There has been some concern recently regarding transmittable diseases
(particularly Hepatitis-B and AIDS [HIV]) and tattoo shops. Just as in a
dentist's office, as long as the area is strictly sanitized, your
chances for infection will be greatly reduced.

Note: If you plan on getting lots of bodyart (pierces or tattoos), you
should seriously consider getting immunized against Hepatitis-B. Hep-B
is a much more serious concern than HIV as the virus is much more
virulent and easier to catch.


WHAT TO LOOK FOR IN A SANITARY SHOP ENVIRONMENT

The current popularity of tattooing and body piercing has also brought
on an increase in potentially hazardous conditions. RAB regulars have
begun posting information on unsanitary practices. For this reason, I am
posting the following guideline of what to look out for (in this
situation, "artist" refers to both tattooists and piercers):

-Lighting: The area must be well-lit so the artist can see what s/he is
doing.

-Counter and floor space should be lightly colored, preferably white so
dirt shows up easier.

-The spray bottle the artist uses on your skin should be disinfected
between customers, or some kind of protective film such as Saran Wrap
should be used.

-Disposing needles: All needles must be either discarded after EACH use
(or at least with each new customer), or autoclaved. Many body piercers
operate out of small booths and may not have spent money for an
autoclaver, in which they MUST dispose of each needle. NO EXCEPTIONS.
Reusing piercing needles is equivalent to sharing IV drugs with
strangers.

-Needles touching other things: The needles, once open from their
sanitary packages, must not be placed on unsanitized surfaces. The
piercer should NOT set the needle down on the table, or, heaven forbid,
DROP THE NEEDLE ON THE FLOOR!!! If this happens, insist they open a new
needle.

-Gloves: The artist must wash their hands prior to putting on their
gloves, preferably with an antibacterial/antiseptic solution. Once they
put their gloves on, they should not touch anything other than your
skin, the needle, and the jewelry. They should not be filling out
receipts beforehand, or answering the phone--unless these have been
wiped clean beforehand.

-Is there a sink separate from the bathroom sink?

-Does the artist use a disposable razor when shaving skin?

-The Speed Stick used as an ahesive for the tattoo pattern should not be
directly applied to the skin, but applied first to a tissue which can
then be used on the skin.

-Autoclaves should be inspected regularly.

-Sterile materials should be stored in sealed containers away from
things that could cause body fluids or ink to splash on them

-The palate that holds the ink caps should be covered with Saran Wrap

-After tattooing, the ink caps should be discarded and the ink not
reused or poured back into the bottles

Be particularly wary of "outdoor fair booths." While many are run by
caring, experienced artists, these booths allow fly-by-night operators
to make some fast money and disappear. If you don't know the artist,
spend time watching them work on others first. Are they reusing needles?
Do they use needles that have dropped on the ground?

If you see any unsanitary conditions that are particularly alarming,
post them to RAB (better yet--email me or Ardvark for the Piercing FAQ)!
If you feel uncomfortable "naming names," then withhold the specifics
for private email. It is each customer's right to guard against getting
a contamination. Worse, If you have had more than one tattoo or pierce
within several months, it will be difficult for you to prove WHICH
artist was responsible!


CAN I GET AIDS FROM TATTOOING?

IMPORTANT NOTE: This section refers to tattooing specifically, and not
to other forms of bodyart. Some, such as piercing and cutting, require
the breaking of the client's skin to a deeper level than what is
achieved with a modern tattoo machine.

This section on AIDS & Tattooing has been contributed by Nick
"Buccaneer" Baban, who studied at the Univ. of Michigan School of
Public Health, Dept. of Epidemiology. He spent the summer researching
AIDS and IV drug use in NYC. "I'm not an expert, but I consider myself
knowledgable. Any furthur questions about AIDS can be e-mailed to me."
<Sadly, Nick has dropped off the net, so I don't have a current address for
him. Still, his information is still good.>

Obviously there is some concern about AIDS and tattooing because when
you get a tattoo, you bleed. But the mechanism of transmission needs to
be better understood.

AIDS is transmitted by intimate contact with bodily fluids, blood and
semen being the most comon. Intimate contact means that the fluid
carrying the AIDS virus (HIV) enters into your system.

Injection drug users (IDUs) use hollow medical syringes and needles to
inject drugs directly into their bloodstream. It is common practice to
withdraw a little blood back into the syringe to delay the onset of the
high. When needles are passed from IDU to IDU and reused without
sterilization, some of that blood remains in the syringe and is passed
on to the next user. If infected blood is passed, the recipient can
become infected with HIV, which leads to AIDS.

Tattooing is VERY different from injecting drugs. The needles used in
tattooing are not hollow. They do, however, travel back and forth
through a hollow tube that acts as an ink reservoir. The tip of the tube
is dipped into the ink, which draws a little into the tube. As the
needle withdraws into the tube, it gets coated with ink. When it comes
forward, it pierces your skin and deposits the ink. You then bleed a
little through the needle hole. This happens several hundred times a
second.

You are only at risk of infection if you come in contact with infected
blood. Since it is only *your* skin that is being pierced during the
tattooing process, only *your* blood is being exposed. This means that
the only person at greater risk is the artist, because s/he is the only
one coming in contact with someone else's (potentially infected) blood.
This is why reputable (and sane) tattoo artist wears surgical gloves
while working.

Another source of infection is through the use of infected tools. *This
is why it is IMPERATIVE that you make sure your tattoo artist uses
sterile equipment.* Needles and tubes need to be autoclaved before EACH
AND EVERY time they are used. Ink should come from separate cups and not
directly from the bottle. Any leftover ink should be disposed of and not
reused under ANY circumstances.

The key to HIV transmission is *transfer of bodily fluids.* Evidence
indicates that infection may require a (relatively) substantial ammount
of fluid to be passed. A pin prick almost certainly won't do it. HIV is
also a very fragile virus that cannot survive long outside the human
body, and is very easy to kill via autoclaving. (I have heard of using
bleach to sterilize needles. While bleach is an effective HIV killer,
I'm not sure of the procedures for cleaning the equipment after bleach
cleaning. As I personally have no desire to have bleach put under my
skin, I go with autoclaving as the proper way to sterilize).

If your tattooer maintains sterile conditions and proceedures, there is
almost no risk of infection. I say "almost" because any risk, no matter
how miniscule, is still a risk and must be recognized. That said, I am
the proud owner of a Jolly Roger tattoo on my right shoulder because I
knew my tattooist and knew he had sterile conditions.


HOW TO LOOK FOR STERILIZATION

Check out the shop thoroughly. Don't be lulled into a false sense of
security by a clean look. If the needles are not disposed of after each
person, then it MUST be "autoclaved." Autoclaving is a process that
pressurizes the instruments and kills any virus or bacteria that might
transmit viruses or bacteria. My dentist has two autoclavers--one gas
and one steam--both pressurizing down to 250fsw. He also has spore
samples that he autoclaves and sends to a pathology lab to make sure the
machines are working. 

Ask the artist how they clean their needles. If they don't say they
autoclave, you are taking your risks. If they say they do, ask to see
their machine. Note that in some states, autoclaving is required by law.
Other common-sense types of things include throwing out the ink after
each customer. Make sure the artists have small wells for each ink color
that they dispense from a larger container, and that these are thrown
out after work on you is done. Compare the conditions of the shop to
that of your dentist--does the artist wear gloves? Are the areas sprayed
clean?

According to the Navy Environmental Health Center Medical Corps in
Norfolk, Virginia, each year, a few cases of Hep-B are reported in
people who've gotten tattoos within the last two months, but they have
not been able to trace the disease back to its source, nor attribute it
directly to the tattoo.

Becky Fenton <AS.RAF@forsythe.stanford.edu> says: "I spoke with a
disease infection specialist at Kaiser [Permanente--US West Coast health
care system], and there have not been any incidents (as of 1990) of HIV
being spread *to* a recipient of a tattoo. If you think about it, the
tattooist is much more at risk, as s/he has to touch the customer's
blood.

David Zinner <dzinner@desire.wright.edu> notes that a blanket statement
regarding the use of autoclaves could be misleading. While an autoclave
will kill the HIV virus, it is not because of the efficacy of the
'clave, but because of the weakness of that particular virus. Far more
insidious is Hepatitis, which is more tenacious, and which a 'clave does
not always kill. He has gotten all of his info from CDC, by the way.

The irony, he says, is that now virtually anyone can afford a 'clave,
because many hospitals are selling them secondhand for a very good
price, and switching either to disposables, or purchasing dry-heat or
chemical sterilizers. Chemical is the best rated, and he says that his
friend's business has increased because of the precautions he takes.

In response to David's well-founded concern, Dr. Milton Diamond
<diamond@hawaii.edu> from the UH School of Medicine who has been
researching sexuality for 30 years, says: Hepatitis is easier to
transmit than HIV but all the bugs will be killed IF the autoclave is
run properly (i.e., set hot enough & long enough). Some instruments can
not, however, be autoclaved since they cant take the heat. These have to
be sterilized with viracides, "bug"acides and so forth. In any case,
here in the States, EVERYONE should be using disposable needles.

The chemical bath is only as effective as how fresh is it, how
concentrated, what chemicals, how "dirty" or contaminated the
instruments, how long in the bath, which particular bug is under attack,
etc. It is not the device, autoclave or chemical bath, that is as
important as the operator. There are many different bugs out there. HIV
may be one of the most deadly and Hep among the more easily transmitted
but many others have to be considered (including Chlamydia, the
infection rate of which is 20%!) and "he who aims at one, hits one." "Mo
betta aim fo dem all." If the artist or piercer is conscientious,
reliable and knowledgeable, either device could serve. Again my general
rule still stands: "EVERYONE should be using disposable needles."

Dr. Kai Kristensen <tattoodoc@jps.net> says: The needles that push the
ink into the skin (below the epidermis or outer covering and into the
mid-dermis or support structure under the epidermis) can transmit
disease UNLESS STERILE TO BEGIN WITH. When they have been used on you,
whatever bugs you carry in your blood can be transmitted to the next
person. The most commonly transmitted disease by needlestick is
Hepatitis B (and C). Clearly AIDS could be transmitted even though not
documented yet to my knowledge.

The skin should be cleaned with antibacterial soap and water and
scrubbing before the procedure to lessen the normal population of germs
on the hide. Alcohol doesn't do much but tends to degrease and cool, so
no harm but no substitute.

USE OF DISPOSABLE GLOVES: A conscientious, professional tattooist or
piercer will often go through A DOZEN DISPOSABLE GLOVES on one client.
Gloves SHOULD be changed every time they touch unsanitized items with
their gloves. If you see that the artist does not change gloves after
answering the phone, they are not being sanitary. Marginally acceptable
is if they pick up the phone (or other objects, such as pencil) with a
tissue. Optimally, they should use a new pair of gloves after each
potential contamination.

AUTOCLAVING TO STERILIZE

Autoclaving is accepted in the industry as the way to sterilize
nondisposable equipment. Autoclave machines look like small metal
washing machines--usually with the door in the front. They are usually
no larger than the computer with which you are reading this.

Uncle Bud <uncbud@rmii.com> recommends that autoclaves should be run at
273 degrees F for 55 minutes (from a cold start) at 15 lbs per square
inch pressure (PSI); the *minimum* standard is 20 minutes at full
temperature and pressure.

Further, he suggests that the solid stainless steel needles and tubes be
ultrasonically cleaned to remove particulate debris before being
packaged into individual autoclaving bags. Even *new* needles need to go
through this cleaning process, to remove any leftover flux from the
soldering process.

Equipment that IS supposed to be autoclaved should be torn out of their
sterile packaging in plain view of the customer.