Statutory requirements vary by state and may be determined by checking with the state government, various Internet sites concerned with tattooing and permanent make-up, the American Academy of Micropigmentation and/or local tattoo and/or permanent make-up artists.
According
to Florida Statute 61F6-19.002 Tattooing: General Supervision, four
requirements are clearly defined:
General
supervision,
distinct from direct supervision, essentially
means oversight of the tattooist and/or permanent make-up artist by an
allopathic or osteopathic physician or dentist, and shall not require the
physical presence of the supervisor when procedures are performed,
though shall require:
Correspondence
with the FLORIDA BOARD OF MEDICINE has been somewhat unresponsive with regard to
strict criteria clarifying this general supervisory relationship; secondary
administrative correspondence suggests lack of a formal response is suggestive
of a favorable opinion to the following criteria.
In
discussion with tattoo and permanent make-up artists, attorneys and other
physicians, general
supervision may be considered as having established a formal relationship
with the tattooist and/or permanent make-up artist and knowledge
the artist is who he or she says she is, works where he or she says she
works, and does what he or she says she does.
For this reason, REGISTRATION requirements necessitate not only a clear understanding of the Florida Statute, but also documentation, and therefore a formal credentialing package should consider including:
In
order to fulfill requirements of inspection, pictures
should include the general location and entire office from the outside entrance to the
room where procedures are performed; pictures of equipment, biohazard containers
and supplies should also be included.
The
physician has an obligation to review procedures for sanitation and
sterilization and the tattooing/permanent make-up technique. Often
these procedures are explained in a prior curriculum; however, tattoo or
permanent make-up artists should be clear to elucidate individual variances, and
pictures demonstrating the application of procedure before and after should be
provided.
Detailed
procedures to be followed in the event of an emergency situation
developing during the performance or as a
result of tattooing or permanent make-up should also be explained. This often
includes response to fainting, anxiety, bleeding, allergic reactions,
infections, abrasions or accidental puncture sticks. A proper understanding
of first aid and/or basic life support is important and may be acquired from a
local Red Cross course.
Infection
control,
especially when dealing with needles and
blood and the occurrence of HIV, hepatitis A, B and C requires appropriate
sterilization and/or disposal of needles which may include pick-up by a
biohazard waste company or disposal of the red needle boxes through a local fire
department, hospital or doctor’s office (documentation by the receiving
organization should be clearly defined). Other methods of disposal include
bonding needles in a polyester resin and depositing in the local waste.
As
part of a medical history and risk assessment, most
tattoo and/or permanent make-up artists ask about past medical problems,
allergies, skin reactions, infections, etc.; a statement from the primary
care physician condoning the decision to have such a procedure should be
provided by those clients with a history of heart disease, bleeding disorders,
eye disease or infections, diabetes, epilepsy, fainting spells, contact lenses,
tendency to fever blisters, history of hepatitis or possible AIDS exposure, or
pregnancy and/or skin diseases or reactions.
Routine
treatment of minor problems
resulting during or from tattooing or
permanent make-up should include an understanding of how to handle a client
who faints, has difficulty breathing, is anxious, bleeding, or develops a local
allergy or mild infection or needle stick.
Before
participating full-time in an active tattoo or permanent make-up practice, an
individual should also clearly understand the recommendation of a baseline
HIV test and/or hepatitis immune profile, or hepatitis B immunization, and make
sure should the artist or client have an inadvertent (accidental) needle stick, both would be
evaluated by their respective physicians or at the public health department.
Of
course, any additional credentials or documentation supporting
the tattoo or permanent make-up artist’s integrity and/or background with
regard to health-related matters should also be a part of this credentialing
package.
Every
six months (semiannually) the supervisor has the responsibility of
reviewing and inspecting techniques, procedures and equipment utilized by the
tattooist and/or permanent make-up artist in the performance of the practice. So,
should any changes in technique, equipment, office location or procedures
occur, the tattooist and/or permanent make-up artist should review these changes
with the general supervising physician, and such changes should be submitted in
writing in addition to any additional pictures of the pertinent additions or
changes, as applicable.
Compliance
with the Florida Statute often comes down to the degree of enforcement by the
State. Certainly a relationship with a local or primary care physician may serve
this need without detailed documentation; however,
as the fields of tattooing and permanent make-up continue to expand, often
the documentation of bureaucratic requirements is one’s best defense in the
game called GOTCHA. For this reason, transparency and a clear
presentation of this aforementioned documentation and a policy manual available
to all clients, as well as government agencies, with pictures of before and
after results makes public relations' sense and bolsters the confidence of the
individual client while satisfying the requirements of state enforcement
agencies.
P.O.
Box 6009
Palm
Harbor, FL 34684
Tel
813.966.1431
David
P. Kalin, M.D., M.P.H.
Masters
in the Science of Public Health
Fellow
American Academy of Family Physicians
Board
Certified in Family Practice, B.C.F.P.
Fellow
American Academy of Disability Evaluating Physicians
Certified Independent Medical Examiner
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