The purpose of this chapter is to set forth a regulatory scheme
for the City of Springfield to protect the health, welfare and safety
of citizens of the City where the City Council seek to enact an ordinance
governing the practice of body art.
For the purpose of the chapter, the following definitions shall
be applicable:
AFTERCARE
Written instructions given to the client, specific to the
body art procedure(s) rendered, about caring for the body art and
surrounding area, including information about when to seek medical
treatment, if necessary.
APPLICANT
Any person who applies to the Department of Health and Human
Services ("HHS") for either a body art establishment permit or practitioner
permit.
AUTOCLAVE
An apparatus for sterilization utilizing steam pressure at
a specific temperature over a period of time.
AUTOCLAVING
A process which results in the destruction of all forms of
microbial life, including highly resistant spores, by the use of an
autoclave for a minimum of 30 minutes at 20 pounds of pressure (PSI)
at a temperature of 270° F.
BLOODBORNE PATHOGENS STANDARD
OSHA guidelines contained in 29 CFR 1910.1030, entitled "Occupational
Exposure to Bloodborne Pathogens," as amended.
BODY ART
The practice of physical body adornment by permitted establishments
and practitioners using, but not limited to, the following techniques:
body piercing, tattooing, cosmetic tattooing, branding, and scarification.
This definition does not include practices that are considered medical
procedures by the Board of Registration in Medicine, such as implants
under the skin, which are prohibited.
BODY ART ESTABLISHMENT or ESTABLISHMENT
A location, place, or business that has been granted a permit
by HHS, whether public or private, where the practices of body art
are performed, whether or not for profit.
BODY ART PRACTITIONER or PRACTITIONER
A specifically identified individual who has been granted
a permit by HHS to perform body art in an establishment that has been
granted a permit by HHS.
BODY PIERCING
Puncturing or penetrating the skin of a client with presterilized
single-use needles and the insertion of presterilized jewelry or other
adornment into the opening. This definition excludes piercing of the
earlobe with a presterilized single-use stud-and-clasp system manufactured
exclusively for ear piercing.
BRANDING
Inducing a pattern of scar tissue by use of a heated material
(usually metal) to the skin, making a serious burn, which eventually
becomes a scar.
CLIENT
A member of the public who requests a body art procedure
at a body art establishment.
CONTAMINATED WASTE
Waste as defined in 105 CMR 480.000, Storage and Disposal
of Infectious or Physically Dangerous Medical or Biological Waste,
State Sanitary Code, Chapter VIII, as amended.
DEPARTMENT
The Department of Public Health or its authorized representatives.
DIRECTOR
The Director of the City of Springfield Health and Human
Services Department.
DISINFECTANT
A product registered as a disinfectant by the United States
Environmental Protection Agency (EPA).
DISINFECTION
The destruction of disease-causing microorganisms on inanimate
objects or surfaces, thereby rendering these objects safe for use
or handling.
EAR PIERCING
The puncturing of the lobe of the ear with a presterilized
single-use stud-and-clasp ear piercing system following the manufacturer's
instructions.
EQUIPMENT
All machinery, including fixtures, containers, vessels, tools,
devices, implements, furniture, display and storage areas, sinks,
and all other apparatus and appurtenances used in connection with
the operation of a body art establishment.
HAND SINK
A lavatory equipped with hot and cold running water under
pressure, used solely for washing hands, arms, or other portions of
the body.
HEALTH AND HUMAN SERVICES
The Department of Health and Human Services, which has jurisdiction
in the City to regulate a body art establishment pursuant to state
laws acting as the Board of Health.
HOT WATER
Water that attains and maintains a temperature of 110°
F. to 130° F.
INSTRUMENTS USED FOR BODY ART
Hand pieces, needles, needle bars, and other instruments
that may come in contact with a client's body or may be exposed
to bodily fluids during any body art procedure.
INVASIVE
Entry into the client's body either by incision or insertion
of any instruments into or through the skin or mucosa, or by any other
means intended to puncture, break, or otherwise compromise the skin
or mucosa.
JEWELRY
Any ornament inserted into a newly pierced area, which must
be made of surgical-implant-grade stainless steel, solid 14k or 18k
white or yellow gold, niobium, titanium, or platinum, or a dense,
low-porosity plastic, which is free of nicks, scratches, or irregular
surfaces and has been properly sterilized prior to use.
MINOR
Any person under the age of 18 years.
OPERATOR
Any person who individually, or jointly or severally with
others owns or controls an establishment, but is not a body art practitioner.
PERMIT
HHS approval in writing to either operate a body art establishment
or operate as a body art practitioner within a body art establishment.
HHS approval shall be granted solely for the practice of body art
pursuant to this chapter. Said permit is exclusive of the establishment's
compliance with other licensing or permitting requirements that may
exist within the community or political subdivision comprising HHS's
jurisdiction.
PERSON
An individual, any form of business or social organization
or any other nongovernmental legal entity, including but not limited
to corporations, partnerships, limited-liability companies, associations,
trusts or unincorporated organizations.
PHYSICIAN
An individual licensed as a qualified physician by the Board
of Registration in Medicine pursuant to MGL c. 112, § 2.
PROCEDURE SURFACE
Any surface of an inanimate object that contacts the client's
unclothed body during a body art procedure, skin preparation of the
area adjacent to and including the body art procedure, or any associated
work area which may require sanitizing.
SANITARY
Clean and free of agents of infection or disease. "Sanitize"
means the application of a United States EPA-registered sanitizer
on a cleaned surface in accordance with the label instructions.
SCARIFICATION
Altering skin texture by cutting the skin and controlling
the body's healing process in order to produce wounds, which
results in permanently raised wheals or bumps known as "keloids."
SHARPS
Any object, sterile or contaminated, that may intentionally
or accidentally cut or penetrate the skin or mucosa, including, but
not limited to, needle devices, lancets, scalpel blades, razor blades,
and broken glass.
SHARPS CONTAINER
A puncture-resistant, leakproof container that can be closed
for handling, storage, transportation, and disposal and that is labeled
with the International Biohazard Symbol.
SINGLE-USE ITEMS
Products or items that are intended for one-time, one-person
use and are disposed of after use on each client, including, but not
limited to, cotton swabs or balls, tissues or paper products, paper
or plastic cups, gauze and sanitary coverings, razors, piercing needles,
scalpel blades, stencils, ink cups, and protective gloves.
STERILIZE
The use of a physical or chemical procedure to destroy all
microbial life, including highly resistant bacterial endospores.
TATTOO
The indelible mark, figure or decorative design introduced
by insertion of dyes or pigments into or under the subcutaneous portion
of the skin.
TATTOOING
Any method of placing ink or other pigment into or under
the skin or mucosa by the aid of needles or any other instrument used
to puncture the skin, resulting in permanent coloration of the skin
or mucosa. This term includes all forms of cosmetic tattooing.
ULTRASONIC CLEANING UNIT
A unit approved by the HHS, physically large enough to fully
submerge instruments in liquid, which removes all foreign matter from
the instruments by means of high-frequency oscillations transmitted
through the contained liquid.
UNIVERSAL PRECAUTIONS
A set of guidelines and controls, published by the Centers
for Disease Control and Prevention (CDC), as "Guidelines for Prevention
of Transmission of Human Immunodeficiency Virus (HIV) and Hepatitis
B Virus (HBV) to Health-Care and Public-Safety Workers" in Morbidity
and Mortality Weekly Report (MMWR), June 23, 1989, Vol. 38 No. S-6,
and as "Recommendations for Preventing Transmission of Human Immunodeficiency
Virus and Hepatitis B Virus to Patients During Exposure-Prone Invasive
Procedures" in MMWR, July 12, 1991, Vol. 40, No. RR-8, as amended.
This method of infection control requires the employer and the employee
to assume that all human blood and specified human body fluids are
infectious for HIV, HBV, and other blood pathogens. Precautions include
hand washing; gloving; personal protective equipment; injury prevention;
and proper handling and disposal of needles, other sharp instruments,
and blood- and body-fluid-contaminated products.
Practitioners are required to comply with the following minimum
health standards:
A. A practitioner shall perform all body art procedures in accordance
with universal precautions set forth by the United States Centers
for Disease Control and Prevention.
B. A practitioner shall refuse service to any person who may be under
the influence of alcohol or drugs.
C. Practitioners who use ear piercing systems must conform to the manufacturer's
directions for use, and to applicable United States Food and Drug
Administration requirements. No practitioner shall use an ear piercing
system on any part of the client's body other than the lobe of
the ear.
D. Health history and client informed consent. Prior to performing a
body art procedure on a client, the practitioner shall:
(1) Inform the client, verbally and in writing, that the following health
conditions may increase health risks associated with receiving a body
art procedure:
(b)
History of hemophilia (bleeding);
(c)
History of skin diseases, skin lesions, or skin sensitivities
to soaps, disinfectants, etc.;
(d)
History of allergies or adverse reactions to pigments, dyes
or other sensitivities;
(e)
History of epilepsy, seizures, fainting or narcolepsy;
(f)
Use of medications such as anticoagulants, which thin the blood
and/or interfere with blood clotting; and
(g)
Any other conditions such as hepatitis or HIV.
(2) Require that the client sign a form confirming that the above information was provided, that the client does not have a condition that prevents him/her from receiving body art, that the client consents to the performance of the body art procedure and that the client has been given the aftercare instructions as required by Subsection
K.
E. A practitioner shall maintain the highest degree of personal cleanliness,
conform to best standard hygienic practices, and wear clean clothes
when performing body art procedures. Before performing body art procedures,
the practitioner must thoroughly wash his/her hands in hot running
water with liquid soap, then rinse hands and dry with disposable paper
towels. This shall be done as often as necessary to remove contaminants.
F. In performing body art procedures, a practitioner shall wear disposable single-use gloves. Gloves shall be changed if they become pierced, torn, or otherwise contaminated by contact with any unclean surfaces or objects or by contact with a third person. The gloves shall be discarded, at a minimum, after the completion of each procedure on an individual client, and hands shall be washed in accordance with Subsection
E before the next set of gloves is put on. Under no circumstances shall a single pair of gloves be used on more than one person. The use of disposable single-use gloves does not preclude or substitute for hand-washing procedures as part of a good personal hygiene program.
G. The skin of the practitioner shall be free of rash or infection.
No practitioner affected with boils, infected wounds, open sores,
abrasions, weeping dermatological lesions or acute respiratory infection
shall work in any area of a body art establishment in any capacity
in which there is a likelihood that the person could contaminate body
art equipment, supplies, or working surfaces with body substances
or pathogenic organisms.
H. Any item or instrument used for body art that is contaminated during
the procedure shall be discarded and replaced immediately with a new
disposable item or a new sterilized instrument or item before the
procedure resumes.
I. Preparation and care of a client's skin area must comply with
the following:
(1) Any skin or mucosa surface to receive a body art procedure shall
be free of rash or any visible infection.
(2) Before a body art procedure is performed, the immediate skin area
and the areas of skin surrounding where the body art procedure is
to be placed shall be washed with soap and water or an approved surgical
skin preparation. If shaving is necessary, single-use disposable razors
or safety razors with single-service blades shall be used. Blades
shall be discarded after each use, and reusable holders shall be cleaned
and autoclaved after use. Following shaving, the skin and surrounding
area shall be washed with soap and water. The washing pad shall be
discarded after a single use.
(3) In the event of bleeding, all products used to stop the bleeding
or to absorb blood shall be single-use, and discarded immediately
after use in appropriate covered containers, and disposed of in accordance
with 105 CMR 480.000.
J. Petroleum jellies, soaps, and other products used in the application
of stencils shall be dispensed and applied on the area to receive
a body art procedure with sterile gauze or other sterile applicator
to prevent contamination of the original container and its contents.
The applicator or gauze shall be used once and then discarded.
K. The practitioner shall provide each client with verbal and written
instructions on the aftercare of the body art site.
(1) The
written instructions shall advise the client:
(a)
On the proper cleansing of the area which received the body
art;
(b)
To consult a health care provider for:
[1]
Unexpected redness, tenderness or swelling at the site of the
body art procedure;
[3]
Unexpected drainage at or from the site of the body art procedure;
or
[4]
A fever within 24 hours of the body art procedure; and
(c) The address, and phone number of the establishment.
(2) A copy shall be provided to the client.
(3) A model
set of aftercare instructions shall be made available by the Department.
L. Contaminated waste shall be stored, treated and disposed of in accordance
with 105 CMR 480.000, Storage and Disposal of Infectious or Physically
Dangerous Medical or Biological Waster, State Sanitary Code, Chapter
VIII, as amended.
A written report of any injury, infection complication or disease
as a result of a body art procedure, or complaint of injury, infection
complication or disease, shall be forwarded by the operator to HHS
which issued the permit, with a copy to the injured client, within
five working days of its occurrence or knowledge thereof. The report
shall include:
A. The name of the affected client.
B. The name and location of the body art establishment involved.
C. The nature of the injury, infection complication or disease.
D. The name and address of the affected client's health care provider,
if any.
E. Any other information considered relevant to the situation.
HHS may summarily suspend a permit pending a final hearing on
the merits on the question of revocation if, based on the evidence
before it, HHS determines that an establishment and/or a practitioner
is an immediate and serious threat to the public health, safety or
welfare. The suspension of a permit shall take effect immediately
upon written notice of such suspension by the Director.
HHS shall refer to the appropriate district attorney, attorney
general, or other law enforcement official any incidents of unauthorized
practice of body art.