HomeMy Public PortalAboutBody Art Regulation 1
Brewster Board of Health Regulations for Body Art Establishments and
Practitioners
Section:
1. Purpose page 1
2. Authority page 2
3. Definitions page 2
4. Exemptions page 6
5. Restrictions page 6
6. Operation of Body Art Establishments page 7
7. Standards of Practice page 13
8. Exposure Incident Report page 16
9. Injury Reports page 16
10. Complaints page 17
11. Application for Body Art Establishment Permit page 17
12. Application for Body Art Practitioner Permit page 18
13. Grounds for Denial of Permit, Revocation of Permit or Refusal to page 20
Renew Permit
14. Grounds for Suspension of Permit page 21
15. Procedure for Hearings
16. Severability page 21
17. Fine for Violation page 22
18. Noncriminal Disposition page 22
19. Effective Date page 22
1. Purpose
Whereas body art is becoming prevalent and popular throughout the Commonwealth; and
whereas knowledge and practice of universal precautions, sanitation, personal hygiene,
sterilization and aftercare requirements on the part of the practitioner should be
demonstrated to prevent the transmission of disease or injury to the client and/or
practitioner; now, therefore the Board of Health of the Town of Brewster passes these
rules and regulations for the practice of body art in the Town of Brewster as part of our
mission to protect the health, safety and welfare of the public.
2. Authority
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These regulations are promulgated under the authority granted to the Board of Health
under Massachusetts General Law 111, section 31.
3. Definitions
Aftercare means written instructions given to the client, specific to the body art
procedure(s) rendered, about caring for the body art and surrounding area,
including information about when to seek medical treatment, if necessary.
Applicant means any person who applies to the Board of Health for either a body
art establishment permit or practitioner permit.
Autoclave means an apparatus for sterilization utilizing steam pressure at a
specific temperature over a period of time.
Autoclaving means 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 thirty minutes at 20 pounds of pressure (PSI) at a temperature of 270
degrees Fahrenheit.
Bloodborne Pathogens Standard means OSHA Guidelines contained in 29 CFR
1910.1030, entitled "Occupational Exposure to Bloodborne Pathogens.”
Board of Health or Board means the Board of Health that has jurisdiction in the
community in which a body art establishment is located including the Board or
officer having like powers and duties in towns where there is no Board of Health.
Body Art means 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. This definition does not include practices that are considered
medical procedures by the Board of Registration in Medicine, such as implants
under the skin, which procedures are prohibited.
Body Art Establishment or Establishment means a location, place, or business that
has been granted a permit by the Board, whether public or private, where the
practices of body art are performed, whether or not for profit.
Body Art Practitioner or Practitioner means a specifically identified individual
who has been granted a permit by the Board to perform body art in an
establishment that has been granted a permit by the Board.
Body Piercing means puncturing or penetrating the skin of a client with
presterilized single-use needles and the insertion of presterilized jewelry or other
adornment into the opening. This definition excludes piercing of the earlobe with
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a presterilized single-use stud-and-clasp system manufactured exclusively for ear-
piercing.
Braiding means the cutting of strips of skin of a person, which strips are then to be
intertwined with one another and placed onto such person so as to cause or allow
the incised and interwoven strips of skin to heal in such intertwined condition.
Branding means inducing a pattern of scar tissue by use of a heated material
(usually metal) to the skin, making a serious burn, which eventually becomes a
scar.
Cleaning area means the area in a Body Art Establishment used in the
sterilization, sanitation or other cleaning of instruments or other equipment used
for the practice of body art.
Client means a member of the public who requests a body art procedure at a body
art establishment.
Contaminated Waste means waste as defined in 105 CMR 480.000: Storage and
Disposal of Infectious or Physically Dangerous Medical or Biological Waste,
State Sanitary Code, Chapter VIII and/or 29 Code of Federal Regulation part
1910.1030. This includes any liquid or semi-liquid blood or other potentially
infectious material; contaminated items that would release blood or other
potentially infectious material in a liquid or semi-liquid 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; sharps and any wastes
containing blood or other potentially infectious materials.
Cosmetic Tattooing, also known as permanent cosmetics, micro pigment
implantation or dermal pigmentation, means the implantation of permanent
pigment around the eyes, lips and cheeks of the face and hair imitation.
Department means the Department of Public Health or its authorized
representatives.
Disinfectant means a product registered as a disinfectant by the U.S.
Environmental Protection Agency (EPA).
Disinfection means the destruction of disease-causing microorganisms on inan-
imate objects or surfaces, thereby rendering these objects safe for use or handling.
Ear piercing means the puncturing of the lobe of the ear with a presterilized
single-use stud-and-clasp ear-piercing system following the manufacturer's
instructions.
Equipment means all machinery, including fixtures, containers, vessels, tools,
devices, implements, furniture, display and storage areas, sinks, and all other
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apparatus and appurtenances used in connection with the operation of a body art
establishment.
Exposure means an event whereby there is an eye, mouth or other mucus
membrane, non-intact skin or parental contact with the blood or bodily fluids of
another person or contact of an eye, mouth or other mucous membrane, non-intact
skin or parenteral contact with other potentially infectious matter.
Hand Sink means a lavatory equipped with hot and cold running water under
pressure, used solely for washing hands, arms, or other portions of the body.
Hot water means water that attains and maintains a temperature 110º-130ºF.
Instruments Used for Body Art means hand pieces, needles, needle bars, and other
instruments that may come in contact with a client's body or may be exposed to
bodily fluids during any body art procedure.
Invasive means entry into the client’s body either by incision or insertion of any
instruments into or through the skin or mucosa, or by any other means intended to
puncture, break, or otherwise compromise the skin or mucosa.
Jewelry means any ornament inserted into a newly pierced area, which must be
made of surgical implant-grade stainless steel; solid 14k or 18k white or yellow
gold, niobium, titanium, or platinum; or a dense, low-porosity plastic, which is
free of nicks, scratches, or irregular surfaces and has been properly sterilized prior
to use.
Light colored means a light reflectance value of 70 percent or greater.
Minor means any person under the age of eighteen (18) years.
Mobile Body Art Establishment means any trailer, truck, car, van, camper or
other motorized or non-motorized vehicle, a shed, tent, movable structure,
bar, home or other facility wherein, or concert, fair, party or other event
whereat one desires to or actually does conduct body art procedures.
Operator means any person who individually, or jointly or severally with others,
owns, or controls an establishment, but is not a body art practitioner.
Permit means Board approval in writing to either (1) operate a body art establish-
ment or (2) operate as a body art practitioner within a body art establishment.
Board approval shall be granted solely for the practice of body art pursuant to
these regulations. Said permit is exclusive of the establishment’s compliance with
other licensing or permitting requirements that may exist within the Board’s
jurisdiction.
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Person means an individual, any form of business or social organization or any
other non-governmental legal entity, including but not limited to corporations,
partnerships, limited-liability companies, associations, trusts or unincorporated
organizations.
Physician means an individual licensed as a qualified physician by the Board of
Registration in Medicine pursuant to M.G.L. c. 112 § 2.
Procedure surface means any surface of an inanimate object that contacts the
client's unclothed body during a body art procedure, skin preparation of the area
adjacent to and including the body art procedure, or any associated work area
which may require sanitizing.
Sanitary means clean and free of agents of infection or disease.
Sanitize means the application of a U.S. EPA registered sanitizer on a cleaned
surface in accordance with the label instructions.
Scarification means altering skin texture by cutting the skin and controlling the
body’s healing process in order to produce wounds, which result in permanently
raised wheals or bumps known as keloids.
Sharps means 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 means a puncture-resistant, leak-proof container that can be
closed for handling, storage, transportation, and disposal and that is labeled with
the International Biohazard Symbol.
Single Use Items means products or items that are intended for one-time, one-
person use and 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,
and protective gloves.
Sterilize means the use of a physical or chemical procedure to destroy all
microbial life including highly resistant bacterial endospores.
Tattoo means the indelible mark, figure or decorative design introduced by
insertion of dyes or pigments into or under the subcutaneous portion of the skin.
Tattooing means any method of placing ink or other pigment into or under the
skin or mucosa by the aid of needles or any other instrument used to puncture the
skin, resulting in permanent coloration of the skin or mucosa. This term includes
all forms of cosmetic tattooing.
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Temporary Body Art Establishment means the same as Mobile Body Art
Establishment.
Three dimensional “3D” Body Art or Beading or Implantation means the form of
body art consisting of or requiring the placement, injection or insertion of 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 means a unit approved by the Board, physically large
enough to fully submerge instruments in liquid, which removes all foreign matter
from the instruments by means of high frequency oscillations transmitted through
the contained liquid.
Universal Precautions means a set of guidelines and controls, 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, Vo1.38 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, Vo1.40, No. RR-8. This method of
infection control requires the employer and the employee to assume that all human
blood and specified human body fluids are infectious for HIV, HBV, and other
blood pathogens. Precautions include 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.
4. Exemptions
(A) Physicians licensed in accordance with M.G.L. c. 112 § 2 who perform
body art procedures as part of patient treatment are exempt from these
regulations.
(B) Individuals who pierce only the lobe of the ear with a presterilized
single-use stud-and-clasp ear-piercing system are exempt from these
regulations.
5. Restrictions
(A) No tattooing, piercing, branding or scarification shall be performed on a
person under the age of 18.
(B) No body art shall be performed upon an animal.
(C) The following body piercings are hereby prohibited: piercing of the uvula;
piercing of the tracheal area; piercing of the neck; piercing of the ankle;
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piercing between the ribs or vertebrae; piercing of the web area of the hand
or foot; piercing of the lingual frenulum (tongue web); piercing of the
clitoris; any form of chest or deep muscle piercings, excluding the nipple;
piercing of the anus; piercing of an eyelid, whether top or bottom; piercing
of the gums; piercing or skewering of a testicle; so called “deep” piercing
of the penis – meaning piercing through the shaft of the penis, or “trans-
penis” piercing in any area from the corona glandis to the pubic bone; so
called “deep” piercing of the scrotum – meaning piercing through the
scrotum, or “transcrotal” piercing; so called “deep” piercing of the vagina.
(D) The following practices hereby prohibited unless performed by a medical
doctor licensed by the Commonwealth of Massachusetts: tongue splitting;
braiding; three dimensional/beading/implementation
tooth filing/fracturing/removal/tatooing; cartilage modification;
amputation; genital modification; introduction of saline or other liquids.
6. Operation of Body Art Establishments
Unless otherwise ordered or approved by the Board, each body art establishment shall be
constructed, operated and maintained to meet the following minimum requirements:
(A) Physical Plant
(1) Walls, floors, ceilings, and procedure surfaces shall be smooth,
durable, free of open holes or cracks, light-colored, washable, and
in good repair. Walls, floors, and ceilings shall be maintained in a
clean condition. All procedure surfaces, including client
chairs/benches, shall be of such construction as to be easily cleaned
and sanitized after each client.
(2) Solid partitions or walls extending from floor to ceiling shall
separate the establishment’s space from any other room used for
human habitation, any food establishment or room where food is
prepared, any hair salon, any retail sales, or any other such activity
that may cause potential contamination of work surfaces.
(3) The establishment shall take all measures necessary to ensure
against the presence or breeding of insects, vermin, and rodents
within the establishment.
(4) Each operator area shall have a minimum of 45 square feet of floor
space for each practitioner. Each establishment shall have an area
that may be screened from public view for clients requesting
privacy. Multiple body art stations shall be separated by a dividers
or partition at a minimum.
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(5) The establishment shall be well ventilated and provided with an
artificial light source equivalent to at least 20 foot candles 3 feet
off the floor, except that at least 100 foot candles shall be provided
at the level where the body art procedure is being performed, where
instruments and sharps are assembled and all cleaning areas.
(6) All electrical outlets in operator areas and cleaning areas shall be
equipped with approved ground fault (GFCI) protected receptacles.
(7) A separate, readily accessible hand sink with hot and cold running
water under pressure, preferably equipped with wrist- or
foot-operated controls and supplied with liquid soap, and
disposable paper towels stored in fixed dispensers shall be readily
accessible within the establishment. Each operator area shall have
a hand sink.
(8) There shall be a sharps container in each operator area and each
cleaning area.
(9) There shall be a minimum of one toilet room containing a toilet
and sink. The toilet room shall be provided with toilet paper,
liquid hand soap and paper towels stored in a fixed dispenser. A
body art establishment permanently located within a retail
shopping center, or similar setting housing multiple operations
within one enclosed structure having shared entrance and exit
points, shall not be required to provide a separate toilet room
within such body art establishment if Board-approved toilet
facilities are located in the retail shopping center within 300 feet of
the body art establishment so as to be readily accessible to any
client or practitioner.
(10) The public water supply entering a body art establishment shall be
protected by a testable, reduced pressure back flow preventor
installed in accordance with 142 Code of Massachusetts
Regulation 248, as amended from time to time.
(11) At least one covered, foot operated waste receptacle shall be
provided in each operator area and each toilet room. Receptacles
in the operator area shall be emptied daily. Solid waste shall be
stored in covered, leakproof, rodent-resistant containers and shall
be removed from the premises at least weekly.
(12) At least one janitorial sink shall be provided in each body art
establishment for use in cleaning the establishment and proper
disposal of non-contaminated liquid wastes in accordance with all
applicable Federal, state and local laws. Said sink shall be of
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adequate size equipped with hot and cold running water under
pressure and permit the cleaning of the establishment and any
equipment used for cleaning.
(13) All instruments and supplies shall be stored in clean, dry, and
covered containers. Containers shall be kept in a secure area
specifically dedicated to the storage of all instruments and supplies.
(14) The establishment shall have a cleaning area. Every cleaning area
shall have an area for the placement of an autoclave or other
sterilization unit located or positioned a minimum of 36 inches
from the required ultrasonic cleaning unit.
(15) The establishment shall have a customer waiting area, exclusive
and separate from any workstation, instrument storage area,
cleaning area or any other area in the body art establishment used
for body art activity.
(16) No animals of any kind shall be allowed in a body art
establishment except service animals used by persons with
disabilities (e.g., Seeing Eye dogs). Fish aquariums shall be
allowed in waiting rooms and nonprocedural areas.
(17) Smoking, eating, or drinking is prohibited in the area where body
art is performed, with the exception of non-alcoholic fluids being
offered to a client during or after a body art procedure.
(B) Requirements for Single Use Items Including Inks, Dyes and Pigments
(1) Single-use items shall not be used on more than one client for any
reason. After use, all single-use sharps shall be immediately
disposed of in approved sharps containers pursuant to 105 CMR
480.000. A copy of which can be obtained from the Brewster
Health Department.
(2) All products applied to the skin, such as but not limited to body art
stencils, applicators, gauze and razors, shall be single use and
disposable.
(3) Hollow bore needles or needles with cannula shall not be reused.
(4) All inks, dyes, pigments, solid core needles, and equipment shall
be specifically manufactured for performing body art procedures
and shall be used according to manufacturer's instructions.
(5) Inks, dyes or pigments may be mixed and may only be diluted with
water from an approved potable source. Immediately before a
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tattoo is applied, the quantity of the dye to be used shall be
transferred from the dye bottle and placed into single-use paper
cups or plastic cups. Upon completion of the tattoo, these single-
use cups or caps and their contents shall be discarded.
(C) Sanitation and Sterilization Measures and Procedures
(1) All non-disposable instruments used for body art, including all
reusable solid core needles, pins and stylets, shall be cleaned
thoroughly after each use by scrubbing with an appropriate soap or
disinfectant solution and hot water, (to remove blood and tissue
residue), and shall be placed in an ultrasonic unit sold for cleaning
purposes under approval of the U.S. Food and Drug Administration
and operated in accordance with manufacturer's instructions.
(2) After being cleaned, all non-disposable instruments used for body
art shall be packed individually in sterilizer packs and subsequently
sterilized in a steam autoclave sold for medical sterilization
purposes under approval of the U.S. Food and Drug
Administration. All sterilizer packs shall contain either a sterilizer
indicator or internal temperature indicator. Sterilizer packs must be
dated with an expiration date not to exceed six (6) months.
(3) The autoclave shall be used, cleaned, and maintained according to
manufacturer's instruction. A copy of the manufacturer's
recommended procedures for the operation of the autoclave must
be available for inspection by the Board. Autoclaves shall be
located away from workstations or areas frequented by the public.
(4) Each holder of a permit to operate a body art establishment shall
demonstrate that the autoclave used is capable of attaining
sterilization by monthly spore destruction tests. These tests shall
be verified through an independent laboratory. The permit shall
not be issued or renewed until documentation of the autoclave’s
ability to destroy spores is received by the Board. These test
records shall be retained by the operator for a period of three (3)
years and made available to the Board upon request.
(5) All instruments used for body art procedures shall remain stored in
sterile packages until just prior to the performance of a body art
procedure. After sterilization, the instruments used in body art
procedures shall be stored in a dry, clean cabinet or other tightly
covered container reserved for the storage of such instruments.
(6) Sterile instruments may not be used if the package has been
breached or after the expiration date without first repackaging and
resterilizing.
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(7) If the body art establishment uses only single-use, disposable
instruments and products, and uses sterile supplies, an autoclave
shall not be required.
(8) When assembling instruments used for body art procedures, the
operator shall wear disposable medical gloves and use medically
recognized sterile techniques to ensure that the instruments and
gloves are not contaminated.
(9) Reusable cloth items shall be mechanically washed with detergent
and mechanically dried after each use. The cloth items shall be
stored in a dry, clean environment until used. Should such items
become contaminated directly or indirectly with bodily fluids, the
items shall be washed in accordance with standards applicable to
hospitals and medical care facilities, at a temperature of 160F or a
temperature of 120F with the use of chlorine disinfectant.
(D) Posting Requirements
The following shall be prominently displayed:
(1) A Disclosure Statement, a model of which shall be available from
the Board. A Disclosure Statement shall also be given to each
client, advising him/her of the risks and possible consequences of
body art procedures.
(2) The name, address and phone number of the Brewster Board of
Health
(3) An Emergency Plan, including:
(a) a plan for the purpose of contacting police, fire or emergency
medical services in the event of an emergency;
(b) a telephone in good working order shall be easily available and
accessible to all employees and clients during all hours of
operation; and
(c) a sign at or adjacent to the telephone indicating the correct
emergency telephone numbers.
(4) An occupancy and use permit as issued by the local building
official, which also conforms with the Brewster Zoning Code.
(5) A current establishment permit.
(6) Each practitioner’s permit.
(E) Establishment Recordkeeping
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The establishment shall maintain the following records in a secure place for a
minimum of three (3) years, and such records shall be made available to the Board
upon request:
(1) Establishment information, which shall include:
(a) establishment name;
(b) hours of operation;
(c) owner's name and address;
(d) a complete description of all body art procedures performed;
(e) an inventory of all instruments and body jewelry, all sharps,
and all inks used for any and all body art procedures, including
names of manufacturers and serial or lot numbers, if applicable.
Invoices or packing slips shall satisfy this requirement;
(f) A Material Safety Data Sheet, when available, for each ink and
dye used by the establishment; and
(g) copies of waste hauler manifests
(h) copies of commercial biological monitoring tests
(i) Exposure Incident Report (kept permanently)
(j) a copy of these regulations.
(2) Employee information, which shall include:
(a) full legal names and exact duties;
(b) date of birth;
(c) home address;
(d) home /work phone numbers;
(e) identification photograph;
(f) dates of employment;
(g) Hepatitis B vaccination status or declination notification; and
(h) training records
(3) Client Information, which shall include:
(a) name;
(b) age and valid photo identification
(c) address of the client;
(d) date of the procedure;
(e) name of the practitioner who performed the procedure(s);
(f) description of procedure(s) performed and the location on the
body;
(g) a signed consent form as specified by 7(D )(2)
Client information shall be kept confidential at all times.
(4) Exposure Control Plan
Each establishment shall create, update, and comply with an Exposure
Control Plan. The Plan shall be submitted to the Board for review so as to
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meet all of the requirements of OSHA regulations, to include, but not
limited to, 29 Code of Federal Regulation 1910.1030 OSHA Bloodborne
Pathogens Standards et seq, as amended from time to time. A copy of the
Plan shall be maintained at the Body Art Establishment at all times and
shall be made available to the Board upon request.
(F) No person shall establish or operate a Mobile or Temporary Body Art
Establishment.
(G) Every Body Art Establishment shall obtain liability insurance, and every
Body Art Practitioner, who is not covered by a liability insurance policy
for a Body Art Establishment, shall obtain liability insurance. The
coverage limits for this liability insurance shall be no less than one million
($1,000,000.00) dollars per incident and one million ($1,000,000.00)
dollars in the aggregate. A certificate of insurance evidencing this
coverage shall be filed with every application for a Body Art Establishment
and with every application for a Body Art Practitioner Permit, and this type
and amount of insurance shall be maintained throughout the term of each
permit.
7. Standards of Practice
Practitioners are required to comply with the following minimum health standards:
(A) A practitioner shall perform all body art procedures in accordance with
Universal Precautions set forth by the U.S Centers for Disease Control and
Prevention.
(B) A practitioner shall refuse service to any person who may be under the
influence of alcohol or drugs.
(C) Practitioners who use ear-piercing systems must conform to the
manufacturers directions for use, and to applicable U.S. Food and Drug
Administration requirements. 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 Client 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:
(a) history of diabetes;
(b) history of hemophilia (bleeding);
(c) history of skin diseases, skin lesions, or skin sensitivities to
soaps, disinfectants etc.;
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(d) history of allergies or adverse reactions to pigments, dyes, or
other sensitivities;
(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 the above
information was provided, that the client does not have a condition
that prevents them from receiving body art, that the client consents
to the performance of the body art procedure and that the client has
been given the aftercare instructions as required by section 7(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 their hands in hot running water
with liquid soap, then rinse hands and dry with disposable paper towels.
This shall be done as often as necessary to remove contaminants.
(F) In performing body art procedures, a practitioner shall wear disposable
single-use gloves. Gloves shall be changed if they become pierced, torn,
or otherwise contaminated by contact with any unclean surfaces or objects
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 hands shall be washed in accordance with section (E) before the next
set of gloves is put on. Under no circumstances shall a single pair of
gloves be used on more than one person. The use of disposable single-use
gloves does not preclude or substitute for handwashing procedures as part
of a good personal hygiene program.
(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 body art equipment,
supplies, or working surfaces with body substances or pathogenic
organisms.
(H) Any item or instrument used for body art that is contaminated during the
procedure shall be discarded and replaced immediately with a new
disposable item or a new sterilized instrument or item before the procedure
resumes.
(I) Preparation and care of a client’s skin area must comply with the
following:
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(1) Any skin or mucosa surface to receive a body art procedure shall
be free of rash or any visible infection.
(2) Before a body art procedure is performed, the immediate skin area
and the areas of skin surrounding where body art procedure is to be
placed shall be washed with soap and water or an approved
surgical skin preparation. If shaving is necessary, single-use
disposable razors or safety razors with single-service blades shall
be used. Blades shall be discarded after each use, and reusable
holders shall be cleaned and autoclaved after use. Following
shaving, the skin and surrounding area shall be washed with soap
and water. The washing pad shall be discarded after a single use.
(3) 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.
(J) Petroleum jellies, soaps, and other products used in the application of
stencils shall be dispensed and applied on the area to receive a body art
procedure with sterile gauze or other sterile applicator to prevent
contamination of the original container and its contents. The applicator or
gauze shall be used once and then discarded.
(K) 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:
(1) on the proper cleansing of the area which received the body art;
(2) to consult a health care provider for:
(a) unexpected redness, tenderness or swelling at the site of the
body art procedure;
(b) any rash;
(c) unexpected drainage at or from the site of the body art
procedure; or
(d) a fever within 24 hours of the body art procedure; and
of the address, and phone number of the establishment.
(3) A copy shall be provided to the client. A model set of aftercare
instructions shall be made available by the Board.
(L) Contaminated waste shall be stored, treated and disposed in accordance
with 105 CMR 480.000: Storage and Disposal of Infectious or Physically
Dangerous Medical or Biological Waster, State Sanitary Code, Chapter
VIII.
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8. Exposure Incident Report
An Exposure Incident Report shall be completed by the close of the business day during
which an exposure has or might have taken place by the involved or knowledgeable body
art practitioner for every exposure incident occurring in the conduct of any body art
activity.
Each Exposure Incident Report shall contain:
(1) A copy of the application and consent form for body art activity completed by any
client or minor client involved in the exposure incident;
(2) A full description of the exposure incident, including the portion of the body involved
therein;
(3) Instrument(s) or other equipment implicated;
(4) A copy of body art practitioner license of the involved body art practitioner;
(5) Date and time of exposure;
(6) A copy of any medical history released to the body art establishment or body art
practitioner; and
(7) Information regarding any recommendation to refer to a physician or waiver to
consult a physician by persons involved.
9. Injury and/or Complication Reports
A written report of any injury, infection complication or disease as a result of a body art
procedure, or complaint of injury, infection complication or disease, shall be forwarded
by the operator to the Board which issued the permit, with a copy to the injured client
within five working days of its occurrence or knowledge thereof. The report shall
include:
(A) the name of the affected client;
(B) the name and location of the body art establishment involved;
(C) the nature of the injury, infection complication or disease;
(D) the name and address of the affected client’s health care provider, if any;
(E) any other information considered relevant to the situation.
10. Complaints
(A) The Board shall investigate complaints received about an establishment or
practitioner’s practices or acts, which may violate any provision of the
Board's regulations.
(B) If the Board finds that an investigation is not required because the alleged
act or practice is not in violation of the Board's regulations, then the Board
shall notify the complainant of this finding and the reasons on which it is
based.
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(C) If the Board finds that an investigation is required, because the alleged act
or practice may be in violation of the Board's regulations, the Board shall
investigate and if a finding is made that the act or practice is in violation of
the Board's regulations, then the Board shall apply whatever enforcement
action is appropriate to remedy the situation and shall notify the
complainant of its action in this manner.
11. Application for Body Art Establishment Permit
(A) No person may operate a body art establishment except with a valid permit
from the Board.
(B) Applications for a permit shall be made on forms prescribed by and
available from the Board. An applicant shall submit all information
required by the form and accompanying instructions. The term
“application” as used herein shall include the original and renewal
applications.
(C) An establishment permit shall be valid from the date of issuance and for
no longer than one year unless revoked sooner by the Board.
(D) The Board shall require that the applicant provide, at a minimum, the
following information in order to be issued an establishment permit:
(1) Name, address, and telephone number of:
(a) the body art establishment;
(b) the operator of the establishment; and
(c) the body art practitioner(s) working at the establishment;
(2) The manufacturer, model number, model year, and serial number,
where applicable, of the autoclave used in the establishment;
(3) A signed and dated acknowledgement that the applicant has
received, read and understood the requirements of the Board’s
body art regulations;
(4) A drawing of the floor plan of the proposed establishment to scale
for a plan review by the Board, as part of the permit application
process; and,
(5) Exposure Report Plan
(6) Such additional information as the Board may reasonably require.
(E) The annual fee for the Body Art Establishment Permit shall be $500.00,
with an annual renewal fee of $300.00.
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(F) A permit for a body art establishment shall not be transferable from one
place or person to another.
12. Application for Body Art Practitioner Permit
(A) No person shall practice body art or perform any body art procedure
without first obtaining a practitioner permit from the Board. The Board
shall set a reasonable fee for such permits. The annual fee for the Body Art
Practitioner shall be $250.00
(B) A practitioner shall be a minimum of 18 years of age.
(C) A practitioner permit shall be valid from the date of issuance and shall
expire no later than one year from the date of issuance unless revoked
sooner by the Board.
(D) Body Art procedures shall only be practiced by a permitted Body Art
Practitioner in a permitted Body Art Establishment.
(E) Application for a practitioner permit shall include:
(1) name;
(2) date of birth;
(3) residence address;
(4) mailing address;
(5) phone number;
(6) place(s) of employment as a practitioner; and
(7) training and/or experience as set out in (F) below.
(F) Practitioner Training and Experience
(1) In reviewing an application for a practitioner permit, the Board
may consider experience, training and/or certification acquired in
other states that regulate body art.
(2) Training for all practitioners shall be approved by the Board and, at
a minimum, shall include the following:
(a) bloodborne pathogen training program (or equivalent)
which includes infectious disease control; waste disposal;
handwashing techniques; sterilization equipment operation
and methods; and sanitization, disinfection and sterilization
methods and techniques; and
(b) Current certification in First Aid and cardiopulmonary
resuscitation (CPR).
Examples of courses approved by the Board include "Preventing
Disease Transmission" (American Red Cross) and "Bloodborne
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Pathogen Training" (U.S. OSHA). Training/courses provided by
professional body art organizations or associations or by equipment
manufacturers may also be submitted to the Board for approval.
(3) The applicant for a body piercing practitioner or a tattoo, branding
or scarification practitioner permit shall provide documentation,
acceptable to the Board, that s/he completed a course on anatomy
and physiology with a grade of C or better at a college accredited
by the New England Association of Schools and Colleges, or
comparable accrediting entity. This course must include
instruction on the system of the integumentary system (skin). Such
other course or program as the Board shall deem appropriate and
acceptable may be substituted for the anatomy course.
(4) The applicant for all practitioners shall submit evidence
satisfactory to the Board of at least two years actual experience in
the practice of performing body art activities of the kind for which
the applicant seeks a body art practitioner permit to perform,
whether such experience was obtained within or outside of the
Commonwealth.
(G) A practitioner’s permit shall be conditioned upon continued compliance
with all applicable provisions of these rules and regulations.
13. Grounds for Suspension, Denial, Revocation, or Refusal to Renew Permit
(A) The Board may suspend a permit, deny a permit, revoke a permit or refuse
to renew a permit on the following grounds, each of which, in and of itself,
shall constitute full and adequate grounds for suspension, denial,
revocation or refusal to renew:
(1) any actions which would indicate that the health or safety of the
public would be at risk;
(2) fraud, deceit or misrepresentation in obtaining a permit, or its
renewal;
(3) criminal conduct which the Board determines to be of such a
nature as to render the establishment, practitioner or applicant unfit
to practice body art as evidenced by criminal proceedings resulting
in a conviction, guilty plea, or plea of nolo contendere or an
admission of sufficient facts;
(4) any present or past violation of the Board’s regulations governing
the practice of body art;
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(5) practicing body art while the ability to practice is impaired by
alcohol, drugs, physical disability or mental instability;
(6) being habitually drunk or being dependent on, or a habitual user of
narcotics, barbiturates, amphetamines, hallucinogens, or other
drugs having similar effects;
(7) knowingly permitting, aiding or abetting an unauthorized person
to perform activities requiring a permit;
(8) continuing to practice while his/her permit is lapsed, suspended, or
revoked; and
(9) having been disciplined in another jurisdiction in any way by the
proper permitting authority for reasons substantially the same as
those set forth in the Board's regulations.
(10) other just and sufficient cause which the Board may determine
would render the establishment, practitioner or applicant unfit to
practice body art;
(B) The Board shall notify an applicant, establishment or practitioner in
writing of any violation of the Board's regulations, for which the Board
intends to deny, revoke, or refuse to renew a permit. The applicant,
establishment or practitioner shall have seven (7) days after receipt of such
written notice in which to comply with the Board's regulations. The Board
may deny, revoke or refuse to renew a permit, if the applicant,
establishment or practitioner fails to comply after said seven (7) days
subject to the procedure outlined in Section 15.
(C) Applicants denied a permit may reapply at any time after denial.
14. Grounds for Suspension of Permit
The Board may summarily suspend a permit pending a final hearing on the merits on the
question of revocation if, based on the evidence before it, the Board determines that an
establishment and/or a practitioner is an immediate and serious threat to the public health,
safety or welfare. The suspension of a permit shall take effect immediately upon written
notice of such suspension by the Board.
15. Procedure for Hearings
The owner of the establishment or practitioner shall be given written
notice of the Board’s intent to hold a hearing for the purpose of
suspension, revocation, denial or refusal to renew a permit. This written
notice shall be served through a certified letter sent return receipt
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requested or by constable. The notice shall include the date, time and place
of the hearing and the owner of the establishment or practitioner’s right to
be heard. The Board shall hold the hearing no later than 21 days from the
date the written notice is received.
At the hearing the Board shall determine whether, by a preponderance of
the evidence, there existed immediately prior to or at the time of the
hearing, an immediate and serious threat to the public health, safety or
welfare. Within fourteen (14) days after the close of the hearing, the
Board shall issue a written decision, which contains a summary of the
testimony and evidence considered and the reasons for the decision.
16. Severability
If any provision contained in the model regulations is deemed invalid for any reason, it
shall be severed and shall not affect the validity of the remaining provisions.
17. Fine for Violation
Any violation of these Regulations is subject to a fine of not more than one thousand
($1000.00) dollars per M.G.L. Chapter 111, Section 31.
18. Noncriminal Disposition
As an alternative to section 17, an enforcement officer may elect noncriminal
enforcement , and for these regulations, the enforcement officers shall be the Health
Director, the Assistant Health Director or any Police Officer. The noncriminal penalty for
violating these regulations shall be three hundred ($300.00) dollars. If the violations
occur as separate incidents, each violation shall be an offense, but if the violation is
ongoing , then each day of violation shall be a separate offense.
19. Effective Date
Adopted: February 20, 2001 Effective: Date of Publication
Amended: December 18, 2001
BOARD OF HEALTH
____________________________ ___________________________
David Corcoran, Chairman Patricia Schmidt, Vice Chairman
____________________________ ___________________________
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Doris Franzago Edward Wanamaker
____________________________
Merton Bernstein
___________________________
Town Clerk