Body Art: Frequently Asked Questions

Any individual who performs body art on a person must be a registered practitioner, even if no money is exchanged or if the body art occurs as part of a training course.  The only exception: The Safe Body Art Act does not restrict the activities of a physician, surgeon, or physician assistant.

No, a body art practitioner cannot work from a non-permitted site. It is the intent of the Act to require that registered practitioners operate only from permitted Body Art Facilities

That is at the discretion of the local jurisdiction. The person with the training certificate would have to provide proof that shows that the course meets all the requirements as noted in California Health and Safety Code (H&SC) Section 119307. If it cannot be provided or be read by staff (in a foreign language), then the individuals should be required to take a California-specific BBP course from a Local Enforcement Agency (LEA) approved trainer.

Any person who will be performing body art is required to take and maintain a Bloodborne Pathogen Exposure Control training certificate. This includes students working in a classroom setting if they are working on a live person. This would also include individuals working in the decontamination and sterilization room, as they may be exposed to instruments with human fluids or tissue.

No, an IPCP is not the same as an ECP. The Infection Prevention and Control Plan, as listed in H&SC Section 119313, requires a body art facility to spell out processes and standard operating procedures that allow the facility to comply with the Safe Body Art Act such as cleaning and sterilizing, set-up and tear down of procedure areas, and ways to keep instruments and procedure areas from being contaminated. An Exposure Control Plan, required by OSHA, requires an operator to list all positions that may have exposure, how employees will be trained to minimize exposure, who is responsible for the site, and how to report and handle an exposure incident to blood or other potentially infectious materials.

The intent of the section is to provide a route to trace back equipment if any complaints or problems implicate the pre-packaged, pre-sterilized instruments. A facility should always maintain records of purchases for these goods and lot numbers or other identifiers that single out a particular package or shipment. A facility can keep a separate master log documenting each piece of equipment used, the client’s name, and the date of use. It would also be acceptable to have an area on the client’s consent form that allows the practitioner to list each pre-packaged, pre-sterilized instrument used during a procedure, which would include a box or lot number or other references to identify the material source.

If the pre-sterilized instruments are not individually labeled to show sterility or have any marking that would indicate when the sterility is no longer valid, it is the operator’s responsibility to either keep the instruments in a box that has the details of the sterility and use by date or to provide some type of documentation that shows the items are sterile. If the box does not have that information or the documentation does not show that information, then the operator should change suppliers to one that provides that information.

Proper usage of sterilizers is addressed in H&SC Section 119315 (b) which states the sterilizer shall be loaded, operated, decontaminated, and maintained according to the manufacturer’s directions. Although no such language exists to address mechanical cleaning systems, such as ultrasonic cleaners, it is the intent of the Safe Body Art Act that they are also operated and maintained according to the manufacturer’s guidelines.

The Class 5 integrators requirement derives from ANSI/AAMI standards for autoclave testing. The Safe Body Art Act states the Class V Integrator is the minimum standard. Other testing methods can be proposed, but they must at least meet the standards set for the Class V integrators.

Yes, H&SC Section 119315 (b) (1) requires all sterilization equipment used to be manufactured for the sterilization of medical equipment. H&SC Section 119309 (e) requires all instruments to be steam sterilized. This section does not allow for the use of chemical sterilizers. Statim machines, which use steam and a cartridge system but not peel packs, may be used to sterilize instruments or jewelry for immediate use, as long as a Class V integrator or better is used with each sterilization run.

No, pursuant to the California Medical Board, any cutting of skin/tissue with scalpels or other medical devices should be referred to them as a complaint. The complaint form is available on their website and it should be mailed to the following address:
Medical Board of California
Central Complaint Unit
2005 Evergreen Street, Suite 1200
Sacramento, CA 95815
https://www.mbc.ca.gov/Consumers/Complaints/

Sharps waste includes any disposable instruments or disposable parts of an instrument that has acute rigid corners, edges, or protuberances capable of cutting or piercing. (e.g., tattoo needles, razors used to prepare skin)

No, H&SC Section 119314 (e) (3) (A) clearly states that sharps waste must be removed from a site by a disposal company or through an approved mail-back system.

No. Service Animals as defined by ADA should be allowed.

There is no clear connection with a practitioner and a procedure in the Safe Body Art Act, but it would be advisable to ask the Body Art Facility to put the practitioner's name on the client consent form.

No clear path is provided in the Safe Body Art Act. The following guidance is based on consultation with Body Art Industry representatives who have worked on the Safe Body Art Act. A pregnant individual should postpone the procedure until after they are no longer pregnant. If a client gives a positive response to any of the conditions in Section 119303 (b) (2), (b) (3) or (b) (4), then that individual should be asked to provide a doctor’s note outlining that they are fit or that it is safe to provide them with the procedure. These responses are in no way required by the practitioner but the intent of the consent questions was to enlighten the practitioner so they could make an informed decision before potentially providing a risky procedure, both for them and the client.

No, there is no grandfathering language in the Act.

Sections 119317 (g) (1) and (2) are very clear in the direction for any hand washing set-up. If there is only one demonstration booth at a temporary body art event, then the hand washing equipment (containerized liquid soap, single-use paper towels, a five-gallon or larger container of potable water accessible via spigot, and a wastewater collection and holding tank of corresponding size) must be located inside the booth. If there are two or more demonstration booths at a temporary body art event, then practitioner hand wash areas shall be provided throughout the event and be located within a booth with partitions at least three feet in height separating the hand wash area from the public. The hand wash area shall be equipped with a commercial, self-contained hand wash station that consists of containerized liquid soap, single-use paper towels, a storage capacity of five gallons or more of potable water, and a trash receptacle. The sponsor shall provide one hand wash area for every two demonstration booths at the event.

Eyewash stations are no longer required at temporary events.