Section 1200-23-06-.05 - BODY PIERCING PROCEDURES(1) Universal precautions, as defined in these rules, shall be observed to prevent contact with blood or other potentially infectious materials. Body piercing technicians and operators shall be trained in universal precautions. (a) Assume all human blood, plasma, serum, body fluids (semen, saliva, breast milk, vaginal secretions and any fluid contaminated with blood) and tissues to be contaminated with Human Immunodeficiency Virus (HIV) and/or Hepatitis viruses (e.g., HBV).(b) The most susceptible route of occupational infection for HIV and HBV is by accidental needle sticks, contamination of the mucous membranes, or through broken, abraded, or irritated skin. Use appropriate caution and maximum protection to prevent such contact.(c) Proper decontamination procedures, emergency biohazard spill management, and proper use of biosafety equipment shall be utilized.(d) Use aseptic technique. Thorough hand washing is essential after patron contact, after handling blood and body fluids, after wearing gloves, and prior to exiting the work area.(e) Needles shall be sterilized prior to use. Due to the hollow nature of body piercing needles, it is not permissible to reuse needles, non-disposable or otherwise, for body piercing.(f) Dispose of needles and other sharps in puncture proof, autoclavable containers, or disposable biohazard containers.(g) All regulated wastes shall be disposed of in labeled, manufacturer's color-coded waste containers.(h) A spill kit (bleach, leak proof container, paper towels, gloves, spray bottle) is to be used to clean up potentially infectious material spills. Small spills can be wiped up, after donning protective gloves, with paper towels and sprayed with freshly made ten percent (10%) bleach solution.(i) Clean all work areas and equipment used in handling human biohazardous materials with proven disinfectant (e.g., 10% dilution of bleach) when concluding work to protect personnel from accidental infection.(j) Eating, drinking, smoking, inserting contacts, and applying cosmetics or lip balm are not permitted in the work area. Food shall be stored in cabinets or refrigerators designated and used for this purpose only. Food storage cabinets or refrigerators shall be located outside the work area.(k) All procedures shall be performed carefully to minimize the creation of aerosols.(l) Report all work related accidents, incidents, and unexplained illness to the body piercing establishment supervisor, operator, and/or physician immediately.(m) Used gloves shall be removed after each operation and prior to contacting work surfaces, door knobs, wall switches, or telephones. Dispose of used gloves in a bagged, trash container.(n) The operator shall maintain written records of operational equipment utilized by the business, including manufacturers, model numbers, and dates of acquisition or purchase.(2) Body Piercing Establishment Personnel(a) The body piercing establishment operator shall make available, at no cost to the personnel, Hepatitis B vaccination series, as well as any routine booster dose(s) to every person who may have occupational exposure to blood or other potentially infectious material. For new personnel the vaccine shall be made available within ten (10) working days of initial work assignment.(b) Personnel who decline to accept the Hepatitis B vaccination series must sign a form indicating their refusal.(c) The outer clothing of all personnel shall be clean.(d) Body piercing technicians/operators shall wash their hands with antiseptic soap before and after treating each patron (i.e., before glove placement and after glove removal) and after barehanded touching of inanimate objects likely to be contaminated by blood, saliva, or respiratory secretions. Hands shall be washed after removal of gloves, smoking, eating, drinking, or using the toilet.(e) Body piercing technicians/operators who have exudative lesions or weeping dermatitis, particularly on the hands, shall refrain from all direct patron contact and from handling equipment until the condition resolves.(f) Personnel shall consume food only in approved, designated areas. There shall be no eating or drinking in the work area of the establishment.(g) Personnel shall not use tobacco in any form while engaged in the operation or process of body piercing a patron, nor while in areas used for equipment or utensil washing. Personnel shall use tobacco only in approved, designated areas.(h) Personnel shall maintain a high degree of personal cleanliness and shall conform to good hygienic practices during all working periods in body piercing establishments.(3) Implementation of infection-control practices(a) Disposable latex or vinyl examination gloves shall be worn by a technician at all times while performing a body piercing. Gloves shall be changed and properly disposed of each time there is an interruption in the body piercing process, or whenever their ability to function as a barrier is compromised. Gloves shall be changed between patrons and used gloves shall be properly disposed of as provided in these rules.(b) Only sterilized equipment or single use supplies, such as disposable razors, single use towels or wipes, lubricants from a collapsible tube, may be used to perform a body piercing. After the piercing procedure, single use items and containers shall be discarded and the work area disinfected.(c) When it is necessary to shave the area for the piercing, a new blade for each patron or customer shall be used when a safety razor is employed, and the permanent part of such razor shall be disinfected. If a straight razor is used, it shall be cleaned with soap and water, rinsed in clear water, and then sterilized in an autoclave.(d) A sterile set of needles shall be used for each patron.(e) Piercing equipment, with the exception of hollow bore needles, shall be sealed for individual patron use in autoclave bags with a chemical or autoclave indicator and date (month and year) of sterilization clearly visible. After piercing, used non-disposable instruments shall be kept in a separate, puncture resistant container until properly cleaned, disinfected, and sterilized using universal precautions and recognized medical methods.(f) Microbiological monitoring for adequate functioning of each autoclave will be done at least weekly using a commercial source of Bacillus stearothermophilus which is then tested in an accredited commercial laboratory. All laboratory reports will be logged and kept for two (2) years and shall be available for inspection.(g) Upon notification of a positive microbiological monitoring report (detection of viable spores), the sterilizer shall be immediately checked for proper use and function. A repeat test shall be performed within three (3) days. Upon a subsequent positive result from a repeat test, discontinue use of the sterilizer until properly serviced and a negative result is obtained.(h) Sterilizer indicator tape and/or sterilizer bags with indicator tape areas which change color will be used with all items sterilized to indicate the item has been autoclaved. All items shall be marked with the date of sterilization.(i) Sterilized items in the sealed, autoclaved bags shall be stored in a clean, dry place, until used, for no more than one (1) year.(j) Sterilization indicators must change color or discontinue use of autoclave until a negative spore sample is obtained.(k) The body piercing establishment shall be exempt from the requirement for an autoclave in cases where there is only the use of manufactured, pre-sterilized single use, preassembled needles and similar body piercing equipment, and/or the use of no other equipment or tools requiring sterilization.(l) Permanent ink pens or similar equipment shall not be reused, between patrons, to mark the location of piercings on the interior of the nose, mouth, male or female genital areas, mucous membranes, or similar interior cavities.(4) Body Piercing Minimum Standards(a) Prior to piercing the area to be pierced, or if the area does not need to be shaved, the piercing site shall be cleaned with soap and water, rinsed with clean water, and germicidal solution applied or wiped with alcohol in a sanitary manner before beginning the procedure.(b) Single-use towels or gauze shall be used in preparing the piercing site and shall be disposed of after use on each patron or customer.(c) Records showing the date of the patron's visit, printed name, signature, address, and age, piercing location on the body, and piercing technician's name shall be kept on the establishment premises for a minimum of two (2) years.(d) After each piercing, written instructions shall be given to each patron or customer on the care of the skin of the pierced site to prevent infection. A copy of these instructions shall be posted in a conspicuous place in the establishment, clearly visible to the customer or patron being pierced. These instructions shall include, but are not limited to, bandaging, cleaning, sun exposure, scratching, and wearing of clothing over or around the pierced site.Tenn. Comp. R. & Regs. 1200-23-06-.05
Original rule filed January 28, 2002; effective April 13, 2002.Authority: T.C.A. §§ 4-5-202 and 62-38-101 et seq.