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Washington Body Art Sterilization Guidelines

Date of Adoption: February 17, 2002.

Purpose: These rules implement RCW 70.54.340 which directs the Department
of Health (DOH) to protect the public's health by adopting sterilization
procedures and infection control standards for electrology and tattooing.

Statutory Authority for Adoption: RCW 70.54.340.

Adopted under notice filed as WSR 02-02-076 on December 31, 2001.

Changes Other than Editing from Proposed to Adopted Version: Based on
written comments as well as comments and discussion heard at the public hearing for
adoption, the department has separated the standards for electrology and
tattooing within WAC 246-145-020 and 246-145-030.

In addition, the department added clarifying language regarding cleaning and
disinfecting countertops, vacuuming and cleaning flooring and the frequency
of spore tests for sterilizers. The department also revised the small business
economic impact statement and cost benefit analysis based on comment. The
department doubled the number of business surveys, and included additional
research on medical impacts of electrology and tattooing. Individuals may
obtain copies of the revised analyses by contacting Anh Berry at 1107 Eastside
Street, Olympia, WA 98504-7879, phone (360) 236-4028.

Revised Small Business Economic Impact Statement

I. What Does the Rule or Rule Amendment Require? The proposed rule sets
standards for electrology and tattooing to prevent transmission of bloodborne
pathogens such as HIV, Hepatitis B, and possibly Hepatitis C Virus. The
standards require prevention behaviors for personnel, sterile equipment, and
needles. The requirements lay out a set of procedures for different types of
circumstances. The proposed procedures include the universal precautions for
infection control recommended by the United States Center for Disease Control
and Prevention, the Alliance of Professional Tattooists, and the National
Environmental Health Association.

The proposed standards require that basic hygienic conditions and
sterilization equipment be maintained through:
. Regular cleaning and disinfecting of walls, floors, and other frequently
touched surfaces such as, equipment, lamps;
. Hand washing;
. Use of fresh, unpunctured gloves for contact [with] each client to prevent
exposure to blood and body fluids, mucous membranes, nonintact skin of all
clients, and surfaces soiled with blood or body fluids;
. Precautions to prevent injuries caused by needles and other sharp instruments
or devices during procedures when cleaning[,] disposing of or handling sharp
instruments;
. Using puncture-resistant containers for sharps disposal;
. Using band aids with gloves if personnel have small unhealed sores;
. Assuring that sterilizers have a thermometer and timer to indicate whether
adequate heat has been applied to packaged equipment;
. Using or checking chemical indicators for each package to assure the items
have been exposed to the sterilization process; and
. Monitoring sterilizers at least once a month with commercial preparations
of spores intended specifically for the type of sterilizer being monitored.

The proposed standards require the use of clean and sterile needles and
sharps. Specific needle and sharps related actions include:
. Using only single-use, disposable needles and sterile sharp items and
instruments;
. Using single-use items on only one client. Single-use items must be disposed
of immediately in a puncture-resistant container;
. Thoroughly cleaning and sterilizing reusable sharp items and instruments
in an autoclave or dry-heat sterilizer between clients;
. Resterilizing instruments or sharps that have been potentially
contaminated by dropping or touching an unsterile surface, by torn, punctured, damaged, or
wet packaging; and
. Discarding any single use item that has been potentially contaminated by
dropping or touching an unsterile surface, by torn, punctured, damaged, or
wet packaging or if the expiration date is expired.

Violations are a misdemeanor and an individual (or violator) may therefore be
subject to penalties of up to ninety days imprisonment and/or $ 1,000 under RCW
9.92.020.
II. What industries are affected? Standard Industrial Classification (SIC)
Code 7299 Miscellaneous Personal Services, Not Elsewhere Classified, contains
both Electrolysis and Tattooing. The average size of the largest 10% of
businesses [*111] in this sector is 19.13 employees and the average size of
the remaining businesses is 4.1 employees.
[A> AVERAGE EMPLOYMENT <A]
Number Total Employ- Small Large
Of Firms ment Business Business
7299 Misc. 530 2,668 4.10 19.13
personal services

III. What are the costs? The Department of Health used a survey of
sixty-one establishments to estimate the costs of the rule. To estimate the potential
cost to firms that may need to adjust their procedures, staff used the
information from firms that are already in compliance with universal precautions for
infection control.

Most shops surveyed reported compliance with all parts of the rule. A few
shops reported they would need to change some practices. The average cost of
compliance for tattoo and electrology shops that are not currently in compliance
with the three reported problem requirements would be $ 16,000 per year.

The rule will have no impact on 93% of the shops interviewed because they
are already in compliance. 6.8% of the companies reported being out of compliance
with one provision.<1>

The following list of provisions indicates the costs by type for each part of
the rule.
. Equipment:
a. Companies may need to replace equipment such as tables or surfaces that
cannot be sterilized. None of the companies interviewed will need to do
this.
b. Companies may need to purchase equipment to sterilize their materials. 3%
of the electrology shops interviewed will need to purchase sterilization equipment.
c. Companies may need to purchase a container for sharps. None of the
companies interviewed will need to purchase a container for sharps.

The companies that need to purchase equipment such as sterilization equipment
will experience an average reported cost of $ 250.
. Supplies and testing services:
a. Companies that do not use gloves will have to purchase gloves. All
respondent companies already use gloves.
b. Companies that do not use disposable needles must shift to disposable
needles. All companies reported using disposable needles already. The average
cost of disposable needles is $ 11,000 per year for a full time tattoo artist
and $ 4,000 per year for a full time electrologist.<2>
c. Companies that use a sterilizer will have to purchase testing chemicals
and/or spores. All but one company cleans and tests their equipment. The
added cleaning, testing and record-keeping costs were reported to average $ 282
per year.<3> The rule has been revised based on comment so that monthly testing
is no longer mandatory, but testing will be done based on a manufacturer's
recommendation. This evaluation is still based on monthly testing because
the survey data was collected using that basis. In hearings, tattoo artists
reported a higher frequency and all tattoo artists surveyed do testing.
Electrologists reported a lower frequency of testing during the hearing. Thus the costs
estimated here are probably overstated. 4% of electrologists responded that
they do not test and the costs are estimated for those shops as if they would
test once a month.

Companies which both shift to disposable needles and shift to purchasing
chemicals or spores and testing themselves or purchasing testing services will
experience costs of about $ 11,700 per year.
. Labor Costs: Most labor costs are already incorporated into some of the
activities covered above. (ex. Cleaning and testing of equipment can be done
in-house or a service can be hired.) Only the remaining labor costs are covered
below.

Companies that do not require that employees wash their hands before and
after handling clients and after handling nonsterile equipment will now have
to do so. The average annual reported costs for hand washing was $ 4400.<4>
. Increased administrative costs were not reported.
. Lost sales or revenue were not reported. 6% of the respondents expect that
the regulation may increase the number of clients. This potential value increase
was not calculated.

IV. Is the Cost Disproportionate? This rule has been reviewed and has
been found to have a disproportionate impact on small businesses.

Average employment in SIC 7299 does not reflect the likely pattern of
employment in the electrology and tattoo shops affected by this rule. All the
companies appear to have only one proprietor. Shops with multiple workstations
simply rent workstations to the staff in the shop. However, all the workstations
share the sterilization mechanisms offered by the shop. If a shop were to have
multiple work stations, whether or not they are employees, it would
automatically have economies of scale.

A worst-case analysis with full noncompliance, for all three reported problem
areas, at a small and a large firm, with average employment in the SIC, would
indicate disproportionate costs given average costs of $ 16,221 per year.

Worst-case analysis for SIC Code 7299.

Miscellaneous Personal Services, Not Elsewhere Classified
Small Large
Business Business
Average Employment 4.10 19.13
Average cost per employee $ 3,956 $ 848

It is important to recognize that most companies already comply with the
rule in response to customer concerns regarding their procedures. Most companies
that did not follow a procedure were only missing one procedure. Only one
respondent did not follow two procedures. Thus the costs above are explicit
overestimates used to form a worst case scenario. The department extrapolated the expected
costs to the 618 companies based on current reported compliance levels.
[*112] The total extrapolated cost of the rule to the state is $ 162,000 in the
first year and $ 159,000 per year thereafter.

V. What Cost Minimizing Features Were Included? The department reduced
the costs of the rule by not including expensive requirements with lower
potential benefits.

A. Reducing, modifying, or eliminating substantive regulatory
requirements. DOH did not include all the requirements from the US Center for Disease
Control and Prevention, the Alliance of Professional Tattooists and the National
Environmental Health Association. Based on cost analysis of the rule and
public comment the DOH has eliminated or modified the following from the proposed
rule:
. Require monthly testing of sterilization equipment
. Allowing bandages and gloves for practitioners with small sores or wounds
. Sterile walls and floors
. Daily cleaning was converted to a regular cleaning

Based on cost considerations DOH did not include the following in the
proposed rule:
. All surfaces should be hard and smooth
. Require a germicide protection barrier
. No carpet should be allowed in the building
. Require a sink and autoclave at each unit
. Require disposable razors
. Prohibit reuse of ink

B. Simplifying, reducing, or eliminating record-keeping and reporting
requirements. The record-keeping requirements were limited to three years.
The department did not propose reporting requirements to evaluate compliance
with sterilization standards.

C. Reducing the frequency of inspections. No inspections are scheduled.

D. Delaying compliance timetables. It is not feasible to delay the
compliance timetable. Over 90% of the companies want this rule to be in place and
expect a greater client base to evolve in response to the new rules.

E. Reducing or modifying fine schedules for noncompliance. It is not possible
to reduce or modify the fines or penalties for noncompliance because they are
set in law.

VI. How Will You Involve Small Business in the Rule Making? The DOH
identified 618 possible electrology and tattoo shops. The DOH sent copies of
the draft rule to all the affected businesses and other interested parties for
comment and they were invited to the hearing. Staff also called sixty-one
companies as part of a survey to collect cost data and feedback on the rule.
All of the companies in the sample turned out to be small businesses.

Number of Sections Adopted in Order to Comply with Federal Statute: New
0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0,
Repealed 0; or Recently Enacted State Statutes: New 5, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0,
Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended
0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform
Agency Procedures: New 0, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended
0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other
Alternative Rule Making: New 5, Amended 0, Repealed 0.

Effective Date of Rule: Thirty-one days after filing.
May 7, 2002
Mary C. Selecky
Secretary

NEW SECTION

WAC 246-145-001 Purpose and scope. These rules establish standard universal
precautions for preventing the spread of diseases by using sterilization
procedures and infection control in the commercial practices of electrology
and tattooing.

Date: April 16, 2001
FOR IMMEDIATE RELEASE
Contact: Rep. Tom Campbell, 360-786-7912

Sterilization standards for tattooing pass Legislature

OLYMPIA -- Rep. Tom Campbell's bill to establish statewide sterilization standards for tattooing and electrolysis has passed the Legislature and now heads for Gov. Gary Locke's desk. The House today concurred with an amendment added last week by the Senate when it approved House Bill 1042.

"Tattooing involves breaking the skin, which means it can spread blood-borne diseases like hepatitis, tuberculosis, syphilis, warts and HIV. Considering how popular tattoos have become, our state needs to have enforceable statewide standards for sterilizing the needles and other instruments that are used," said Campbell, R-Roy, who is co-chair of the House Health Care Committee.

It will be a misdemeanor to violate the new standard.

The state Department of Health supported the measure, which passed the House and Senate unanimously. The Senate amendment requiring House members' agreement would consider violations of the standard to be negligence, from a civil standpoint.

If Locke does not sign the bill within 20 days, it becomes law automatically

HOUSE BILL 1042 _____________________State of Washington 57th Legislature 2001 Regular Session By Representatives Campbell, Schual-Berke, Skinner, Haigh and Lantz Read first time 01/12/2001. Referred to Committee on Health Care. *1 AN ACT Relating to sterilization procedures in the commercial *2 practices of electrology and tattooing; amending RCW 18.130.040; *3 and adding new sections to Title 70 RCW. *4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON: *5 {+ NEW SECTION. +} Sec. 1. A new section is added to Title 70 RCW to *6 read as follows: *7 The legislature finds and declares that the practices of *8 electrology and tattooing involve an invasive procedure with the *9 use of needles and instruments which may be dangerous when 10 improperly sterilized presenting a risk of infecting the client 11 with bloodborne pathogens such as HIV and Hepatitis B. It is in the 12 interests of the public health, safety, and welfare to regulate 13 the sterilization procedures in the commercial practices of 14 electrology and tattooing in this state. 15 {+ NEW SECTION. +} Sec. 2. A new section is added to Title 70 RCW to 16 read as follows: p. 1 HB 1042 *1 The definitions in this section apply throughout sections 1, 3, *2 and 4 of this act unless the context clearly requires otherwise. *3 (1) "Electrologist" means a person who practices the business *4 of electrology for a fee. *5 (2) "Electrology" means the process by which hair is *6 permanently removed through the utilization of solid needle/probe *7 electrode epilation, including thermolysis, being of shortwave, *8 high frequency type, and including electrolysis, being of galvanic *9 type, or a combination of both which is accomplished by a 10 superimposed or sequential blend. 11 (3) "Tattoo artist" means a person who practices the business 12 of tattooing for a fee. 13 (4) "Tattooing" means the indelible mark, figure, or decorative 14 design introduced by insertion of nontoxic dyes or pigments into 15 or under the subcutaneous portion of the skin upon the body of a 16 live human being for cosmetic, medical, or figurative purposes. 17 {+ NEW SECTION. +} Sec. 3. A new section is added to Title 70 RCW to 18 read as follows: 19 The secretary of health shall adopt by rule requirements for 20 the sterilization of needles and instruments by electrologists and 21 tattoo artists in accordance with nationally recognized 22 professional standards. The secretary shall consider the universal 23 precautions for infection control, as recommended by the United 24 States centers for disease control, and guidelines for infection 25 control, as recommended by the national environmental health 26 association and the alliance of professional tattooists, in the 27 adoption of these sterilization requirements. 28 {+ NEW SECTION. +} Sec. 4. A new section is added to Title 70 RCW to 29 read as follows: 30 A violation of rules adopted under section 3 of this act 31 constitutes unprofessional conduct under RCW 18.130.180. The 32 procedures, and sanctions to the extent appropriate, of the 33 uniform disciplinary act, chapter 18.130 RCW, govern the 34 discipline of persons under this section and sections 1 through 3 35 of this act. The secretary shall act as the disciplining authority 36 under this section and sections 1 through 3 of this act. HB 1042 p. 2 *1 *2 Sec. 5. RCW 18.130.040 and 1999 c 335 s 10 are each amended to *3 read as follows: *4 (1) This chapter applies only to the secretary and the boards *5 and commissions having jurisdiction in relation to the professions *6 licensed under the chapters specified in this section. This chapter *7 does not apply to any business or profession not licensed under *8 the chapters specified in this section. *9 (2)(a) The secretary has authority under this chapter in 10 relation to the following professions: 11 (i) Dispensing opticians licensed under chapter 18.34 RCW; 12 (ii) Naturopaths licensed under chapter 18.36A RCW; 13 (iii) Midwives licensed under chapter 18.50 RCW; 14 (iv) Ocularists licensed under chapter 18.55 RCW; 15 (v) Massage operators and businesses licensed under chapter 16 18.108 RCW; 17 (vi) Dental hygienists licensed under chapter 18.29 RCW; 18 (vii) Acupuncturists licensed under chapter 18.06 RCW; 19 (viii) Radiologic technologists certified and X-ray technicians 20 registered under chapter 18.84 RCW; 21 (ix) Respiratory care practitioners licensed under chapter 22 18.89 RCW; 23 (x) Persons registered or certified under chapter 18.19 RCW; 24 (xi) Persons registered as nursing pool operators under chapter 25 18.52C RCW; 26 (xii) Nursing assistants registered or certified under chapter 27 18.88A RCW; 28 (xiii) Health care assistants certified under chapter 18.135 29 RCW; 30 (xiv) Dietitians and nutritionists certified under chapter 31 18.138 RCW; 32 (xv) Chemical dependency professionals certified under chapter 33 18.205 RCW; 34 (xvi) Sex offender treatment providers certified under chapter 35 18.155 RCW; 36 (xvii) Persons licensed and certified under chapter 18.73 RCW 37 or RCW 18.71.205; p. 3 HB 1042 *1 (xviii) Persons registered as adult family home providers and *2 resident managers under RCW 18.48.020; *3 (xix) Denturists licensed under chapter 18.30 RCW; *4 (xx) Orthotists and prosthetists licensed under chapter 18.200 *5 RCW; (({- and -})) *6 (xxi) Surgical technologists registered under chapter 18.215 *7 RCW{+ ; and +} *8 {+ (xxii) Electrologists and tattoo artists pursuant to sections 1 +} *9 {+ through 4 of this act +}. 10 (b) The boards and commissions having authority under this 11 chapter are as follows: 12 (i) The podiatric medical board as established in chapter 18.22 13 RCW; 14 (ii) The chiropractic quality assurance commission as 15 established in chapter 18.25 RCW; 16 (iii) The dental quality assurance commission as established in 17 chapter 18.32 RCW; 18 (iv) The board of hearing and speech as established in chapter 19 18.35 RCW; 20 (v) The board of examiners for nursing home administrators as 21 established in chapter 18.52 RCW; 22 (vi) The optometry board as established in chapter 18.54 RCW 23 governing licenses issued under chapter 18.53 RCW; 24 (vii) The board of osteopathic medicine and surgery as 25 established in chapter 18.57 RCW governing licenses issued under 26 chapters 18.57 and 18.57A RCW; 27 (viii) The board of pharmacy as established in chapter 18.64 28 RCW governing licenses issued under chapters 18.64 and 18.64A RCW; 29 (ix) The medical quality assurance commission as established in 30 chapter 18.71 RCW governing licenses and registrations issued 31 under chapters 18.71 and 18.71A RCW; 32 (x) The board of physical therapy as established in chapter 33 18.74 RCW; 34 (xi) The board of occupational therapy practice as established 35 in chapter 18.59 RCW; 36 (xii) The nursing care quality assurance commission as 37 established in chapter 18.79 RCW governing licenses issued under 38 that chapter; HB 1042 p. 4 *1 (xiii) The examining board of psychology and its disciplinary *2 committee as established in chapter 18.83 RCW; and *3 (xiv) The veterinary board of governors as established in *4 chapter 18.92 RCW. *5 (3) In addition to the authority to discipline license holders, *6 the disciplining authority has the authority to grant or deny *7 licenses based on the conditions and criteria established in this *8 chapter and the chapters specified in subsection (2) of this *9 section. This chapter also governs any investigation, hearing, or 10 proceeding relating to denial of licensure or issuance of a license 11 conditioned on the applicant's compliance with an order entered 12 pursuant to RCW 18.130.160 by the disciplining authority. 13 (4) All disciplining authorities shall adopt procedures to 14 ensure substantially consistent application of this chapter, the 15 Uniform Disciplinary Act, among the disciplining authorities 16 listed in subsection (2) of this section. --- END --- p. 5 HB 1042

WAC 296-17-714 Classification 6501.

6501-00 Barber shops
Applies to establishments engaged in providing barber and hair cutting services which may be performed in the shop, at the customer's home, or in hospitals. Barber services contemplated by this classification include, but are not limited to, shampooing and cutting hair, shaving or trimming mustaches or beards, and facials. Unique to this industry is the "booth renter." A booth renter performs cosmetology, barbering, or manicuring services in a shop, but is not an employee of the shop owner. They pay a fee for the use of the shop's booth and facilities. Classification 6501-00 applies to booth renters who elect optional coverage. This classification includes clerical office and sales personnel.

6501-01 Beauty parlors; sun tanning parlors
Applies to establishments engaged in providing beauty parlor or sun tanning parlor services which may be performed at the shop, at the customer's home, or in hospitals. Beauty parlor services contemplated by this classification include, but are not limited to, shampooing, cutting, styling or dyeing hair, manicures, pedicures, facials, and the use of body toning equipment. Indoor sun tanning booths may be operated as part of a beauty shop or conducted as a separate business. Unique to this industry is the "booth renter." A booth renter performs cosmetology, barbering, or manicuring services in a salon, but is not an employee of the salon owner. They pay a fee for the use of the salon's booth and facilities. Classification 6501-01 applies to booth renters who elect optional coverage. This classification includes clerical office and sales personnel.
This classification excludes establishments engaged exclusively as nail salons which are to be reported separately in classification 6501-02.

6501-02 Cosmetologists and electrolysis studios; tattoo parlors; nail salons
Applies to establishments engaged in cosmetology and electrolysis services and to tattoo parlors or nail salons. Cosmetologists provide personalized instructions on the application of cosmetics. Some offer "permanent cosmetic" services such as, but not limited to, application of permanent eyeliner or restructuring eyebrows. Electrolysis involves the removal of facial or body hair by destroying hair roots with an electrified needle. Nail salons may specialize in the application of artificial fingernails. This classification includes clerical office and sales personnel.

[Statutory Authority: RCW 51.16.035. 98-18-042, § 296-17-714, filed 8/28/98, effective 10/1/98; 85-24-032 (Order 85-33), § 296-17-714, filed 11/27/85, effective 1/1/86; 85-06-026 (Order 85-7), § 296-17-714, filed 2/28/85, effective 4/1/85; 83-24-017 (Order 83-36), § 296-17-714, filed 11/30/83, effective 1/1/84; Order 73-22, § 296-17-714, filed 11/9/73, effective 1/1/74.]

S-0625.1
_______________________________________________

SENATE BILL 5138
_______________________________________________

State of Washington 56th Legislature 1999 Regular Session

By Senator Roach

Read first time 01/13/1999. Referred to Committee on Health & Long Term Care.

AN ACT Relating to regulating body art facilities; amending RCW 43.20.050; adding a new section to chapter 70.05 RCW; and creating a new section.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

{+ NEW SECTION. +} Sec. 1. The legislature finds that members of the public are obtaining body art including tattooing and body piercing. Body art involves procedures where the skin is broken and the chance for exposure to virus and infection exists. These procedures involve health risks, some of which are significant because of bloodborne pathogens contained in blood and other bodily fluids and the exposure to contaminated waste. Although many providers of body art, including tattooing and body piercing, maintain sufficient health and safety standards and use proper techniques that protect and promote public health and the health and safety of members of the public, others do not. Currently, members of the public have no way of knowing which body artists and facilities are fully qualified to perform these invasive procedures. While significant work has been done by many providers as a group and individually to develop and implement health and safety standards, intervention by state and local health authorities is needed to protect the public's health and safety.

Sec. 2. RCW 43.20.050 and 1993 c 492 s 489 are each amended to read as follows:
(1) The state board of health shall provide a forum for the development of public health policy in Washington state. It is authorized to recommend to the secretary means for obtaining appropriate citizen and professional involvement in all public health policy formulation and other matters related to the powers and duties of the department. It is further empowered to hold hearings and explore ways to improve the health status of the citizenry.
(a) At least every five years, the state board shall convene regional forums to gather citizen input on public health issues.
(b) Every two years, in coordination with the development of the state biennial budget, the state board shall prepare the state public health report that outlines the health priorities of the ensuing biennium. The report shall:
(i) Consider the citizen input gathered at the forums;
(ii) Be developed with the assistance of local health departments;
(iii) Be based on the best available information collected and reviewed according to RCW 43.70.050 (({- and recommendations from the council -}));
(iv) Be developed with the input of state health care agencies. At least the following directors of state agencies shall provide timely recommendations to the state board on suggested health priorities for the ensuing biennium: The secretary of social and health services, the health care authority administrator, the insurance commissioner, the superintendent of public instruction, the director of labor and industries, the director of ecology, and the director of agriculture;
(v) Be used by state health care agency administrators in preparing proposed agency budgets and executive request legislation;
(vi) Be submitted by the state board to the governor by January 1 of each even-numbered year for adoption by the governor. The governor, no later than March 1 of that year, shall approve, modify, or disapprove the state public health report.
(c) In fulfilling its responsibilities under this subsection, the state board may create ad hoc committees or other such committees of limited duration as necessary.
(2) In order to protect public health, the state board of health shall:
(a) Adopt rules necessary to assure safe and reliable public drinking water and to protect the public health. Such rules shall establish requirements regarding:
(i) The design and construction of public water system facilities, including proper sizing of pipes and storage for the number and type of customers;
(ii) Drinking water quality standards, monitoring requirements, and laboratory certification requirements;
(iii) Public water system management and reporting requirements;
(iv) Public water system planning and emergency response requirements;
(v) Public water system operation and maintenance requirements;
(vi) Water quality, reliability, and management of existing but inadequate public water systems; and
(vii) Quality standards for the source or supply, or both source and supply, of water for bottled water plants.
(b) Adopt rules and standards for prevention, control, and abatement of health hazards and nuisances related to the disposal of wastes, solid and liquid, including but not limited to sewage, garbage, refuse, and other environmental contaminants; adopt standards and procedures governing the design, construction, and operation of sewage, garbage, refuse and other solid waste collection, treatment, and disposal facilities;
(c) Adopt rules controlling public health related to environmental conditions including but not limited to heating, lighting, ventilation, sanitary facilities, cleanliness and space in all types of public facilities including but not limited to food service establishments, schools, institutions, recreational facilities and transient accommodations and in places of work;
(d) Adopt rules for the imposition and use of isolation and quarantine;
(e) Adopt rules for the prevention and control of infectious and noninfectious diseases, including food and vector borne illness, and rules governing the receipt and conveyance of remains of deceased persons, and such other sanitary matters as admit of and may best be controlled by universal rule; and
(f) Adopt rules for accessing existing data bases for the purposes of performing health related research.
(3){+ (a) The state board of health may adopt rules for the purpose of permitting local health jurisdictions to regulate body art operators and body art facilities. These rules shall establish requirements regarding:
(i) Minimum standards for facility cleanliness and education of body artists;
(ii) Incorporation of national standards as developed by nationally recognized organizations with extensive expertise in body art; (iii) Knowledge and practice by operators of universal precautions, and requirements for sanitation, personal hygiene, sterilization, and aftercare requirements to prevent transmission of disease;
(iv) Appropriate exemptions for physicians and other medical personnel performing within their legal scope of practice;
(v) Requirements for disclosure of the health risks, aftercare requirements, and contacts at the local health department to whom complaints or inquiries may be addressed to customers or potential customers of body art. +}
{+ (b) For the purposes of this subsection:
(i) "Body art" means the practice of physical body adornment by body piercing, tattooing, branding, and scarification. "Body art" does not include practices that are considered medical or nursing procedures, such as implants under the skin that are within the licensed professionals' scope of practice;
(ii) "Body art facility" means a place or premise, whether public, private, temporary, or permanent in nature or location, where the practices of body art are performed, even if no compensation is received;
(iii) "Body piercing" means any method of piercing or invading the skin or mucosa, except an ear lobe, in order to place any object or forms of jewelry through the skin or mucosa. "Body piercing" does not include practices that are considered medical or nursing procedures, such as implants under the skin that are within the licensed professionals' scope of practice;
(iv) "Jewelry" means a personal ornament inserted into a pierced area. "Jewelry" must be: Made of surgical implant grade steel or other appropriate metal, including gold; free of nicks, scratches, or irregular surfaces; and properly sterilized before insertion. Ear studs are not considered jewelry for the purposes of this subsection;
(v) "Operator" means a person who controls, operates, manages, conducts, or practices body art activities and who is responsible for compliance with this chapter, whether or not the person actually performs body art. "Operator" includes a technician who performs body art under the direction of an operator; and
(vi) "Tattooing" means any method of placing ink or other pigment into or under the skin or mucosa, by the aid of needles or any other instrument used to puncture the skin, resulting in permanent coloration of the skin or mucosa.
(4) +} The state board may delegate any of its rule-adopting authority to the secretary and rescind such delegated authority.
(({- (4) -})) {+ (5) +} All local boards of health, health authorities and officials, officers of state institutions, police officers, sheriffs, constables, and all other officers and employees of the state, or any county, city, or township thereof, shall enforce all rules adopted by the state board of health. In the event of failure or refusal on the part of any member of such boards or any other official or person mentioned in this section to so act, he shall be subject to a fine of not less than fifty dollars, upon first conviction, and not less than one hundred dollars upon second conviction.
(({- (5) -})) {+ (6) +} The state board may advise the secretary on health policy issues pertaining to the department of health and the state.

{+ NEW SECTION. +} Sec. 3. A new section is added to chapter 70.05 RCW to read as follows:
(1) The local public health officer, under powers and duties provided in RCW 70.05.070, may establish a program to regulate body art operators and body art facilities, based on standards adopted by rule by the state board of health.
(2) Local public health officers may develop their own standards, if the standards are not less rigorous than those developed by the state board of health.
(3) Local public health officers may charge a fee or fees to body art facilities and artists sufficient to cover the expenses of their regulatory program under this chapter, but the fee or fees may not be more than the actual cost of the regulatory program.
(4) Local public health officers that adopt a regulatory program are encouraged to work with local body artists in promoting public awareness of the risks of body art and the need to use body artists who meet at least the minimum standards as set forth in the state board of health rules.

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