The public health impact of infection control, sterilization and regulation in tattooing
Authors: Hansen Kat , BCIT School of Health Sciences, Environmental Health  , Heacock Helen , Eykelbosh Angela 
Published: September 2020

Background: The purpose of this study was to look at infection control and sterilization procedures in relation to invasive services performed at Personal Service Establishments (PSEs) in British Columbia. The objective was to collect data on the opinions of regulation and infection control practices of persons currently working in the industries of: tattooing, micro-blading and permanent make-up. Method: Data was collected from a survey that was created and distributed online through Survey Monkey. A list of 261 personal service establishments throughout Vancouver Costal Health and Fraser Health were called and/or e-mailed and asked to participate in the online survey. Results and Analyses: Among the 261 PSEs contacted, 30 agreed to participate. They were asked about the regulation of their profession and their standard practices for infection control and sterilization. 3% of the respondent’s primary service was permanent make-up, 7% micro-blading, 7% piercing and 80% was tattooing. The majority of opinions on regulation were divided where 50% felt the industry was under regulated and 40% felt it was adequately regulated. 90% of the respondents agreed that formal training should be required before being allowed to tattoo and 43% of the respondents also agreed that the use of an autoclave should require certification. For infection control/sterilization procedures 100% of shops use one-time use (disposable) needles and ink caps, 80% use disposable tubes, 93% use cord and machine covers and 90% use disposable razors. 63% of the respondents do not use autoclaves because they use disposable items and therefore do not need to clean and sterilize re-usable equipment. The data compared in chi-squared analysis, age and formal training had a p-value of 0.01460 which indicates that there is an association between age and the belief that formal training should be required for those who practice tattooing. Those under 40 were more likely to indicate that formal training should be required. Conclusion: With a low response rate for micro-blading and permanent make-up it is not feasible to compare or contrast opinions and/or practices between the three services. The tattooing industry had the highest response rate and can be looked at in more detail. The information collected on tattooing could be used to develop a course to improve the safety of PSE’s. EHO knowledge in inspecting food service establishments is very high as a system has been put into place that ensures effective inspections. As well, the FOODSAFE program teaches safe practices to those who work in the kitchen. The growing popularity of PSEs now gives EHOs the opportunity to focus on creating safe work environments through the implementation of a training course and possibly altering the way inspections of each different PSE are conducted. Results of this study, along with other Canadian published data, should be considered when developing standardized training and education in the industry where invasive procedures are used.