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General Information

State of Tennessee
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Tennessee Body Art Sterilization Guidelines

1200-23-3-.04 TATTOO OPERATION

(1) Universal precautions, as defined in these rules, shall be observed to prevent contact with blood or other

potentially infectious materials. Employees shall be trained in universal precautions.

(a) Assume all human blood, plasma, serum, body fluids (semen, saliva, breast milk, vaginal secretions

and any fluid contaminated with blood) and tissues to be contaminated with Human

Immunodeficiency Virus (HIV) and/or Hepatitis viruses (e.g., HBV).

(b) The most susceptible route of occupational infection for HIV and HBV is by accidental needle

sticks, contamination of the mucous membranes, or through broken, abraded, or irritated skin. Use

appropriate caution and maximum protection to prevent such contact.

(c) Proper decontamination procedures, emergency biohazard spill management, and proper use of

biosafety equipment shall be utilized.

(d) Use aseptic technique. Thorough hand washing is essential after client contact, after handling blood

and body fluids, after wearing gloves, and prior to exiting the work area.


(Rule 1200-23-3-.04, continued)

December, 2000 (Revised) 10

(e) Needles and needle bar assemblies shall be sterilized prior to use. It is permissible to use sterilized

disposable needles and disposable needle bar assemblies for tattooing.

(f) Nondisposable needle and nondisposable needle bar assemblies shall be soaked in a disinfectant

solution for a minimum of thirty (30) minutes prior to removing the needle. Do not remove a used

needle from a needle bar by hand. Needles shall be removed from needle bars through the use of

gloves and pliers or similar means to prevent accidental puncture. Dispose of needles and other

sharps in puncture proof, autoclavable containers, or disposable biohazard containers.

(g) After soldering a new needle to the needle bar, the completed assembly (needle and needle bar) shall

be sterilized.

(h) All regulated wastes shall be disposed of in labeled, manufacturer's color-coded waste containers.

(i) A spill kit (bleach, leak proof container, paper towels, gloves, spray bottle) is to be used to clean up

infectious material spills. Small spills can be wiped up, after donning protective gloves, with paper

towels and sprayed with freshly made ten percent (10%) bleach solution.

(j) Clean all work areas and equipment used in handling human biohazardous materials with proven

disinfectant (e.g., 10% dilution of bleach) when concluding work to protect personnel from

accidental infection.

(k) Eating, drinking, smoking, and applying cosmetics or lip balm are not permitted in the work area.

Food shall be stored in cabinets or refrigerators designated and used for this purpose only. Food

storage cabinets or refrigerators shall be located outside the work area.

(l) All procedures shall be performed carefully to minimize the creation of aerosols.

(m) Report all work related accidents, incidents, and unexplained illness to your supervisor and/or

physician immediately.

(n) Used gloves shall be removed after each operation and prior to contacting work surfaces, door

knobs, wall switches, or telephones. Dispose of used gloves in a bagged, trash container.

(2) Personnel of a tattoo establishment

(a) The tattoo establishment operator shall make available, at no cost to the personnel, Hepatitis B

vaccination series, as well as any routine booster dose(s) to every person who may have

occupational exposure to blood or other potentially infectious material. For new personnel the

vaccine shall be made available within ten (10) working days of initial work assignment.

(b) Personnel who decline to accept the Hepatitis B vaccination series must sign a form indicating their


(c) The outer clothing of all personnel shall be clean.

(d) Each tattoo artist shall use a single use lap cloth.

(e) Tattoo artist/operators shall wash their hands with antiseptic soap before and after treating each

client (i.e., before glove placement and after glove removal) and after barehanded touching of

inanimate objects likely to be contaminated by blood, saliva, or respiratory secretions. Hands shall

be washed after removal of gloves, smoking, eating, drinking, or using the toilet.

(f) Tattoo artist/operators who have exudative lesions or weeping dermatitis, particularly on the hands,

shall refrain from all direct client contact and from handling equipment until the condition resolves.


(Rule 1200-23-3-.04, continued)

December, 2000 (Revised) 11

(g) Personnel shall consume food only in approved, designated areas. There shall be no eating or

drinking in the operation area of the establishment.

(h) Personnel shall not use tobacco in any form while engaged in the operation or process of tattooing,

nor while in areas used for equipment or utensil washing. Personnel shall use tobacco only in

approved, designated areas.

(i) Personnel shall maintain a high degree of personal cleanliness and shall conform to good hygienic

practices during all working periods in tattoo studios.

(3) Implementation of infection-control practices

(a) Disposable latex or vinyl examination gloves shall be worn by a tattoo artist at all times while

administering any tattoo. Gloves shall be changed and properly disposed of each time there is an

interruption in the application of a tattoo, or whenever their ability to function as a barrier is

compromised. Gloves shall be changed between clients and used gloves shall be properly disposed

of as provided in these rules.

(b) Only single use supplies (or sterilized equipment) may be used to apply a tattoo and shall be

disposed of after each tattoo. This subsection includes single use disposable razors; single use

towels or wipes; lubricants removed from a collapsible tube; and single use paper stencils or plastic

stencils soaked in a germicidal solution. If the design is drawn directly onto the skin, it shall be

applied only with a single use article. Single use or individual portions of dye and ink pots or trays

shall be used. After tattooing, single use items, dyes, and containers shall be discarded and the

tattoo work area disinfected.

(c) When it is necessary to shave the area to be tattooed, a new blade for each patron or customer shall

be used when a safety razor is employed, and the permanent part of such razor shall be treated as

hereinafter set forth for the care of the straight razor or disposable safety razor. If a straight razor is

used, it shall be cleaned with soap and water, rinsed in clear water, and then sterilized in an


(d) A sterile set of needles, needle bar, and tube shall be used for each patron or customer. Dried inks

and other materials on instruments must be removed by either ultrasonic cleanser or by soaking in

either detergent or disinfectant solution followed by rinsing in clean water prior to sterilization.

(e) All tubes, needles, and needle bars shall be sealed for individual client use in autoclave bags with a

chemical or autoclave indicator and date (month and year) of sterilization clearly visible. After

tattooing, used non-disposable instruments such as tubes shall be kept in a separate, puncture

resistant container until properly cleaned, disinfected, and sterilized using universal precautions and

recognized medical methods. The needle tube of the tattooing machine shall be cleaned and

sterilized in a similar method after use.

(f) Microbiological monitoring for adequate functioning of each autoclave will be done at least monthly

using a commercial source of Bacillus stearothermophilus which is then tested in an accredited

commercial laboratory. All laboratory reports will be logged and kept for two years and shall be

available for inspection.

(g) Upon notification of a positive microbiological monitoring report (detection of viable spores), the

sterilizer shall be immediately checked for proper use and function. A repeat test shall be performed

within three (3) days. Upon a subsequent positive result from a repeat test, discontinue use of the

sterilizer until properly serviced and a negative result obtained.


(Rule 1200-23-3-.04, continued)

December, 2000 (Revised) 12

(h) Sterilizer indicator tape and/or sterilizer bags with indicator tape areas which change color will be

used with all items sterilized to indicate the item has been autoclaved. All items shall be marked

with the date of sterilization.

(i) Sterilized items in the sealed, autoclaved bags shall be stored in a clean, dry place, until used, for no

more than one (1) year.

(j) Sterilization indicators must change color or discontinue use of autoclave until a negative spore

sample is obtained.

(k) The requirement for an autoclave shall be exempt in cases where there is only the use of

manufactured, pre-sterilized single use, preassembled needle and needle bar, disposable needles,

needle bars and needle tubes and similar tattooing equipment, and/or the use of no other equipment

or tools requiring sterilization.

(4) Minimum standards for tattooing

(a) After shaving the area to be tattooed, or if the area does not need to be shaved, the site of the tattoo

shall be cleaned with soap and water, rinsed with clean water, and germicidal solution applied or

wiped with alcohol in a sanitary manner before the design is placed on the skin.

(b) Single-use towels or gauze shall be used in preparing the site to be tattooed and shall be disposed of

after use on each patron or customer. The use of roll-on or stick deodorants for tattoo site

preparation is prohibited.

(c) Excess dye applied to the skin shall be removed with single-use gauze pads, towels, or cotton only.

The entire site shall be covered with a sterile gauze dressing or telfa pad.

(d) The stencil for transferring the design to the skin shall be maintained in a clean, sanitary condition.

(e) Records showing the date of the client’s visit, printed name, signature, address, age, design of the

tattoo, its location on the body, and tattooist’s name shall be kept on the establishment premises for

a minimum of 2 years.

(f) After each tattooing, written instructions shall be given to each patron or customer on the care of the

skin of the tattooed site to prevent infection. A copy of these instructions shall be posted in a

conspicuous place in the tattoo establishment, clearly visible to the customer or patron being

tattooed. These instructions shall include, but are not limited to, bandaging, cleaning, sun exposure,

scratching, and wearing of clothing over or around the tattoo site.

Authority: T.C.A. 4-5-202, 62-38-201 et seq., and 68-1-103. Administrative History: Original rule filed

September 26, 2000; effective December 10, 2000.

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