Streetwise Tatto - Safe Practices Seminar

SAFE PRACTICES SEMINAR

AS APPLICABLE TO THE BODYART INDUSTRY

Seminar presented by Shane Johnston

The following seminar information is intended as a guide,Reference source and study aid for all people who care

about the promotion and practice of responsible body piercing.It is imperative that each paricipant seek out and evaluate new

Health and safety techniques and products for his or herself

This material is copyright © 2003 Streetwise body piercing® & Tattoo Ltd.All rights reserved. This material is for the use of seminar participants.

The material may not be reproduced further or used to coach, present seminarsCourses or workshops without the written permission of Streetwise piercing Ltd Directors

CONTENTSCONTENTS1. Hepatitis The Dangers2. Protocols for Equipment Processing3. Cold Sterilisation4. Ultrasonic Cleaner5. Autoclave6. Sterilisation Room7. The Well Equipped Procedural Room8. The Counter Area9. Gloves10. Implant Materials11. Ethical Information12. Temporary Operators13. Bio hazardous Waste14. Anaesthetics

Hepatitis

Hepatitis C is a viral infection of the liver

It is a global health problem of significant importance

Chronic infection with hepatitis C can lead to years of ill health, reduced quality of life, cancer of the liver & liver failure.

There is no known cure or vaccine

Treatment for hepatitis is very expensive (interferon Ribavirin combination) for treatment.

Majority of people in NZ infected with HCV contracted the virus from needles or infected blood.

HCV can remain dormant in its host for up to 20 years then suddenly activate.

Can live on a hard surface (eg counter top) for up to 3 months.

HCV cannot be killed by disinfecting

HCV can survive in boiling water – needs 134c for 4 minutes to kill

HCV is a bloodborne pathogen

Mian transmission – sharing needles & Indirect contact

19% - 30% Of people with tattoos have tested positive for hep B in NZ. (hep C focus group)

This risk icreases with every new tattoo & peirce.

41% Hep C cases from tattooing

Hepititas goes largely underreported due to the social stigma connected with this.

Hepatitis

Protocols for Equipment Processing

Isolation

Moving contaminated equipment out of general area,

Preferably into closed puncture-proof container (not to exceed 12 hours)

Decontamination

Removing gross debris from equipment, preferably by ultrasonic cavitation (15min. min minimum)

Disinfection

Inactivating microbial life (except for endospores) preferably by chemical high-level disinfectant either by soak or saturation *15min. Minimum)

Bio-shielding

Wrapping, sealing, dating and initialling of equipment in material(s) suited for the sterilisation process to be used, preferably clear-view self seal packaging

Protocols for Equipment Processing (continued…)

SterilizationCompletely eliminating all microbial life (including endospores), preferably by super-heated steam under pressure or a gamma ionizing radiation sterilizer.

Documentation Entering into record all items sterilized.

Storage Placing all sterile packaged equipment/supplies within a closed container specifically used for sterilized items only. (Not to be stored more than one month)

Handling Only touching with gloved hands, watching for tears in bio shielding, keeping away from moisture and only placing on appropriate fields, to avoid compromising sterility.

Cold SterilisationCold Sterilisation

Gluteralydhydes 2%ZenacideAidyl Plus

CarcinogenicRequire monitoring of the air

Perasafe also other similar brands.No proof of sterility.Compromised during packaging.Used for cleaning endoscopy equipment.

Cold SterilisationCold Sterilisation

Peiercing gunsPiercing gun operators need to have hand wash and dry facilities, clean separate area to pierce.

Skin cleaning procedure and product

Skin marking procedure and product

Gun cleaning procedure and product

Nostril piercing equipment (disposable attachment)

Plastic Piercing guns melt when autoclaved

Autoclaving & soaking in alcohol will damage the spring mechnism

Ultrasonic CleanerWhen the ultrasonic cleaner is in useAlways wear

Always run in conjunction with expel air fan

Always keep the lid on when in use

Never put hot water in ultrasonic cleaner

Bio-hazardous sink close to ultrasonic cleaner

2ft radius of contamination with lid on

4ft radius of contamination with lid off

Can drive pathogens through examination gloves

Examination gloves, Heavy rubber glovesProtective gloves, Safety glasses & Face maskFace shield, Disposable apron

Autoclave

The autoclave mustOnly be handled with clean glovesHave distilled water onlyHave records of autoclaved packges(how many, descriptions of items, date processed, by whom)Have spore test monthlyHave no contaminated water

The auto clave needs to be in its own steralisation room because thePotential is there for it to do an incomplete cycle and upon venting contaminate a whole room.

When packaging is used on an autoclave with no dry packging, the door must be left ajar after the cycle has finished enabling package to dry.(Do not leave sitting in autoclave still wet/damp)

A record of serial numbers taken from the autoclave printout wouldbe an advantage.

Autoclave

An autoclave indicator is unreliable. An integrator will not change unless the proper sterilisation process has taken place. An indicator will change if stuck on a 100 watt ligth bulb or left out in the sun.

Integrator will no change unless all conditions have been achieved eg. Correct temperature

Correct steam qualityCorrect time

Monthly spore tests/Sterilisation log

Sterilisation Room

The only safe means of cleaning and sterilisation

This must be a separate room

Lockable

Completely enclosed withIt’s own lightingAir vent system, (expel air)Sink to rinse contaminated tools(must not be used for hand washing)

Sterilisation Room

THE ROOM SHOULD BE DIVIDED INTO TWO HALVES

This half is for Piercing equipmentTattoo MachinesHeavy rubber gloves (for ultrasonic)Safety glasses or visor maskFace maskDisposable plastic apron

For packagingAutoclave tubing,Autoclave envelopesScissors,Paper TowelsAutoclave tape Date stamp or penSealerAir ventUltrasonic cleanerSink

This half is for Sterilising

In this area should be Printer for autoclave Distilled waterAirtight containersSterilisation log

CONTAMINATED SIDE CLEAN SIDE

There should be nothingFrom the contaminated side here.

The well Equipped Procedural Room for PiercingRooms designated for piercing must be an enclosed room, (Separate from pathogens in reception area)

Hand wash facilities – correct taps & sinks etcAntibacterial soapEvery surface must be wipeable (no carpet or porous curtains etc)

Signs clearly stating CLEAN areas, BIOHAZARD areas

Tattoo/piercing table or chair, non porous, disinfected betweenClients or couchroll, gladwrap barriers.

Bright lighting without shadowsLidded trash receptacles with foot pedalWipeable drawers for safe storage of equipment Sharps container in designated spotImplement trays to minimise cross contaminationDisposable barriers for hands eg tissue or paper towelsDisposable relish cups, jewellery, skin prep etc

Latex gloves, every size for every operater (1 weeks supply)

Hard surface disinfectants and disposable wipes

Marking pens, toothpicks, gentian violet, Indian ink

Supply of sterile packed, needles, forceps, tattoo equipment, made up needlebars etc (1 week supply)

The well Equipped Procedural Room for Piercing

The Counter Area

This is an area constantly contaminated. Usually by clients touching their piercing then touching the counter area, or by placing Contaminated (previously worn) jewellery on the counter top.

To keep this area clean use :Relish cups for pre worn jewelery Antibacterial wipes to clean the counterOffer client antibacterial wipes for their hands

Both staff & clients need to refrain from touching their peircing in the store. This should only be done under controlled conditionsEg. Piercing room with gloves

The Counter Area

Aseptic Hand wash Procedure

1. 10c coin amount of soap2. Lather in palm of hands3. Fingers between fingers/Palm to palm/back & forth4. Fingers between fingers/palm to back of hand/back & forth5. Fingertips inside fingertips back & front6. Fingertips inside fingertips other hand inside7. Rinse with water/allow water to run off fingertips.

GLOVES

Always wash hands prior to gloving

For the purpose of piercing and tattooing sterile gloves are more expensive than non sterile and in this environment, quickly compromise.

Non sterile examination gloves with plenty of glove changes are a more workable option. It must be remembered that non sterile gloves begin to Become compromised after only 3 minutes.

Implant Materials

Safe Unsafe

316 LVM (stainless steel implant grade Nickel316 L (marine) Nickel silverTi Sterling silverN/B Pure silverTeflon Gold platedTygon Other platedHard woods CopperGlass – PyrexAcrylic – LuciteTusk – IvoryHornCrystals – Stone Poorly fitted jewellery

Too Stretched Too large jewellery

MSDS – MILL CERTIFICATE

MSDS

Material safety data sheet

Medical term for chemicals & metals to prove they are bio campatable.

Mill certificates are used by engineers on all surgical implant to show bio compatability of materials and all raw materials eg. Teflon

For our purposes

These are basically one and the same

ETHICAL INFORMATION

Every operator should have a current St Johns Training First Aid Workplace certificate or Red Cross equivilant.

Every operator should have a Hep A & B vaccination, or have antibodies.

First aid kit for emergencies

Bloodborne pathogen training

Hygiene training

Temporary Operators

Have a great potential to infect the masses in a very short time.

Can pack up and leave at short notice

Working under adverse conditions

Need large stocks of sterile packed jewellery, equipment & needles.

Often no hand washing facilities.(Must be able to demonstrate an acceptable alternative)

Clientele hazardous, intoxicated or under the influence

Clients many underage – hard to check identification.

Bio-Hazardous Waste

All needles and needle groups must be disposed of in a biohazard waste sharpies container

These are picked up and delivered by a Biohazardous waste company (no exception)

Needles placed in a puncture proof drink bottle and disposed at the tip is not good enough. Ask to see documentation to prove this.

In the context of the Body Art Industry paper towels, tissues, swabs & dressings are considered contaminated but not necessarily bio-hazardouswaste.

The rule of thumb is when compressed does this waste release any potentially infectious material.

ANAESTHETICS

INJECTED ANAESTHETICS

All injected anaesthetics can only be administered by a qualified doctor, nurse, dentist or anaesthetists. For others this practice is illegal.

Possibility of anaphylactic shock ( strong allergic reaction)

Once in the bloodstream is irreversible.

Distorts the area to be pierced.

ANAESTHETICS

TOPICAL ANAESTHETICS

Topical cream, gels & sprays

Takes up to 3 hours to fully anaesthetise although 60-70% after 1 hour

This type of anaesthetic give no garuntee when the skin is punctured (allergic reaction)

Swelling can occur, distorting piercing site.

Discolouration usually occurs (red or white)

Increased chnace of rejection Freeze spray is non sterile, not for broken skin, can cause frostbite if used incorrectly.