Legal Responsibilities

The Health and Safety at Work etc Act, 1974 stipulates the need to ensure safe systems of work, provision and maintenance of suitable equipment and supervision and training for ear piercing practices.

There is no recognised qualification available from an independent body and no standard guidelines that can be used to assess competence in practice.

Issues of concern associated with piercing include:
• Age of consent
• Use of local anaesthetic by non-medical personnel
• No guidelines on sterilisation/infection control measures
• Local and systemic infections (cellulitis, wound infection, HIV, Hepatitis B & C)
• Non-infectious outcomes (excessive bleeding, scar tissues, disfigurement)
• Outcomes linked to client's health status (heart disease, impetigo, allergies, HIV, Hepatitis, diabetes, etc)
• No requirement for record of procedures or outcomes
• Training - (no professional guidance/ regulation)
• Legal protection by way of professional indemnity cover

The Local Government (Miscellaneous Provisions) Act 1982 requires that persons who practice ear piercing be registered with the Local Authority. In addition these activities should only be undertaken at registered premises. Applications for registration should be made to local authority Environmental Health Departments

Key Points Steps

• Register the premises with the Local Authority for the purpose of ear piercing.
• Implement a proprietary method of ear piercing using pre-sterilised earrings.
• Ensure staff are properly trained in the chosen method.
• Maintain the premises in a sound and clean condition.
• Advise customers of the risks associated with the procedure of ear piercing and keep a record of all treatments.

Premises

Premises must be clean and capable of being kept clean. All internal parts of the structure should be kept in proper repair. Wallpaper should not be used as a wall covering unless of a durable washable type. The floor should be even, impervious and continuous.

A wash hand basin with a hot and cold water supply located in the workroom is essential. It is preferable that taps be foot or elbow operated, soap be in a liquid form and an approved means of hand drying be provided such as disposable paper towels.

All chairs, couches, working surfaces, etc must have a smooth impervious surface, be in good repair and kept clean with regular washing and disinfection.
Shelves, cabinets and cupboards must contain only the equipment that is used in connection with the business of skin piercing.

The room used must be well ventilated and provided with suitable and sufficient artificial lighting.

Health and Personal Hygiene

The person carrying out piercing must ensure that her/his own personal health and hygiene does not in any way endanger the personal health of the client.

The person carrying out the piercing should wear clean washable or disposable clothing whilst carrying out procedures and should not drink, eat or smoke whilst engaged in procedures. Nails must be kept short and clean.

A first aid kit complying with the requirements of the Health and Safety (First Aid) Regulations, 1981 must be kept on the premises and be readily available for use with clients.

Those suffering from an infectious disease may transmit infections to clients in various ways including through breaks and punctures in the skin during treatment. They should consult their own doctor about any personal illness that may be of an infectious nature ensuring to mention that they are engaged in ear piercing.

Medical advice should be obtained if a cut is sustained from any instrument being used on a client.

Health of the Client

The person carrying out the piercing must ensure that the ear(s) to be treated is clean and free from any cuts, wounds or disease. If the client has a history of hepatitis, checks should ensure they are not suffering currently and consideration given to not administering the treatment because of the risks involved until they have consulted their own doctor as to any possible infective state.

Disinfection

Chemical disinfectants are not recommended for needles and other instruments used in ear piercing. Disinfectants such as surgical spirit (70% alcohol) or alcohol wipes may be used to wipe down surfaces. The best means of avoiding cross-infection is to use sterile disposable equipment where available and in preference to other types.

Ear Piercing

A wide selection of well-designed instruments using pre-sterilised earrings, means that ear piercing can be performed conveniently, easily and safely.

Medical advice should always be sought as soon as possible if signs of an infection occur after any ear piercing and especially if the cartilaginous/fibrous part of the ear has been pierced. Clients should be warned about this before piercing is performed. The area of the ear to be pierced i.e. the earlobe or auricle, should be wiped over with an alcohol impregnated swab or iodine-alcohol solution to disinfect the skin prior to needle insertion.
Once a packet of pre-sterilised studs have been opened contamination is possible. Therefore in instances where the client requires one ear only to be pierced, the spare stud should not be kept to be used for another customer.

Disposal of Material

Needles should be placed in an approved yellow plastic ‘sharps' disposal box which should be clearly marked ‘DANGER. CONTAMINATED SHARPS ONLY. TO BE INCINERATED'. Small items such as swabs, tissues etc may be placed in the approved sharps box.

Waste material not contaminated with blood or bodily fluids should be disposed of in a receptacle lined with a leak proof sealable plastic bag and provided with a close fitting lid. Used disinfectants must be carefully poured down the sink after use and flushed with running water.

Record Keeping

It is important to keep records of customers. Such records may prove invaluable if there is any question of infection linked to the premises. Details should be recorded of all treatments and kept for at least one year and should include: the date of the procedure, the name of the client, contact address and telephone number, the procedure carried out and any additional relevant comments.

References

Infection Control for Tattoists, body peircers and acupuncturists- Health Protection Agency June 2004 Revised June 2007

Byelaws relating to the skin piercing-published by your local authority.

Advice on safe practice for body piercing can be found at http://www.salford.gov.uk/beautyindustry.htm

A relevant Local Authority circular published by the Health & Safety Executive can be found at http://www.hse.gov.uk/LAU/Lacs/76-2.htm

Article courtesy of Aviva plc.