THE TATTOOING, PIERCING, ACUPUNCTURE and ELECTROLYSIS (GUERNSEY and ALDERNEY) LAW, 2000 APPROVED CODE OF PRACTICE Office of Environmental Health & Pollution Regulation Code of Practice Page 1 of 73 Version 1.2 TABLE OF CONTENTS CHAPTER 1: INTRODUCTION AND OVERVIEW OF THE LAW .......................................... 4 CHAPTER 2: PROCEDURES COVERED BY THE LAW ....................................................... 5 CHAPTER 3: PERSONS COVERED BY THE ORDER .......................................................... 9 3.1. Person or Premises – Registration Requirements ......................................................... 9 3.2. Excluded Persons ........................................................................................................ 11 3.2.1. Regulated Healthcare Professionals .................................................................... 11 CHAPTER 4: REQUIREMENTS OF THE LAW – PREMISES ............................................... 12 4.1. General State of Repair ............................................................................................... 12 4.2. Physical Layout of Premises ........................................................................................ 12 4.3. Requirements of Waiting Area ..................................................................................... 13 4.4. Requirements of the Treatment Room ......................................................................... 14 CHAPTER 5: REQUIREMENTS OF THE LAW – PRACTITIONER AND EQUIPMENT ....... 17 5.1. The Practitioner ............................................................................................................ 17 5.1.1. Cleanliness and Clothing ...................................................................................... 17 5.1.2. Conduct ................................................................................................................ 18 5.1.3. Training ................................................................................................................ 18 5.2. Equipment .................................................................................................................... 21 5.2.1. Skin Preparation Equipment ................................................................................. 22 5.2.2. Anaesthetics ......................................................................................................... 23 5.2.3. Needles ................................................................................................................ 25 5.2.4. Body Piercing Jewellery ....................................................................................... 25 5.2.5. Tattoo Inks ............................................................................................................ 26 5.2.6. General Stock Requirements ............................................................................... 28 CHAPTER 6: REQUIREMENTS – CLIENT INFORMATION ................................................. 29 6.1. Collection of Information on Client ............................................................................... 29 6.1.1. Age ....................................................................................................................... 29 6.1.2. Medical History ..................................................................................................... 29 6.1.3. Consent Forms ..................................................................................................... 30 6.2. Provision of Information to Client ................................................................................. 30 CHAPTER 7: REQUIREMENTS– PERIPATETIC PRACTITIONERS ................................... 32 CHAPTER 8: REQUIREMENTS – EAR PIERCING .............................................................. 33 Code of Practice Page 2 of 73 Version 1.2 8.1. Collection of Information on Client ............................................................................... 34 8.1.1. Age ....................................................................................................................... 34 8.1.2. Medical History ..................................................................................................... 34 8.1.3. Consent Forms ..................................................................................................... 35 8.2. Requirements of the Premises ..................................................................................... 35 CHAPTER 9: REQUIREMENTS OF THE LAW – ACUPUNCTURE ..................................... 37 CHAPTER 10: CLEANING, DISINFECTION AND STERILISATION .................................... 38 10.1. Definitions .................................................................................................................. 38 10.2. Requirements for Equipment ..................................................................................... 38 10.3. Cleaning ..................................................................................................................... 39 10.4. Disinfection ................................................................................................................ 40 10.5. Sterilisation ................................................................................................................ 41 10.5.1. Standard Steam Autoclaves (Passive Air Removal) ........................................... 42 10.5.2. Pre-Sterilisation Vacuum Steam Autoclaves ...................................................... 42 10.5.3. Storage and Sterility of Items Following Sterilisation .......................................... 43 10.5.4. Maintenance and Operation of Autoclaves ......................................................... 44 10.5.5. Use of Indicators ................................................................................................ 44 10.5.6. UK and Jersey Legislation .................................................................................. 45 CHAPTER 11: ADDITIONAL SOURCES OF INFORMATION ............................................. 47 APPENDIX 1 .......................................................................................................................... 48 APPENDIX 2 .......................................................................................................................... 51 APPENDIX 3 .......................................................................................................................... 55 APPENDIX 4 .......................................................................................................................... 60 APPENDIX 5 .......................................................................................................................... 61 APPENDIX 6 .......................................................................................................................... 64 APPENDIX 7 .......................................................................................................................... 66 APPENDIX 8 .......................................................................................................................... 69 APPENDIX 9 .......................................................................................................................... 71 Version/ Revision Log Version No. Date Released Comments/ Changes Author 1.0 07/10/2014 TC 1.1 23/12/2014 Changes to appendix 2, addition of version log RB 1.2 23/03/2016 Change of logo from HSSD to HSC TC Code of Practice Page 3 of 73 Version 1.2 CHAPTER 1: INTRODUCTION AND OVERVIEW OF THE LAW The Tattooing, Piercing, Acupuncture and Electrolysis (Guernsey and Alderney) Law, 2000 came into force in Guernsey and Alderney on 1st November 2001 and gives the Board of the Health and Social Services Department the power to register individuals who carry out skin piercing or tattooing activities as a business. This is delivered by the Office of Environmental Health and Pollution Regulation. The Law lays out a number of requirements in relation to key issues aimed at reducing, if not removing, risks to public health from these practices. Included in this is a provision for the Department to issue Codes of Practice setting out the practice and procedures that should be adopted by registered persons administering any treatment, the standards to which registered premises and any equipment used in connection with the administration of treatment should conform and the records that should be kept in respect of persons to whom, and the premises at which, the treatment is administered. This information provided within this Code of Practice is intended to assist officers and inform registrants about the Law, and provides information on best practice as well as specific requirements of the Law. The information is generic other than where there are specific requirements for particular activities. This document is intended to complement the Law and will be used by officers in conjunction with the Law itself. Code of Practice Page 4 of 73 Version 1.2 CHAPTER 2: PROCEDURES COVERED BY THE LAW The Law is very specific in the range of activities that it aims to control: body piercing ear piercing acupuncture electrolysis tattooing Definitions provided within the Law itself are very precise but the key issues from those definitions are as follows: body piercing is defined as the “total or partial penetration of any part of the skin other than the lower non-cartilaginous lobe of the pinna, using a needle or other implement, with the intention of creating an aperture for decorative or cosmetic purposes, including insertion through or into the skin….of decorative jewellery” ear piercing is defined as the “total or partial penetration of the lower non cartilaginous lobe of the pinna, using a needle or other implement, with the intention of creating an aperture for decorative or cosmetic purposes, including insertion through or into the skin….of decorative jewellery” tattooing is defined as “the insertion into the skin of any colouring material for decorative or cosmetic purposes” - this definition includes procedures such as cosmetic tattooing, e.g. eyebrow or lip lining and other advertised “semi-permanent make up“ as these procedures result in permanent pigmentation electrolysis is defined as the “insertion of needles into the skin in order to apply electrical current for medical or cosmetic purposes” acupuncture is defined as the “insertion of needles into the skin in order to stimulate nerve impulses for medical purposes” Table 1 provides descriptions of skin piercing, beauty treatments and other body modification procedures and indicates those procedures covered by the Law. For those procedures not covered by the Law, the following notes and links to existing information sources are provided in order to assist officers in dealing with procedures of that type. Code of Practice Page 5 of 73 Version 1.2 Table 1 – Description of procedures covered/not covered by the Law Procedure Description Covered? Notes Acupuncture the insertion of solid needles into the  skin in order to stimulate nerve impulses for medical purposes Beading Insertion of beads under skin to X Could be classed as physical create 3-dimensional effect assault and would require police investigation on case-by-case basis Bio skin jetting Injection of skin below wrinkles to X promote formation of new tissue containing young collagen and elastic fibres which fill out the wrinkle Botox Injection of Clostridium botulinum X Botox not currently licensed for toxin through the skin and into cosmetic use in UK – requires specific muscles to fill out frown lines prescription from medical practitioner Braiding Form of scarification which involves X Could be classed as physical cutting strips of skin, leaving one end assault and would require police attached, braiding adjacent strips and investigation on case-by-case re-attaching the ends of the strips to basis skin Branding Form of scarification in which hot X Could be classed as physical metal is used to burn the skin and assault and would require police scar in a desired design investigation on case-by-case basis Chiropody Treatment of problems associated X with the feet and lower limbs Collagen Injection of collagen under creased X Injections or sunken areas of the face to plump up and reduce their appearance Code of Practice Page 6 of 73 Version 1.2 Table 1 continued – Description of procedures covered/not covered by the Order Procedure Description Covered? Notes Colon Use of warm water, introduced X Hydrotherapy into the colon via the rectum, to disperse stored waste Cutting A form of scarification which X Could be classed as physical involves cutting or slitting the assault and would require skin to leave permanent police investigation on case- scarring by-case basis Ear Piercing Piercing of the ear which could  Law requirements differ for include lobe, upper cartilage, piercing of different parts of the tragus, conch or rook ear using different techniques Earlobe Stretching Gradual enlargement of an  Can be carried out on earlobe piercing. Tissue is piercings at other sites of the stretched, micro-tears are body but earlobes are most formed which are then allowed common to heal before further stretching takes place Electrolysis Removal of body hair by a  controlled electrical current to cauterise or coagulate the hair root using an electrified needle Eyebrow Piercing Insertion of jewellery through  Caution required to avoid the eyebrow nerves just below the eyebrow Genital Piercing Piercing of the clitoral hood,  labia, triangle or fochette (females) or glans, foreskin, scrotum or urethra (males) Implants Insertion of 3-dimensional X Could be classed as physical objects under skin to create assault and would require raised effect police investigation on case- by-case basis Lip Piercing Piercing of upper or lower lip X Piercing of the coloured part of area the lips is not recommended Code of Practice Page 7 of 73 Version 1.2 Table 1 continued – Description of procedures covered/not covered by the Order Procedure Description Covered? Notes Micro- Insertion of semi-permanent dye or  HELA LAC 14/1 provides pigmentation pigment into the dermis of the skin additional information on this procedure Navel Piercing Piercing of either the skin  surrounding the navel or the umbilicus Nose Piercing Piercing either through the septum  Nose piercing cannot be or nostril carried out using dedicated ear piercing guns Scarification Cutting and peeling of the skin to X Could be classed as create permanent scarring physical assault and would require police investigation on case-by-case basis Stapling Insertion of metal staples into the X Could be classed as skin physical assault and would require police investigation on case-by-case basis Surface Piercing Piercing of flat surface skin,  Very often rejected by the typically on the neck or forearms body – particularly in areas where skin is tight across piercing Tattooing Insertion of permanent dye or  Definition used within the pigment underneath the epidermis Law covers both permanent of the skin and semi-permanent tattooing (micro- pigmentation) Tongue Piercing Piercing of the central area of the  Caution is required to avoid tongue major blood vessels Code of Practice Page 8 of 73 Version 1.2 CHAPTER 3: PERSONS COVERED The Law applies to all individuals and premises offering and administering the procedures identified in Chapter 2. 3.1. Person or Premises – Registration Requirements Registration is required for both the premises from which treatments and procedures as set out in the Law are undertaken and for any individual practitioners administering any treatments or procedures. In order to clarify the requirements for a range of potential circumstances that may arise, Table 2 provides examples for illustration. Table 2 – Registration Requirements for Business Practitioners and Practitioners Situation Requirement The practitioner shall require registration both for the premises from which the business is carried on and as a practitioner and is required to comply with all conditions and requirements of registration. The registered person shall be responsible for: Self-employed business ensuring compliance with the standards in the code of operator/practitioner working practice alone within a fixed premises ensuring that any changes to the original registration applications are notified to the issuing Authority within 30 days surrendering the registration certificates to the Department if called upon to do so for the purpose of alteration The principle operator/practitioner, i.e. the one who is in charge of the premises and employs or rents out space to other practitioners, shall require registration both for the premises from which the business is carried on and as a practitioner and is required to comply with all conditions and requirements of registration. All practitioners working within the premises shall require registration. N.B. Someone who is merely a landlord and not a practitioner will Operator/Practitioner who not require registration. It is the responsibility of the person works within a fixed premises registered in respect of the premises to ensure that the premises and employs or “rents” space comply with the registration requirements. out to other practitioners Registrants are responsible for: ensuring compliance with the standards in the code of practice ensuring that any changes to the original registration application are notified to the issuing Authority within 30 days surrendering the registration certificate to the Department if called upon to do so for the purpose of alteration Code of Practice Page 9 of 73 Version 1.2 Table 2 continued – Registration Requirements for Business Practitioners and Practitioners Situation Requirement The practitioner shall require registration both for the premises from which the business is carried on and as a practitioner and is required to comply with all conditions and requirements of registration. The registered person shall be responsible for: ensuring compliance with the standards in the code of practice ensuring that any changes to the original registration Practitioners who work solely applications are notified to the issuing Authority within 30 from home days surrendering the registration certificates to the Department if called upon to do *The home shall be treated as a premises for the purposes of the registration process and should meet all requirements of the Law. The practitioner shall require registration as a practitioner and must have the prior approval of the Department and is required to comply with all conditions and requirements of the registration. The registered person shall be responsible for: ensuring compliance with the standards in the code of Practitioner who works practice peripatetically ensuring that any changes to the original registration applications are notified to the issuing Authority within 30 days surrendering the registration certificates to the Department if called upon to do Code of Practice Page 10 of 73 Version 1.2