State Of Alabama
Body Art Practice and Facilities 420-3-23
1
RULES FOR BODY ART PRACTICE AND FACILITIES
420-3-23
Table of Contents
420-3-23-.01 General Provisions
420-3-23-.02 Definitions
420-3-23-.03 Body Art Operator Requirements and Professional Standards
420-3-23-.04 Exemptions
420-3-23-.05 Client Information and Site Care Information
420-3-23-.06 Client Health
420-3-23-.07 Records Retention
420-3-23-.08 Preparation and Care of the Body Art Area
420-3-23-.09 Sanitization and Sterilization Procedures
420-3-23-.10 Inks, Dyes, Pigments, Needles, and Equipment
420-3-23-.11 Single-use Items
420-3-23-.12 Physical Facilities
420-3-23-.13 Licenses and Permits
420-3-23-.14 Temporary Establishment License or Operator Permit
420-3-23-.15 Prohibitions
420-3-23-.16 Compliance and Enforcement
420-3-23-.17 Department Personnel Competency Requirement
420-3-23-.18 Repealer
Body Art Practice and Facilities 420-3-23
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420-3-23-.01 General Provisions.
(1) Purpose – The purpose of these
rules is to protect the health of the public by
establishing standards for the prevention of disease that may be associated
with tattooing, body
piercing, and branding. These rules shall be interpreted and applied to
protect the public
health.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.02 Definitions.
(1) "Biohazard waste" means
any liquid or semi-liquid blood or other potentially
infectious materials; contaminated items that would release blood or other
potentially infectious
materials in a liquid or semi-liquid state if compressed; items that are
caked with dried blood or
other potentially infectious materials and are capable of releasing these
materials during
handling; sharps; and any wastes containing blood and other potentially
infectious materials.
(2) "Body art" means the
practice of physical body adornment using invasive
procedures and, for the purpose of these rules, is an inclusive term for any
procedures utilizing
body piercing, tattooing, cosmetic tattooing, branding or scarification.
Physicians
licensed by
the Alabama Licensure Commission and who perform body art procedures as part
of patient
treatment are exempt from these rules. Nor does this definition include, for
the purposes of
these rules, piercing of the ear using pre-sterilized single use stud and
clasp ear piercing
systems.
(3) "Body art facility" or
"Tattoo
facility" means the geographic
location at which an
individual does one or more of the following for compensation:
(a) Places an indelible mark upon the body of another individual by the
insertion of a
pigment in or under the skin.
(b) Places an indelible design upon the body of another individual by
production of
scars (branding).
(c) Performs body piercing.
(4) "Body piercing" means
the perforation of human tissue other than ear for a
nonmedical purpose.
(5) "Branding" means a
permanent mark made on human tissue by burning with a hot
iron or other instrument.
(6) "Clean technique" means
the technique used to prevent or reduce the
transmission of microorganisms from one person to another or from one place
to another. It
includes, but is not limited to:
Body Art Practice and Facilities 420-3-23
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(a) Meticulous handwashing with soap and water;
(b) Maintaining the sterility of supplies;
(c) Using barriers; in particular, clean, disposable, single-use gloves;
(d) Proper cleaning and preparation of the body site area; and
(e) Maintaining a clean and sanitary environment by using a detergent to
remove soil
and a disinfectant agent to clean up a spill of blood or other potentially
infectious materials.
(7) "Cosmetic tattooing" means
a tattoo procedure designed primarily to place a
permanent color or pigment in or under the skin or mucosa and that is
intended to be used in
lieu of cosmetic make-up, such as permanent eyeliner or lip color.
(8) "Critical item" means:
(a) a provision of these rules that, if in non-compliance, has the potential
for immediate
impact on the public health by resulting in infection of either clients or
staff of a body art facility,
or disease transmission among clients or staff of a body art facility, or
(b) an administrative provision of these rules that is necessary to ascertain
the
likelihood of infection or disease transmission among clients or staff of a
body art facility or to
inform the public, and
(c) are referred to in Appendix A of these rules.
(9) "Department" means the
State Department of Public Health.
(10) "Disinfectant " means
an agent that destroys microorganisms, particularly
pathogenic microorganisms.
(a) These can be disinfectants or sanitizers that are registered with the
U.S.
Environmental Protection Agency (EPA). Household bleach (sodium hypochlorite)
with no
fragrance or other additives may also be used as a germicide.
(b) Over-the-counter pre-mixed bleach products can be used or a 1:100
dilution of
household chlorine bleach (5.25% sodium hypochlorite) can be made fresh daily
and dispensed
from a spray bottle (500ppm, 1/4 cup per gallon of water or 2 tablespoons per
quart of water).
(11) "Disinfection" means a
process that eliminates many or all pathogenic
microorganisms,
with the exception of
bacterial spores, on inanimate objects,
thereby rendering
them safe for use or handling.
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(12) "Equipment" means all
machinery, including fixtures, containers, vessels, tools,
devices, implements, furniture, display and storage areas, sinks and all
other apparatus and
appurtenances used in connection with the operation of a body art facility.
(13) "Handwashing sink" means
a lavatory equipped with hot and cold running water
under pressure, through a mixing valve, used solely for washing hands, arms
or other portions
of the body.
(14) "Hot water" means water
which attains and maintains a temperature of at least
100º F.
(15) "Informed consent" means
a written consent signed by the client prior to having
any body art procedure performed and which provides information and/or
counseling on risks
and possible complications of the procedure to be performed.
(16) "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 possible
exposure to bodily
fluids during body art procedures.
(17) "Invasive" means entry
into the body either by incision or insertion of an
instrument into or through the skin or mucosa, or by any other means intended
to puncture,
break or compromise the skin or mucosa.
(18) "Jewelry" means any
personal ornament inserted into a newly pierced area.
Jewelry for body piercing use shall be made of surgical implant grade
stainless steel; solid 14k
or 18k white or yellow gold; niobium, titanium, or platinum; which is free of
nicks, scratches, or
irregular surfaces; has been properly sterilized prior to use, and has not
been previously used.
The Department may approve other materials upon request and review.
(19) "License" means the
written document issued by the Department for the
operation of a tattoo facility. Approval is given in accordance with these
rules and is separate
from any other licensing requirement of any local laws, rules, or ordinances.
(20) "Minor" means an
individual under 18 years of age who is not emancipated. An
emancipated minor is or has been married or has by court order otherwise been
legally freed
from the care, custody, and control of his or her parents.
(21) "Operator" means any
person who controls, operates, manages, conducts, or
practices body art activities at a body art facility and who is responsible
for compliance with
these rules, whether actually performing body art activities or not. The term
includes
technicians or apprentices who work under the operator and perform body art
activities.
(22) "Permit" means the
written document issued by the Department to an individual
denoting that the individual has received training as specified in these
rules. The permit is
given in accordance with these rules and is separate from any other licensing
requirement of
these rules for the body art facility or any local laws, rules, or
ordinances.
Body Art Practice and Facilities 420-3-23
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(23) "Person" means an
individual, any form of business or social organization or any
other non-governmental legal entity including but not limited to a
corporation, partnership,
limited liability company, association, trust or unincorporated organization.
(24) "Physician" means a
person licensed by the Alabama Licensure Commission to
practice medicine in all its branches.
(25) "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.
(26) "Sanitize/sanitization procedure" means
a process of using a disinfectant to
reduce the numbers of microorganisms on cleaned surfaces and equipment to a
safe level.
(27) "Shall" means a
mandatory requirement.
(28) "Sharps" means any
object (sterile or contaminated) that may purposefully or
accidentally cut or penetrate the skin or mucosa including, but not limited
to, pre-sterilized,
single use needles, scalpel blades and razor blades.
(29) "Sharps container" means
puncture-resistant, leak-proof container that can be
closed for handling, storage, transportation and disposal and is labeled with
the International
Biohazard Symbol.
(30) "Single-use" means
products or items that are intended for one-time, one-person
use and are disposed of after use on each client. This includes, but is not
limited to, cotton
swabs or balls, tissues or paper products, paper or plastic cups, gauze and
sanitary coverings,
razors, piercing needles, tattoo needles, scalpel blades, stencils, ink cups
and protective
gloves.
(31) "Site care" means
written instructions on caring for the body art and surrounding
area given to the client, and specific to the body art procedure(s) rendered.
(32) "Sterilization" means
the complete elimination or destruction of all forms of
microbial life, including highly resistant bacterial spores and is
accomplished by the use,
according to manufacturer’s directions, of a properly functioning autoclave
or dry heat sterilizer
that is manufactured to be used for sterilization.
(33) "Tattoo" means an
indelible mark made upon the body of another individual by
the insertion of a pigment in or under the skin or an indelible design upon
the body of another
individual by production of scars other than by branding.
(34 ) "Tattoo facility" means
a facility as defined under "Body art facility" in this rule.
Body Art Practice and Facilities 420-3-23
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(35) "Tattooing" means any
method of placing ink or other pigment into or under the
skin or mucosa of another individual by the aid of needles or any other
instrument used to
puncture the skin, resulting in permanent coloration of the skin or mucosa.
This includes all
forms of cosmetic tattooing.
(36) "Temporary body art facility" means
any place or premise operating at a non-mobile,
fixed location where an operator performs body art procedures for no more
than 14
days consecutively in conjunction with a single event or celebration.
(37) "Universal precautions" or "Standard precautions" means
a set of guidelines
and controls established by the Center for Disease Control and Prevention (CDC)
for the
prevention of transmission of bloodborne pathogens (specifically; the human
immunodeficiency
virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)).
(a) This method of infection control requires the employer and employee to
assume that
all human blood and body fluids are potentially infectious.
(b) 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.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.03 Body art operator requirements and professional standards.
(1) Licensed facility required – Except
as otherwise allowed in these rules, all
body
art procedures shall be performed in a body art facility which has a current,
valid license issued
by the Department.
(2) Consent age -
(a) No person shall perform any body art procedure upon a minor unless the
person
obtains the prior, written, informed consent of the parent or legal guardian
of the minor, as
shown in Appendix B, Consent for Minor.
(b) The parent or legal guardian of the minor shall execute the written
informed consent
required in this rule in the presence of the individual performing the body
art procedure on the
minor, or in the presence of an employee or agent of that individual.
(c)
Nothing in this section is intended
to require an operator to perform any body art
procedure on a minor with parental or guardian consent.
(3) Clients under the influence - A
person shall not perform any body art procedure
upon another individual if, in the opinion of the operator, the other
individual, or the consenting
parent or guardian, is under the influence of intoxicating liquor or a
controlled substance.
Body Art Practice and Facilities 420-3-23
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(4) Gloves -
(a) The operator shall wear clean, intact, single-use gloves when performing
body art
procedures.
(b) Under no circumstances shall a single pair of gloves be used on more than
one
person. Gloves shall be changed if they become contaminated by contact with
any non-clean
surfaces or objects or 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
washed prior to
donning the next set of gloves.
(c) The use of single-use gloves does not preclude or substitute for hand
washing
procedures as part of a good personal hygiene program.
(d) If, while performing a body art procedure the operator's glove is
pierced, torn or
otherwise contaminated, the contaminated glove shall be immediately discarded
and the hands
washed thoroughly (see section (5)(b) of this rule) before a new pair of
gloves is applied. Any
item or instrument used for body art, which is contaminated during the
procedure, shall be
discarded and replaced immediately with a new disposable or sterilized item
or a new sterilized
instrument before the procedure resumes.
(5) Hygienic practices –
(a) The operator or technician shall maintain a high degree of personal
cleanliness,
conform to hygienic practices, and wear clean clothes when performing body
art procedures.
(b) Before performing body art procedures, the operator or technician 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. Disposable
liquid soap dispensers shall not be refilled.
(c) Smoking, eating or drinking by anyone is prohibited in the work area
where body art
is performed.
(6) Operator information required - The
following information shall be kept on file on
the premises of a body art facility and available for inspection by the
Department:
(a) Full name and exact duties of each body art operator/technician;
(b) Date of birth of each body art operator/technician;
(c) Gender of each body art operator/technician;
(d) Home address of each body art operator/technician;
(e) Identification photos of each body art operator/technician;
(f) Social security number of each body art operator/technicia
n.
Except that, refusal
by the employee to give the social security number will not result in denial
of any right, privilege
or benefit.
Body Art Practice and Facilities 420-3-23
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(7) Procedures information required - A
complete listing of all body art procedures
performed shall be kept on file on the premises of a body art facility and
available for inspection
by the Department.
(8) Inventory information required - 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, shall be kept on file
on the premises of a
body art facility and available for inspection by the Department. Invoices or
orders shall satisfy
this requirement.
(9) Biohazard waste and sharps disposal –
(a) Biohazard waste, as defined in these rules, shall be disposed in
accordance with all
applicable local, state, and federal laws, rules, and ordinances, to include,
at a minimum, 29
CFR Part 1910.1030, Occupational Exposure to Bloodborne Pathogens.
(b) Waste which does not release liquid blood or body fluids when compressed
or does
not release dried blood or body fluids when handled may be placed in a
covered receptacle and
disposed through normal, approved disposal methods. Storage of such waste
on-site shall not
exceed the period specified by the Department or more than a maximum of 30
days, as
specified in 29 CFR Part 1910.1030 whichever is less.
(c) Sharps ready for disposal shall be disposed of in approved biohazard
sharps
containers.
(10) Skin condition of clients and operators -
(a) Any skin or mucosa surface to receive a body art procedure shall be free
of rash or
any visible infection.
(b) The skin of the operator shall be free of rash or infection. No person or
operator
affected with boils, infected wounds, open sores, abrasions, or weeping
dermatological lesions
shall work in any area of a body art facility in any capacity in which there
is a likelihood that they
could contaminate body art equipment, supplies or working surfaces with body
substances or
pathogenic organisms.
(11) Hepatitis B vaccination - Proof
shall be provided upon request of the
Department that all operators and technicians have either completed or were
offered and
declined, in writing, the hepatitis B vaccination series. This offering
should be included as a
pre-employment requirement. Documentation of immunity, based on a blood test
of the
operator, in written form and from an approved laboratory, may be used for
this requirement of
proof.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
Body Art Practice and Facilities 420-3-23
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420-3-23-.04 Exemptions.
(1) Physicians - Physicians licensed
by the State of Alabama who perform body art
procedures as part of patient treatment are exempt from these rules.
(2) Ear piercing - Ear piercing is
exempt from these rules. This does not prohibit the
Department from investigating consumer complaints relating to alleged misuse
or improper
disinfection of ear piercing systems.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.05 Client information and site care information.
(1) Information given prior to a procedure -
(a) Body art facilities shall prominently display a Disclosure Statement
which advises
the public of the risks and possible consequences of body art services. The
Disclosure
Statement shall be posted in a conspicuous place in the facility’s waiting
or general public area,
and easily seen by potential clients wanting to receive a body art procedure.
(b) The Disclosure Statement shall include, at a minimum, the following
wording in bold
type:
"There may be risks associated with the procedures of commercial body
art which
includes permanent tattoos, body piercing and permanent cosmetic application,
that may
adversely affect the healing process, or may be a concern due to potential
disease
transmission, if you have, or have had, any of the following conditions:
a. History of Hepatitis B or Hepatitis C;
b. HIV/AIDS;
c. Diabetes;
d. History of hemophilia or any other blood disorder/disease;
e. History of skin diseases or skin lesions;
f. History of sensitivities to soaps, disinfectants, etc.;
g. History of allergies or adverse reactions to pigments, dyes, latex, etc.;
h. Tuberculosis;
i. Immune disorders;
j. History of epilepsy, seizures, fainting, or narcolepsy;
k. Scarring (keloids);
l. History of heart murmur or any heart disease/condition;
m. History of taking medications such as anticoagulants that thin the blood
and/or
interferes with blood clotting;
n. Pregnancy or breast feeding/nursin
g."
(c) In the event a body piercing procedure is to be performed which involves
the oral
area ("oral piercing"), the client should be given oral piercing
information such as shown in
Body Art Practice and Facilities 420-3-23
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Appendix C.
(2) Site care information - A written
information sheet, shown in Appendix D, with
instructions for general site care which shall be provided as a minimum to
each client. The
facility may provide additional information as it deems appropriate. The body
art procedure site
care information shall be provided to each client by the operator upon
completion of the
procedure. The written information sheet shall also contain the name, address
and phone
number of the body art facility.
(b) The written information shall advise the client to consult a physician at
the first sign
of infection; such as redness, swelling, drainage, prolonged pain at the body
art procedure site,
or onset of fever.
(3) Reporting known infections, complications, or diseases required - A
person
who owns or operates a licensed tattoo facility shall, within 24 hours of
becoming aware that an
individual tattooed, branded, or body pierced at the tattoo facility is
infected with a
communicable disease, notify the department or a local county health
department.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.06 Client health.
(1) Client health medical information form -
(a) In order for the operator or technician to properly evaluate the client's
medical
condition prior to receiving a body art procedure and not violate the
client's rights or confidential
medical information, a written request for medical information shall be given
to the client. The
request for medical information shall include, at a minimum, the conditions
noted on the Model
Medical History shown in Appendix E.
(b) The operator should ask the client to sign this form confirming that the
information
was obtained or attempted to be obtained.
(c) This form shall be signed and dated by both parties, with a copy given to
the client
and the operator retaining the original with all other required records.
(d) Nothing in this rule shall be construed to require the operator to
perform a body art
procedure upon a client.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.07 Records retention.
Body Art Practice and Facilities 420-3-23
11
(1) Client records required - The body
art facility shall keep a record of all persons
who have had body art procedures performed. The record shall include the
name, date of birth,
and address of the client, the date of the procedure, name of operator who
performed the
procedure(s), type and locations of procedure(s) performed, signature of
client and if the client
is a minor, proof of parental or guardian consent, that is, signature.
(2) Record retention time - Such
records, any release forms, and all materials signed
by the client, shall be retained permanently and made available to the
Department upon
request. The records for the previous three years shall be kept on the
premises of the body art
facility; records older than three years may be kept offsite provided they
are readily accessible
upon request of the Department. The Department and the body art facility
shall keep such
records confidential.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.08 Preparation and care of the body art area.
(1) Skin preparation - If shaving is
necessary, single use disposable razors with
single service blades shall be used and discarded after each use. Following
shaving, the skin
and surrounding area shall be cleaned with soap and water or an approved
surgical skin
preparation, depending on the type of body art to be performed. When shaving
is not done,
the immediate and surrounding area of the skin where the body art procedure
is to be placed
shall be cleaned with soap and water or an approved surgical skin
preparation. Cleansing pads
shall be discarded after a single use.
(2) Supplies contaminated with blood - In
the event of blood flow, all products used
to check the flow of blood or to absorb blood shall be single-use and
disposed of immediately
after use in appropriate covered containers, unless the disposal products
meet the definition of
biomedical waste. 420-3-23-.09 Sanitation and sterilization procedures.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.09 Sanitation and sterilization procedures.
(1) Instrument cleaning - All
non-single use, non-disposable instruments used for
body art shall be cleaned thoroughly after each use by scrubbing with an
appropriate soap or
detergent solution and hot water or follow the manufacturer's instructions to
remove blood and
tissue residue, and placed in an ultrasonic unit which shall also be operated
in accordance with
manufacturer's instructions.
(2) Instruments packaged following cleaning - After
cleaning, all non-disposable
instruments used for body art shall be packaged individually in peel-packs
and subsequently
Body Art Practice and Facilities 420-3-23
12
sterilized. All peel-packs shall contain either a sterilizer indicator or
internal temperature
indicator. Peel-packs must be dated and may be used as long as the package
integrity has not
been breached.
(3) Instrument sterilization -
(a) All cleaned, non-disposable instruments and jewelry used for body art
shall be
sterilized in a steam autoclave or dry heat sterilizer. Equipment used for
sterilization shall be
used, cleaned, and maintained according to the manufacturer's instructions. A
copy of the
manufacturer's recommended procedures for the operation of their
sterilization unit must be
available for inspection by the Department.
(b) The use of equipment not specifically designed for medical instrument
sterilization,
such as, but not limited to, food pressure cookers, microwave ovens, and
baking ovens, is
prohibited.
(4) Package integrity - Sterile
equipment shall not be used if the package integrity has
been breached. If the package integrity is breached, the equipment shall be
removed from the
package, and cleaned and sterilized as required in sections (1) and (2) of
this rule.
(5) Location of sterilizers, when required - Sterilizers
shall be located away from
work stations or areas frequented by the public. If the body art facility
uses all single use,
disposable instruments and products, and utilizes sterile supplies, an
autoclave shall not be
required.
(6) Sterilizer efficacy testing - Each
holder of a license to operate a body art facility
shall demonstrate that the sterilizer used is capable of attaining
sterilization by conducting
monthly spore destruction tests. These tests shall be verified through an
independent
laboratory. The license shall not be issued or renewed until documentation of
the sterilizer's
ability to destroy spores is determined by the Department. These test records
shall be retained
by the operator for a period of three (3) years and made available to the
Department upon
request.
(7) Storage of sterilized instruments and other instruments and supplies - Unless
received from the manufacturer as a sterile instrument and in a package
maintaining sterility
and package integrity, all needles
used in tattooing and cosmetic tattooing shall be cleaned and
sterilized prior to use and stored in peel-packs. After sterilization, the
instruments used for
tattooing/body piercing shall be stored in a dry, clean cabinet or other
tightly covered container
reserved for the storage of such instruments. All other instruments and
supplies shall be stored
in clean, dry and covered containers.
(8) Sanitization and disinfection of surfaces - Procedure
surfaces, counter tops
used for equipment assembly, and any other similar surfaces where necessary
shall be cleaned
and sanitized with a disinfectant solution after each client.
(9) Reusable cloth items - Reusable
cloth items shall be mechanically washed with
detergent and dried after each use. The cloth items shall be stored in a dry,
clean environment
Body Art Practice and Facilities 420-3-23
13
until used. Soiled cloth items shall be stored in a manner to preclude
contamination of any
clean items, equipment, or instruments.
(10) Clean techniques required - All
instruments used for tattooing/body piercing
shall remain stored in sterile packages until just prior to performing a body
art procedure.
When assembling instruments used for performing body art procedures, the
operator shall wear
disposable single-use gloves and use clean techniques to ensure that the
instruments and
gloves are not contaminated.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.10 Inks, dyes, pigments, needles and equipment.
(1) Use according to manufacturer’s directions - All
inks, dyes, pigments, needles
and equipment shall be specifically manufactured for performing body art
procedures and shall
be used according to manufacturer's instructions and standard professional
practice.
(2) Ink used during a procedure - Immediately
before applying a tattoo, the quantity
of the dye to be used shall be transferred from the dye bottle and placed
into single-use paper
or plastic cups. Upon completion of the tattoo, these single cups and their
contents shall be
discarded.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.11 Single-use items.
(1) Use restricted – Single-use
items shall not be used on more than one client for any
reason. After use, all single-use needles, razors and other sharps shall be
immediately
disposed of in approved sharps containers.
(2) Products applied to the skin -
(a) All products applied to the skin, including body art stencils, shall be
single-use and
disposable.
(b) Acetate stencils shall be allowed for re-use if sanitization procedures
are performed
between uses.
(c) Petroleum jellies, soaps and other products used in the application of
stencils shall
be dispensed and applied on the area to be tattooed with sterile gauze or in
a manner to
prevent contamination of the original container and its contents. The gauze
shall be used only
once and then discarded.
Body Art Practice and Facilities 420-3-23
14
(d) The operator shall use only single-use sterile gauze and single-use
antibacterial
ointments to cover the procedure site(s).
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.12 Physical facilities.
(1) Plans required - Body art
facilities applying for a license after adoption of these
rules shall submit a scale drawing and floor plan of the proposed facility
for a plan review by the
Department, as part of the license application process.
(2) Floors, walls, and ceiling -
(a) All walls and floors of the procedure area of a body art facility shall
be smooth, free
of open holes or cracks, washable and in good repair. Ceilings in all
procedure areas shall be
maintained in good repair with no open holes.
Walls
in waiting rooms and non-procedure areas
may have decorative attachments if the wall and decorations are kept clean.
(b) Carpeting is prohibited as a floor covering in the body art procedure
area.
(c) Walls, floors and ceilings in the body art facility shall be maintained
in a clean
condition.
(3) Water supply -(
a) Water used for the sanitary operations of the body art facility shall be
provided from
a source operated and constructed according to law.
(b) At least one water sample shall be collected annually from any body art
facility if the
body art facility’s water supply is not from a source approved by the
Alabama Department of
Environmental Management.
(c) If the water sample results show coliform present as reported by the
Alabama
Department of Public Health Bureau of Clinical Laboratories, a resample shall
be taken within
seven days of the report being received by the county health department.
Whenever two
consecutive samples taken on separate days show coliform present, body art
facility’s license
shall be suspended in accordance with appropriate administrative procedures.
A sample result
of coliform absent with no confluent growth is required prior to
reinstatement of the license.
(4) Sewage disposal – All sewage,
and liquid waste such as mop water, shall be
disposed of by a public sewerage system or by a sewage disposal system
constructed and
operated according to law.
(5) Sinks and toilet facilities -
Body Art Practice and Facilities 420-3-23
15
(a) A readily accessible handwashing sink with hot and cold running water,
under
pressure, dispensed through a mixing valve, with no aerator, preferably
equipped with wrist or
foot operated controls, and supplied with liquid soap in disposable
dispensers and disposable
paper towels at the sink, shall be provided convenient to the work area
within any procedure
room in the body art facility.
(b) When there are multiple procedure areas or operators in one room, one
handwashing sink shall serve no more than three (3) operators or three (3)
work areas.
(c) Toilet facilities shall be installed according to law; shall be the
number required by
law as enforced by local plumbing officials, but at least one; shall be under
the care and control
of the body art facility operator; and shall be accessible to employees at
all times.
(d) Each toilet room shall have a handwashing sink, designed and supplied as
required
in section (3)(a) of this rule, inside the toilet room or outside the toilet
room immediately
adjacent to the toilet room door.
(e) Handwashing sinks shall be used for no other purpose.
(f) A utensil sink with hot and cold water under pressure, supplied through a
mixing
valve with no aerator, shall be provided for washing reusable instruments or
other reusable
items.
(g) A service sink or utility sink, with at least hot water under pressure,
shall be provided
for the disposal of liquid waste.
(6) Procedure surfaces - All procedure
surfaces, including client chairs and/or
benches, shall be of such construction and maintained to be easily cleaned
and sanitized with a
disinfectant solution after each client.
(7) Separation from other areas - All
body art facilities shall be completely separated
by solid partitions or by walls extending from floor to ceiling, from any
room used for human
habitation, or any room used for living or sleeping quarters or a bathroom
used for a personal
residence, or from a food establishment or room where food is prepared, a
hair salon, retail
sales, or other such activity which may cause potential contamination of work
surfaces.
(8) Procedure (work station) area - There
shall be a minimum of thirty-five (35)
square feet of floor space at each work station in the body art facility
unencumbered by non-portable
furniture or equipment. Each body art facility shall have an area which may
be
screened from public view for clients requesting privacy. Multiple body art
stations shall be
separated by dividers, curtains or partitions, at a minimum.
(9) Ventilation - The facility shall
be well-ventilated.
(10) Lighting - The facility shall be
provided with an artificial light source equivalent to
at least twenty (20) foot candles three (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, and where
Body Art Practice and Facilities 420-3-23
16
instruments and sharps are assembled and/or processed.
(11) Insects, vermin, and rodents prohibited - Effective
measures shall be taken by
the body art operator to protect the entrance into the facility and the
breeding or presence on
the premises of insects, vermin and rodents. Insects, vermin and rodents
shall not be present
in any part of the facility, its appurtenances or appertaining premises.
(12) Animals prohibited - No animals
of any kind shall be allowed in body art facility
except service animals used by persons with disabilities shall be allowed.
Fish aquariums may
be allowed in waiting rooms and non-procedural areas.
(13) Refuse containers - At least one
covered waste receptacle shall be provided in
each operator work area and each toilet room. Receptacles in the operator
work area shall be
emptied daily and solid waste shall be removed from the premises at least
weekly. All refuse
containers shall be lidded, cleanable and kept clean.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.13 Licenses and permits.
(1) Body art facility licenses required -
(a) No person shall operate a body art facility until obtaining a license
from the
Department. Any person desiring to operate a body art facility shall make
written application
for a license on forms provided by the Department. Such application shall
include the name
and address of each applicant, the physical location of the proposed body art
facility, the type of
all body art procedures proposed to be conducted at the facility, and the
signature of each
applicant. The license shall be issued on forms provided by the Department.
(b) If the Department determines that the application is complete and the
body art
facility proposed or operated by the applicant meets the requirements of
these rules, the
Department shall issue a license to the applicant for the operation of that
body art facility.
(c) Licenses shall automatically expire on the date upon which state, county,
and
municipal annual privilege licenses expire or on a date designated by the
local county health
department and shall be renewable annually upon written application from the
operator not less
than thirty (30) days prior to expiration.
(d) The body art facility applicant shall pay a fee as set by law for each
body art facility
license, which is:
1. $250.00 for the initial annual license.
2. $200.00 for a one-year renewal of an annual license.
Body Art Practice and Facilities 420-3-23
17
3. $50.00 for a temporary license.
(e) Body art facility license fees are not prorated.
(f) A license for a body art facility shall not be transferable from one
place or person to
another.
(g) A current body art facility license shall be displayed in a conspicuous
place within
the customer service area of the body art facility where it may be readily
observed by clients
upon entering the facility.
(2) Operator permits required -
(a) The holder of a body art facility license shall hire, employ, or use
operators or
technicians who have complied with the operator permit requirements of these
rules.
(b) No person shall practice body art procedures without first obtaining an
operator
permit from the Department.
(c) The operator permit shall be valid from the date of issuance and shall
automatically
expire at the end of the facility license year following the current year
when issued unless
revoked sooner by the Department in accordance with these rules. Application
for operator
permits shall include:
1. Name;
2. Date of birth;
3. Sex;
4. Residence address;
5. Mailing address;
6. Phone number;
7. Place(s) of employment as an operator;
8. Years experience;
9. Social security number.
Provided
that, refusal by the employee to give the social
security number will not result in denial of any right, privilege or benefit;
10. Proof of attendance within the 36 months prior to making application at a
bloodborne pathogen training program (or equivalent), given or approved by
the Department, to
include demonstration of knowledge of the following subjects:
Body Art Practice and Facilities 420-3-23
18
( i) Anatomy;
(ii) Skin diseases, disorders, and conditions (for example, diabetes) which
may affect
the skin;
(iii) Infection control procedures including waste disposal, hand washing
techniques,
sterilization equipment operation and methods, and sanitization/disinfection/sterilization
methods and techniques;
(iv) Facility safety and sanitation.
(d) Knowledge of the subjects in section 420-3-23-.13(2)(c)10 must be
demonstrated
through submission of documentation of attendance or completion of courses
approved or
given by the Department prior to issuance of the operator's permit. Examples
of courses
approved by the Department would include such courses as Prevention of
Disease
Transmission and Bloodborne Pathogen Training.
(e) No operator permit shall be issued unless, following reasonable
investigation by the
Department, the body art operator has demonstrated compliance with the
provisions of this
section and all other provisions of these rules.
(f) All operator permits shall be conditioned upon continued compliance with
the
provisions of this section as well as all applicable provisions of these
rules.
(g) All operator permits shall be posted in a conspicuous place within the
customer
service area where they may be readily observed by clients upon entering the
body art facility.
(3) Existing body art facilities and operators -
(a) Body art facilities operating at the time of the enactment of these
rules, as
evidenced by the possession of a current and valid business license, shall,
within 30 days of the
effective date of these rules, make application to the Department for a body
art facility license
and pay the fee for a new license as required in this rule. This first
license for these existing
facilities shall be considered a Provisional License and shall not be renewed
unless all the
requirements of these rules are met by the license expiration date. In the
event all the
requirements of these rules are not met by the time the Provisional License
expires, or
application for a Provisional License is not made within 30 days of the
effective date of these
rules, the body art facility shall not be considered an existing facility and
shall make application
for a license as a new facility.
(b) Operators conducting body art procedures at the time of the enactment of
these
rules shall make application to the Department for an Operators Permit and
obtain an
Operators Permit within 6 months of the effective date of these rules.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
Body Art Practice and Facilities 420-3-23
19
420-3-23-.14 Temporary Facility License or Operator Permit.
(1) Licenses and permits -
(a) Temporary body art facility licenses and, when required, operator
permits, may be
issued for body art services provided outside of the physical site of a fixed
licensed facility for
the purposes of product demonstration, industry trade shows or for
educational reasons.
(b) Temporary licenses issued under the provisions of these rules may be
suspended
by the Department for failure of the holder to comply with the requirements
of these rules.
(c) All facility licenses and operator permits and the disclosure notice must
be readily
visible to clients.
(2) Requirements - Temporary operator
permits and/or facility licenses shall not be
issued unless:
(a) The applicant furnishes proof of compliance with 420-3-23-.13(2) relating
to
operator's permits and/or
(b) The applicant is currently affiliated with a fixed location or permanent
facility which,
where applicable, is permitted by the appropriate State and/or local
jurisdiction; and
(c) The temporary site complies with section (9) of this rule.
(3) Training - In lieu of attendance
at a bloodborne pathogens training program
approved by the Department within the past three (3) years as specified in
420-2-23-13(2)(c)
above, the applicant may furnish proof of attendance at equivalent training
which is acceptable
to the Department.
(4) Time limit - Temporary body art
facility licenses and/or operator permits expire
after fourteen (14) days or the conclusion of the special event, whichever is
less.
(5) Fee required - Temporary body art
facility licenses shall not be issued unless the
applicant has paid the fee set by law.
(6) Non-transferable - The temporary
body art facility license or operator permit shall
not be transferable from one place or person to another.
(7) License and permits posted - The
temporary body art facility license and operator
permit shall be posted in a prominent and conspicuous area where they may be
readily seen by
clients upon entering the facility.
(8) Temporary Operator Permit Requirements -
Body Art Practice and Facilities 420-3-23
20
(a) A temporary permit may be issued by the Department for educational, trade
show or
product demonstration purposes only. The permit may not exceed fourteen (14)
calendar days.
(b) A person who wishes to obtain a temporary demonstration permit must
submit the
request in writing for review by the Department, at least thirty (30) days
prior to the event. The
request shall specify:
1. The purpose for which the permit is requested;
2. The period of time during which the permit is needed (not to exceed
fourteen
(14) calendar days per event), without re-application;
3. The fulfillment of temporary operator requirements as specified in section
(2) of this
rule;
4. The location where the temporary demonstration will be conducted.
(9) Temporary Establishment Physical Facilities -(
a) The temporary demonstration project must be contained in a completely
enclosed,
non-mobile facility (that is, inside a permanent building).
(b)
Except as otherwise provided in
this rule, the temporary body art
facility and
operator shall comply with all of the requirements of these rules, including
but not limited to:
1. Conveniently located handwashing facilities with liquid soap, paper towels
and hot
and cold water under adequate pressure shall be provided; along with sanitary
drainage in
accordance with local plumbing codes.
2. A minimum of eighty (80) square feet of floor space;
3. At least one hundred (100) foot candles of light at the level where the
body art
procedure is being performed.
4. Facilities to properly sterilize instruments with evidence of a spore test
performed on
sterilization equipment thirty (30) days or less prior to the date of the
event, shall be provided;
or only single use, prepackaged, sterilized equipment obtained from reputable
suppliers or
manufacturers shall be allowed;
5. Ability to properly clean and sanitize the area used for body art
procedures.
The facility where the temporary demonstration is proposed shall be inspected
by the
Department and a license issued prior to any body art procedures being
performed.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
Body Art Practice and Facilities 420-3-23
21
420-3-23-.15 Prohibitions.
(1) Prohibited acts include, but are not limited to, the following:
(a) Performing body art on any body part of a minor without the informed
written
consent of the parent or legal guardian of such minor. This consent is to be
given in person to
the operator or responsible person at the facility by the parent or legal
guardian at the time the
tattooing or piercing is to commence.
(b) Performing body art on a person who, in the opinion of the operator is
inebriated or
appears to be under the influence of alcohol or drugs.
(c) Owning, operating or soliciting business as a body art facility or
operator without first
obtaining all necessary permits and approvals from the Department, unless
specifically
exempted by these rules.
(d) Obtaining or attempting to obtain any body art facility license or
operator permit by
means of fraud, misrepresentation or concealment.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.16 Compliance and Enforcement.
(1) Inspection frequency -
(a) A representative of the Department shall properly identify him or herself
upon
entering a body art facility to make an inspection. Inspections shall be
conducted at least every
180 days or as often as necessary throughout the year to ensure compliance
with these rules.
(b) The routine inspection frequency shall be determined by the compliance
status
found on inspection as below.
Nothing
in this section precludes the Department from issuing an
immediate Notice of Intent to Suspend/Revoke order, or issuing an emergency
order to
immediately cease operation or cease using a particular item of equipment or
a particular
process, if necessary in order to protect the public health.
(c) A routine re-inspection shall be conducted within 180 days when:
1. No critical items were found in non-compliance or any critical items found
in non-compliance
are corrected during the inspection, or
2. No second-time repeat non-critical items were found in non-compliance.
(d) A compliance check shall be conducted within 30 days when:
Body Art Practice and Facilities 420-3-23
22
1. One or more critical items are found in non-compliance and are not
corrected during
the inspection, or one or more repeat corrected critical items from the
previous inspection were
found in non-compliance regardless of being corrected during the current
inspection, or
2. One or more second-time repeat non-critical items from the previous
routine
inspection were noted in non-compliance regardless of being corrected during
the current
inspection.
(e) Whenever a compliance check to determine correction of any item finds the
item in
continuing non-compliance; a Notice of Intent to Suspend or Revoke the
license or permit shall
be issued to the person in charge at the body art facility. If the item in
non-compliance and
being the cause for issuance of the Notice is corrected, the body art
facility shall retain the
inspection status but shall be re-inspected within 30 days.
(2) Inspection report -
(a) The original of the inspection report (see Appendix F) shall be furnished
to the
permit holder or operator of the body art facility, with the Department
retaining possession of a
copy.
(b) The inspection report shall designate the compliance status of the body
art facility
as Routine re-inspection or Compliance Check Necessary, based on the result
of the inspection
as specified in 420-3-23-.16(1).
(3) Correction of non-critical violations -
(a) Upon finding a violation of any provision of these rules that is deemed a
non-critical
item, the Department shall advise the licensee or permitted operator, in
writing, of its findings
and instruct the operator to correct such violations within a reasonable
period of time, but no
later than the time of the next routine inspection.
(b) In the event a non-critical violation is not corrected by the time of the
next routine
inspection, or is the same violation as on the preceding routine inspection,
it shall be noted on
the inspection report as a repeat violation. In the event one or more
non-critical items are found
in violation on a second consecutive routine inspection, they shall be noted
on the inspection
report as a second repeat violation, and shall be corrected as required for
critical items in 420-
3-.16(4).
(4) Correction of critical violations -
(a) Violation of any provision of these rules that is deemed a critical item
should be
corrected immediately, during the course of the inspection, but in any event
within 30 days
following the inspection.
(b) In the event the violation cannot be corrected during the course of the
inspection, or
if the critical violation is the same as on the immediately preceding
inspection and was
corrected at that time but is now in violation again, notice of intent to
suspend the body art
Body Art Practice and Facilities 420-3-23
23
facility license or operator permit, or both, shall be issued by the
Department representative
conducting the inspection. The body art facility license holder or permit
holder may request a
hearing on the notice of intent to suspend in accordance with these rules.
(5) Suspension of licenses and permits -
(a) Licenses and permits issued under the provisions of these rules may be
suspended
temporarily by the Department for failure of the holder to comply with the
requirements of these
rules or for repeated or critical violations of any of the requirements if
these rules.
(b) Whenever the Department is aware of, or has reasonable cause to suspect
that, 1)
a communicable disease has been, or may be, transmitted by an operator to a
client; or 2)
there is use of unapproved or malfunctioning equipment; or 3) insanitary or
unsafe conditions
