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Steve Gulbin takes piercing equipment out of the autoclave sterelization machine at Marc’s Tattooing, Wilkes-Barre.

Aimee Dilger / The Times Leader

There are two ways of looking at a tattoo or body piercing: as a permanent piece of unique artwork or body adornment or as an open wound with the potential to become infected and cause a serious illness.

A person excited about getting a tattoo, be it his or her first or 21st, may not take the risk factor into account.

Likewise, someone getting a navel piercing may be only thinking of the diamond stud or dangling jewel that will adorn a bare midriff just in time for spring, taking for granted that the piercer her has sanitized the needle.

But both parties could head home with something in addition to that handiwork — a skin infection, a staph infection, Hepatitis B, Hepatitis C or even HIV.

These are the risk factors that face potential clients of piercing and tattoo parlors as well as the artists themselves, according to Steve Gulbin, piercer and manager of the Wilkes-Barre location of Marc’s Tattooing.

The incidence of Hepatitis C in the Luzerne County area is skyrocketing, according to Mark Innocenzi, director of health and safety at the Wilkes-Barre chapter of the American Red Cross. And while there is no way of breaking down that number to find out the causes, he is sure much of it can be attributed to unsafe piercings and tattoos. “The risk components are frightening,” he said. “You see so many teens heavily tattooed and pierced, and you know that they’re underage and they have to be getting it done somewhere. And you know that it’s not being done safely.”

The body art may be applied by untrained staff, in unsanitary establishments or underground in someone’s home, where needles are shared and not disinfected beforehand and where used items are simply tossed into a wastebasket.

“When you’re talking about piercing and tattooing, there is blood,” said Innocenzi. “You are going into another layer of the skin. And there is clear fluid under the skin that is released when someone is tattooed.”

That is why the American Red Cross teaches a course on blood-borne pathogens for many industries, including tattoo parlors. Blood involves its components and products made from blood, like plasma. Blood-borne pathogens means pathogenic microorganisms that are present in human blood and can cause disease in humans. These pathogens include, but are not limited to, Hepatitis B, Hepatitis C and HIV.

The training session, which lasts for three hours, teaches body artists how to deal with blood spills, removal of gloves, disposal of needles and bandages and how to react during a risk situation.

Gulbin offers this grim assessment: “I treat every client like he has HIV,” said the piercer, who changes gloves about five or six times during the course of a session with a single customer.

He teamed up with Innocenzi recently to present a body art safety education program to local college students. Lest anyone think that Innocenzi is against the art of tattooing, he’ll contradict that by rolling up his sleeve and showing you his tattoos.

The pair had also pitched the program to the local high schools, but it did not go forward out of reluctance on the part of educators to be perceived as promoting body art.

On the contrary, counters Innocenzi, who feels the idea of having a tattoo parlor worker talk to students gives him street-credibility among the youth. “If you have someone who is in the business of doing tattoos tell you what you should and shouldn’t look out for, you’re going to sit up and listen,” he said. “What we wanted to do was empower the kids with knowledge about the health risks.”

“The kids aren’t listening and they’re still rolling up their sleeves to get work done,” said Gulbin. “Since tattoos are so popular these days, more and more teens are going to parlors which don’t adhere to not tattooing minors or doing it themselves.”

Marc’s Tattooing is the only local tattoo and piercing parlor that may display the American Red Cross logo in its shop, according to Innocenzi. “The degree with which we have such a good relationship with a tattoo parlor is rare,” he said.

Marc’s staff members are all certified in CPR, first aid and blood-borne pathogens.

The only law on the books in the commonwealth regarding tattoos and tattoo parlors deals with age requirements. Pennsylvania Tattoo Law 4729 Tattooing Minors states: “Whoever tattoos any person under the age of eighteen (18) years without the consent of the living parents, or of the legal guardian thereof, if such minor is under the care of a guardian, is guilty of a misdemeanor, and shall, upon conviction thereof, be sentenced to pay a fine of not more than one hundred dollars ($100), or to undergo imprisonment of not more than three (3) months, or both.”

There are no regulations mandating sanitary conditions of an establishment, proper sterilization techniques or disposal of materials, according to Innocenzi. And there is no recourse if a client comes away from a tattoo parlor with a serious infection.

While someone interested in tattooing must be at least 18 years of age, a person wishing a piercing must be at least 16 years old, with a state-issued photo identification card, either a driver’s license, non-driver’s identification, military identification or passport, said Gulbin regarding his studio’s policy. School ID cards are not allowed. A parent must accompany the minor to the studio and show his state-issued photo ID card. He must also show a birth certificate with both child’s and parent’s name on it or a legally notarized document proving guardian rights.

Gulbin said that if a teen shows up at the studio without proof of age, that person is turned away.

There is also no city ordinance regarding the safety of tattoo parlors, said Innocenzi. What most people don’t realize is that tattoo parlors do not get regular inspections from the Pennsylvania Department of Health as do beauty salons.

No one is more in favor of stricter body art regulations than Gulbin. “I’ve actually lobbied for stronger laws,” he said. “I met with Wilkes-Barre City officials to try to get tougher laws on the books. I know kids are getting the work done somewhere and it’s not here. I see them with all the piercings in their ears, noses and tongues and the sleeves of tattooing and I know that they’re not being done at our place. They’re either being done at another parlor ignoring the law or underground at someone’s house.”

Gulbin said one of the most important things a tattoo parlor should do is practice hygiene. An artist should thoroughly wash his hands with antibacterial solution immediately before and after each tattoo application. He should pour a new ink supply into a new disposable container. He should wear new latex gloves before the tattooing procedure. The artist and piercer should use single-service materials and equipment for each individual.

The instruments, like the needle and tube set, should be individually packaged, dated and sealed. The needles should be sterile and disposable. “The needles permeate the skin,” said Gulbin. “So they are single use and we throw them away.”

Even forceps for piercing must be soaked in a sanitizing solution. The workspace should be sanitized with an EPA-approved verdical disinfectant.

“Sterilization is the first three months of any apprenticeship for a tattoo artist,” said Gulbin. “You just clean and sterilize everything. And you have to learn the ins and outs of germs.”

The artist should thoroughly rinse the tube and the needle set from the tattoo machine using an ultrasonic tank before discarding it. He must properly dispose of the contaminated materials.

The single most important piece of equipment in a tattoo parlor is the autoclave machine. This is essentially a pressure cooker for sterilizing medical instruments. An autoclave, which costs about $3,000, must maintain a temperature of at least 246 degrees for 30 minutes in order to fully sterilize the equipment.

There are two major types of autoclave sterilizers — steam and chemical. Most dentists use chemi-claves, but steam is really the only kind acceptable in the tattoo field. Autoclaves need to be regularly tested to ensure that they are working properly. “All equipment that is used and reused must be autoclaved,” said Gulbin

The piercer said he knows many teens are bypassing the sterilization process because no one can afford to purchase such a machine and keep it in their residence. He feels many teens are taking major short-cuts which can impair their lives. “Just opening up a package of new needles is not enough,” he stressed. “Just because something is in a plastic bag doesn’t mean that it was sterilized. I always tell someone just because I seal something in a plastic bag doesn’t make it germ-free.”

Kitchen pressure cookers do not reach the temperature or pressure required to effectively kill all blood-borne pathogens, so even if someone was doing piercing or tattooing out of his home, the instruments would not be properly sterilized.

Gulbin cautions any artist must also be aware of cross-contamination. In the way that a cook should not place another food item on a cutting board that has been touched by raw meat, a piercer or tattooer must be careful where he places the instruments or what he touches in between the session. “Everything that touches that person’s skin must be sterile,” said Gulbin. “Even if you’re wearing gloves and touch something else, you risk contamination.”

He also feels many tattoo parlors have taken shortcuts in the training of their staff. “There are greater risks because it’s like wanting to be a rock star, where you just pick up a guitar,” he said. “We have people out there who pick up a machine and start tattooing people. I have people who get trained in my shop who stay as an apprentice for two years. At other places, they’re practicing on human beings.”

Another reason to be careful about just who does your work isn’t that it might end up looking shoddy, it may end up hurting. “When you are tattooing, you are puncturing the second and third layer of skin,” said Gulbin. “A non-professional doesn’t know how deep to go and may hit something.”

Spring is usually the busiest time for tattoo parlors, according to Gulbin, since it is a time for wearing barer clothing which shows off piercing and artwork and since many students have some extra money to spend, thanks to income tax refunds.

Marc’s Tattooing will do only basic piercing, like ears, nostrils, lips — “nothing below the belt.” Popular areas for tattoos are the upper arm and shoulder for men and the foot or lower back for women.

Innocenzi is still hopeful that the Red Cross can present a body art safety program in area high schools next year. “A lot of these kids don’t understand what a commitment of getting a tattoo means,” he said. “It’s there forever. When you hit 25 or 30 and you go for a job interview, you better be certain that it’s done tastefully and it’s what you want, where you want it.”

And, adds Gulbin: “If you want it done safely and the right way, you’ll wait.”

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