Two weeks ago, I ventured outside my comfort zone and attended the annual Tattoo Festival in Santa Maria. It was a scene full of colorful people – literally. Men in motorcycle leathers getting naked women inked into their biceps, half-naked women getting fiery dragons carved from their back to their buttocks, and more facial piercings in one room than I’ve seen in my collective years. Although the 70 booths of tattoo artists were sandwiched together in one large showroom, and the buzzing of electric needles and Metallica filled the air, the potential sense of chaos was ameliorated by the starched white Public Health Permits hung conspicuously above each booth. Our health inspectors had given their stamp of approval the day before, and the artists were clearly abiding by regulations.
As I wandered among the ink enthusiasts that Saturday evening, aware that nobody suspected I was the health official responsible for disease control, I was impressed by the sanitation – and sanity – of this eclectic gathering. Since the dawn of humanity, the ancient art form of body tattooing has symbolically identified people with their tribes, their gods, and their culture. When Otzi the Iceman, who lived and died around 3300 BC, was discovered frozen in a glacier in the Alps recently, his most mysterious feature was the 57 tattoos adorning his mummified body. As it turns out, we are not so different from our ancestors.
Unlike them, however, we are now aware of diseases spread through the blood – a problem that probably didn’t worry Otzi and his contemporaries. With this knowledge comes responsibility, and public health has made increasing efforts recently to ensure safe practices in the tattoo industry.
The Safe Body Art Act, or AB 300, became effective in California in July of 2012. This ordinance provides consumers with increased peace of mind that the registered artist inscribing that giant sunburst on your back received Public Health’s stamp of approval. The Safe Body Art Act requires all body art practitioners to register with the Public Health Department, obtain annual blood-borne pathogen training, and provide documentation of Hepatitis B vaccination status. It also requires that body art facilities operate in a safe and clean manner, maintain records of training and equipment sterilization, and undergo annual inspection.
Problem solved for infectious diseases from tattoos? Not quite.
A very real danger still exists for those who choose to get tattooed by non-permitted, or “underground,” providers. These providers work out of their garages, kitchens, or vehicles in an effort to avoid having to comply with Public Health’s pesky hygiene standards. Thanks to the Internet, anyone can watch “Tattooing for Dummies” on Youtube, purchase tattoo equipment online, and advertise on Facebook or Craigslist – all without a drop of knowledge about the dangers of HIV, Hepatitis B, or Hepatitis C.
These underground providers pose a significant risk to our communities. Hepatitis B virus can survive for seven days in a miniscule drop of dried blood. HIV only needs one exposure through recycled needles or equipment to devastate a life. For these blood-borne pathogens, one exposure is enough.
Because underground tattoo artists avoid identification by public health officials, and operate in the shadows of our community, putting them out of business is a responsibility that falls on the consumer. Consumers must drive change by directing their business to legitimate, health-permitted artists who work in sanitary, inspected environments. I cringed yesterday when I saw a teenager on Facebook sharing a photo of her amateur tattoo, encouraging her friends to solicit this bogus tattoo artist. Doing amateur tattoos out of your garage, on teenagers too naïve to understand what risks you’re imposing on them, does not make you a bona fide artist, but an imposter. It degrades this ancient art form.
Why is it that we often ask more rigorous questions of our auto mechanic than we do of a stranger about to stick needles into our body? I pondered that mystery last weekend as I stood behind a crowd of people watching a man get inked over the last remaining un-inked smidgeon of his body. I was captivated.
I believe the answer is simple. We don’t know what we don’t know. But, unlike Otzi, we have the ability to approach body art with considerable knowledge about how to stay healthy and safe, while continuing to enjoy the remarkable skills of a true – and licensed/ registered/inspected – artist.