Health and Safety Executive/Local Authorities Enforcement Liaison Committee (HELA)

Enforcement of skin piercing activities

Core document	Purpose and scope
	Key messages
	Definitions and legislation overview
	Background
Appendix 1	Primary legislation considerations for cosmetic piercing activities
Appendix 2	Pre-consultation with client
Appendix 3	Infection control
Appendix 4	Cleaning and disinfection
Appendix 5	Aftercare advice
Appendix 6	Safe waste disposal
Appendix 7	Anaesthetics
Appendix 8	Additional areas of the legislation & guidance
Appendix 9	Enforcement
Appendix 10	Website links and relevant publications
Appendix 11	Glossary of body adornment terms
Table 1	Selected enforcement approaches
Table 2	Disinfectant usage & supporting notes

Purpose and scope of this Local Authority Circular

1. This Local Authority Circular (LAC) provides technical guidance to enforcement officers and others on health, safety and legal issues related to cosmetic piercing, permanent tattooing and scarification. Much of the information is discussed in the context of cosmetic piercing, i.e. ear piercing and body piercing, as defined in section 120 of the Local Government Act 2003, but has relevance for the other two subject areas. The LAC highlights health and safety issues that local authority (LA) enforcement officers should assess when visiting premises that perform cosmetic piercing. The intention of this guidance is to standardise information to eliminate confusion and misinterpretation of legal, health and safety issues generally related to cosmetic piercing activities.

2. Although the document is primarily intended for health and safety inspectors it may also be circulated and made available to those involved with these and similar treatments (manufacturers, importers, suppliers, purchasers, practitioners and anyone considering these treatments) to ensure: -

• That any health and safety risks to those involved are adequately controlled; and
• Consistent standards are applied and achieved.

3. This guidance does not cover micropigmentation – also known as temporary tattooing and semi-permanent makeup – as this is covered in LAC 14/1. However, recent amendments to the Local Authorities (Miscellaneous Provisions) Act, 1982 now mean that LAs will regulate all cosmetic piercing, micropigmentation, tattooing and stud-type ear piercing under the same area of law.

Key messages

• LA enforcement officers are not expected to assess the treatment techniques used by cosmetic piercing operators. However, under the Health and Safety at Work etc. Act 1974 and/or the Local Government (Miscellaneous Provisions) Act 1982 and new byelaw provisions, enforcement officers can ensure that certain levels of hygiene and training exist, and that operators are correctly licensed.
• Effective infection control is essential .
• Enforcement officers should ensure that a suitable working environment is maintained, and that no aspects of business on the registered premises adversely affects the health of the public or those employed at the premises.
• Related issues to consider here include legal framework, infection control measures, COSHH assessments, health questionnaires for clients and the appropriateness of working location. These are covered in more detail below.
• Currently, enforcement action on issues associated with:
  • Enforcement of skin piercing activities falls to LA enforcement officers under paragraph 8 of Schedule 1 of the Health and Safety (Enforcing Authority) Regulations, 1998.
  • Peripatetic use (those without fixed premises)/design/manufacturing/supply falls to the HSE

Definitions and legislation overview

4. Definitions of body adornment and modification procedures

To fully appreciate the legal, health and safety issues for treatments covered in this document, some knowledge of the techniques available is necessary. The Chartered Institute of Environmental Health’s ‘Body art, cosmetic therapies and other special treatments’ gives comprehensive information on the practice of skin piercing, ear piercing and beauty treatments. A glossary of the common terms is provided in Appendix 11.

5. Legislation

The main areas of law relevant to cosmetic skin piercing are:

• The Health and Safety at Work etc Act (HSWA,1974);
• The Local Government (Miscellaneous Provisions) Act 1982, which has been recently amended by the Local Government Act 2003
• Age and consent issues
• The Tattooing of Minors Act 1969
• Assault implications;
• The Prohibition of Female Circumcision Act (1985);
• Anaesthetics – The Medicines Act (1968); and
• Legal exemptions affecting some special treatments.

6. The Government has recently amended the Local Government (Miscellaneous Provisions) Act 1982 by means of the Local Government Act, 2003 (Section 120), to give LAs specific powers to regulate businesses providing cosmetic piercing (ear piercing or body piercing) and semi-permanent skin-colouring (e.g. micropigmentation, semi-permanent make-up and temporary tattooing). This change in the law was brought into force on the 1st April, 2004. This extends the powers that local authorities already had in relation to tattooing, ear piercing, electrolysis and acupuncture. The Department of Health has published guidance about the change in the law: Local Government Act 2003: Regulation of cosmetic piercing and skin-colouring businesses – guidance on section `120 and schedule 6

7. The London LAs typically use the London Local Authorities Act, 1991, which already gives them powers to regulate special treatment businesses, including cosmetic piercing and micropigmentation.

8. As mentioned above, there is an existing legal requirement for businesses involved in ear piercing and permanent tattooing to register under the Local Government (Miscellaneous Provisions) Act. Previously, some LAs had added a memorandum of understanding to byelaws under this Act, to include cosmetic body piercing, micropigmentation and similar activities. The recent amendment to the 1982 Act gives them specific statutory powers to regulate these businesses. See Appendix 1 for further information relating to this Act, and regarding recent amendments to its scope.

9. The Health and Safety at Work etc. Act (HSWA), 1974 applies to all employers, whether a business is registered with its LA or not; and serves to protect employees and others, such as members of the public, who may be affected by a work activity. LAs will enforce the provisions of the HSWA 1974 where cosmetic piercing takes place in premises to which the Health and Safety (Enforcing Authority) Regulations 1998, Regulation 3, Schedule 1, applies. I.e. beauty salons, leisure centres, high street, exhibitions etc.

10. The HSE is the enforcing authority where such work is carried out peripatetically, i.e. where someone works at a variety of locations and travels between them.

11. Additionally, the HSE also enforces the Supply of Machinery (Safety) Regulations, 1992 as amended by the Supply of Machinery (Safety) (Amendment) Regulations 1994 (SMSR),governing the supply of any machinery related to the special treatment. Any potential breaches of the Machinery Regulations noted during inspections should be passed to HSE via the Environmental Liaison Officer.

Background

12. This guidance document resulted from the growing concerns of health professionals, reputable cosmetic piercers/tattooists and enforcement officers, and the need for consistent enforcement and advice in this area. The escalation in cosmetic piercing practices over recent years, along with a previous lack of specific legislation for cosmetic body piercing businesses outside London, has led to some confusion on how to enforce health, safety and other related legislation. Some piercing and aftercare problems are avoidable if clear, reliable information is easily accessible via LA enforcement officers.

13. Body modification and adornment have their origins in ancient history. Various techniques have been developed and are now employed globally for numerous cultural reasons, and their development is on going. In recent decades, tattooing, traditional ear (lobe) piercing and body modification through traditional cosmetic surgery have become well established and socially acceptable. Other body adornment and modification practices have expanded in popularity from their previous position as fringe activities. Techniques involving cosmetic body piercing of regions other than the ears are now performed routinely at many permanent premises across the UK, and by some mobile cosmetic skin piercers. Some also undertakes branding and other scarification treatments, though legal complaints relating to such treatments would have to be considered on an individual basis.