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Sharps must be disposed of into an approved sharps container and when full taken to an approved collection site.
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Skin Penetration Premises
The following information is intended for operators and staff of those premises on which a skin penetration activity within the meaning of the Public Health Act 1991 is carried out.
What is a Skin Penetration Procedure?
- Acupuncture
- Tattooing
- Ear piercing
- Body piercing
- Hair removal (with wax, shaving or electrolysis)
- Cosmetic enhancement or semi permanent/permanent makeup
- Colonic Lavage
What is Councils' role?
To protect public health by ensuring all operators are registered, conduct inspections of premises to ensure compliance with regulations and guidelines, maintain a public register.
Powers of entry
Environmental Health Officers have powers to enter premises to:
- Inspect premises
- Ask questions
- Inspect and test equipment
- Take samples, photos and videos
- Check records
Why do Inspections?
- Minimise the potential to spread disease such as Hepatitis
- Infection control techniques and procedures are followed
- Premises are clean and fitted out correctly
- Articles and equipment are clean and appropriate for the procedure
- Single use items are used only once
- Personal Protective Equipment is used
- Records are kept
- Premises are registered with Council
Best Practice
Single use equipment:
Pre-sterilised single use items are recommended for each skin penetration procedure. Using pre-sterilised single use equipment with the correct infection control techniques will ensure micro-organisms are not being transferred from person to person.
Hand Washing:
Hand washing and hand care are the first steps in any infection control program. Cuts and abrasions on exposed skin should be covered by a waterproof dressing and hands should always be washed before and after a treatment.
The following method is recommended for hand cleaning:
- Wet hands
- Use soap and running water
- Rub hands vigorously
- Wash hands all over including backs of hands and between fingers for at least 15-20 seconds
- Rinse hands well
- Dry hands thoroughly on single use paper towel
Gloves:
Gloves are worn as a physical barrier to protect the wearer's hands from contamination. Single use gloves must be worn at all times during a skin penetration procedure to protect both the operator and the client. The use of single use gloves does not substitute or eliminate the need to wash hands.
When not to perform skin penetration:
Skin penetration should not be performed on persons under the age of 18 without the written consent of the parent or legal guardian. It is illegal under the Children (Care and Protection) Act 1998 to tattoo a person under the age of 18 years without consent. It is also not permitted to carry out a skin penetration procedure if a person appears to be under the influence of drugs or alcohol.
Record Keeping:
In addition to any sterilisation of equipment records must be kept and should include the following information.
- Date and time
- Procedure performed
- Name and address of person
- Name of operator who performed the procedure
- Aftercare information provided
Skin preparation:
Before commencing a skin penetration procedure, skin should be wiped with a suitable antiseptic and allowed to air dry. Suitable solutions include:
- 70% W/W ethyl alcohol
- 80% V/V ethyl alcohol
- 70% V/V isopropyl alcohol
- Alcoholic (isopropyl and ethyl) formulations of 0.5 - 4% W/V chlorhexidine
- Aqueous or alcoholic formulations of povidine iodine (1% W/V available iodine)
Clothing:
A clean washable garment should be worn daily. Protective over clothes are required to be worn by all skin penetration operators and should be removed and stored in the work area before breaks for lunch, smoking, drinking and using the toilet.
Eating and drinking:
Operators must not eat or drink while attending to clients.
Animals:
It is recommended that animals not be in rooms where skin penetration procedures are performed. An exemption may be granted for companion animals used by a person with a disability.
Linen:
Clean linen, towels or garments should be used on each client. Single use paper towelling or liners can be used on benches instead of linen.
Smoking:
In August 2000 the NSW Government passed legislation that bans smoking in certain enclosed public places.
Equipment - Cleaning / Disinfection / Sterilisation
Cleaning:
All re-useable equipment must be cleaned before it is reused. Cleaning greatly reduces the microbial load on the dirty item, it is essential to clean before disinfection or sterilisation to remove all visible matter.
Good cleaning processes include:
- Moving equipment directly to an area set aside for cleaning
- Pulling equipment apart disposing of all non re-useable pieces
- Immersing equipment in warm water and detergent and scrub carefully with a clean brush to remove visible soil
- Rinse equipment in warm to hot water and allow to air dry
- Store equipment in sealed containers
Disinfection:
All re-useable equipment that penetrates the skin must be cleaned, disinfected and sterilised, disinfection helps to remove micro-organisms but is not effective unless equipment has been cleaned.
The ability of a chemical disinfectant to work properly will depend on:
- Contact time
- Chemical concentration
Sterilisation:
All re-useable equipment that penetrates the skin must be firstly cleaned, disinfected and then sterilised. Sterilisation is the killing of all micro-organisms including spores.
The recommended method for sterilisation of equipment is autoclaving, equipment must meet the requirements of AS 2182 'Sterilisers - Steam - Bench top' and be operated in accordance with AS 4815:2001.
Sterilisation depends on the following factors:
- Temperature - the correct temperature shall be maintained for the specified time
- Cleanliness - the equipment must be clean to enable sterilisation
- Circulation - the chamber must be designed to allow steam to circulate around the equipment.
It is important to remember that the following sterilisation methods should not be used:
- Boiling
- Wiping or soaking with disinfectant
- Ultraviolet light
- Pressure cookers
- Ultrasonic cleaners
- Dishwashers
- Microwave ovens
Waste Disposal
Sharps must be disposed of into an approved sharps container and when full taken to an approved collection site. Operators should:
- Ensure that there is an accessible sharps container for the disposal of sharps as close as practical to the point of generation
- Immediately dispose of sharps
- Ensure sharps container is not accessible to the public
- Ensure sharps containers are not overfilled
- Ensure sharps containers are sealed
General waste should be placed in plastic lined receptacles at the site of generation and where possible should be double bagged.
Basic Requirements for Procedures
Work Area:
Work area incorporates the treatment area and includes any workbenches, sinks and other structural items necessary to carry out the skin penetration operation. It is recommended that all work area surfaces be finished in materials that are rigid, smooth and impervious and easily cleaned and complies with Council building requirements. The work area must be maintained in a clean and hygienic state, have good lighting and clear access to a potable running water supply.
Hand Basins:
A separate hand basin, with running hot and cold water that can be mixed so the temperature reaches a minimum of 40°C must be available. The basin must be supplied with soap and single use paper towels. It is recommended that the hand basin be located within the procedure area.
Sinks:
A cleaning sink should be available in addition to the hand wash basin with running hot and cold water that can be mixed so the temperature reaches a minimum of 40°C. Sinks should be deep enough to allow equipment to be scrubbed under water.
Chemical Storage:
It is recommended that all chemicals used on the premises be stored in a cool, dry and well ventilated placed, be out of reach to visitors and preferably in a locked room or cabinet.
Provision of toilets:
The provision of a toilet that is available for use by clients is advisable for all businesses.
Mobile Operators
- Must inform the local council
- Must be registered with a home based local council
- Have access to hand washing facilities or alcohol-based antiseptic hand gels
- Carry enough single use equipment for each client
- Work area must be clean at all times
Health and the Workplace
- Workplace must be safe to work in, with working procedures that are safe to use
- Adequate staff training in safe work procedures, infection control and hygiene
- Properly maintained facilities and equipment including provision of sharps containers, personal protective equipment
- Clean and suitable work place with safe storage of chemicals
- First aid kit
- Training and management procedures for exposure to blood and body substances
Additional Information
- NSW Health Fact Sheets which can be downloaded from the NSW Health Web site.
- Council Inspection Report (download at right)
- Guidelines
If further information contact Council's Environmental Health and Customer Services Group on (02) 4780 5000.