Guidelines for Infection Control in the Studio Environment

Before tattoo or piercing procedure

  • Handle all financial transactions. Handling financial transactions before the procedure reduces the risk of transmitting bacteria. Currency has been shown to harbor bacteria.
  • Complete consent forms. Consent forms are required as a permanent form of record keeping in the event of an outbreak of infectious disease. Keep this information on premises. Client receives a copy of the consent forms.

Hand Washing

  • Wash and dry hands thoroughly to remove microbial agents
  • Inspect hands and fingernails for small cuts and abrasions; if abrasions are present use “seal skin” product or a small Band-Aid
  • Don a fresh pair of gloves

Set up equipment in front of client

  • Place plastic protection on spray bottles (optional)
  • Explain sterilization procedure to client
  • Single service, autoclave sterilized equipment
  • Bagged, dated and sealed autoclave bag
  • Open in front of client and discard bag
  • Shave and disinfect area to be tattooed or pieced, taking care to disinfect the surrounding areas
  • Set aside razor blade if using a straight razor, or re-cap disposable razor and discard
  • Place sterile beaker or cup in ultrasonic tank filled with a detergent for EACH client. If you use an ultrasonic in conjunction with a sink, you must use a sterile beaker or cup. Do not use an ultrasonic tank alone for rinsing contaminated equipment.

During tattoo application

  • Check gloves periodically for small pinhole tears and be aware that ointment will actually erode latex
  • Do not touch eyes, ears, mouth or nose during application
  • No smoking with gloves on – fresh or contaminated
  • Pour out pigment in advance, if necessary to add more palette, use a fresh tissue to open the pigment bottle and do not allow the nozzle to come into contact with contaminated trays
  • When rinsing tubes for color changes, do not blow excess water from tube with the mouth, rise and then pat dry
  • Do not directly spray the bleeding area with liquid soaps as blood can become aerosolized, spray into tissue and then wipe away excess fluids from tattoo
  • If you can taste or smell the soap, you can taste and smell the waste
  • If you have used a pen for freehand artistry, give the pen to the client
  • Place foot operated waste receptacle close to the work site
  • If tissue or paper towel ends up on the floor area leave it there until finished

Bandage your client properly

  • Bandage client with packaged, sterile non-stick variety bandage, use “surgi-last” or gauze to secure bandage, tape the bandage to the site using hypo-allergenic products
  • Remove gloves, WASH HANDS
  • Give proper care instructions

After tattoo application

  • Don fresh gloves
  • Remove tube and needle sets from machines, immediately place in ultrasonic tank for rinsing and evening discard – this should be in a separate room
  • Remove contaminated beaker or cup from ultrasonic and wash autoclave
  • Clean ultrasonic tank and re-fill with fresh water
  • Discard gloves

Don fresh gloves for room disinfection

  • Move in a manner to avoid re-contamination of surfaces
  • Begin with the machines – discard rubber bands, disinfect machines, set aside
  • Disinfect the work site (see instructions under Awareness…)
  • Discard soiled lap cloths into plastic bag for laundering. Fabric lap cloths harbor bacteria and may contain blood filled pigment splatters. Lap cloths should be of impermeable plastic/paper sheeting instead of cloth.
  • Remove contaminated materials after each client, double bag, and discard
  • Disinfect waste receptacle
  • Replace liner in receptacle

Awareness of items and materials contaminated

During the application process, many items and materials become contaminated with blood and body fluids. Many items are often over looked when disinfecting the work site and preparing the environment for the next client, these areas include:

  • The telephone
  • Lamps
  • Clipcords
  • Power supplies
  • Modulator knobs
  • Pigment bottles
  • Mirrors
  • Floor areas
  • Tissue boxes
  • Paper towel rolls
  • Pens
  • Tattoo machines
  • Rubber bands
  • Drawer pulls
  • Countertops
  • Sink areas
  • Cabinetry
  • Chairs, tables
  • Pigment holder
  • Trays
  • Door handles
  • Waste cans
  • Faucet knobs
  • Ultrasonic tank

General clean up techniques

  • Biohazard area: this room should be separate and apart from tattoo work site, do not allow clients to enter the biohazard area
  • Restrooms open to the public do not qualify as biohazard areas

Removal of needles

  • Don puncture proof gloves when removing needles from bars
  • Use wire snips to remove needles
  • If acetylene is used keep away from flammable liquids
  • Place needle in puncture proof, leak resistant “sharps container” filled with 5.25% bleach
  • Clean needle bars with abrasive cleanser, rinse residue
  • Remember not to mix bleaches and abrasives cleansers as toxic vapors are created

Remember that all blood and body fluids must be completely removed from tubes and bars before sterilization

  • Don gloves for this procedure
  • Scrub tubes with abrasive cleanser to remove blood and pigment, rinse
  • Soak in ultrasonic tank overnight in germicidal, remove, rinse and dry
  • AUTOCLAVE ALL TUBES AND BARS BEFORE ATTACHING NEW NEEDLES. If you use the proper concentration of germicidal solutions, you may not need to autoclave before attaching new needles, this is a safety precaution because HBV can withstand many commercial preparations if the concentrations are not accurate. Check labels for killing time to ensure microbial spore death.

Needle preparation for autoclaving

  • Insert needle into sterile tube
  • Pack tip of needle into cotton ball, (this will prevent hooked needles during autoclaving
  • Date bag
  • Seal bag
  • Place loosely in autoclave onto trays, (if you have a three tray autoclave, eight pieces for each tray for proper steam concentration)
  • Insert biological indicator

Autoclaving procedures

  • Autoclave fifty-five minutes from cold start, thirty-five forty-five from hot
  • 250-273° Fahrenheit
  • 15-30 psi
  • Log in records book: name, time, temperature, psi and amount and type of equipment for future reference and proof of reaching thermal kill
  • Clean autoclave weekly to maintain proper function
  • Use dated biological indicators with each load
  • Use spore indicators weekly, monthly and quarterly
  • Scrub surfaces in biohazard areas after each use, and after spills
  • Scrub floors and remove waste daily

Hand Care

Tattooists must pay attention to their hands. Hands are your means to your livelihood, yet at the same time a potential source of entry for infection. Intact skin, free of cuts, abrasions or other breaks provide the best barrier for protection against many infectious diseases. Unless chemicals, heat, cold or trauma has injured your hands, infectious organisms have difficulty in establishing themselves on the surface of your skin. Tattooists who have allergic reactions to gloves, lesions, or dermatitis should refrain from tattooing until the condition is cleared.

Skin problems do arise from frequent hand washing. Using a hand lotion or “seal skin” to prevent infection may alleviate drying and chapping. Allergic reactions to gloves, (specifically the talc powder inside the glove), may be corrected by switching to a different brand, powderless gloves or hypoallergenic types. Gloving has actually increased the importance of proper hand washing. Bacteria beneath gloves thrive in a moist, warm environment and may produce enough waste to irritate the skin.

Some allergic reactions are in fact caused by a bacterial irritation. Therefore it is important to dry your hands before donning a fresh pair of gloves.

Hands should be inspected before each application for hangnails, cuts, sores, and abrasions. A bandage may be applied for added protection before gloving. Take special care of nails; long nails can penetrate latex or vinyl gloves, which the artists may not notice during the procedure. Studies have shown that impacted blood can remain for up to five days underneath the fingernail if proper hand washing or gloving techniques is not strictly followed. Effective hand washing techniques include the removal of all watches, rings and other jewelry since these items do harbor bacteria. Check your gloves often for small pinhole tears and defects before and during the application.