[Added 9-8-1997; amended 9-14-1998]
A.
The Town of Chelmsford is promulgating rules and regulations
which provide minimum requirements to be met by any person performing
body piercing upon any individual and for any establishment where
body piercing is performed. These requirements shall include, but
are not limited to, general sanitation of premises wherein body piercing
is to be performed along with sterilization of instruments. These
rules and regulations are necessary to protect the public's health
by preventing diseases, including but not limited to transmission
of Hepatitis B and/or human immunodeficiency virus (HIV/AIDS).
B.
In addition, these rules and regulations shall establish
procedures for registration with the Board of Health of all persons
performing body piercing, for the requirement of minimal training
standards for the prevention of disease transmission and for knowledge
of anatomy and physiology, for regular inspection of premises wherein
body piercing is performed and for revocation of the registration
of any person or establishment deemed in violation of the rules and
regulations promulgated under this article. An annual, nontransferable
registration fee, set by the Chelmsford Board of Health, shall be
paid by any person or establishment registered under this article.
The following words, as used in these rules
and regulations, unless the context otherwise requires, shall have
the following meanings:
Any solution used to retard the growth of bacteria for application
to human skin and which is so labeled.
The Director of the Chelmsford Board of Health and his or
her clerk, officers, agents, assistants and/or inspectors.
Any person who performs piercing of any part of the body
other than the earlobe which is pierced by use of an appropriate piercing
gun.
A written instrument, issued by the Board of Health, authorizing
the person named therein to engage in the work of body piercing.
Any method of inserting a needle into the body to place jewelry
in the perforation produced by the needle. Establishments and/or individuals
involved in the piercing of earlobes only and using approved ear piercing
guns are subject only to the general rules and regulations.
Any solution which destroys germs and is so labeled.
Any person under the age of 18.
Any person who owns, controls, operates, conducts or manages
any piercing establishment, whether actually performing the work of
piercing or not.
Any room or space where piercing is practiced or where the
business of piercing is conducted or any part thereof.
Clean and free of agents of infection or disease.
Effective bacterial treatment by a process that provides
sufficient concentration of chemicals for enough time to reduce the
bacteria count, including pathogens, to a safe level on equipment.
Holding in an autoclave for 30 minutes, at 20 pounds' pressure,
at a temperature of 275° F.
A.
No minor shall receive body piercing unless accompanied
by a parent or legal guardian who has signed a consent form. No piercing
of the genitalia of minors shall be allowed.
B.
No piercing of animals shall be allowed in piercing
studios.
C.
Preprocedural consultation to discuss body piercing,
its risks and potential complications shall be required with each
client not less than 72 hours prior to the procedure. An informed
consent form shall be signed by all clients. Clients shall be supplied
a copy of the consent form and the consent form shall be kept on file
by the body piercer. Clients should be told to consult with their
physician regarding any medical condition which could be exacerbated
by the piercing procedure (i.e., hemophilia, open sores, etc.).
D.
Patrons who admit to or are obviously under the influence
of alcohol or other judgment-altering drugs shall not receive a body
piercing.
E.
Body piercers shall not be under the influence of
any substance, legal or illegal, which might impair their judgment
or ability to properly perform body piercing.
F.
Patrons should receive verbal and written instructions
on the cleaning, use of antiseptics and other specific instructions
for each piercing after the piercing, including the signs and symptoms
of complications.
G.
Appropriate disinfectants must be used to disinfect
the surface of the skin in the area to be pierced prior to piercing.
H.
Infections and adverse reactions of any kind suspected
from the application of piercing which become known to the body piercer
shall be reported to the Board of Health within 24 hours and the patron
referred to a physician for examination.
I.
Body piercers who receive needle stick injuries and/or
any potential exposure to blood-borne pathogens on the job shall follow
the Occupational Safety and Health Administration (OSHA) guidelines
on the reporting and follow-up on needle stick injuries. OSHA guidelines
for needle stick follow-up shall be posted in the employee area [Code
of Federal Regulations 29 CFR 1910.1030(f)].
J.
It is mandated that body piercers receive the series
of Hepatitis B vaccinations and tetanus doses or booster shot.
K.
The gun used for the piercing of ear lobes only must
be disinfected with an Environmental Protection Agency (EPA) approved
disinfectant, such as madicide or a similar product.
L.
Failure to comply with any of the above regulations
may result in immediate revocation of registration.
A.
No person or body piercer shall perform body piercing,
display a sign or in any other way advertise or purport to be a body
piercer unless that person holds a valid certificate of registration
from the Board of Health.
B.
An applicant for registration shall pay a fee of $100
with an annual renewal fee of $100 and shall show to the satisfaction
of the Board of Health that the applicant:
(1)
Has complied with the applicable rules and regulations
of the Board of Health.
(2)
Upon application, has provided evidence in the form
of a driver's license/state identification card or federal identification
card that the applicant is not less than 18 years of age.
(3)
Upon application, has signed a form consenting to
abide by the rules and regulations and recommended procedures on the
prevention of disease transmission in body piercing, sanitation, sterilization,
handling of infections, universal body fluid precautions, sharp and
biologic waste disposal and wound care as stated in the federal register
of EPA rules and regulations on blood-borne pathogens.
(4)
Upon application, shall notify the Board of Health,
in writing, of the regular address of the place where the person performs
or intends to perform body piercing and shall keep the registration
certificate conspicuously posted in the place of business at all times.
Body piercers shall operate only out of facilities approved by the
Board of Health to perform body piercing. Body piercers shall be required
to demonstrate proper sanitary procedures and to develop and submit
their policy on infection control to the Board of Health.
C.
Minimal requirements. Whoever, not being registered
as a qualified nurse under MGL c. 112, § 74 or as a qualified
physician under MGL c. 112, § 2, or corresponding earlier
laws, punctures a body part (excluding the ear) of any person by means
of body piercing shall be punished by a fine of not more than $1,000.
A.
Facilities.
(1)
Facilities must be located in an area zoned for business.
(2)
Studio design, furniture, lighting, plumbing, water
and sewage must be in accordance with local bylaws.
(3)
With the exception of service animals (e.g., guide
dogs), no animals should be allowed on the premises.
(4)
The floor and all other surfaces shall be maintained
in a clean condition at all times. The walls and ceilings shall be
kept clean and in good repair at all times. Light fixtures, decorative
materials and similar equipment attached to the walls or ceilings
shall be kept clean.
(5)
Adequate ventilation (such as air conditioning, etc.)
to keep the area dry and air circulating should be used. ("Adequate
ventilation" shall mean a free and unrestricted circulation of fresh
air throughout the body piercing studio and the expulsion of foul
or stagnant air.) The use of a HEPA ventilation system is required.
(6)
Convenient, clean and sanitary toilet and hand washing
facilities shall be made accessible to customers. A sign shall be
posted in the bathroom which forbids insertion or handling of piercing/jewelry.
The plumbing fixtures and toilet room shall be maintained in a sanitary
manner and in good repair. Single-service hand towels or mechanical
means for hand drying shall be provided.
(7)
Proper biologic waste and sharps disposal of single-use
items and needles exposed to body fluids shall be required in accordance
with state and local regulations. Only medical-grade sharps containers
that are puncture-resistant with tight-fitting lids are acceptable.
(8)
Body piercers shall be equipped with appropriate sterilizing
equipment (i.e., a working steam autoclave). Autoclaves must be spore
tested monthly by independent laboratories to ensure that they are
working adequately, and a record shall be kept available for review
by the Board of Health.
(9)
Body piercers shall be equipped with appropriate cleansing
equipment (i.e., a working ultrasonic cleaner).
B.
Work area.
(1)
Each body piercing studio shall have a separate work
area not used for any other purpose.
(2)
No one shall be pierced at any other location in the
studio other than the work area.
(3)
No customer should be allowed to perform their own
piercing/insertions anywhere on the premises.
(4)
Work areas shall not be used as a corridor for access
to other rooms.
(5)
Body piercing must be performed in a room approved
by the Board of Health.
(6)
The floors, chairs and table tops where body piercing
equipment and body piercing work is done should be nonporous. Carpet
is not permitted as a floor covering in the work area where the body
piercing is applied.
(7)
The work area should be well lighted. The work area
shall have at least 50 footcandles of light measured at the height
of the work table.
(8)
Facilities shall be equipped with sinks and basins
with hot and cold running water for the exclusive use of the piercers
for washing their hands and preparing their clients for body piercing.
(9)
A covered waste receptacle with disposable liner bags
shall be located in the work area.
(10)
No person shall smoke, consume any food or drink
in the work area.
(11)
No other activities (such as hair styling, etc.)
shall be performed in any room designated for body piercing.
A.
Business procedure and jewelry.
(1)
Body piercers shall, prior to body piercing, complete
all business transactions and complete the client consent form and
provide a copy to the client.
(2)
Client and piercer must have appropriate size and
quality jewelry chosen before the procedure begins.
(3)
Only appropriate jewelry should be used in piercing.
Appropriate jewelry is made of implant-grade, high-quality surgical
steel (316E Series), solid 14K or 18K gold, niobium, titanium or platinum.
Appropriate jewelry has no nicks, scratches or irregular surfaces
which might endanger the tissues.
(4)
Ear studs or other jewelry designed for earlobe piercing
is not appropriate jewelry for other body parts and must not be used
by piercers.
B.
Hand washing and general health of body piercer. Before
working on each patron, the body piercer shall:
(1)
Inspect hands for small cuts and abrasions.
(2)
Refrain from body piercing or handling equipment if
he or she has open sores, weeping dermatitis or lesions on hands or
arms until the condition has cleared.
(3)
Refrain from body piercing until the condition has
cleared if he or she has a cold, flu or other communicable disease.
(4)
Wash hands, wrists and up to elbows with antibacterial
solution.
(5)
Dry hands thoroughly with single-use disposable towel,
such as a paper towel, or air dry under a heat dryer.
C.
Body piercing procedures.
(1)
Body piercers shall set up equipment in front of client.
(2)
Sealed autoclave bags containing any equipment required
to be sterile shall be opened in front of the client and the autoclave
bag discarded.
(3)
All jewelry contaminated with only airborne pathogens
(not previously worn or contaminated) should be disinfected with a
nonhazardous hard surface disinfectant and must comply with OSHA regulations.
All jewelry contaminated or potentially contaminated with blood-borne
pathogens (previously worn by another person) should be autoclaved,
stored in sterile indicator bags, sealed and dated.
(4)
All needles used in piercing must be presterilized,
used on one person, in one sitting, for single piercing and immediately
disposed of in a medical sharps container.
(5)
All forceps, tubes, etc., must be presterilized, stored
in sterile indicator bags, sealed and dated and used on one person
and in one sitting. After one such use, they must be autoclaved and
stored in sterile indicator bags, sealed and dated.
D.
Disinfection routine.
(1)
Body piercers shall:
(a)
Put on fresh gloves for disinfection routine.
(b)
Move in such a manner to avoid recontamination
of surfaces.
(c)
Discard disposable items and remove from areas.
(d)
Remove plastic barrier film (if used) and disinfect
surface areas, drawer pulls, cabinetry, telephones, lamps, chairs,
sinks, ultrasonic tanks, tables, chairs, floor area and any other
surfaces that might have become contaminated.
(e)
Dispose of single-use (disposable) lap cloths.
(f)
Remove gloves, discard gloves and wash hands.
(g)
Double bag or use biohazard bags and discard
materials after each client.
(h)
Discard materials in a medically appropriate
manner.
(2)
All reusable, nonsterilizable implements, such as
marking pen, should be nonporous and disinfected after each use with
EPA approved hard surface disinfection liquid. Nonspray wipes for
surfaces and liquids for soaking jewelry are preferred over spray
disinfectants which may disperse pathogens into the air.
(3)
Cleansing with ultrasonic cleaners should be the rule
for removal of bacitracin or other triple antibiotic solutions, blood
and other particles from a used contaminated implement (i.e., jewelry,
forceps, insertion tapers and pliers), followed by steam autoclave.
(4)
Steam autoclave must be used on all equipment that
may come in contact with the client or the jewelry (i.e., receiving
tubes, rubber bands, insertion tapers, forceps, files, gauge wheels,
pliers, etc.). Equipment shall be bagged, dated and sealed and stored
in a nonporous dark, dry cool place, such as a medical credenza, etc.
Spore indicators shall be used with each load to ensure spore eradication.
Instruments shall be autoclaved at a temperature of 275° F. under
pressure of 20 pounds per square inch for 30 minutes from start. Autoclaves
shall be spore tested by independent laboratories at least once each
month to induce efficacy. Immersion in cold germicidal solutions provides
incomplete sterilization and is inappropriate.
(5)
Appropriate ear piercing guns should only be used
for piercing ear lobes and shall not be used for piercing any other
body part.
(6)
Iodine, antiseptics and other ointments used shall
be applied with single-use applicators. Applicators that have touched
a client once may not be used to retrieve antiseptics, iodine, etc.,
from containers and shall be disposed of after single use.
A.
Bar setups, piercing needles, razor blades or other
sharp instruments which are not to be sterilized shall be disposed
of in medically approved sharps containers that are puncture-resistant
and have tight-fitting lids.
B.
Containers of sharps wastes shall be sent to a facility
where they are either incinerated or otherwise rendered nonhazardous.
C.
Disposable waste shall be placed in easily cleanable,
closed containers with tight-fitting lids to prevent leakage or spoilage.
D.
Waste containers shall be kept closed when not in
use.
E.
Disposable waste shall be handled, stored and disposed
of to minimize direct exposure of personnel to waste material.
F.
The Board of Health medical/waste generator form must
be completed and returned to the Board of Health prior to issuance
of a certificate of registration.
Mobile piercing studios shall not be allowed
to operate in Chelmsford.
A.
The piercer's registration shall be suspended immediately
upon notice to the holder (without a hearing) when the Board of Health
has reason to believe that an imminent health hazard exists. In all
other instances of violation of the provisions of this regulation
the Board of Health shall serve the registrant a written notice specifying
the violations and afford the registrant or certificate holder a reasonable
opportunity to correct the same.
B.
Whenever a registrant has failed to comply with any
written notice issued under the provisions of this section, the Board
of Health may suspend the body piercer's registration on the 10th
day following receipt of written notice of such suspension.
If any provision of these regulations is declared
invalid or unenforceable, the other provisions shall not be affected
thereby but shall continue in full force and effect.
These regulations were adopted by the Board
of Health, Chelmsford, Massachusetts, in accordance with MGL c. 111,
§ 31, September 8, 1997, and revised September 14, 1998.
