RULES FOR BODY ART PRACTICE AND FACILITIES
RULES FOR BODY ART PRACTICE AND FACILITIES
State Of Alabama
Body Art Practice and Facilities 420-3-23
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RULES FOR BODY ART PRACTICE AND FACILITIES
420-3-23
Table of Contents
420-3-23-.01 General Provisions
420-3-23-.02 Definitions
420-3-23-.03 Body Art Operator Requirements and Professional Standards
420-3-23-.04 Exemptions
420-3-23-.05 Client Information and Site Care Information
420-3-23-.06 Client Health
420-3-23-.07 Records Retention
420-3-23-.08 Preparation and Care of the Body Art Area
420-3-23-.09 Sanitization and Sterilization Procedures
420-3-23-.10 Inks, Dyes, Pigments, Needles, and Equipment
420-3-23-.11 Single-use Items
420-3-23-.12 Physical Facilities
420-3-23-.13 Licenses and Permits
420-3-23-.14 Temporary Establishment License or Operator Permit
420-3-23-.15 Prohibitions
420-3-23-.16 Compliance and Enforcement
420-3-23-.17 Department Personnel Competency Requirement
420-3-23-.18 Repealer
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420-3-23-.01 General Provisions.
(1) Purpose – The purpose of these rules is to protect the health of the public by
establishing standards for the prevention of disease that may be associated with tattooing, body
piercing, and branding. These rules shall be interpreted and applied to protect the public
health.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.02 Definitions.
(1) "Biohazard waste" means any liquid or semi-liquid blood or other potentially
infectious materials; contaminated items that would release blood or other potentially infectious
materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or
other potentially infectious materials and are capable of releasing these materials during
handling; sharps; and any wastes containing blood and other potentially infectious materials.
(2) "Body art" means the practice of physical body adornment using invasive
procedures and, for the purpose of these rules, is an inclusive term for any procedures utilizing
body piercing, tattooing, cosmetic tattooing, branding or scarification. Physicians licensed by
the Alabama Licensure Commission and who perform body art procedures as part of patient
treatment are exempt from these rules. Nor does this definition include, for the purposes of
these rules, piercing of the ear using pre-sterilized single use stud and clasp ear piercing
systems.
(3) "Body art facility" or "Tattoo facility" means the geographic location at which an
individual does one or more of the following for compensation:
(a) Places an indelible mark upon the body of another individual by the insertion of a
pigment in or under the skin.
(b) Places an indelible design upon the body of another individual by production of
scars (branding).
(c) Performs body piercing.
(4) "Body piercing" means the perforation of human tissue other than ear for a
nonmedical purpose.
(5) "Branding" means a permanent mark made on human tissue by burning with a hot
iron or other instrument.
(6) "Clean technique" means the technique used to prevent or reduce the
transmission of microorganisms from one person to another or from one place to another. It
includes, but is not limited to:
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(a) Meticulous handwashing with soap and water;
(b) Maintaining the sterility of supplies;
(c) Using barriers; in particular, clean, disposable, single-use gloves;
(d) Proper cleaning and preparation of the body site area; and
(e) Maintaining a clean and sanitary environment by using a detergent to remove soil
and a disinfectant agent to clean up a spill of blood or other potentially infectious materials.
(7) "Cosmetic tattooing" means a tattoo procedure designed primarily to place a
permanent color or pigment in or under the skin or mucosa and that is intended to be used in
lieu of cosmetic make-up, such as permanent eyeliner or lip color.
(8) "Critical item" means:
(a) a provision of these rules that, if in non-compliance, has the potential for immediate
impact on the public health by resulting in infection of either clients or staff of a body art facility,
or disease transmission among clients or staff of a body art facility, or
(b) an administrative provision of these rules that is necessary to ascertain the
likelihood of infection or disease transmission among clients or staff of a body art facility or to
inform the public, and
(c) are referred to in Appendix A of these rules.
(9) "Department" means the State Department of Public Health.
(10) "Disinfectant " means an agent that destroys microorganisms, particularly
pathogenic microorganisms.
(a) These can be disinfectants or sanitizers that are registered with the U.S.
Environmental Protection Agency (EPA). Household bleach (sodium hypochlorite) with no
fragrance or other additives may also be used as a germicide.
(b) Over-the-counter pre-mixed bleach products can be used or a 1:100 dilution of
household chlorine bleach (5.25% sodium hypochlorite) can be made fresh daily and dispensed
from a spray bottle (500ppm, 1/4 cup per gallon of water or 2 tablespoons per quart of water).
(11) "Disinfection" means a process that eliminates many or all pathogenic
microorganisms, with the exception of bacterial spores, on inanimate objects, thereby rendering
them safe for use or handling.
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(12) "Equipment" means all machinery, including fixtures, containers, vessels, tools,
devices, implements, furniture, display and storage areas, sinks and all other apparatus and
appurtenances used in connection with the operation of a body art facility.
(13) "Handwashing sink" means a lavatory equipped with hot and cold running water
under pressure, through a mixing valve, used solely for washing hands, arms or other portions
of the body.
(14) "Hot water" means water which attains and maintains a temperature of at least
100º F.
(15) "Informed consent" means a written consent signed by the client prior to having
any body art procedure performed and which provides information and/or counseling on risks
and possible complications of the procedure to be performed.
(16) "Instruments used for body art" means hand pieces, needles, needle bars and
other instruments that may come in contact with a client's body or possible exposure to bodily
fluids during body art procedures.
(17) "Invasive" means entry into the body either by incision or insertion of an
instrument into or through the skin or mucosa, or by any other means intended to puncture,
break or compromise the skin or mucosa.
(18) "Jewelry" means any personal ornament inserted into a newly pierced area.
Jewelry for body piercing use shall be made of surgical implant grade stainless steel; solid 14k
or 18k white or yellow gold; niobium, titanium, or platinum; which is free of nicks, scratches, or
irregular surfaces; has been properly sterilized prior to use, and has not been previously used.
The Department may approve other materials upon request and review.
(19) "License" means the written document issued by the Department for the
operation of a tattoo facility. Approval is given in accordance with these rules and is separate
from any other licensing requirement of any local laws, rules, or ordinances.
(20) "Minor" means an individual under 18 years of age who is not emancipated. An
emancipated minor is or has been married or has by court order otherwise been legally freed
from the care, custody, and control of his or her parents.
(21) "Operator" means any person who controls, operates, manages, conducts, or
practices body art activities at a body art facility and who is responsible for compliance with
these rules, whether actually performing body art activities or not. The term includes
technicians or apprentices who work under the operator and perform body art activities.
(22) "Permit" means the written document issued by the Department to an individual
denoting that the individual has received training as specified in these rules. The permit is
given in accordance with these rules and is separate from any other licensing requirement of
these rules for the body art facility or any local laws, rules, or ordinances.
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(23) "Person" means an individual, any form of business or social organization or any
other non-governmental legal entity including but not limited to a corporation, partnership,
limited liability company, association, trust or unincorporated organization.
(24) "Physician" means a person licensed by the Alabama Licensure Commission to
practice medicine in all its branches.
(25) "Procedure surface" means any surface of an inanimate object that contacts the
client's unclothed body during a body art procedure, skin preparation of the area adjacent to
and including the body art procedure or any associated work area which may require sanitizing.
(26) "Sanitize/sanitization procedure" means a process of using a disinfectant to
reduce the numbers of microorganisms on cleaned surfaces and equipment to a safe level.
(27) "Shall" means a mandatory requirement.
(28) "Sharps" means any object (sterile or contaminated) that may purposefully or
accidentally cut or penetrate the skin or mucosa including, but not limited to, pre-sterilized,
single use needles, scalpel blades and razor blades.
(29) "Sharps container" means puncture-resistant, leak-proof container that can be
closed for handling, storage, transportation and disposal and is labeled with the International
Biohazard Symbol.
(30) "Single-use" means products or items that are intended for one-time, one-person
use and are disposed of after use on each client. This includes, but is not limited to, cotton
swabs or balls, tissues or paper products, paper or plastic cups, gauze and sanitary coverings,
razors, piercing needles, tattoo needles, scalpel blades, stencils, ink cups and protective
gloves.
(31) "Site care" means written instructions on caring for the body art and surrounding
area given to the client, and specific to the body art procedure(s) rendered.
(32) "Sterilization" means the complete elimination or destruction of all forms of
microbial life, including highly resistant bacterial spores and is accomplished by the use,
according to manufacturer’s directions, of a properly functioning autoclave or dry heat sterilizer
that is manufactured to be used for sterilization.
(33) "Tattoo" means an indelible mark made upon the body of another individual by
the insertion of a pigment in or under the skin or an indelible design upon the body of another
individual by production of scars other than by branding.
(34 ) "Tattoo facility" means a facility as defined under "Body art facility" in this rule.
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(35) "Tattooing" means any method of placing ink or other pigment into or under the
skin or mucosa of another individual by the aid of needles or any other instrument used to
puncture the skin, resulting in permanent coloration of the skin or mucosa. This includes all
forms of cosmetic tattooing.
(36) "Temporary body art facility" means any place or premise operating at a non-mobile,
fixed location where an operator performs body art procedures for no more than 14
days consecutively in conjunction with a single event or celebration.
(37) "Universal precautions" or "Standard precautions" means a set of guidelines
and controls established by the Center for Disease Control and Prevention (CDC) for the
prevention of transmission of bloodborne pathogens (specifically; the human immunodeficiency
virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV)).
(a) This method of infection control requires the employer and employee to assume that
all human blood and body fluids are potentially infectious.
(b) Precautions include hand washing, gloving, personal protective equipment, injury
prevention, and proper handling and disposal of needles, other sharp instruments, and blood
and body fluid-contaminated products.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.03 Body art operator requirements and professional standards.
(1) Licensed facility required – Except as otherwise allowed in these rules, all body
art procedures shall be performed in a body art facility which has a current, valid license issued
by the Department.
(2) Consent age -
(a) No person shall perform any body art procedure upon a minor unless the person
obtains the prior, written, informed consent of the parent or legal guardian of the minor, as
shown in Appendix B, Consent for Minor.
(b) The parent or legal guardian of the minor shall execute the written informed consent
required in this rule in the presence of the individual performing the body art procedure on the
minor, or in the presence of an employee or agent of that individual.
(c) Nothing in this section is intended to require an operator to perform any body art
procedure on a minor with parental or guardian consent.
(3) Clients under the influence - A person shall not perform any body art procedure
upon another individual if, in the opinion of the operator, the other individual, or the consenting
parent or guardian, is under the influence of intoxicating liquor or a controlled substance.
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(4) Gloves -
(a) The operator shall wear clean, intact, single-use gloves when performing body art
procedures.
(b) Under no circumstances shall a single pair of gloves be used on more than one
person. Gloves shall be changed if they become contaminated by contact with any non-clean
surfaces or objects or contact with a third person. The gloves shall be discarded at a minimum
after the completion of each procedure on an individual client and hands washed prior to
donning the next set of gloves.
(c) The use of single-use gloves does not preclude or substitute for hand washing
procedures as part of a good personal hygiene program.
(d) If, while performing a body art procedure the operator's glove is pierced, torn or
otherwise contaminated, the contaminated glove shall be immediately discarded and the hands
washed thoroughly (see section (5)(b) of this rule) before a new pair of gloves is applied. Any
item or instrument used for body art, which is contaminated during the procedure, shall be
discarded and replaced immediately with a new disposable or sterilized item or a new sterilized
instrument before the procedure resumes.
(5) Hygienic practices –
(a) The operator or technician shall maintain a high degree of personal cleanliness,
conform to hygienic practices, and wear clean clothes when performing body art procedures.
(b) Before performing body art procedures, the operator or technician must thoroughly
wash their hands in hot running water with liquid soap, then rinse hands and dry with disposable
paper towels. This shall be done as often as necessary to remove contaminants. Disposable
liquid soap dispensers shall not be refilled.
(c) Smoking, eating or drinking by anyone is prohibited in the work area where body art
is performed.
(6) Operator information required - The following information shall be kept on file on
the premises of a body art facility and available for inspection by the Department:
(a) Full name and exact duties of each body art operator/technician;
(b) Date of birth of each body art operator/technician;
(c) Gender of each body art operator/technician;
(d) Home address of each body art operator/technician;
(e) Identification photos of each body art operator/technician;
(f) Social security number of each body art operator/technician. Except that, refusal
by the employee to give the social security number will not result in denial of any right, privilege
or benefit.
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(7) Procedures information required - A complete listing of all body art procedures
performed shall be kept on file on the premises of a body art facility and available for inspection
by the Department.
(8) Inventory information required - An inventory of all instruments and body jewelry,
all sharps, and all inks used for any and all body art procedures, including names of
manufacturers and serial or lot numbers, if applicable, shall be kept on file on the premises of a
body art facility and available for inspection by the Department. Invoices or orders shall satisfy
this requirement.
(9) Biohazard waste and sharps disposal –
(a) Biohazard waste, as defined in these rules, shall be disposed in accordance with all
applicable local, state, and federal laws, rules, and ordinances, to include, at a minimum, 29
CFR Part 1910.1030, Occupational Exposure to Bloodborne Pathogens.
(b) Waste which does not release liquid blood or body fluids when compressed or does
not release dried blood or body fluids when handled may be placed in a covered receptacle and
disposed through normal, approved disposal methods. Storage of such waste on-site shall not
exceed the period specified by the Department or more than a maximum of 30 days, as
specified in 29 CFR Part 1910.1030 whichever is less.
(c) Sharps ready for disposal shall be disposed of in approved biohazard sharps
containers.
(10) Skin condition of clients and operators -
(a) Any skin or mucosa surface to receive a body art procedure shall be free of rash or
any visible infection.
(b) The skin of the operator shall be free of rash or infection. No person or operator
affected with boils, infected wounds, open sores, abrasions, or weeping dermatological lesions
shall work in any area of a body art facility in any capacity in which there is a likelihood that they
could contaminate body art equipment, supplies or working surfaces with body substances or
pathogenic organisms.
(11) Hepatitis B vaccination - Proof shall be provided upon request of the
Department that all operators and technicians have either completed or were offered and
declined, in writing, the hepatitis B vaccination series. This offering should be included as a
pre-employment requirement. Documentation of immunity, based on a blood test of the
operator, in written form and from an approved laboratory, may be used for this requirement of
proof.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
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420-3-23-.04 Exemptions.
(1) Physicians - Physicians licensed by the State of Alabama who perform body art
procedures as part of patient treatment are exempt from these rules.
(2) Ear piercing - Ear piercing is exempt from these rules. This does not prohibit the
Department from investigating consumer complaints relating to alleged misuse or improper
disinfection of ear piercing systems.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.05 Client information and site care information.
(1) Information given prior to a procedure -
(a) Body art facilities shall prominently display a Disclosure Statement which advises
the public of the risks and possible consequences of body art services. The Disclosure
Statement shall be posted in a conspicuous place in the facility’s waiting or general public area,
and easily seen by potential clients wanting to receive a body art procedure.
(b) The Disclosure Statement shall include, at a minimum, the following wording in bold
type:
"There may be risks associated with the procedures of commercial body art which
includes permanent tattoos, body piercing and permanent cosmetic application, that may
adversely affect the healing process, or may be a concern due to potential disease
transmission, if you have, or have had, any of the following conditions:
a. History of Hepatitis B or Hepatitis C;
b. HIV/AIDS;
c. Diabetes;
d. History of hemophilia or any other blood disorder/disease;
e. History of skin diseases or skin lesions;
f. History of sensitivities to soaps, disinfectants, etc.;
g. History of allergies or adverse reactions to pigments, dyes, latex, etc.;
h. Tuberculosis;
i. Immune disorders;
j. History of epilepsy, seizures, fainting, or narcolepsy;
k. Scarring (keloids);
l. History of heart murmur or any heart disease/condition;
m. History of taking medications such as anticoagulants that thin the blood and/or
interferes with blood clotting;
n. Pregnancy or breast feeding/nursing."
(c) In the event a body piercing procedure is to be performed which involves the oral
area ("oral piercing"), the client should be given oral piercing information such as shown in
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Appendix C.
(2) Site care information - A written information sheet, shown in Appendix D, with
instructions for general site care which shall be provided as a minimum to each client. The
facility may provide additional information as it deems appropriate. The body art procedure site
care information shall be provided to each client by the operator upon completion of the
procedure. The written information sheet shall also contain the name, address and phone
number of the body art facility.
(b) The written information shall advise the client to consult a physician at the first sign
of infection; such as redness, swelling, drainage, prolonged pain at the body art procedure site,
or onset of fever.
(3) Reporting known infections, complications, or diseases required - A person
who owns or operates a licensed tattoo facility shall, within 24 hours of becoming aware that an
individual tattooed, branded, or body pierced at the tattoo facility is infected with a
communicable disease, notify the department or a local county health department.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.06 Client health.
(1) Client health medical information form -
(a) In order for the operator or technician to properly evaluate the client's medical
condition prior to receiving a body art procedure and not violate the client's rights or confidential
medical information, a written request for medical information shall be given to the client. The
request for medical information shall include, at a minimum, the conditions noted on the Model
Medical History shown in Appendix E.
(b) The operator should ask the client to sign this form confirming that the information
was obtained or attempted to be obtained.
(c) This form shall be signed and dated by both parties, with a copy given to the client
and the operator retaining the original with all other required records.
(d) Nothing in this rule shall be construed to require the operator to perform a body art
procedure upon a client.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.07 Records retention.
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(1) Client records required - The body art facility shall keep a record of all persons
who have had body art procedures performed. The record shall include the name, date of birth,
and address of the client, the date of the procedure, name of operator who performed the
procedure(s), type and locations of procedure(s) performed, signature of client and if the client
is a minor, proof of parental or guardian consent, that is, signature.
(2) Record retention time - Such records, any release forms, and all materials signed
by the client, shall be retained permanently and made available to the Department upon
request. The records for the previous three years shall be kept on the premises of the body art
facility; records older than three years may be kept offsite provided they are readily accessible
upon request of the Department. The Department and the body art facility shall keep such
records confidential.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.08 Preparation and care of the body art area.
(1) Skin preparation - If shaving is necessary, single use disposable razors with
single service blades shall be used and discarded after each use. Following shaving, the skin
and surrounding area shall be cleaned with soap and water or an approved surgical skin
preparation, depending on the type of body art to be performed. When shaving is not done,
the immediate and surrounding area of the skin where the body art procedure is to be placed
shall be cleaned with soap and water or an approved surgical skin preparation. Cleansing pads
shall be discarded after a single use.
(2) Supplies contaminated with blood - In the event of blood flow, all products used
to check the flow of blood or to absorb blood shall be single-use and disposed of immediately
after use in appropriate covered containers, unless the disposal products meet the definition of
biomedical waste. 420-3-23-.09 Sanitation and sterilization procedures.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.09 Sanitation and sterilization procedures.
(1) Instrument cleaning - All non-single use, non-disposable instruments used for
body art shall be cleaned thoroughly after each use by scrubbing with an appropriate soap or
detergent solution and hot water or follow the manufacturer's instructions to remove blood and
tissue residue, and placed in an ultrasonic unit which shall also be operated in accordance with
manufacturer's instructions.
(2) Instruments packaged following cleaning - After cleaning, all non-disposable
instruments used for body art shall be packaged individually in peel-packs and subsequently
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sterilized. All peel-packs shall contain either a sterilizer indicator or internal temperature
indicator. Peel-packs must be dated and may be used as long as the package integrity has not
been breached.
(3) Instrument sterilization -
(a) All cleaned, non-disposable instruments and jewelry used for body art shall be
sterilized in a steam autoclave or dry heat sterilizer. Equipment used for sterilization shall be
used, cleaned, and maintained according to the manufacturer's instructions. A copy of the
manufacturer's recommended procedures for the operation of their sterilization unit must be
available for inspection by the Department.
(b) The use of equipment not specifically designed for medical instrument sterilization,
such as, but not limited to, food pressure cookers, microwave ovens, and baking ovens, is
prohibited.
(4) Package integrity - Sterile equipment shall not be used if the package integrity has
been breached. If the package integrity is breached, the equipment shall be removed from the
package, and cleaned and sterilized as required in sections (1) and (2) of this rule.
(5) Location of sterilizers, when required - Sterilizers shall be located away from
work stations or areas frequented by the public. If the body art facility uses all single use,
disposable instruments and products, and utilizes sterile supplies, an autoclave shall not be
required.
(6) Sterilizer efficacy testing - Each holder of a license to operate a body art facility
shall demonstrate that the sterilizer used is capable of attaining sterilization by conducting
monthly spore destruction tests. These tests shall be verified through an independent
laboratory. The license shall not be issued or renewed until documentation of the sterilizer's
ability to destroy spores is determined by the Department. These test records shall be retained
by the operator for a period of three (3) years and made available to the Department upon
request.
(7) Storage of sterilized instruments and other instruments and supplies - Unless
received from the manufacturer as a sterile instrument and in a package maintaining sterility
and package integrity, all needles used in tattooing and cosmetic tattooing shall be cleaned and
sterilized prior to use and stored in peel-packs. After sterilization, the instruments used for
tattooing/body piercing shall be stored in a dry, clean cabinet or other tightly covered container
reserved for the storage of such instruments. All other instruments and supplies shall be stored
in clean, dry and covered containers.
(8) Sanitization and disinfection of surfaces - Procedure surfaces, counter tops
used for equipment assembly, and any other similar surfaces where necessary shall be cleaned
and sanitized with a disinfectant solution after each client.
(9) Reusable cloth items - Reusable cloth items shall be mechanically washed with
detergent and dried after each use. The cloth items shall be stored in a dry, clean environment
Body Art Practice and Facilities 420-3-23
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until used. Soiled cloth items shall be stored in a manner to preclude contamination of any
clean items, equipment, or instruments.
(10) Clean techniques required - All instruments used for tattooing/body piercing
shall remain stored in sterile packages until just prior to performing a body art procedure.
When assembling instruments used for performing body art procedures, the operator shall wear
disposable single-use gloves and use clean techniques to ensure that the instruments and
gloves are not contaminated.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.10 Inks, dyes, pigments, needles and equipment.
(1) Use according to manufacturer’s directions - All inks, dyes, pigments, needles
and equipment shall be specifically manufactured for performing body art procedures and shall
be used according to manufacturer's instructions and standard professional practice.
(2) Ink used during a procedure - Immediately before applying a tattoo, the quantity
of the dye to be used shall be transferred from the dye bottle and placed into single-use paper
or plastic cups. Upon completion of the tattoo, these single cups and their contents shall be
discarded.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.11 Single-use items.
(1) Use restricted – Single-use items shall not be used on more than one client for any
reason. After use, all single-use needles, razors and other sharps shall be immediately
disposed of in approved sharps containers.
(2) Products applied to the skin -
(a) All products applied to the skin, including body art stencils, shall be single-use and
disposable.
(b) Acetate stencils shall be allowed for re-use if sanitization procedures are performed
between uses.
(c) Petroleum jellies, soaps and other products used in the application of stencils shall
be dispensed and applied on the area to be tattooed with sterile gauze or in a manner to
prevent contamination of the original container and its contents. The gauze shall be used only
once and then discarded.
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(d) The operator shall use only single-use sterile gauze and single-use antibacterial
ointments to cover the procedure site(s).
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.12 Physical facilities.
(1) Plans required - Body art facilities applying for a license after adoption of these
rules shall submit a scale drawing and floor plan of the proposed facility for a plan review by the
Department, as part of the license application process.
(2) Floors, walls, and ceiling -
(a) All walls and floors of the procedure area of a body art facility shall be smooth, free
of open holes or cracks, washable and in good repair. Ceilings in all procedure areas shall be
maintained in good repair with no open holes. Walls in waiting rooms and non-procedure areas
may have decorative attachments if the wall and decorations are kept clean.
(b) Carpeting is prohibited as a floor covering in the body art procedure area.
(c) Walls, floors and ceilings in the body art facility shall be maintained in a clean
condition.
(3) Water supply -(
a) Water used for the sanitary operations of the body art facility shall be provided from
a source operated and constructed according to law.
(b) At least one water sample shall be collected annually from any body art facility if the
body art facility’s water supply is not from a source approved by the Alabama Department of
Environmental Management.
(c) If the water sample results show coliform present as reported by the Alabama
Department of Public Health Bureau of Clinical Laboratories, a resample shall be taken within
seven days of the report being received by the county health department. Whenever two
consecutive samples taken on separate days show coliform present, body art facility’s license
shall be suspended in accordance with appropriate administrative procedures. A sample result
of coliform absent with no confluent growth is required prior to reinstatement of the license.
(4) Sewage disposal – All sewage, and liquid waste such as mop water, shall be
disposed of by a public sewerage system or by a sewage disposal system constructed and
operated according to law.
(5) Sinks and toilet facilities -
Body Art Practice and Facilities 420-3-23
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(a) A readily accessible handwashing sink with hot and cold running water, under
pressure, dispensed through a mixing valve, with no aerator, preferably equipped with wrist or
foot operated controls, and supplied with liquid soap in disposable dispensers and disposable
paper towels at the sink, shall be provided convenient to the work area within any procedure
room in the body art facility.
(b) When there are multiple procedure areas or operators in one room, one
handwashing sink shall serve no more than three (3) operators or three (3) work areas.
(c) Toilet facilities shall be installed according to law; shall be the number required by
law as enforced by local plumbing officials, but at least one; shall be under the care and control
of the body art facility operator; and shall be accessible to employees at all times.
(d) Each toilet room shall have a handwashing sink, designed and supplied as required
in section (3)(a) of this rule, inside the toilet room or outside the toilet room immediately
adjacent to the toilet room door.
(e) Handwashing sinks shall be used for no other purpose.
(f) A utensil sink with hot and cold water under pressure, supplied through a mixing
valve with no aerator, shall be provided for washing reusable instruments or other reusable
items.
(g) A service sink or utility sink, with at least hot water under pressure, shall be provided
for the disposal of liquid waste.
(6) Procedure surfaces - All procedure surfaces, including client chairs and/or
benches, shall be of such construction and maintained to be easily cleaned and sanitized with a
disinfectant solution after each client.
(7) Separation from other areas - All body art facilities shall be completely separated
by solid partitions or by walls extending from floor to ceiling, from any room used for human
habitation, or any room used for living or sleeping quarters or a bathroom used for a personal
residence, or from a food establishment or room where food is prepared, a hair salon, retail
sales, or other such activity which may cause potential contamination of work surfaces.
(8) Procedure (work station) area - There shall be a minimum of thirty-five (35)
square feet of floor space at each work station in the body art facility unencumbered by non-portable
furniture or equipment. Each body art facility shall have an area which may be
screened from public view for clients requesting privacy. Multiple body art stations shall be
separated by dividers, curtains or partitions, at a minimum.
(9) Ventilation - The facility shall be well-ventilated.
(10) Lighting - The facility shall be provided with an artificial light source equivalent to
at least twenty (20) foot candles three (3) feet off the floor, except that at least 100 foot candles
shall be provided at the level where the body art procedure is being performed, and where
Body Art Practice and Facilities 420-3-23
16
instruments and sharps are assembled and/or processed.
(11) Insects, vermin, and rodents prohibited - Effective measures shall be taken by
the body art operator to protect the entrance into the facility and the breeding or presence on
the premises of insects, vermin and rodents. Insects, vermin and rodents shall not be present
in any part of the facility, its appurtenances or appertaining premises.
(12) Animals prohibited - No animals of any kind shall be allowed in body art facility
except service animals used by persons with disabilities shall be allowed. Fish aquariums may
be allowed in waiting rooms and non-procedural areas.
(13) Refuse containers - At least one covered waste receptacle shall be provided in
each operator work area and each toilet room. Receptacles in the operator work area shall be
emptied daily and solid waste shall be removed from the premises at least weekly. All refuse
containers shall be lidded, cleanable and kept clean.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.13 Licenses and permits.
(1) Body art facility licenses required -
(a) No person shall operate a body art facility until obtaining a license from the
Department. Any person desiring to operate a body art facility shall make written application
for a license on forms provided by the Department. Such application shall include the name
and address of each applicant, the physical location of the proposed body art facility, the type of
all body art procedures proposed to be conducted at the facility, and the signature of each
applicant. The license shall be issued on forms provided by the Department.
(b) If the Department determines that the application is complete and the body art
facility proposed or operated by the applicant meets the requirements of these rules, the
Department shall issue a license to the applicant for the operation of that body art facility.
(c) Licenses shall automatically expire on the date upon which state, county, and
municipal annual privilege licenses expire or on a date designated by the local county health
department and shall be renewable annually upon written application from the operator not less
than thirty (30) days prior to expiration.
(d) The body art facility applicant shall pay a fee as set by law for each body art facility
license, which is:
1. $250.00 for the initial annual license.
2. $200.00 for a one-year renewal of an annual license.
Body Art Practice and Facilities 420-3-23
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3. $50.00 for a temporary license.
(e) Body art facility license fees are not prorated.
(f) A license for a body art facility shall not be transferable from one place or person to
another.
(g) A current body art facility license shall be displayed in a conspicuous place within
the customer service area of the body art facility where it may be readily observed by clients
upon entering the facility.
(2) Operator permits required -
(a) The holder of a body art facility license shall hire, employ, or use operators or
technicians who have complied with the operator permit requirements of these rules.
(b) No person shall practice body art procedures without first obtaining an operator
permit from the Department.
(c) The operator permit shall be valid from the date of issuance and shall automatically
expire at the end of the facility license year following the current year when issued unless
revoked sooner by the Department in accordance with these rules. Application for operator
permits shall include:
1. Name;
2. Date of birth;
3. Sex;
4. Residence address;
5. Mailing address;
6. Phone number;
7. Place(s) of employment as an operator;
8. Years experience;
9. Social security number. Provided that, refusal by the employee to give the social
security number will not result in denial of any right, privilege or benefit;
10. Proof of attendance within the 36 months prior to making application at a
bloodborne pathogen training program (or equivalent), given or approved by the Department, to
include demonstration of knowledge of the following subjects:
Body Art Practice and Facilities 420-3-23
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( i) Anatomy;
(ii) Skin diseases, disorders, and conditions (for example, diabetes) which may affect
the skin;
(iii) Infection control procedures including waste disposal, hand washing techniques,
sterilization equipment operation and methods, and sanitization/disinfection/sterilization
methods and techniques;
(iv) Facility safety and sanitation.
(d) Knowledge of the subjects in section 420-3-23-.13(2)(c)10 must be demonstrated
through submission of documentation of attendance or completion of courses approved or
given by the Department prior to issuance of the operator's permit. Examples of courses
approved by the Department would include such courses as Prevention of Disease
Transmission and Bloodborne Pathogen Training.
(e) No operator permit shall be issued unless, following reasonable investigation by the
Department, the body art operator has demonstrated compliance with the provisions of this
section and all other provisions of these rules.
(f) All operator permits shall be conditioned upon continued compliance with the
provisions of this section as well as all applicable provisions of these rules.
(g) All operator permits shall be posted in a conspicuous place within the customer
service area where they may be readily observed by clients upon entering the body art facility.
(3) Existing body art facilities and operators -
(a) Body art facilities operating at the time of the enactment of these rules, as
evidenced by the possession of a current and valid business license, shall, within 30 days of the
effective date of these rules, make application to the Department for a body art facility license
and pay the fee for a new license as required in this rule. This first license for these existing
facilities shall be considered a Provisional License and shall not be renewed unless all the
requirements of these rules are met by the license expiration date. In the event all the
requirements of these rules are not met by the time the Provisional License expires, or
application for a Provisional License is not made within 30 days of the effective date of these
rules, the body art facility shall not be considered an existing facility and shall make application
for a license as a new facility.
(b) Operators conducting body art procedures at the time of the enactment of these
rules shall make application to the Department for an Operators Permit and obtain an
Operators Permit within 6 months of the effective date of these rules.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
Body Art Practice and Facilities 420-3-23
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420-3-23-.14 Temporary Facility License or Operator Permit.
(1) Licenses and permits -
(a) Temporary body art facility licenses and, when required, operator permits, may be
issued for body art services provided outside of the physical site of a fixed licensed facility for
the purposes of product demonstration, industry trade shows or for educational reasons.
(b) Temporary licenses issued under the provisions of these rules may be suspended
by the Department for failure of the holder to comply with the requirements of these rules.
(c) All facility licenses and operator permits and the disclosure notice must be readily
visible to clients.
(2) Requirements - Temporary operator permits and/or facility licenses shall not be
issued unless:
(a) The applicant furnishes proof of compliance with 420-3-23-.13(2) relating to
operator's permits and/or
(b) The applicant is currently affiliated with a fixed location or permanent facility which,
where applicable, is permitted by the appropriate State and/or local jurisdiction; and
(c) The temporary site complies with section (9) of this rule.
(3) Training - In lieu of attendance at a bloodborne pathogens training program
approved by the Department within the past three (3) years as specified in 420-2-23-13(2)(c)
above, the applicant may furnish proof of attendance at equivalent training which is acceptable
to the Department.
(4) Time limit - Temporary body art facility licenses and/or operator permits expire
after fourteen (14) days or the conclusion of the special event, whichever is less.
(5) Fee required - Temporary body art facility licenses shall not be issued unless the
applicant has paid the fee set by law.
(6) Non-transferable - The temporary body art facility license or operator permit shall
not be transferable from one place or person to another.
(7) License and permits posted - The temporary body art facility license and operator
permit shall be posted in a prominent and conspicuous area where they may be readily seen by
clients upon entering the facility.
(8) Temporary Operator Permit Requirements -
Body Art Practice and Facilities 420-3-23
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(a) A temporary permit may be issued by the Department for educational, trade show or
product demonstration purposes only. The permit may not exceed fourteen (14) calendar days.
(b) A person who wishes to obtain a temporary demonstration permit must submit the
request in writing for review by the Department, at least thirty (30) days prior to the event. The
request shall specify:
1. The purpose for which the permit is requested;
2. The period of time during which the permit is needed (not to exceed fourteen
(14) calendar days per event), without re-application;
3. The fulfillment of temporary operator requirements as specified in section (2) of this
rule;
4. The location where the temporary demonstration will be conducted.
(9) Temporary Establishment Physical Facilities -(
a) The temporary demonstration project must be contained in a completely enclosed,
non-mobile facility (that is, inside a permanent building).
(b) Except as otherwise provided in this rule, the temporary body art facility and
operator shall comply with all of the requirements of these rules, including but not limited to:
1. Conveniently located handwashing facilities with liquid soap, paper towels and hot
and cold water under adequate pressure shall be provided; along with sanitary drainage in
accordance with local plumbing codes.
2. A minimum of eighty (80) square feet of floor space;
3. At least one hundred (100) foot candles of light at the level where the body art
procedure is being performed.
4. Facilities to properly sterilize instruments with evidence of a spore test performed on
sterilization equipment thirty (30) days or less prior to the date of the event, shall be provided;
or only single use, prepackaged, sterilized equipment obtained from reputable suppliers or
manufacturers shall be allowed;
5. Ability to properly clean and sanitize the area used for body art procedures.
The facility where the temporary demonstration is proposed shall be inspected by the
Department and a license issued prior to any body art procedures being performed.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
Body Art Practice and Facilities 420-3-23
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420-3-23-.15 Prohibitions.
(1) Prohibited acts include, but are not limited to, the following:
(a) Performing body art on any body part of a minor without the informed written
consent of the parent or legal guardian of such minor. This consent is to be given in person to
the operator or responsible person at the facility by the parent or legal guardian at the time the
tattooing or piercing is to commence.
(b) Performing body art on a person who, in the opinion of the operator is inebriated or
appears to be under the influence of alcohol or drugs.
(c) Owning, operating or soliciting business as a body art facility or operator without first
obtaining all necessary permits and approvals from the Department, unless specifically
exempted by these rules.
(d) Obtaining or attempting to obtain any body art facility license or operator permit by
means of fraud, misrepresentation or concealment.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.16 Compliance and Enforcement.
(1) Inspection frequency -
(a) A representative of the Department shall properly identify him or herself upon
entering a body art facility to make an inspection. Inspections shall be conducted at least every
180 days or as often as necessary throughout the year to ensure compliance with these rules.
(b) The routine inspection frequency shall be determined by the compliance status
found on inspection as below. Nothing in this section precludes the Department from issuing an
immediate Notice of Intent to Suspend/Revoke order, or issuing an emergency order to
immediately cease operation or cease using a particular item of equipment or a particular
process, if necessary in order to protect the public health.
(c) A routine re-inspection shall be conducted within 180 days when:
1. No critical items were found in non-compliance or any critical items found in non-compliance
are corrected during the inspection, or
2. No second-time repeat non-critical items were found in non-compliance.
(d) A compliance check shall be conducted within 30 days when:
Body Art Practice and Facilities 420-3-23
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1. One or more critical items are found in non-compliance and are not corrected during
the inspection, or one or more repeat corrected critical items from the previous inspection were
found in non-compliance regardless of being corrected during the current inspection, or
2. One or more second-time repeat non-critical items from the previous routine
inspection were noted in non-compliance regardless of being corrected during the current
inspection.
(e) Whenever a compliance check to determine correction of any item finds the item in
continuing non-compliance; a Notice of Intent to Suspend or Revoke the license or permit shall
be issued to the person in charge at the body art facility. If the item in non-compliance and
being the cause for issuance of the Notice is corrected, the body art facility shall retain the
inspection status but shall be re-inspected within 30 days.
(2) Inspection report -
(a) The original of the inspection report (see Appendix F) shall be furnished to the
permit holder or operator of the body art facility, with the Department retaining possession of a
copy.
(b) The inspection report shall designate the compliance status of the body art facility
as Routine re-inspection or Compliance Check Necessary, based on the result of the inspection
as specified in 420-3-23-.16(1).
(3) Correction of non-critical violations -
(a) Upon finding a violation of any provision of these rules that is deemed a non-critical
item, the Department shall advise the licensee or permitted operator, in writing, of its findings
and instruct the operator to correct such violations within a reasonable period of time, but no
later than the time of the next routine inspection.
(b) In the event a non-critical violation is not corrected by the time of the next routine
inspection, or is the same violation as on the preceding routine inspection, it shall be noted on
the inspection report as a repeat violation. In the event one or more non-critical items are found
in violation on a second consecutive routine inspection, they shall be noted on the inspection
report as a second repeat violation, and shall be corrected as required for critical items in 420-
3-.16(4).
(4) Correction of critical violations -
(a) Violation of any provision of these rules that is deemed a critical item should be
corrected immediately, during the course of the inspection, but in any event within 30 days
following the inspection.
(b) In the event the violation cannot be corrected during the course of the inspection, or
if the critical violation is the same as on the immediately preceding inspection and was
corrected at that time but is now in violation again, notice of intent to suspend the body art
Body Art Practice and Facilities 420-3-23
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facility license or operator permit, or both, shall be issued by the Department representative
conducting the inspection. The body art facility license holder or permit holder may request a
hearing on the notice of intent to suspend in accordance with these rules.
(5) Suspension of licenses and permits -
(a) Licenses and permits issued under the provisions of these rules may be suspended
temporarily by the Department for failure of the holder to comply with the requirements of these
rules or for repeated or critical violations of any of the requirements if these rules.
(b) Whenever the Department is aware of, or has reasonable cause to suspect that, 1)
a communicable disease has been, or may be, transmitted by an operator to a client; or 2)
there is use of unapproved or malfunctioning equipment; or 3) insanitary or unsafe conditions
exist which may adversely impact the health of the public; the Department may, upon written
notice to the owner or operator, do any or all of the following:
1. Issue an order excluding any or all operators from the licensed body art facility who
are responsible, or reasonably appear responsible, for the transmission of a communicable
disease until the Department determines there is no further risk to public health.
2. Issue an order to immediately suspend or revoke the license of the body art facility
until the Department determines there is no further risk to the public health. Such an order shall
state the cause for the action.
(6) Reinstatement - Any person whose license or permit has been suspended may, at
any time, make application for reinstatement of the permit. Within ten (10) days following
receipt of a written request, including a statement signed by the applicant that in his opinion the
conditions causing the suspension have been corrected, the Department shall re-inspect the
body art facility or evaluate documentation provided by an operator. If the applicant is in
compliance with the provisions of these rules, the license or permit will be reinstated.
(7) Revocation -
(a) For failure to comply with a notice of license or permit suspension, or for repeated or
critical violations of any of the requirements of these rules, or for interference with Department
personnel in the performance of their duties, the license or permit may be permanently revoked
after a hearing. Before taking such action, the Department shall notify the license or permit
holder or operator in writing, stating the reasons for which the license or permit is subject to
revocation and advising the license or permit holder or operator of the requirements for filing a
request for a hearing. A license or permit may be suspended for cause, pending its revocation
or hearing relative thereto.
(b) A revocation shall last no less than 90 days. After that time, any person whose
license or permit has been revoked may make application for a new license or permit. If the
applicant is in compliance with the provisions of these rules as required for new applicants, the
new license or permit will be issued.
Body Art Practice and Facilities 420-3-23
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(8) Service of notice - Whenever a licensee or permit holder or operator has failed to
comply with any notice issued under the provisions of these rules, the operator shall be notified
in writing that the license or permit is, upon service of this notice, immediately suspended. The
notice shall inform the license holder or permitted operator that an opportunity for a hearing will
be provided if a written request for a hearing is filed with the Department within fifteen (15)
days. Service of notice may be accomplished by mailing the notice, regular mail, to the address
listed on the body art facility license or operator permit application.
(9) Hearings -
(a) A person who, 1. after proper application, is denied a permit, license, or
authorization; or 2. is in possession of a valid permit, license, or authorization, and is notified in
writing of the intent to suspend, revoke, or deny renewal of said permit, license, or
authorization, shall be provided the reasons therefore and may, within 15 days following receipt
of said notice, apply in writing for an informal hearing to the Health Officer, or his/her designee,
of the county from which said denial(s) or notice of intent was issued, in accordance with the
Rules of the State Board of Health governing appeals.
(b) If, after the informal hearing, the matter is not resolved to the satisfaction of the
aforesaid person, written appeal, in accordance with the Rules of the State Board of Health
governing appeals, may be made to the State Health Officer within 15 days following said
hearing. This appeal shall be sent directly to the State Health Officer, State Department of
Health, P.O. Box 303017, Montgomery, Alabama 36130-3017, with a copy furnished to the local
county health department of the county from which said denial or notice of intent was issued.
(10) Emergency suspension -
(a) Notwithstanding any other provision of these rules, whenever the Department finds
insanitary or other conditions which, in the judgment of the designee of the Department
authorized to conduct inspections of body art facilities, constitute a substantial hazard to the
public’s health, he or she may, without warning, issue a written notice to the license holder or
permit holder citing such conditions, specifying the corrective action to be taken, and specifying
the time period within which such action shall be taken.
(b) If deemed necessary, such order shall state that the license and/or permit is
immediately suspended, and all body art procedures shall be immediately discontinued.
(c) Any person to whom such order is issued shall comply immediately therewith.
(11) Penalty -
(a) A person who violates any provision of these rules shall be guilty of a Class C
misdemeanor, punishable by imprisonment for not more than 90 days, or a fine of not more
than $100.00, or both, for each violation.
Body Art Practice and Facilities 420-3-23
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(b) In addition to any other enforcement action authorized by law, a person alleging a
violation of Act 321-2000 may bring a civil action for appropriate injunctive relief.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.17 Department personnel competency requirement.
(1) Department personnel performing environmental health/sanitary evaluations or
complaint investigations of body art facilities shall meet the same requirements as specified for
operators in section 420-3-23-.13(2)(c)10 of these rules prior to assuming responsibilities for
this program.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
420-3-23-.18 Repealer.
Any rules promulgated by the State Board of Health which are in conflict with these
rules, or with any portion thereof, are hereby expressly repealed.
AUTHORS: Ronald Dawsey and Charlotte Denton
STATUTORY AUTHORITY: Section 22-17A-7, Code of Alabama, 1975.
EFFECTIVE DATE: May 4, 2001
Body Art Practice and Facilities 420-3-23
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APPENDIX A
CRITICAL ITEMS
Critical items are those sections of these rules pertaining to:
Body art procedures performed on minors;
Body art procedures performed on clients under the influence;
Use of gloves by the operator;
Hygienic practices by the operator;
Operator’s hands washed and clean;
Biohazard and sharps disposal ;
Skin condition of the operator and client;
Evidence of Hepatitis B vaccination acceptance/declination for the operator on file and
available;
Site care information provided to clients as required;
Required client health information requested before any procedure;
Skin prepared as required before any procedure;
Instruments used for body art properly cleaned, sterilized, packaged, dated, stored, and
used;
Sterilizer tested (spore destruction) by independent 3
rd
party and documentation
available;
Body Art Practice and Facilities 420-3-23
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Sterilizer manufacturer’s instructions for use available and followed;
Clean techniques used for assembly of instruments used for body art prior to beginning
procedure;
Inks, dyes, pigments, needles, other equipment used for body art procedures approved
and properly used;
Single-use items used as required;
Water supply from approved source;
Sewage disposal approved;
Waste water disposed through service sink;
Toilet(s) on premises, under care and control of operator, accessible, supplied and
designed as required;
Handwashing sinks used, provided, accessible, supplied, designed as required;
Utensil washing sink used, provided, accessible, supplied, and designed as required;
Service sink used, provided, accessible, supplied, and designed as required;
Insects, rodents, vermin, other animals not present unless specifically allowed by these
rules;
Display for public view of license, permits, disclosure statement.
Body Art Practice and Facilities 420-3-23
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APPENDIX B
CONSENT FOR MINOR
I, _________________________________, attest that I am the legal guardian of
___________________________________ who is currently __________ years of age and
that I give him/her consent to have the following procedure(s):
______________________________________________________
______________________________________________________.
I further attest that I have been informed of the possible risks i
Votes:36
Comments: 0