PURPOSE: This rule outlines the standards that a practitioner will be held to in the course of performing tattoos, body piercing or branding. Such standards relate to practitioners’ personal hygiene, safe and sanitary practices in performing procedures and the protection of the health and welfare of tattoo, body piercing and branding patrons.

1. (1) Competence.

   1. (A) Each licensed tattooist, body piercer or brander shall:

      1. 1. Practice within his or her scope of

practice and shall not attempt any procedure that is beyond his or her level of competence or training;

1. 2. Perform only those procedures for

which he or she holds a license to perform pursuant to sections 324.520 to 324.524, RSMo; and

1. 3. Maintain the safe and sanitary prac-

tice of his or her profession, taking all necessary precautions to prevent the transfer of disease or infection from one patron to another, or from the licensee to a patron.

1. (B) A licensee shall not perform or attempt to perform any procedure intended to remove a tattoo. Any attempt by a licensee to perform a tattoo removal procedure shall be grounds for disciplinary action.
2. (C) Licensed tattooists shall retain records of the dyes used in their tattoos, including the lot number of each pigment used for each patron.
3. (D) No licensee shall delegate professional responsibilities to a person who is not qualified and licensed to perform such responsibilities.

1. (2) Identification.

   1. (A) Each practitioner shall carry on his or her person proper picture identification when practicing pursuant to sections 324.520 to 324.524, RSMo. When requested to produce identification by an authorized agent of the division or office the licensee shall comply. A licensee’s failure to produce proper picture identification upon request of an authorized agent shall be grounds for discipline by the division.

2. (3) Client Welfare.

   1. (A) Each practitioner shall:

      1. 1. Conduct business and professional

activities with honesty and integrity;

1. 2. Obtain a signed informed consent

from each patron prior to performing a tattooing, body piercing and/or branding procedures;

1. 3. Not engage in the practice of tattoo-

ing, body piercing, or branding on a patron with an exposed rash, skin lesion, boil or any situation where contraindications exist;

1. 4. Not engage in the practice of tattoo-

ing, body piercing or branding while under the influence of alcohol or drug(s);

1. 5. Not allow smoking or consumption of

food or alcohol in the area where a tattoo, body piercing or branding procedure is performed. Licensees and patrons may consume non-alcoholic beverages during the procedure. Alcoholic beverages shall not be consumed on the premises;

1. 6. Utilize universal precautions at all

times as defined in 4 CSR 267-1.010. This includes handwashing before and after each procedure and refraining from exposing clients to infectious or contagious diseases;

1. 7. Thoroughly wash his or her hands

and the exposed portions of his or her arms with dispensed soap and tempered water before and after each procedure and more often as necessary to keep them clean;

1. 8. Dry his or her hands and arms with

individual single-service towels;

1. 9. Maintain a high degree of personal

cleanliness and conform to good hygiene practices during procedures;

1. 10. Wear clean, washable outer cloth-

ing;

1. 11. Wear non-absorbent gloves when

preparing the skin and while performing each procedure. The non-absorbent gloves shall be for single-use only and disposed of after the completion of each procedure;

1. 12. If while performing a tattoo, body

piercing or body branding, the practitioner’s glove is pierced, torn or otherwise contaminated, the contaminated gloves shall be immediately discarded and replaced with new gloves; and

1. 13. If interrupted during a procedure

and the interruption requires the use of the hands, a practitioner shall rewash his or her hands and put on new gloves before resuming the procedure.

1. (4) Equipment.

   1. (A) All surfaces, counters and general-use equipment in the tattoo, body piercing, and branding areas shall be cleaned and disinfected before each patron is seated.
   2. (B) All inks and pigments shall be obtained from reputable ink and pigment manufactur- 20 CSR 2267-5

ers. Information indicating the sources of all inks and pigments shall be available to the office upon request. Single-use containers of pigment or ink shall be used for each patron. No pigment or ink in which needles are dipped may be used on another patron. The remainder of unused portions shall be properly and permanently disposed of and/or destroyed after each application.

1. (C) Instruments, dyes, pigments, stencils, branding irons and other branding instruments used for tattooing, body piercing and branding shall be sterilized and stored in a safe and sanitary manner in order to prevent contamination.
2. (D) Disposable-type razors shall be for single-use only and disposed of in an approved manner.
3. (E) Tattoo stencils shall be single-use and each stencil shall be properly discarded after one (1) use.
4. (F) The use of piercing guns shall be prohibited for anything other than ears.
5. (G) Body piercing needles shall be disposable, sterile and for single-patron use only. All needles shall be placed in an approved sharps container after each use.
6. (H) Body piercing jewelry purchased at the establishment shall be cleaned, individually packaged and sterilized prior to use. Patrons that wish to use their own jewelry for body piercing must sign a waiver releasing the establishment from liability associated with the use of the patron’s own jewelry.
7. (I) Bars, tubes, branding irons and other branding instruments shall be constructed in a manner that permits easy cleaning and sterilizing.
8. (J) Branding irons and other instruments used to brand may be reused if cleaned, sterilized and stored in an approved manner between each patron.
9. (K) Contaminated waste that may release liquid blood or bodily fluids when handled must be placed in an approved “red” bag that is marked with the international “biohazard” symbol. It must then be disposed of by, or delivered to, an approved medical waste facility pursuant to all applicable laws and regulations. Sharps ready for disposal shall be disposed of in an approved sharps container.
10. (L) Contaminated waste that does not release liquid blood or body fluids when handled may be placed in a covered receptacle and disposed of through normal approved disposal methods.
11. (M) Practitioners shall use single-use plastic covers to cover reusable accessories such as spray bottles to minimize the possibility of transmitting body fluids or disease during application of a tattoo, body piercing or branding to successive patrons. FINANCIAL INSTITUTIONS AND PROFESSIONAL REGISTRATION
12. (N) Insects, vermin and rodents shall not be present in any part of the tattoo, body piercing and/or branding establishments and any appurtenances or appertaining premises.

AUTHORITY: section 324.522, RSMo Supp. 2001.* This rule originally filed as 4 CSR 267-5.010. Original rule filed Aug. 15, 2002, effective Feb. 28, 2003. Moved to 20 CSR 2267-5.010, effective Aug. 28, 2006. *Original authority: 324.522, RSMo 1998, amended 1999, 2001.