during tattooing produce greater pain. Sometimes food or drink can merely calm a client down. To prohibit this tried and proven technique to maintain the energy level of clients (and the artist) violates the wisdom and experience of the body art world.  Tattooists and piercers have experience day after day and year after year that no outsider can match.  This prohibition should not be allowed to remain. When mentioned, an inspector said he never heard of this, and if true he would have been told.  This year, 2006, in Brooklyn a client died in a tattoo shop because he left his chair to get some food.  He got up, walked toward the counter and fainted, his head crashing into a glass showcase, slicing his neck. He died in the shop.

In defense of the prohibition it was said "Don't you know food can cause infection?"  This was a sad statement.