Health
Matters
Body art and environmental health:
A partnership in consumer protection,
by Patrick Jacuzzo, Marquette County Health Department
During the past two decades, body art has become increasingly commonplace in mainstream culture. This trend has been established across the nation and has a strong movement in Marquette County as well. The history of body art is long and varied in cultural origins, but only recently has it entered the realm of public health regulation.
The origins of the practice of tattooing are uncertain. The oldest known evidence of this practice can be found on the mummy known as Oetzi, an iceman found in the Austrian Alps, dating back 5,300 years. Tattooing in the developed world of today has its origins in Polynesia, where eighteenth-century explorers discovered this practice among natives. The practice became popular among European sailors and spread to the Western world.
In the United States, tattoo history began around 1769 when Captain James Cook traveled to Tahiti to observe the sk
in marking customs of the natives. The word “tattoo” actually is derived from the Tahitian word “tatu.” The first professional tattooist in the United States was a German immigrant named Martin Hilderbrandt, who tattooed both Confederate and Union soldiers in the Civil War. The first electric tattoo machine came on the scene in 1891 and was owned by the Irish tattoo artist Samuel O’Reilly. It is estimated that by the end of the nineteenth century ninety percent of American sailors had tattoos.
The oldest historical evidence of piercing also is found on Oetzi, who had an ear piercing of about seven to eleven millimeters. Ear piercing is known to have been practiced worldwide since ancient times, and most commonly in tribal cultures. The oldest earrings discovered by archeologists date to 2500 BC. Nose piercing jewelry has been discovered that dates back as far as 1500 BC. Much of the body piercing history for other parts of the body has origins in the Middle East and India.
The popularity of body piercing in modern Western culture began with the rising popularity of ear piercing among women in the 1960s. The body piercing movement became more mainstream in the 1970s when the practice was embraced by the punk rock movement in the U.S. and England. The founding fathers of modern body piercing are believed to be two Californian men by the names of Malloy and Ward who operated one of the first known body piercing businesses in the late 1970s. Malloy and Ward also helped popularize body piercing by producing the first illustrated publication on the subject. Modern body art, however, is not limited to piercing and tattooing. Procedures also can include permanent make-up, scarification, branding and implants.
Throughout the history of body art, regulation has been limited and sporadic. It has been stated that some of the earliest regulations can be found in the Bible in Leviticus 19:28 which forbids any cuttings into the flesh or the printing of any marks. There also were decrees by Roman and Japanese emperors banning tattooing. The French included language banning tattooing in their 1869 national laws. In the United States, there currently is no federal oversight of body art procedures and equipment, and the Food and Drug Administration has not yet approved any tattooing pigment for intradermal injection.
Throughout the United States, body art permitting and licensing regulations have been slow to be established at the state level. In the 1950s, several states passed tattooing regulations allowing only physicians to tattoo. While Florida still has such a law, it has expanded the list of those qualified to administer a tattoo to doctors of osteopathy and dentists. Also in the 1950s, a dramatic increase in hepatitis cases resulted in New York City health officials banning the practice of tattooing in the city. Some states, such as South Carolina, banned tattooing statewide until recent years. By the late 1990s and early in the twenty-first century, public health officials had become more aware of the increasing popularity of tattooing and other forms of body art. An increasing number of people were receiving body art procedures across all socioeco
nomic classes. Based on the perceived increase in public health risk across the population, most states began to pass legislation to regulate body art. Currently, all states have some form of body art regulation, except New Mexico and North Dakota. Washington D.C. also currently has no body art regulations.
Professional body art practitioners are very concerned regarding the image of their industry and are supportive of mandatory operating standards. In addition, they are highly aware of the level of risk to their profession and personal business that so much as one body art related illness could cause. As such, the professional body art community is very supportive of communicable disease controls. To this end, the body art community has been involved directly in the development of its own regulation. What is unique regarding the regulation of the body art industry is the partnership in the process. Body art practitioners, primarily tattoo artists, have been proactive and cooperative with public health officials and lawmakers throughout the development and application of the regulatory process. Nowhere has this partnership been better demonstrated than in Marquette County and, subsequently, Michigan.
Body art was unregulated in Marquette County until January 1, 1994, and was not regulated statewide in Michigan until December 13, 2007. In the early 1990s, environmental sanitarians from the Marquette County Health Department’s Environmental Health Division worked with the local tattoo artists of that time to become educated in tattooing procedures and equipment and develop the appropriate statutory language and requirements for the proposed ordinance. What you have read is correct; the body art industry provided the training to the regulatory authorities. At the state level, tattoo artists representing their industry lobbied to push a bill through the House and Senate that would require body art licensing and rules of operation statewide. When Public Act 149 of 2007 was finally signed by the governor, tattoo artists representing their industry worked with the Michigan Department of Community Health to develop Body Art Rules that would be adopted by reference. For a second time, the tattooing industry fundamentally pushed to develop the statutes and rules under which they would operate and played a large role in the writing of those statutes and rules. Education regarding body art procedures and safety also has been provided statewide by health educators from the body art industry. The industry’s commitment to regulation development and training of regulatory authorities demonstrates a true partnership in public health between regulators and the industry being regulated.
So why is the body art industry so proactive in its own regulation? Body art procedures compromise the skin and involve blood exposure, which creates an increased risk of transmission of blood borne pathogens and infections. One such infection linked to a body art facility could destroy that business and severely damage the image of the industry. When a body art facility is licensed and inspected by the health department, it provides a level of consumer confidence with regard to risk of disease transmission. All licensed body art practitioners must complete blood borne pathogen training, must employ sterile techniques, and have specific procedures for sanitization and sterilization including autoclaves that are spore tested for efficacy routinely. The equipment procedures and paperwork required for these processes are reviewed prior to licensing and annually thereafter by the local health department.
The industry also is pro-regulation because regulations tend to control unfair business competition. Most licensed body art facilities train new artists through an extensive apprenticeship program. This helps insure that artists can produce quality work in a safe manner prior to providing services to the general public. It is currently a violation of state law for an individual to conduct body art procedures outside of a licensed body art establishment. For the health department, this helps control the spread of communicable diseases and potential infections. For the body art industry, this helps control the image of the industry and the competition by forcing new artists to apprentice at an established shop, or meet all the training, certification and associated business expenses of opening their own shop.
Tattoo and body piercing equipment can be purchased by anyone, and is available in several locations on the Internet. This can, and does, lead to untrained and unlicensed individuals conducting body art procedures outside of licensed body art facilities. The body art industry refers to these individuals as “scratchers.”
What’s at risk if you have work done by a “scratcher?” You could end up with a nasty blood borne disease such as hepatitis or HIV, contract a skin or systemic blood infection, end up with unattractive scarring, excessive bleeding from a bad piercing, or just a bad tattoo that you must display for life.
So protect yourself as a consumer. If you’re going to have body artwork done, work with the true professionals who have gone out of their way to partner with public health and protect their profession. Give your business to the professionals at a licensed body art facility.
The current body art legislation regulates tattooing, piercing other than that of the earlobe, cosmetic tattooing or permanent make-up, scarification, branding and micro-dermal implants. Subdermal and transdermal implants must be installed by a licensed surgeon in Michigan. Marquette County currently is home to two licensed permanent make-up facilities and four licensed tattooing/piercing facilities.
–– Patrick Jacuzzo, Marquette County Health Department
