Title 10
DEPARTMENT OF HEALTH AND MENTAL HYGIENE
Subtitle 06 DISEASES

Communicable Diseases

Statement of Purpose
The purpose of this action is to require standard infection control measures during medical procedures that penetrate the skin and during skin penetrating body adornment procedures, including body piercing and tattooing.

Comparison to Federal Standard
There is no corresponding federal standard to this proposed regulation.

Estimate of Economic Impact
The proposed action has no economic impact.

Economic Impact on Small Businesses
The proposed action has minimal or no economic impact on small businesses.

Opportunity for Public Comment
Comments on the proposed action may be sent to Michele Phinney, Regulations Coordinator, O’Conor Building, Fifth Floor, 201 Preston Street, Baltimore, Maryland 21201, or call (410) 767-6499. These comments must be received by January 21, 1997. No public hearing has been scheduled.

.02 Definitions

A. (text unchanged)

B. Terms defined

(1)—(11) (text unchanged)

(11-1) Skin Penetrating Body Adornment Procedure.

1. "Skin penetrating body adornment procedure" means a process that involves piercing or entering the skin or the mucous membrane of an individual for the purpose of inserting pigmented patterns, jewelry, or other forms of body decoration.
2. "Skin penetrating body adornment procedure" includes body piercing and tattooing.
3. "Skin penetrating body adornment procedure" does not include piercing of an earlobe using a properly disinfected ear piercing gun and single use, sterile studs and clutches.

(12)—(13) (text unchanged)

.06 General Control Measures.

A.—F. (text unchanged)

G. Use of Sterile Instruments or Equipment. An individual who performs a procedure that penetrates the skin or the mucous membrane of another individual shall:

(1) Utilize only sterile instruments or equipment for the procedure;

(2) Discard, after a single use, in accordance with COMAR 10.06.06, 26.13.11, and 26.13.12, any instruments or equipment designed for single use; and

(3) Clean and sterilize before reuse any instruments or equipment designed for multiple use.

H. Skin Penetrating Body Adornment Procedures—Infection Control.

(1) An individual who performs a skin penetrating body adornment procedure shall:

(a) Disclose the risks of the procedure, obtain the client’s written consent for the performance of the procedure, or, in the case of a minor, the consent of the parent or legal guardian, and retain the consent on file for a period of 3 years and make it available to the health officer, if requested;

(b) Maintain records of the name of the customer, the date and type of procedure performed, and the technician performing the procedure for a period of 3 years and make these records available to the health officer, if requested;

(c) Perform the procedure in a separate, enclosed room that has adequate lighting, and floors, walls, and a ceiling that are constructed to be smooth, impervious, and washable;

(d) Use only sterile instruments, equipment, and bandages;

(e) Wash both hands using soap and running water and dry the hands using individual single use towels before and after each procedure;

(f) Wear single use disposable latex or vinyl gloves for each procedure and discard the gloves after the procedure is completed;

(g) Wear a gown and face shield, or goggles and a mask, if spattering of blood is likely to occur during the procedure;

(h) Cleanse the client’s skin before and after the procedure;

(i) Discard, after single use, in accordance with COMAR 10.06.06, 26.13.11, and 26.13.12, any instruments or equipment designed for single use or any blood-soiled article;

(j) Clean and sterilize, before reuse, any instruments or equipment designed for multiple use;

(k) Provide written after-care instructions to the client;

(l) Use universal precautions in all situations where exposure to blood or body fluids may occur and comply with all applicable State and Federal laws and regulations regarding worker protection; and

(m) Post the following notice in a prominent place:

"NOTICE"

Any procedure that involves penetrating the skin, such as body piercing or tattooing, carries some risks.

The risks from such procedures include: pain, bleeding, swelling, infection at the site of the procedure, transmission of blood-borne infections, scarring and nerve damage.

 

The technician performing your procedure should:

1. Obtain written consent for the procedure
2. Properly wash his/her hands
3. Cleanse your skin
4. Use sterile instruments, equipment, and bandages
5. Use proper technique to prevent infection at the site of the procedure
6. Provide you with written instructions to tell you what to expect about healing and how you should care for the area after the procedure has been done.

(2) An individual who performs a procedure that penetrates the skin or mucous membrane may not;

1. Perform a procedure on skin or mucous membrane that has a rash, infection or other lesion;
2. Perform a procedure when the technician performing the procedure has an infected or bleeding lesion on the hands;
3. Use a styptic pencil or alum block to staunch bleeding; or
4. Reuse instruments or equipment intended for single use.

(3) The health officer may investigate complaints received regarding compliance with this section.

 

MARTIN P. WASSERMAN, M.D.
Secretary of Health and Mental Hygiene