RULES AND REGULATIONS FOR BODY ART ESTABLISHMENTS
SECTION 1: DEFINITIONS AND PURPOSE:
1-101. The purpose of these regulations is to establish the safe and sanitary practice of body art, the safe and sanitary physical environment where body art is performed, and the safe and sanitary conditions of equipment utilized in body art procedures.
(a) AFTERCARE INSTRUCTIONS means written instructions given to the client, specific to the body art procedure(s) rendered. These instructions shall include information regarding when to seek medical treatment, if necessary.
(b) ANTISEPTIC means a substance that inhibits growth of bacteria and other microorganisms when applied to the skin (e.g., chlorhexadine gluconate, alcohol, iodophor). It should not be used to decontaminate inanimate objects.
(c) BODY ART ESTABLISHMENT means any location, whether temporary or permanent, where the practices of body art are performed.
(d) BODY ART means the practice of physical body adornment by establishments or artists utilizing, but not limited to, the techniques of body piercing, tattooing, branding, sculpting, and scarification. This definition does not include practices conducted under the supervision of a physician licensed to practice medicine under Colorado law nor piercing of the outer perimeter or lobe of the ear with by means of sterilized stud- and- clasp ear piercing systems.
(e) BODY ARTIST means any person who performs performs body art procedures.
(f) BRANDING means a potentially invasive procedure in which a permanent mark is burned into or onto the skin using either temperature, mechanical or chemical means.
(g) CONTAMINATED means the presence or reasonably anticipated presence of blood, infectious materials or other types of impure materials that have corrupted a surface or item through contact.
(h) CONTAMINATION means to make unfit for use by the introduction or potential introduction of blood, infectious materials or other types of impure materials.
(i) DEPARTMENT means the Colorado Department of Public Health and Environment, or its authorized agents, and employees.
(j) DISINFECTANT means an EPA registered hospital grade disinfectant which has effectiveness against Salmonella cholerasesuis, Staphylococcus aureus and Pseudomonas aeruginosa or a 1:100 dilution of 5.25% sodium hypochlorite (chlorine bleach) and water, made fresh daily, dispensed from a spray bottle, and used to decontaminate inanimate objects and surfaces.
(k) DISINFECTION means to destroy or inhibit pathogenic microorganisms on inanimate objects or surfaces.
(l) GLOVES mean those which are disposable and single use, and are labeled for surgical or examination purposes. Gloves for instrument cleaning shall be heavy-duty, multi use and water-proof.
(m) HECTOGRAPHIC means a copy made from a prepared gelatin surface to which the original document has been transferred.
(n) INFECTIOUS WASTE or REGULATED WASTE means blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials; items caked with blood or other potentially infectious materials that can release these materials upon handling; contaminated sharps; and human pathological/anatomical waste.
(o) INVASIVE means entry into the body through the skin or mucosa either by incision or insertion of an instrument, body ornament, or any other means.
(p) JEWELRY means any ornament inserted into the body, 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.
(q) PERSON IN CHARGE means the owner, manager or individual(s) present at the body art establishment who is responsible for the operation at the time of an inspection. If no individual is responsible, then any employed person present is the person in charge. If multiple body artists share operation of the establishment, then each artist may shall be considered a person in charge and shall be responsible for all requirements of this regulation with regard to common areas and practices in addition to his/her own individual separate areas and practices.
(r) PIERCING means puncturing or penetration of the skin or mucosa of a person and the insertion of jewelry or other adornment in the opening, except that puncturing of the outer perimeter or lobe of the ear with sterilized stud-and-clasp ear piercing system shall not be included.
(s) PRE STERILIZED INSTRUMENTS means those that are commercially sterilized by the manufacturer. Packaging shall bear a legible sterilization lot number and expiration date.
(t) PROCEDURE AREA means any surface of an inanimate object that contacts the client’s skin during a body art procedure and all surfaces where instruments and supplies are placed during a procedure.
(u) SCARIFICATION means an invasive procedure in which the intended result is the production of scar tissue on the surface of the skin.
(v) SCULPTING means a modification of the skin, mucosa, cartilage, or tissue of the body for non medical purposes.
(w) SHARPS CONTAINER means a puncture resistant, leak proof, rigid container that can be closed for handling, storage, transportation and disposal and is labeled with the Universal Biological Hazard Symbol.
(x) SHARPS mean any all objects (sterile or contaminated) that may purposely or accidentally cut the skin or mucosa including, but not limited to, single use needles, scalpel blades and razor blades. It does not include disposable safety razors which have not broken the skin.
(y) STERILIZATION means a process that results in the total destruction of all forms of microbial life, including highly resistant bacterial spores.
(z) STERILIZER means an autoclave that is designed and labeled by the manufacturer as a medical instrument sterilizer and is used for the destruction of microorganisms and their spores.
(aa) TATTOOING means inserting pigment under the surface of the human skin or mucosa by pricking with a needle or other means, to permanently change the color or appearance of the human skin or to produce an indelible mark or figure visible through the human skin.
(bb) UNIVERSAL PRECAUTIONS mean a set of precautions designed to prevent transmission of human immunodeficiency virus (HIV), hepatitis B and other blood borne pathogens as defined by the Centers for Disease Control. Under Universal Precautions, blood and certain body fluids of all individuals are considered infectious.
SECTION 2: MINIMUM REQUIREMENTS FOR BODY ARTISTS
2-201 All body artists shall comply with the following:
(a) Possess and demonstrate knowledge of Universal Precautions, disinfection and sterilization techniques, procedures for infection and exposure control required in section 7-701(a), and the Infectious Waste Management Plan as required in Section 7-701(b)4.
(b) Receive vaccination against the hepatitis B (HBV) or provide a written statement to the manager or owner of the body art establishment stating that he or she declines the vaccination.
SECTION 3: MINIMUM REQUIREMENTS FOR BODY ART ESTABLISHMENTS
3-301 The body art establishment must have a person(s) in charge at all times who is responsible for the operation.
3-302 The following information on each employee of a body art establishment shall be on file and available for inspection by the Department.
(a) Full legal name
(b) Home address
(c) Home phone number
(d) Proof that all employees handling sharps and/or infectious waste have either completed or were offered and declined, in writing, the hepatitis B vaccination series. This offering shall be included as a pre employment requirement and comply with 2-201(b).
3-303 The person in charge shall have access to the following information and it shall be on the premises for review by the Department:
(a) Contract or agreement for sharps disposal and/or other Infectious/Regulated Waste disposal.
(b) Spore test log and test results
(c) Client records
(d) Manufacturer’s information on sterilization equipment
(e) Infection and exposure control written procedures
SECTION 4: CLIENT RECORDS
4-401. The person in charge shall have access to and shall maintain client records on the premise for a minimum of three (3) years. The client records shall be available for review by the Department.
4-402 The following information shall be documented and used by the body artist to determine the client’s suitability for receiving a body art procedure. In order for to assure insofar as possible the proper healing of a client following a the body art procedure, the client shall be asked to disclose if he/she has had any of the following:
(c) Skin diseases or skin lesions
(d) Allergies or adverse reactions to latex, pigments, dyes, disinfectants, soaps or metals.
(e) Treatment with anticoagulants or other medications that thin the blood and/or interfere with blood clotting.
(f) Any other information that would aid the body artist in the client’s healing process evaluation.
4-403 Client consent form for all procedures shall include the following:
(a) Name, address and current phone number of the client
(b) Date of the procedure
(c) The type and location of the body art
(d) Documentation that both written and verbal instructions regarding risks, outcome and aftercare were given to the client including:
1. Name, Address, and phone number of the establishment and the name of the body artist who performed the procedure;
2. Direction of when to consult a physician at the first sign of infection, allergic reaction and expected duration of healing.
3. Detailed description of how to care for the body art procedure site.
4. Explanation that body art should be considered permanent; and
5. Possible side effects from the procedure.
SECTION 5: FACILITY AND OPERATIONAL REQUIREMENTS
5-501 All procedure areas and instrument cleaning areas shall have floors, walls and ceilings constructed of smooth, nonabsorbent and easily cleanable material.
5-502 Toilet facilities shall be provided and shall be made available to both patrons and employees during all business hours. Floors and walls within toilet facilities shall be constructed of smooth, nonabsorbent and easily cleanable material.
5-503 The premises shall be kept clean and in good repair.
5-504 At least fifty (50) foot candles of artificial light shall be provided at the level where the body art procedure is performed and in instrument cleaning and sterilization areas.
5-505 All surfaces, including, but not limited to, counters, tables, equipment, chairs, recliners, shelving and cabinets in the procedure area and instrument cleaning room shall be made of smooth, nonabsorbent materials to allow for easy cleaning and disinfection.
5-506 Hand sinks shall be supplied with hot and cold running water delivered through a mixing faucet and under pressure. Hand sinks shall be easily accessible to each procedure area and shall be located so that one artist does not potentially contaminate another artist’s area. Each hand sink shall be provided with soap and disposable towels or a hand drying device providing heated air. In addition, a hand sink shall be provided in or adjacent to each toilet room.
5-507 Distinct, separate areas shall be used for cleaning equipment, wrapping/packaging equipment, and for the handling and storage of sterilized equipment.
5-508 Instrument cleaning sinks, hand washing sinks, and, where provided, utility sinks shall only be used for their designated purpose.
5-509 Water shall be supplied from a source approved by the Department.
5-510 Sewage, including liquid wastes, shall be discharged to a sanitary sewer or to a sewage system constructed, operated and maintained according to law.
5-511 Refuse, excluding infectious wastes, shall be placed in a lined waste receptacle and disposed of at a frequency that does not create a health or sanitation hazard.
5-512 All facilities shall have a waiting area that is separate from the body art procedure area, and from the instrument cleaning, sterilization, and storage areas.
5-513 Reusable cloth items shall be mechanically washed with detergent in water at a minimum of 140o F as specified by the manufacturer. Clean cloth items shall be stored in a clean, dry environment until used. Soiled laundry shall be stored in a nonabsorbent container until removed for laundering and shall be stored separate from clean cloths.
5-514 Animals shall not be allowed in the body art procedure areas, or the instrument cleaning, sterilization, or storage areas. Fish aquariums and/or service animals shall be allowed in waiting rooms and non-procedural areas.
5-515 All chemicals shall be labeled with contents properly stored and used according to label instructions.
5-516 All body art establishments shall be completely separated from areas used for human habitation, food preparation, or other such activities that may cause potential contamination of work surfaces.
5-517 Utensil washing and utility sinks with threaded faucets shall be equipped with back flow prevention devices approved by the Department.
5-518 Sharps and Infectious/Regulated Waste must be handled in a manner consistent with CRS 25-15-401.
(a) Discarded sharps shall be disposed of in sharps containers.
(b) Infectious/Regulated waste other than sharps shall be placed in impervious, tear resistant, plastic bags which are red in color and marked with the Universal Biological Hazard Symbol.
(c) Sharps and Infectious/Regulated waste shall be disposed of by an approved, off-site treatment facility, or waste may be treated on-site if the treatment complies with all Federal, State and Local requirements.
(d) On-site treatment requires a written plan outlining disposal as required in Section 7-701(b)4.
SECTION 6: TEMPORARY, SPECIAL EVENT AND MOBILE BODY ART REQUIREMENTS
6-601 All provisions of these regulations shall apply with the following exceptions:
(a) Hand wash facilities shall be easily accessible to each procedure area and designated for use by artists only. Hand wash facilities shall comply with 5-506 or, temporary hand was facilities shall consist of soap, single use paper towels and an adequate supply of potable water dispensed through a continuous flow spout. Wastewater shall be collected and disposed of in a sanitary manner.
(b) Body artists may bring pre sterilized instruments, or instruments which have been sterilized at another location with documentation showing a negative spore test result within the previous 30 days. On site sterilization units may be used and shall comply with Section 8-803.
6-602 After the last procedure is completed, all procedure areas shall be cleaned and disinfected.
SECTION 7: INFECTION AND EXPOSURE CONTROL WRITTEN PROCEDURES
7-701 Written Procedures
(a) Every body art establishment shall have and comply with written procedures for infection and exposure control. All procedures developed for the written plan shall be in compliance with standards, and all local and state regulations. (b) These written procedures shall include, but are not limited to:
1. Instrument cleaning and sterilization
2. Cleaning and disinfection of the procedure area(s), as required in Section 9-902(g)
3. Universal Precautions procedures
4. Infectious Waste Management plan, consistent with CRS 25-15-401, including segregation, identification, packaging, storage, transport, treatment, disposal and contingency planning for blood spills or loss of containment of Infectious/Regulated Waste.