Pennsylvania General Assembly, Health Department Asked to Step Up Regulation of Tattoo Parlors

Pennsylvania auditor general Jack Wagner today called on the General Assembly and the state department of health to step up the state's role in regulating the tattoo parlor industry because of potential health risks to the general public, including hepatitis C.

Wagner said that requiring Pennsylvania's more than 750 known tattoo parlors and artists to obtain a state license would protect public health while helping state officials monitor one of the fastest-growing segments of the local economy.

"We license cosmetologists, hair salons and nail salons; it's time we join the growing number of states that also regulate tattoo parlors," Wagner says. "If we do not, the potential health risk to Pennsylvanians increases with every needle puncture."

In a letter sent today to the Pennsylvania Department of Health, Wagner pointed out that 21 percent of U.S. adults have at least one tattoo, according to a recent Harris poll. Reflecting the national popularity, Pennsylvania has upwards of 750 tattoo parlors or artists, including 84 in Philadelphia, 83 in Pittsburgh, 54 in Allentown, 51 in Scranton, 31 in Harrisburg and 15 in State College.

A tattoo is a permanent design created by using a needle to inject indelible ink under the skin, altering the skin's pigmentation. It is an invasive procedure which presents a risk of infection with bloodborne pathogens and other infections, especially if the tattoo equipment is not properly sterilized.

The Centers for Disease Control and Prevention (CDC) has cited the use of non-sterile equipment and suboptimal infection control as causes for skin infections in people receiving tattoos. It has also warned that the risk of contracting the hepatitis C virus is also possible with poor infection control practices. Hepatitis C primarily infects the liver, and is spread by blood-to-blood contact that may occur through the sharing of unsterilized needles or contaminated dyes. An estimated 130 million people are thought to be infected with the hepatitis C virus, according to the World Health Organization. The Pennsylvania Department of Health estimates that almost 4 million persons in the U.S., and 120,000 to 170,000 in Pennsylvania, are infected with the Hepatitis C virus.

The estimated 750 tattooists in Pennsylvania is based on known advertising and does not include those operating out of homes, mobile units or other non-sterile environments. These underground operators may employ dangerous practices such as reusing ink or using contaminated needles.

The only regulation now on the books in Pennsylvania makes it unlawful to tattoo a person under the age of 18 without parental consent.  In 2009, the General Assembly considered regulating the tattooing industry, but legislation was not enacted.

Of the 10 most populous states, all but Pennsylvania have approved tattoo regulations or have legislation pending. California enacted one of the most comprehensive bills regulating its tattoo industry in July. Known as "The Safe Body Art Act," it requires consent forms signed by the client acknowledging that he or she understands the procedure and post-procedure instructions. It also requires tattoo owners to register with local health agencies and to obtain a permit certifying that it meets federal Occupational Safety and Health Administration health and safety guidelines.

Several local Pennsylvania communities have regulations in place for tattoo parlors, including Philadelphia, State College and Erie County.

Wagner's letter recommended several legislative and enforcement steps, including:
- The licensing of all tattoo parlors by the Department of Health, requiring regular safety and sanitation inspections.
- Requiring training for tattoo artists, which may include apprenticeships with a professional tattoo artist, certification of blood-borne pathogens, first aid and CPR training.
- Requiring tattoo establishment owners to purchase adequate liability insurance to cover clients and the premises.
- Imposing monetary fines for artists who operate illegally.

Wagner said that any approved legislation should help limit problem practitioners who operate under unsanitary conditions and also help to eliminate unqualified artists from applying tattoos.

Source: Pennsylvania Department of the Auditor General