2. Modern modification

3. Tattoo. Pierce. How come?

4. Hepatitis C

5. To regulate?

An unexpected endorsement of regulation came from individuals working in tattoo parlors, according to Monica Raymond, an epidemiologist in a county public health department in Washington State. During a study of attitudes among Minneapolis tattoo artists (see "Regulation of Tattooing ..." in the bibliography), she found that many favored regulation.

"The profession seems to feel it's the right thing to do," says Raymond. "They don't want to transmit diseases to clients, because they are going to go out of business. They felt it could help their business to have a certificate on the wall, saying the health department has inspected the tattoo business, because people are getting more and more concerned about getting disease."

A second reason for concern is more personal, Raymond added. "They feel they are at risk more than the clients. They are exposed to blood all day long, they really needed to take precautions to protect themselves."

However, Raymond and her colleagues acknowledged the presence of a small outlaw element in the business. "Tattooists most in need of improvement may be difficult to reach due to opposition to government intrusion."

But tattoo regulation is a helter-skelter operation, varying by locality and state, Haley cautions. "When a parent agrees that child can get a tattoo, they assume that it's like a restaurant, where the government in inspecting, but ... that's not true. It's putting children at great risk, now that it's become a fashion symbol. A high proportion of kids are getting tattoos, most, probably, with the blessing of their parents, who are ill-informed about how dangerous this is."

And why aren't more states inspecting? "Because the CDC says it's not important," Haley charges.

Dangerous biz?
Teresa Hanbey, director of the Hepatitis C Outreach Project, argues that the whole process of tattooing has not been proven safe. "We have a difficult enough time controlling infections in hospitals and operating rooms," she says. "It's a little more dicey in tattoo parlors," especially since the industry has no mandatory infection-control practices or training requirements.

Even when disinfection is performed, the details are questionable, she continues. "Can it be made safe? Is it possible, given current technology, given what is commonly used?"

Here are the details. She says tattoo machines cannot be sterilized in autoclaves because that would cook their electronics, so they must be chemically disinfected. But the major virus-killing solutions, she charges, have not been tested against hepatitis C, because their permits were issued before hepatitis C was identified. "I called the manufacturer and asked, what is the science on all this," Hanbey told us. "I came away with this: It's never been tested on hepatitis C. PCR [polymerase chain reaction] testing has never been done because it already had FDA [Food & Drug Administration] approval as a virucide."

We tried to check with Advanced Sterilization Products, the Johnson & Johnson subsidiary that makes Cidex, one of the disinfectants sold to tattoo parlors. But seven phone calls to the giant health-care outfit failed to raise a response.

At any rate, hep C is a durable virus. A recent CDC study of its ability to survive outside the body concluded, "Infectivity studies in a chimpanzee suggest that HCV may survive on environmental surfaces at room temperature at least 16 hours but not longer than 4 days. The potential for HCV to survive in the environment re-emphasizes the importance of cleaning and disinfection procedures, safe therapeutic injection practices, and harm damage only the patient, Hanbey points out. "That makes it unsafe not just for those wearing the tattoos, but for society in general." Presence of hepatitis C, or in some cases simply having a tattoo, would disqualify a person for blood donation and for organ donation.

No needles, no hooks, in our bod-mod biblio.

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