Bloodborne pathogen risk reduction activities in the body piercing and tattooing industry

Published:November 13, 2009DOI:


      This study examines how well regulations for bloodborne pathogens (BBPs), established primarily to reduce exposure risk for health care workers, are being followed by workers and employers in the tattooing and body piercing industry.


      Twelve shops performing tattooing and/or body piercing (body art) in Pennsylvania and Texas were assessed for compliance with 5 administrative and 10 infection control standards for reducing exposure to BBPs.


      All shops demonstrated compliance with infection control standards, but not with administrative standards, such as maintaining an exposure control plan, offering hepatitis B vaccine, and training staff. Shops staffed with members of professional body art organizations demonstrated higher compliance with the administrative standards. Shops in locations where the body art industry was regulated and shops in nonregulated locations demonstrated similar compliance, as did contractor- and employee-staffed shops.


      Regulations to control occupational exposure to BBPs have been in place since 1991. This study corroborates noncompliance with some standards within the body art industry reported by previous studies. Without notable enforcement, regulation at national, state, or local levels does not affect compliance. In this study, the factor most closely associated with compliance with administrative regulations was the artist's membership in a professional body art association.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Infection Control
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Centers for Disease Control and Prevention
        Recommendations for prevention of HIV transmission in health care settings.
        MMWR Morb Mortal Wkly Rep. 1987; 36: 1-16
        • Centers for Disease Control and Prevention
        Update: universal precautions for prevention of transmission of HIV, HBV and other bloodborne pathogens in health care settings.
        MMWR Morb Mortal Wkly Rep. 1988; 37: 377-388
        • Centers for Disease Control and Prevention
        Standards for prevention of transmission of human immunodeficiency virus and hepatitis B virus to health care and public safety workers. A response to P.L. 100–607, the Health Omnibus Programs Extension Act of 1988.
        MMWR Morb Mortal Wkly Rep. 1989; 38: 3-37
      1. Title 29 Code of Federal Regulations, part 1910.1030, Exposure to Bloodborne Pathogens.

      2. Needlestick Safety and Prevention Act 2000.
        Public Law 106-430 US Statutes at Large 1901. 2000; : 114
        • Huy J.M.
        • Ross C.S.
        • Boudreau A.Y.
        • Weber A.M.
        Occupational blood-borne pathogen exposures among community workers.
        Clin Occup Environ Med. 2002; 2: 537-556
      3. Occupational Safety and Health Administration. Standard interpretations: applicability of the Bloodborne Pathogens Standard to the tattoo and body piercing industries. July 29, 2002.

        • National Institute for Occupational Safety and Health
        What every worker should know: how to protect yourself from needlestick injuries.
        NIOSH Publication, Cincinnati (OH): Centers for Disease Control and Prevention2000 (135)
        • National Institute for Occupational Safety and Health
        Alert: preventing needlestick injuries in health care settings.
        NIOSH Publication, Cincinnati (OH): Centers for Disease Control and Prevention;2000 (108)
        • Tattoo and Certain Body Piercing Studio Act
        Texas Health and Safety Code, Chapter 146. April 23, 2000;
        • Raymond M.
        • Pirie L.
        • Halcon L.
        Infection control among professional tattooists in Minneapolis and St Paul, MN.
        Public Health Rep. 2001; 116: 249-256
        • Raymond M.
        • Halcon L.
        • Pirie L.
        Regulation of tattooing in Minneapolis and St Paul, Minnesota: tattooists' attitudes and relationship between regulation and practice.
        Public Health Rep. 2003; 118: 154-161
        • Goudey R.E.
        • Thompson S.C.
        Evaluation of infection control in registered tattooing premises in Victoria, 1994.
        Aust NZ J Public Health. 1997; 21: 22-28
        • Weber A.M.
        Evaluation of potential bloodborne pathogen exposures among body piercers.
        Appl Occup Environ Hyg. 2001; 16: 925-935
        • City of Philadelphia
        Department of Public Health.
        Regulations Governing Operation and Conduct of Tattoo and Body Piercing Establishments. February 26, 2002;
        • Armstrong M.L.
        Tattooing, body piercing, and permanent cosmetics: a historical and current view of state regulations, with continuing concerns.
        J Environ Health. 2005; 67: 38-43
        • Occupational Safety and Health Administration
        Multi-Employer Citation Policy.
        CPL 02-00-124. 1999;
        • Armstrong M.L.
        • Ekmark E.
        • Brooks B.
        Body piercing: promoting informed decision making.
        J School Nurs. 1995; 11: 20-25
        • Gauthier D.K.
        • Turner J.G.
        • Langley L.G.
        • Neil C.J.
        • Rush P.L.
        Monitoring universal precautions: a new assessment tool.
        Infect Control Hosp Epidemiol. 1991; 12: 597-601
      4. Occupational Safety and Health Administration. Standard interpretations: most frequently asked questions concerning the Bloodborne Pathogens Standard. February 1, 1993.