Body art practitioners should demonstrate knowledge of and practice
universal precautions, sanitation, personal hygiene, sterilization
and aftercare safety measures to prevent the transmission of disease
or injury to the client and/or practitioner. In advancement of these
principles, the Board of Health of the Town of Lexington passes these
rules and regulations for the practice of body art in the Town of
Lexington as part of its mission to protect the health, safety and
welfare of the public.
These regulations are promulgated under the authority granted
to the Board of Health under MGL c. 111, § 31.
As used in this article, the following terms shall have the
meanings indicated:
AFTERCARE
Written instructions given to the client, specific to the
body art procedure(s) rendered, concerning how the client should care
for the body art site, including information about when to seek medical
treatment, if necessary.
ANTISEPTIC
An agent that destroys disease-causing microorganisms on
human skin or mucus.
APPLICANT
Any person who applies to the Board of Health for either
a body art establishment permit or practitioner permit.
APPRENTICE
An individual who has completed the minimal education requirements
of this regulation but has not met the training requirement and is
practicing a kind of body art at a body art establishment under supervision
of a fully licensed body art practitioner as defined in this regulation.
AUTOCLAVE
An apparatus for sterilization which utilizes steam pressure
at a specific temperature over a particular 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.
BOARD OF HEALTH
The Town of Lexington agency or its authorized representatives,
having jurisdiction to promulgate, monitor, administer, and enforce
these regulations.
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.
The term "body art" shall not include ear piercing, as defined herein,
nor practices that are considered medical procedures by the Board
of Registration in Medicine, such as implants under the skin, and
are otherwise regulated as such.
BODY ART ESTABLISHMENT or ESTABLISHMENT
A location, place or business (whether public or private)
that has been granted a permit by the Board of Health pursuant to
these regulations where the practices of body art are performed, whether
or not for profit.
BODY ART SITE
The specific area of the body in or on which any body art
procedure is performed.
BODY PIERCING
Puncturing or otherwise penetrating the skin of a client
with pre-sterilized single-use needles and the insertion of pre-sterilized
jewelry or other adornment into the opening. The term "body piercing"
shall exclude ear piercing as defined herein.
BRAIDING
The cutting of strips of skin of a person, which strips are
then to be intertwined with one another and placed onto such person
for the purpose of causing the incised and interwoven strips of skin
to heal in such intertwined condition.
BRANDING
The use of a heated material (usually metal) to the skin
for the purpose of causing a serious burn to induce a pattern of scar
tissue on the skin.
CLEANING AREA
The location in a body art establishment which is used for
the sterilization, sanitation or other cleaning of equipment used
in the practice of body art.
CLIENT
An individual who requests and receives a body art procedure(s)
at a body art establishment.
CONTAMINATED WASTE
Waste as defined in 105 CMR 480.000 et seq., Storage and
Disposal of Infectious or Physically Dangerous Medical or Biological
Waste (State Sanitary Code, Chapter VIII) and/or 29 CFR 1910.1030.
The term "contaminated waste" shall include, but shall not be limited
to, any liquid or semiliquid blood or other potentially infectious
material; contaminated items that would release blood or other potentially
infectious material in a liquid or semiliquid state if compressed;
items on which there is dried blood or other potentially infectious
material and which are capable of releasing these materials during
handling; and sharps and any wastes containing blood or other potentially
infectious materials.
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.
EAR PIERCING
The puncturing of the lobe of the ear with a pre-sterilized
single-use stud-and-clasp ear-piercing system.
EQUIPMENT
All machinery, fixtures, containers, vessels, tools, devices,
implements, furniture, display and storage areas, sinks and all other
apparatuses and appurtenances used in the operation of a body art
establishment.
EXPOSURE
Contact of an eye, mouth or other mucus membrane, non-intact
skin with potentially infectious matter, including but not limited
to blood or other bodily fluids of another person.
HAND SINK
A lavatory equipped with hot and cold running water under
pressure, used solely for washing or disinfecting hands, arms or other
portions of the body.
HOT WATER
Water that attains and maintains a temperature of 110°
to 130° F.
INKS/PIMENTS/DYES
Metal- or salt-based substances injected into the subcutaneous
portion of the skin in the act or process of creating a tattoo.
INSTRUMENTS
Hand pieces, needles, needle bars, and other implements that
may come in contact with a client's body or may be exposed to
blood or other bodily fluids during any body art procedure.
INVASIVE
Describes any body art procedure during which any instruments
enter the client's body into or through the skin or mucosa, either
by incision or insertion, 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.
MICROBLADING
A pulling or swiping motion with a set of slightly curved
needles. It results in a fine line or scoring of the skin into which
the temporary color is delivered by multiple needles being moved as
they rotate through the skin in a slight curve.
MINOR
Any person under the age of 18 years.
MOBILE OR TEMPORARY BODY ART ESTABLISHMENT
Any trailer, truck, car, van, camper or other motorized or
nonmotorized vehicle; a shed, tent or other movable structure; a bar,
home or other facility; or a concert, fair, party or other event or
temporary establishment used to conduct body art procedures.
OPERATOR
Any person that individually, or jointly or severally with
others, owns or controls a body art establishment but is not a body
art practitioner.
PERMIT
Approval of the Board of Health in writing to either operate
a body art establishment or operate as a body art practitioner within
a body art establishment. Said permit is exclusive of the establishment's
compliance with other federal, state or local licensing or permitting
requirements.
PERSON
Any person, firm, partnership, association, corporation,
company or organization of any kind.
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 or on which skin preparation
of the area adjacent to and including the body art procedure is performed.
SANITARY
Clean and free of agents of infection or disease.
SANITIZE
The application of an 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, resulting
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 of sharps 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 that 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, protective gloves, inks, dyes
and pigments. All products applied to the skin, such as but not limited
to body art stencils, applicators, gauze and razors, are single-use
items.
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 creating a tattoo. This term includes all forms
of cosmetic tattooing.
THREE-DIMENSIONAL (3D) BODY ART or BEADING or IMPLANTATION
Placing, injecting or inserting an object, device or other
thing made of matters such as steel, titanium, rubber, latex, plastic,
glass or other inert materials beneath the surface of the skin of
a person. This term does not include body piercing.
ULTRASONIC CLEANING UNIT
A unit which removes all foreign matter from instruments
by means of high-frequency oscillations transmitted through the contained
liquid. Such unit must be approved by the Board of Health and must
be large enough to fully submerge instruments in liquid.
UNIVERSAL PRECAUTIONS
Includes 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.
Pursuant to universal precautions, body art practitioners and operators
and clients must assume that all human blood and specified human body
fluids are infectious for HIV, HBV and other blood pathogens. The
complete set of guidelines and controls is 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.
Body art practitioners must comply with the following minimum
health standards:
A. A practitioner shall perform all body art procedures in accordance
with universal precautions, as defined herein.
B. A practitioner shall refuse service to any person who appears to
a reasonable person to be under the influence of alcohol or drugs.
C. 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 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 (or other bleeding condition);
(c)
History of skin diseases, skin lesions, or skin sensitivities
to soaps or disinfectants;
(d)
History of allergies or adverse reactions to pigments or dyes;
(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:
(a)
The information specified in Subsection
D(1) was provided;
(b)
The client does not have a condition that prevents him or her
from receiving body art;
(c)
The client consents to the performance of the body art procedure;
and
(d)
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 her hands in hot running water
with liquid soap, then rinse her hands and dry them with disposable
paper towels. This shall be done as often as necessary to remove contaminants.
F. When performing body art procedures, a practitioner must wear disposable single-use gloves. Under no circumstances shall a single pair of gloves be used on more than one person. Gloves shall be changed if they become pierced, torn, or otherwise contaminated by contact with any unclean surface or object 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 the practitioner's hands must be washed in accordance with Subsection
E before the next set of gloves is put on.
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 that person could contaminate
clients, other practitioners, body art equipment, supplies, or working
surfaces with body fluids or pathogenic organisms.
H. Any item or instrument used for body art that is contaminated during
the body art procedure shall be discarded and replaced immediately
with a new disposable item or a new sterilized instrument or item
before the procedure resumes.
I. A practitioner's preparation of and care for a client's
skin must comply with the following:
(1)
Any body art site must be free of rash or any visible infection.
(2)
Before a body art procedure is performed, the body art site
shall be washed with soap and water and an approved surgical skin
preparation.
(3)
If shaving is necessary, single-use disposable razors or safety razors with single-service blades must be used. Blades shall be discarded after each use, and reusable holders shall be cleaned and autoclaved after use pursuant to §
155-123C. Following shaving, the skin and surrounding area shall be washed with soap and water. The washing pad shall be discarded after a single use.
(4)
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 et seq.
J. Petroleum jellies, soaps, and other products used in the application
of stencils shall be dispensed and applied on the body art site with
sterile gauze or a similarly sterile applicator to prevent contamination
of the original container and its contents. The applicator or gauze
shall be discarded after a single use.
K. Aftercare instructions.
(1)
The practitioner shall provide each client with verbal and written
instructions on the aftercare of the body art site. The written instructions
shall advise the client:
(a)
On the proper cleansing of the body art site;
(b)
To consult a health care provider for:
[1]
Redness, tenderness or swelling at the body art site;
[3]
Drainage at or from the body art site; or
[4]
A fever within 24 hours of the body art procedure; and
(c)
Of the address and phone number of the body art establishment
and the name of the practitioner involved.
(d)
These written instructions for the aftercare shall be signed
and dated by both the practitioner and the client, with a copy given
to the client. The operator must retain the original with all other
required records.
(2)
A model set of aftercare instructions shall be made available
by the Board of Health.
L. Contaminated waste shall be stored, treated and disposed of in accordance
with 105 CMR 480.000 et seq., Storage and Disposal of Infectious or
Physically Dangerous Medical or Biological Waste (State Sanitary Code,
Chapter VIII).
If any section, paragraph or part of these regulations is for
any reason declared invalid or unconstitutional by any court, every
other section, paragraph and part shall continue in full force.
Nothing in these regulations shall be construed to restrict,
amend, repeal, or otherwise limit the application or enforcement of
existing Town of Lexington bylaws or Commonwealth of Massachusetts
laws.
In accordance with MGL c. 40, § 21D, any person violating any provision of these regulations is subject to the penalties under Chapter
1, §
1-6, of the General Bylaws. Each day that a violation continues shall be deemed to be a separate offense.
These regulations shall be effective as of January 16, 2002,
and shall supersede all existing body art regulations promulgated
by the Lexington Board of Health.