Author:
HA Aronow, MD Medical Director & Teresa Hanbey Exec Director
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Date Posted: Mon, March 25 2002, 11:50:54 PST
Hepatitis C Outreach Project on Tattooing
Friday, March 22, 2002
(Los Angeles, CA) Tattooing has a long way to go before a consumer can determine what a safe shop is versus one that is unsafe. The methods used, autoclaved or not, have some serious questions that need answers.
Many in the HCV community will remember the struggles and derision HCOP endured resulting from a number of HCV positive tests in Kentucky resulting from a tattooist.
We were on the front page of the Lexington Herald, the nurse who came to us for help (after being turned away from other organizations) was ridiculed and the CDC called us to tell us how irresponsible we were to be calling tattoos into question with regard to the Hepatitis C virus.
All true. The year was 1998.
The fact is, the machines used to do tattooing are tube systems. These are "iffy" contraptions to sterilize no matter how clean the floors and walls are and no matter how "educated" or convincing the tattooist is. Do you really believe the cleanliness of the room means there is no possibility of contamination by a virus scientists struggle to see with an electron microscope?
The Association for Professional Tattooists is a member driven organization and you will also read on its website that they are what their members want them to be. In an article today on WebMD they are quoted as follows:
"It's a difficult situation," says Dennis Dwyer, executive director of the Alliance for Professional Tattoo Artists (APT), an organization that educates the public and tattoo practitioners about infection control procedures.
APT is the tattoo industry's attempt at self-monitoring, says Dwyer.
"Many people are trying their best to provide safe tattooing. But this industry has a lot of nonconformists," he says "Even if health departments or cities passed laws, they would not be able to catch up with 'Johnny Tabletop' at the flea markets."
Dr. Robert Haley and Teresa Hanbey presented the topic of tattooing and adolescents to the American Public Health Association's 129th Congress
on Global Health in October 2001.Dr. Haley is from the University of Texas Southwestern in Dallas. His study found that commercial tattooing was a high risk for hepatitis C.
Since October I have been interviewed often and made appearances speaking on this topic to public health and to industry.
Consider this: the FDA Advisory panel did not accept the CDC's position on this in a recent ruling regarding the blood supply. They felt they had enough credible data to disregard the CDC's position that tattoos are not a high risk for hepatitis C. The FDA Advisory board went on to rule against the CDC's recommendation to allow blood donation within a year of a tattoo. .
Also think about our young citizens being the future source of blood, tissue and organ donations. The impact of this practice on our healthcare system could be enormous over time. The current treatment (alfa-interferon plus ribavirin) has had a low impact on the disease in this country, approximately 7%. It is not FED approved for pediatric use due to side effect profiles that negatively impact emotional and physical development, possibly including reproduction. There is no vaccine. Without routine testing and access to care, we won't know for a long time how much real impact this may have.
We have difficulty enough in this country controlling hospital acquired infections. Medical professionals who puncture skin are required to go to school for a lot longer than the eight hours of OSHA training provided by the APT at Tattoo Festivals. Would you allow an unlicensed nurse or physician to do a medical procedure on you?
It is one thing for an adult to make this decision. It is another to be marketing everything from shoes to alcohol, to (what else?) love and sex to adolescents on MTV, BET, and Teen People.
Get this: it is questionable whether you can adequately sterilize "the machine" used for tattooing. It is a tube system, a system that has proven to be difficult to sterilize in the hospital environment.
Practitioners should not only be educated, they should be licensed in a healthcare profession prior to opening shop, be supervised by or, possibly, have a healthcare professional on site at all times.
The EPA approved viracide used may or may not have ever been tested on Hepatitis C. I haven't seen any studies on any such product specific to hepatitis C, in spite of an extensive search.
The concepts of dermatology, allergy reactions (to the inks) and the basis to deal with someone who has a adverse reaction in the shop should be subjects incorporated into training and practice in the tattoo industry.
Oh, by the way, OSHA means Occupational Health and Safety Administration. It is designed to protect the employees. It is NOT consumer protection law. There is no consumer protection when it comes to buying "art," even "body art." The recommendation to follow OSHA standards in the tattooing industry does not address the questions that arise regarding consumer protection.
Teresa Hanbey
Executive Director
H.A. Aronow, MD
Medical Director
Hepatitis C Outreach Project (since 1992)
Portland, Oregon
www.hcop.org
info@hcop.org
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