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Hepatitis A

INSIDEStatim 4Benefits of APP Membership 5Alcohol- based hand Gels 7Membership Levels 8Choosing Piercer Brochures 10

To Pierce or Not? 11Adolescent Body Piercing 13Board Happenings 14Spore Testing 14Classifieds 15

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October, 1999 Issue 16

The Official Newsletter for the Association of Professional Piercers

The APP had it’s most recent conferencein May, at the Hard Rock Hotel in LasVegas. Piercers and piercing enthusiastsfrom all over the world attended the 4-day event. During the conference manyworkshops were held on topics such asanatomy, wound care, and jewelry, just toname a few. In addition to these work-shops piercers were able to take first aidand CPR classes and obtain certificationin these areas. The Conference was a timefor ALL piercers and piercing enthusiaststo share information and concerns relat-ing to the industry.Once all the attendees were signed in, thefirst day was off to a great start. This con-ference was attended by many more peoplethan during the previous year This helpsto confirm the increase in the popularityof our industry. Several of the major jew-elry manufacturers opened the conference

by sitting on a panel and discussing po-tential industry jewelry standards. Theywere also available to answer many ques-tions as to how they feel about certain typesof jewelry and whether they are appropri-ate for use in piercing. It was interestingto hear the manufacturers’ perspectives onmany of the issues we as piercers face ev-ery day.The afternoon session allowed everyoneat the conference to either get certified orrecertified by the Red Cross in CPR. TheAPP and many states require piercers tohave current CPR training and certifica-tion. After the CPR training many of theattendees gathered out by the pool and con-tinued to chat about our craft. For manythis was their first conference and otherswere attending for the 3rd or 4th time.People were often amazed as to how openlyand freely information was shared by all.Dr. Jack opened the second day with hisdiscussion on piercing anatomy. Heshowed many slides of good piercings andalso images of piercings so awful that itwould make your skin crawl. Dr. Jack is asurgeon and a piercer. We are truly fortu-nate that he is always willing to imparthis vast relevant and valuable knowledge.He showed the attendees anatomical issuesabout certain piercings that should possi-bly not be performed.Sky Renfro, Dave Vidra, and Al D. con-ducted an Occupational Health and SafetyAdministration (OSHA) seminar. Thiscourse explained clearly to the attendeeswhat is required by law for a piercing stu-

dio to conform to OSHA standards. Muchdiscussion was focused on hepatitis A, B,and C, and on the vaccination shots forHepatitis B. Many new safety productswere displayed including, all the protec-tive gear that could be worn to protect astudio’s employees.The highlight of the third day was the ses-

The 1999 Conference was a great success

sion on aftercare. A Registered DentalHygienist and an Oral Micro-Biologistlead an in-depth discussion on the oralstructures and how they relate to pierc-ing. They also spoke on what they feel isthe optimal care for oral piercings to ac-celerate the healing time and decrease thechance of infection. Many questions were

Jim Ward receiving his life-time achievement award

What is hepatitis A?Hepatitis A is a highly contagious liver

disease caused by the Hepatitis A virus.

How serious is hepatitis A?Between 11 and 20% of the people with

hepatitis A require hospitalization. Adultswho become ill are often out of work forseveral weeks. There are approximately100 deaths each year in the US from hepa-titis A.

What is the risk of getting hepatitis A.Hepatitis A infects over 100,000 people

in the US each year. Persons who havemultiple sexual partners or who practicerimming or fingering are more likely toacquire hepatitis A. It can also be trans-mitted in unwashed foods or drinkingcontaminated water.

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The PointCopyright © 1999. All rights reserved.

APP Board MembersPresident Pat McCarthy

Vice President Steve Joyner

Secretary Bethera Szumski

Treasurer Scott Brewer

Outreach Coordinator Elayne Angel

International Liason April Williams-

Warner

Medical Liason Dr. Jack Ward

The Association of Professional Piercers goalis to circulate vital health, safety and educationalinformation to the piercing industry. The Point iscopyrighted under federal law. Any reproductionof it’s contents is prohibited unless written per-mission is obtained.

Any material submitted for publication will besubject to editing. The Point cannot guarantee re-turn of any such materials unless accompanied bya stamped, self-addressed envelope.

The Point is not responsible for claims madeby advertisers. We reserve the right to reject ad-vertising which is unsuitable for our publication.

If you wish to advertise, and would like a speci-fication sheet please contact:

Pat McCarthy614-297-9925Fax 614-297-6855e-mail adornit@piercology.com

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asked and the answers helped make it ob-vious that aftercare is a complicated is-sue.The Red Cross conducted the next sessionon First Aid. First Aid certificates forpiercers are required by the APP for mem-bership, and also by many states. The lastSession was conducted by Gahdi Elias andElayne Angel on grounding and bedsidemanner. Issues were discussed regardinghow to stay focused and deal successfullywith clients.The Final day was started by Pat McCar-thy and Karen Cookston, from AmericanExpress. They conducted an in-depth dis-cussion on how to run a studio, deal withemployees, write job descriptions andhandle finances. Pat shared his employeemanual and job descriptions which couldbe used by attendees.After lunch the open meeting was con-ducted. In the open meeting the board ofthe APP reviewed their efforts and accom-plishments from the past year and what isplanned for the upcoming year.Many changes took place to the APP overthe last year; one of the most importantthings was the election of a new Board. InSeptember a new Vice President, Secre-

tary, and Outreach Coordinator wereelected. Then, in April a new Presidentand International Liaison were introduced.During the meeting the new Board mem-bers were introduced to the membership.Also at the open meeting many individu-als shared what was taking place in theirparticular states regarding legislation. Thepossibility of having a vendor fair at nextyear’s conference was discussed. The ad-dition of different types of membershipswithin the APP was also a topic.A lifetime achievement award was pre-sented to Jim Ward for his leadership inpiercing, and a presidential award wasgiven to Bethra Szumski for her role inpulling together the conference.If you were at the conference you knowthe delight of meeting others involved inpiercing and exchanging information. Fre-quently, we feel like we are all alone strug-gling to inform and educate people whohave the desire for piercing and bodymodification. A conference such as thisrefreshes all of us and gives a sense of hopeand fulfillment in our quest for informa-tion.Next year’s conference dates are being setand a much different more in-depth con-ference is being planned. We hope to seeyou there! Keep reading the POINT forupdated information.

Above:

This year�s con-vention was thelargest ever and itcontinues to groweach year.

Across:

One presidentsays good bye andthe other says�Why me!�

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Concerns regarding steriliza-tion security and tracking shouldbe the utmost priority for any per-son in our practice. Inappropri-ate sterilization practices com-promise client safety. Conjectureabout variations in cycle timesand temperatures has movedthrough the grapevine to thePoint, without proposing a sci-entifically referenced standard.

was thoroughly tested by morethan a dozen respected Universi-ties, Military hospitals, and theAssociation for Advancement ofMedical Instrumentation's ownchairman of the SterilizationStandards Committee (James L.Whitby, Ph.D Chief of microbi-ology, University Hospital -Lon-don, Canada). His results of thereference standard Statim steril-

Statimsthe controversy continues

"Technology is forcing us into professional status whetherwe want to be professionals or not. One thing that distin-

guishes a professional from a crafts-person is knowledge oftheory, the underlying principles that make the craft work.A craft is learned by emulation: watching a master performand then imitating that person. A profession is learned fromfirst principles so that when things change, the professional

understand the changes and adjusts techniques to fit. "~Philip Meyer,Knight Chair in Journalism UNC Chapel Hill

tioning of the cassette chamber.This is a small, pump pressurizedinsulated container, unlike con-ventional table top autoclaves,and behaves more efficiently, asnoted below: "All biological in-dicators tested in cycles werekilled; in fact, the purge and pres-surization portions of the cyclewere sufficient to kill the biologi-cal indicators."In reference to every type of Sta-tim cycle, unwrapped, wrapped,and rubber & plastics: "All cycleswere found to perform satisfac-torily to achieve a substantialsafety margin over the perfor-mance claimed. The apparatuswas easy to use and functionedwithout giving any trouble. Theapparatus appears very satisfac-tory for its intended use."

In closing, I also suggest add-ing a sterilization tracking itemnoting when, how and by whomitems used and sold were steril-ized, with every client record. Aprocess indicator for each pro-vides an added level of assuranceto clients and for a conscientiousdefense of your safety measures.

I can help by addressing anyspecific questions or concerns.Brian Skellie

izer are quoted below:In reference to the unwrapped

3.5' cycle: "All biological indi-cators were killed provided thatthey had been subjected to a ster-ilization cycle of 75" or greater.This represents a very satisfac-tory safety margin." On average,that is before the timed 3.5' cyclebegins, during the initial condi-

Different methods achieve differ-ent results, and must be testedand proven accordingly. The bot-tom line is, what makes effectivesterilization?

The previous Flash Steriliza-tion article in the Point does notapply to the Statim apparatus, asit is not narrowly regarded byANSI [American National Stan-dards Institute], AAMI [Associa-tion for Advancement of Medi-cal Instrumentation] or the AMAor ADA as "flash sterilization".Although the cycle times areshort, the sterilizer is consideredacceptable for Federal service useas a general purpose sterilizer. Allcycles tested performed safelyunder computer control and with-out guesswork.

The Statim 2000 sterilizer

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Benefits of APP MembershipThe mission of the APP is to

circulate vital health, safety and educationalinformation for the professional piercing industry.

The APP?• is an international nonprofit, educa-

tional, health and safety organization.• is dedicated to the dissemination of

information about body piercing• is a voluntary organization concerned

with the practice of body piercing• is a membership of piercers who meet

minimal guidelines.

Philosophy• body piercing is a social institution

that provides significant services andmeets evolving social needs.

• a body piercer should use knowledge,judgement, and skills based on sci-ence and experience.

• body piercers must act ethically andresponsibly and be accountable forquality service

• minimal guidelines provide a meansof accountability

• research creates a foundation for ad-vances in body piercing

• piercers must assume responsibilityfor their continued education

• the organization is committed to en-abling piercers to meet this respon-sibility

• standards of body piercing practice,interactive collaboration, and appro-priate use of information enhancebody piercing practices.

Why should I join?Very importantly, you will have the

support of other professionals in yourfield. You will get backing of theindustry’s only professional organization,and access to all of the knowledge gainedby its members over time. You will havecontact with a network of like-mindedprofessionals who have skills and infor-mation to share. You will gain the recog-

nition due to you for upholding appropri-ate standards and helping to advance pro-fessional piercing as a safe, respectable,and reasonable endeavor. You will havethe peace of mind that comes from know-ing that you are doing things the rightway.

Face it: The better you are at what youdo, the more opportunity you will have todo it. If people have a pleasant piercingexperience, heal well without infections,and feel that you are a competent and car-ing professional, they will tell theirfriends. That’s good for business. It’s awin/win situation.

GoalsThe primary goals of the APP are to

organize professional piercers, unitemembers, and provide education, repre-sentation, and quality standards for bodypiercing.

What are the benefitsto membership in theAPP?

Procedural ManualThe APP procedural manual provides

an overview of basic guidelines and indepth piercing safety suggestions. Non-members may purchase the ProceduralManual.

A website

www.safepiercing.orgwhich includes:

• Member piercers listed by name andlocation.

• Links to piercing friendly doctors• Links to worldwide legislation relat-

ing to body piercing.• The Point, APP’s newsletter, on-line• Discussion Bulletin Board (BBS)• FAQ Section• Resource listings, and more.

“The Point” APPNewsletter includes

• Letters from readers• Information on technique, after care,

new products and jewelry• Legislation and business news

A handsome Membership Certifi-cate to hang on your wall.

Piece of mind:Knowing you belong to agroup of individuals the careabout piercing and shareinformation for the benifit ofthe industry.

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Jail-time for piercing aminor?A Slidell man was booked on Tues-day August 8 1999 with illegallypiercing the tongue of a 16-year oldgirl without her parents orguardian’s permission as required bystate law. The piercer could be jailedfor up to a year and fined a maxi-mum of $500.00 if convicted of il-legal body piercing of a juvenile.Authorities are cracking down onpiercing in the state. The arrest isthe second this year in which anadult is accused of altering the bodyof a juvenile. The police said thegirl’s mother filed a complaint Fri-day saying her daughter had re-ceived a pierced tongue without

parental approval. After question-ing the girl, police said they deter-mined that the piercing took placeAug. 6 at piercer’s home and thatthe girl agreed to have it done, al-though under state law, she cannotgive legal consent because of herage.

The police spokesman said that an-other girl had her tongue pierced atthe same time but her parents arenot filing charges. If they decide to,the piercer could face a secondcount increasing the penalty. Thepiercer was booked and in now freeon a misdemeanor signature bond.The police do not know if the twogirls paid for the piercing and if theydid how much. If they didn’t pay

the charge will still stand. “We takethese complaints seriously becauseit is a serious concern of parents ofteen-agers, both tattoos and bodypiercing. Neither case involved aperson working in a professionalbody piercing studio. In both cases,we determined that these individu-als know how to do it and offer todo it in their homes. “But there isalways a risk of injury and infec-tion,” he said.

Editors note: There have been anumber of cases in the news wherepeople have complained about mi-nors getting pierced, The APP atthis time doesn’t have a stance re-garding the piercing of minors. Youneed to be aware of your state andlocal laws, and whether you thinkis appropriate to pierce minors, withor without parental consent.NEW MAILING ADDRESS

The APP has a new address, send ALLcorrespondence to this address, unless youare sending information to a specific boardmember, or committee:

APPPMB 286

5446 Peachtree Industrial Blvd.Chamblee, GA 30341

The addresses of the board mem-bers are:

Pat McCarthyAPP President

872 N. High St.Columbus, OH 43215

614-297-4743 Studio Line614 297-9925 APP Line

Steve JoynerAPP Vice-President

4000-b Cedar SpringsDallas, TX 75219-3505

214-559-3706

Bethra SzumskiSecretary

2271 Cheshire Bridge Rd.Atlanta, GA 30324

404-315-6900

Scott BrewerTreasurer

2009 Greene St., Suite 112Columbia, SC 29205

803-799-2877

Elayne AngelOutreach Coordinator

1128 Decatur St., 2nd FloorNew Orleans, LA 70116

504-524-6147

Dr. Jack WardMedical Liaison

2210 Line AvenueSuite 202

Shreveport, Louisiana 71104800-849-2404

ConferenceCommittees

We have already started to plan nextyear’s conference at the Gold Coast Ho-tel in Vas Vegas, April 10 - 14.

Because of the scope of the confer-ence this year, with a vendor mart, andover 15 different classes to be held weare asking for help in the planning andexecuting the conference.

Some if the committees we are form-ing are a speaker committee, entertain-ment, banquet, and fund raising. If youhave a specialty in one of these areas andhave about 10 extra hours per week todevote to the convention please feel freeto help out. You can contact us by writ-ing to the APP mail box.

Help make this year’s conference thebest ever!

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Alcohol- based Antimicrobial Hand GelsBy Sharon KrystofiakInfection Control Practitioner,

UPMC Presbyterian

There are numerous new productscrowding the hand soap shelves ofyour local drug and grocery storesthat promise to “disinfect” yourhands. The alcohol-based hand gelshave been available in the health careindustry for years. They are prima-rily for use in situations in whichhand washing facilities are not avail-able (ambulances, in event of watershutdowns). As they’ve been mar-keted now for the general public,there are several misconceptions in-volved about their proper use. Thenumber one rule is: they do not re-place the need for good old soap andwater hand washing. The frictioncaused by rubbing the hands to-gether during washing loosens deadskin cells which harbor most of the

removal. You might want to suggestthis additional hand disinfection stepto clients as part of their aftercare.Since it is unlikely they will weargloves during cleanings, they couldinoculate the piercing site with bac-teria such as Staph, which is oftenpresent on hands.

The gels should not be used for skinpreps (reread paragraph #2) or af-tercare on the piercing site as thealcohol could harm the new granu-lation tissue (and it won’t removedead cells).

The last tip is: a little dab will do ya.About a quarter-size squirt is ad-equate, and the product should berubbed around on the hands and be-tween the fingers until it has evapo-rated. Contrary to logic it doesn’tdry out the skin because most brandscontain emollients. One final warn-ing: do not use the alcohol gelsaround fire or flames as they areuniversally flammable!

“transient” bacteria on the hands.Rinsing with running water furtherremoves the dirt and debris. Onlywashing will do if your hands aredirty, as the gels can’t penetratethrough the layer of crud coatingdirty hands!

The positive part of hand gels arethat with proper use, in addition tohand washing, transient hand florais reduced to even smaller quanti-ties. This additional “disinfection”step is now being recommendedmore in hospitals. Utilizing as fewas 2 or 3 applications per shift fur-ther reduces the chance of spread-ing infections from patient to patienton the hands of health care work-ers.

Contact lens wearers are anothergroup using the products for handdisinfection before lens insertion and

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In response to the changes and growthin the body piercing field, the APP nowoffers a greater variety of types of mem-berships! One of the new membership lev-els allows those who are not piercers, butwho support the piercing field to becomeinvolved with the organization. Anothernew level accommodates piercers whowork at more than one studio. Details onthe specific requirements, dues structureand benefits for each type are outlinedbelow.

The usual type of membership withwhich most are familiar remains as be-fore:

Professional Business MemberThis is for a Piercer who works full timeat a body piercing studio and meets theAPP environmental (studio) criteria formembership (see below). These individu-als must have at least one (1) year profes-sional piercing experience. This type ofmembership does carry voting rightswithin the organization.

Each individual applicant must presentthe following:

• A completed questionnaire, in Englishand preferably typewritten.

• Proof that the applicant has been pierc-ing at least one full year. (A notarizedstatement, dated business document,newspaper article, etc.).

• A copy of current CPR (renewed an-nually), and First Aid (renewed ev-ery 3 years) certificates.

Dues are $150.00 for the first year and$50.00 per year to renew.

A new and improved type of membershipto allow for those who work in multiplestudios is:

Professional Member at LargeThis is a piercer who works part or full

time at one or more studios. All studio lo-cations must meet the APP environmen-tal (studio) criteria for membership (seebelow). These individuals must have overthree (3) years professional piercing ex-perience.

This type of membership does carry vot-ing rights within the organization.Each individual applicant must present thefollowing:

•Completed questionnaire, preferably

typewritten, and in English.• Proof that the applicant has been pierc-

ing at least 3 years. (A notarized state-ment or dated business document.)

• A copy of current CPR (renewed an-nually), and First Aid (renewed ev-ery 3 years) certificates.

• Documentation that the environmen-tal criteria is being met is requiredfrom each location of business whichis not already on file with the Secre-tary. The documentation is to be filedquarterly. Dues are the same as for aProfessional Business Member.

Associate MemberThis type of member does not pierce, or

has less than one year of experience. Theseindividuals must work in a field which isassociated with the application of bodypiercing. If working in a piercing-relatedbusiness APP environmental (studio) cri-teria must be met.If the individual works in a related fieldthey must submit a letter outlining in whatway their trade is relevant and beneficialto the profession of body piercing. Ex-amples of related fields include staff otherthan piercers within a piercing studio, jew-elry manufacturers, medical supply dis-tributors, etc..This type of membershipdoes not carry voting rights within the or-ganization.

The dues are $100.00 for the first year,and $50.00 pear year to renew.

PatronNot actively involved in the body piec-

ing industry or related industries, but sup-ports the actions of the APP. There are noparticular requirements for membership.This type of membership does not carryvoting rights within the organization. Thedues are $50.00 per year.

Corporate MembersIs an entity or individual working in a

field or providing a service which is asso-ciated with the application of body pierc-ing. Applicants must provide a letter out-lining in what way they are beneficial andrelevant to the profession of body pierc-ing. Examples of Corporate members arejewelry manufactures, medical suppliers,Insurance Companies, and educators, etc.

Dues are $200.00 per year.

Environmental CriteriaThe Environmental Criteria which must

be maintained for APP membershipstatus are as follows:

• A business license, local permit, orother documentation showing thatstudio operates within local or statelaw. If no laws or ordinances exist,proof that business is legitimate, i.e.,retail business license.

• A photograph of the autoclave whichis currently in use with make, modeland serial number on reverse.

• A copy of most recent spore test.Spore tests are required monthly tomaintain membership.

• A walk-through 360 degree video ofthe entire facility. This is to include:store front, foyer, piercing room/s,biohazard area, sterilization area,restrooms, insides of drawers andclosets, etc..

• Copies of all release and aftercaresheets currently in use withinapplicant’s studio.

• One or more samples of theapplicant’s advertisement(s).

LogosAlong with ALL membership levels will

be logo usage. The different members willhave different logos and must only use thelogo designed for their level. Any misuseof the logo can lead to removal of mem-bership.

Once you are approved a membershiplevel logo with specifications for it’s usewill be sent to you.

If you are interested in becoming one ofthese new levels and meet the qualifica-tions you can send in your information to:

Bethra Szumski APP

PMB 2865446 Peachtree Industrial Blvd.

Chamblee, GA 30341

For a number of years now individualshave been asking for different levels ofmemberships and we are excited to allowmore individuals to become part of thegrowing APP membership.

NEW LEVELS of APP MEMBER-

SHIP

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PRESIDENT’S CORNER Pat McCarthy

Choosing YourPiercer Brochures

We now have brochures available to youwhich explaining to the public, in termseasy to understand, what to look for inchoosing a piercer and piercing studio.We believe you will find these of value ifyou are an APP studio and also if you arenot. The handout was designed to bepassed out in studios, at vendor marts, orjust about anywhere. The pamphlet wasdesigned in a tri-fold, two-color formatso it can be placed in a pocket or easilysent by mail. It briefly but concisely cov-ers the following topics and others onwhat to look for in a professional studio:

Do they have an autoclave?

Does the shop reuse needles?

Do they use piercing guns?

Do the offer appropriate aftercare?

Do they set up the rooms properly?

Are they knowledgeable ?

How to check out the studio.

Not only does the easy-to-read brochureanswer these questions and many others,it also outlines simple ideas on helpfulhints, and what to avoid for piercing af-ter care!

As a member you can receive 100 ofthese brochures to pass out in your stu-

dio. You can reorder more at a cost ofonly $12.95 for 100. Of course you cancopy the handout and continue to dis-tribute it. The APP does not want anychanges made to the brochures, becausewe need to establish consistency. If anychanges are made to the brochure, theboard requests that you remove the APPlogo from the pamphlet.

If you are not an APP member or youwould like more brochures you can sendyour check made payable to APP: BethraSzumski, PMB 286, 5446 Peachtree In-dustrial Blvd., Chamblee, GA 30341

Hello,First I want to thank everyone who

voted for me for the Board position ofPresident. Well, now that I have had theoffice for a about 4 months, all I can sayis, “wow!”

I was warned by many about what Iwas getting into and they were right.Much of what needed to get done first wasa lot of back work to get the correct pa-perwork, insurance, taxes, financials aswell as many other things together to movethe APP along.

Let me say that the Board you haveelected is fantastic and hard-working? Idon’t need to tell you that the piercing in-dustry has exploded and the APP needs tomove with it. The APP was set on a solid

base by past board members but in do-ing so much work themselves, many ofour industry leaders burned out.

Starting any organization such as theAPP truly takes tremendous amounts oftime, effort, and energy. It is my desireto establish many more committees ofdedicated members to help the APP grow.If you are interested or if you are con-tacted to help, please make sure you havethe desire and time to commit, and thengo for it.

You will soon be seeing APP adver-tising in magazines and the onset of amajor information dissemination to thepiercing/tattoo industry. I urge all of youto talk to your friends in the industry andhelp them to become better informed.

As our membership grows so do ourproblems. I want to remind everyone thatthe APP is not the piercing police. Theboard will soon be asking individuals tosit on a committee to handle studio dis-putes. This committee will report directlyto the Board. The committee will have a2 board members, 2 full members, a cor-porate representative, and a person out-side the piercing community. I feel this isa great cross mix and will free most of theboard up to move along with other mat-ters.

I have personally have learned a num-ber of lessons, and am more prepared thenever to do what you have elected me todo.

The NextPoint!

The next Point will take a little differentlook. We are going to dedicate the nextissue to mostly health related concerns.We are going to do a mass mailing tomany health departments, health inspec-tors, hospitals, tattoo studios, and pierc-ing studios. We are doing this to makepeople aware of the APP and it’s missionto educate people on piercing safety. Weare hoping to have many of the peopleattend next year’s convention. The Pointwill be a little larger we have been col-lecting many articles regarding piercingand are going to be including them in thenext issue. If you have an article you feelis relevant please send it to editor

This Point is a little late in comingbut many other APP issues need to be ad-dressed first. The next Point will be com-ing sometime after Thanksgiving so getthe articles to us soon. You will also no-tice on the last page we have started aclassified ad section. This section is to ad-vertise yourself as a piercing looking forwork or a studio looking for a piercer. Inno way does advertising in the POINTrepresent that the APP has certified thestudio or the piercer. You must do thatyourself.

If you have comments regarding thePOINT please send them to the editor viamail or email.

11

To Pierce or Not to PierceQ This year, my daughter movedaway from home for her freshman yearin college. A few weeks after she wasthere, she got her tongue pierced. Sheknows her father and I do not under-stand why she would want to do this,but I wondered if you knew of any pos-sible medical reason that she should nothave had this done. I’d like to tell hersome legitimate medical reason to getthis “tongue stud” out of her mouth andnot to get anything else pierced.

A I’m afraid I can’t give you astrong argument to convince your daugh-ter to remove the stud from her tongue.Even if I could, that would be similar totelling people reasons why they shouldn’tsmoke. Simply having a good reason notto do something isn’t always convincing.

Body piercing among adolescents andyoung adults is an growing fad of the ’90s.It seems to stem from a mixture of forces:part counterculture, part youthful rebel-lion, part style and part group identity.However, the practice of body piercinggoes back thousands of years.

Besides the conventional site of the ear-lobe, other popular sites include the eye-brow, lip, nose, tongue and outer ear, aswell as the navel, nipples and genital area’If done properly, body piercing carries avery low risk of serious complications.However, there are growing reports in themedical literature about complications ofbody piercing, from minor to serious.

It’s hard to get good estimates of thenumber of people who get body piercings,or the risk of complications. As an ex-ample, though, between 10 and 35 per-cent of people who pierce their ears de-velop a minor complication. The mostcommon type is an infection that respondsto simple remedies, including local cleans-ing, topical antibiotics and, in some cases,antibiotic pills.

The next most common complication isan allergic reaction to the metal stud. Toavoid this, it’s best to use stainless steelstuds, which have a low risk of allergicreactions. Another complication that oc-curs occasionally is a keloid scar-large,rubbery scar tissue. Keloids particularlytend to develop in African Americans,though they can occur in anyone.

Other rare but serious complications ofbody piercing include infections thatspread to other parts of the body throughthe bloodstream. There are reports of in-fections of the heart, bones, joints and kid-ney that have resulted from body pierc-ing. Infections of the ear cartilage (withinthe outer ear) can sometimes lead to de-struction of ear tissue and a permanentdeformity of the ear-as if someone hadtaken a bite out of it.

As for tongue piercing, there are rarereports of serious infection spreadingthroughout the mouth area.! There are alsorare reports of the tongue swelling so muchthat it threatens the ability to eat orbreathe.

If done properly,piercing carries a

very low risk of se-rious complications.

Besides common bacteria, other germscan be transmitted in rare instances ifproper piercing technique isn’t followed.For example, you can develop hepatitis Bor hepatitis C, as you can from any expo-sure to blood from contaminated needlesor piercing instruments. To avoid this,use sterile, disposable needles; if a pierc-ing gun is used, it’s essential that it beproperly sterilized between customers.

Because of their moist, covered location,the navel and genital areas are prone toyeast infection, in addition to infectionfrom common skin bacteria. You mayneed treatment for both. Also, you mayneed a culture to tell for sure what type ofgerm is causing the infection, so you cantake the right treatment for it. There’seven a case of genital warts being spreadfrom a penis piercing.

To prevent infections from initially de-veloping, the area to be pierced should becleaned with an antiseptic liquid. Fortongue piercings, it’s recommended thatyou rinse with an antiseptic mouthwashseveral times a day afterward. For skinpiercings that later become infected, somephysicians recommend that you leave thering in place, and clean and treat the area

until the infection clears. If you take thering out, the hole will close up, whichmight lead to a deeper infection-an ab-scess-which would then need to bedrained.

After a piercing, it can take weeks ormonths for the site to heal. During thistime, you’re more prone to an infectionsetting in. The ears, lips and eyebrowsheal within six to eight weeks, the tonguewithin three to six weeks. Navel pierc-ings take the longest, in some cases up tonine months.

Jay Siwek, chairman of the departmentof family medicine at Georgetown Univer-sity Medical Center, practices at the FortLincoln Family Medicine Center andProvidence Hospital in Northeast Wash-ington.

Consultation is a health education col-umn and is not a substitute for medicaladvice from your physician. Send ques-tions to Consultation, .’Health Section,The Washington Post, 1150-15th St. NW,Washington, DC 90071. Questions can-not be answered personally.

What are the symptoms of hepatitis A• extreme tiredness, muscle weakness• pain in joints• loss of appetite, nausea• fever• dark-colored urine• bloated and tender belly• yellowish tinged skin and eyesAbout 7 out of 10 adults who get hepa-

titis A will develope systems. Thesesymptoms can last up to six months. Withor without sysptoms, people with hepati-tis A infection can spread the disease toothers.

HEPATITIS A Cont:

Answers to the ques-tions in issue 15

12

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Adolescent Body PiercingBY MYRNA L. ARMSTRONG, EDD, RN. FAAN. ELAINE EKMARK, MS, RN. CS. AND BARBARA BROOKS, MS, RN, CCRN

Body piercing is relatively new in the United States. Currently, most of the information is found inthe mass media, and the procedure is described as risque’ and carefree behavior There is little orno discussion of risk. The medical literature about body piercing is limited. Antbropological andsociological literature contain many descriptions of body modifications.

Part of the rationale for body piercingoriginates from ideas embedded in ancientcultures, often as a mark- of royalty or elit-ism. Egyptian Pharaohs underwent ritesof passage by piercing their navels; Ro-man soldiers demonstrated manhood bypiercing their nipples; and both sexes ofVictorian royalty chose nipple and geni-tal piercing. Although health concerns arenot widely discussed in the literature, ado-lescents are having medical problems fol-lowing the procedure.

SIMILARITIES TO TATTOOINGIt is common to see piercing done in

tattoo studios. A significant difference be-tween the two procedures is permanence;in piercing, the jewelry can be removedand the hole allowed to close, comparedwith the “semi-permanent” tattooingmarkings which are costly and difficult-at best-to remove. Body piercing, like tat-tooing, is done by unlicensed personnel,yet many times they are referred to as “pro-fessionals;” they have learned their tradefrom colleagues, magazines or videos.Often, if state mandates are present, thebody piercing establishment is not regu-lated by health standards, or enforced.

THE BODY PIERCING PROCE-DURE

Various pieces of medical equipment areused to pierce the skin and create the holesfor body jewelry. Ear piercing guns, sur-gical clamps, forceps, and hemostats, orlarge gauge hollow needles, are the instru-ments most commonly used. Studio pierc-ers are not qualified to administer anes-thesia, and furthermore clients often wantto experience the sensation, or “rush” as-sociated with piercing.

Earlobes are the simplest site for holes,since the area contains no tough tissue orcartilage, and the “fleshy” skin will easilyform scar tissue needed for the openings,Yet, as ear piercings extend upward alongthe cartilaginous rim, there is more diffi-culty creating the holes, as well as in-creased pain and healing, The tongue is

muscular and vascular, and produces moreimmediate swelling upon piercing.Nipple, navel, and genitalia piercings pen-etrate different types of tissue and produceother problems. These sites are usuallycovered with tight-fitting clothes, creat-ing increased friction and buildup of bodymoisture, producing infections. Nipplepiercings will also burrow through someof the lactating ducts. Naval piercingshave a tendency to “pull out” unless theyare placed deep enough into the abdomi-nal depression, because the reparative andprotective nature of our skin always wantsto remove foreign objects.

The actual body piercing procedure isusually brief The skin site is marked toguide the needle path, the skin is held tautby forceps, and the opening made with ahollow needle; the client-selected jewelryis attached to the needle. Similar to aneedle and thread action, once the hole ismade, the body jewelry is quickly pulledthrough the piercing site. As a small tomoderate amount of bleeding may bepresent following the procedure, manualpressure is applied to the site.Jewelry needs to be kept in place at alltimes to keep the hole open. To avoid in-fections and allergic reactions, piercersrecommend specially made inert, non-toxic metal substances, such as surgicalstainless steel, 14K gold, niobium, or ti-tanium, with no rough edges. The aver-age healing times, depending on the loca-tion, range from one to five months. Fa-cial piercings are open to the air and there-fore tend to heal faster. Tongue piercingsusually heal quickly owing to the great vas-cularization.

After the procedure, studio piercers pro-vide after-care instructions for the pierc-ing sites and anticipated healing times. Ingeneral, the hole and jewelry should bewashed frequently with soap and water toremove any exudate, then rinsed thor-oughly. Other, over-the-counter disinfec-tants may be recommended; however, al-cohol is discouraged as a skin cleaningagent since it also dries the area.

EXPERIENCES OF STUDENTSTo gain further understanding about

body piercing experiences, we spoke with20 high school students who came to ourclinic to see the school nurse. They openlydiscussed their body piercings. Questionswere asked about their decision to bodypierce, age, cost, healing time, anestheticjewelry, health problems, tattooing, andparental awareness.

Their average age at the time of pierc-ing was 15.5, years of age, and all 20 stu-dents maintained good school -,attendanceand academic grades of B’s and C’s. Whilemost of the students said they would neverget a tattoo, all of the students had one ormore ear piercings and a total of 26 otherbody piercing sites such as the nose, na-vel, nipple, tongue, tragus, and eyebrow.The most common choice was the navel.Many were considering additional pierc-ings.

Fourteen of the 20 students reported thattheir parents were aware of the piercings.Parents usually accompanied them to thestudio, in t few cases, to “overcome” theState of Texas age restriction. Others re-ported their parents paid for the procedureor lent them the money to have it done.The navel was the most commonly cho-sen site if the student did not want the par-ent to know or if the parent insisted thesite be covered.

Sixteen students had their piercingsdone in a tattoo studio, commonly called“body shops,” and one student had the pro-cedure done by a “professional” in a boothat a summer rock concert. Most had in-vestigated the studio’s reputation by ask-ing their friends, as well as specific hy-giene questions of the piercers. A few ofthe students made spur-of-the-moment de-cisions while they were with their friendswho were having their bodies pierced.

EFFECTS OF BODY PIERCINGWhen asked what the students would rec-ommend to others, all stressed the need tofollow the suggested skin care regimen.Continued from page 13

Reprinted from School Health Reporter

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IMPORTANT!!!!!Spore Testing

The rules of membership of the APP require that EVERYmember send in a copy of there monthly spore testing to theAPP. This is the only way the APP can determine if you asfull members, are keeping up with the spore testing and run-ning your autoclaves correctly. The board does get calls fromtime to time asking if certain studios are up to date with theretesting. This is the only way we can tell.

In the past we have had you send the results to AL D. orBethra, we would like to change that. Because of the numberof tasks the board has taken on, and in an effort to get mem-bers more involved we are asking that you send your SporeTest results to Venus and Mars, there address and fax is be-low.

They will inform the board as to what members are up todate and what ones need to be placed on notice. In order tomake this easy on everyone would like to have all the sporetests sent in or faxed by the 15th of the month. Your coopera-tion is greatly appreciated.

Venus and MarsSpore test results

1115 E Colonial Dr.Orlando, FL 32803

or(407) 894-8891

BoardHappenings

This letter is to inform all members andperspective members what is being doneby the board now and in the future. Muchof what the board has been doing is notonly the day to day answering of questions,but establishing procedures that futureboard members can use to make there jobeasier allowing the membership to moveforward. The board is having a financialstatements produced to see where we standthis will be made available to all mem-bers. The APP has not paid taxes for thelast 5 years, and the correct paperwork hasnot been file to allow us non-prophet sta-tus.

The webpage is being reworked and up-dated, which was not done for over a year.So take a look at www.safepiercing.org.and contribute to the bulletin board andthe chat line. The conference is set for nextyear and the workshops have already beendecided and speakers and being soughtnow, so content of all speakers can be re-

view and handouts produced ahead oftime. The standardization standards of thejewelry we decided on 2 years ago is befinalized for records and will be in placeby the end of the year, if not sooner. Thedifferent member levels are in place andyou can read more about them on page 8.

The APP is increasing it visibilitythrough a number of ways. First we arestarting an advertising campaign that youwill see in some of the major tattoo maga-zines. We have produced a new brochurecalled, “Choosing your piercer” which in-forms perspective clients what to look forin a professional studio. We are in themiddle of updating the procedural manualinto smaller booklets, or easier changingand distribution. A professional display isbeing made so the board and members canuse the display at different advents, allow-ing a more professional and consistentlook. And a macromedia CD presenta-tion is being made for distribution.

We are working with the Red Cross tosee if we can get them to change theremind and let people who are pierced in anAPP studio to give blood. (Angel add moreabout his, and can you write about some

of the other stuff we are doing)

As you can see we are real busy and aremoving forward. Your constructive inputis welcome. We have asked many of ourmembers to take on certain tasks, so theworkload can be spread out about manymembers. If you have some free timeplease let us know! We are also lookingfor volunteers to help on committees fornext years convention.

The elections for a new treasure are overand Scott Brewer was elected . We con-gratulate Scott and look forward to work-ing with him.

Steve Joyner was recently sent to thestate of Colorado to help with the writingof the states body piercing rules and regu-lations.

Elaye Angel and Dave Vedra will beholding a educational session for the FDAto inform them on the state of body pierc-ing in the US.

Much more is in the works and we willbe keeping everyone abreast of what weare doing.

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ClassifiedsThis is a new section for the POINT so please feel free to inform us if you arelooking for a piercer or if you are a piercer looking for a studio to work in!

We have a well established tattoo shopthat has been in the 29 PalmsCalifornia area for over 15 years. My Fa-ther In-law Col. Todd was in thebusiness for over 45 years and since hehas passed away his son Larry Morahas been running the shop and he has over25 years experience.

We have a very high volume shop be-ing right next to the USMC base. We areopen 10:00 am to 12:00 midnight 7 daysa week with 3 tattoo artists.

A few months ago a piercer called ourshop for employment. We decided totry it out so we hired her because her cre-dentials seemed great. We soonfound out there was a tremendous needfor this in our area and she wasdoing fantastic! Until, all the personalproblems started and we now nolonger have a piercer.

I do have a wonderful person withgreat credentials coming in from Los

Angeles to help us out during my pay-days for the military. But, as youwell know you must have some one on staffpermanent not just every otherweek.

I am in desperate need to find someone full time for our shop. If youknow of any one seeking a full time posi-tion who would like to relocate tothe desert area or could let me know whatavenues to go through which mightget me some results I would really appre-ciate it.

I hope to hear from you soon. Thanksfor your time.

Sincerely,Barbara Mora(760) 365-2776honeymora@thegrid.netor call Larry at:Custom Tattoo Art Gallery(760) 367-6867

AdolescentMany of the students, or others they knew,experienced frequent soreness, rednessand occasional pus-like drainage fromtheir pierced sites, regardless of the piercerand their hygiene habits. Some studentschose to remove the jewelry and let thesite close because of skid problems.

Some students expressed personal sat-isfaction with their piercings, others re-ported negative reactions by others whenthe piercing site was seen. One studentsaid, “I have sensed a negative reactionsince I got my eyebrow pierced. Peoplemay treat you different so you have to havea ‘don’t care’ attitude regarding the wayyour are treated. I would tell someone toconsider their career choice or collegechoice because of other’s reactions:’

HEALTH EDUCATION FOR BODY

PIERCINGDiscussions on this topic need to start

now. School personnel can assume theywill encounter adolescents who have al-ready talked about it, or have encounteredpeers who have had body piercing experi-ences. It is recommended that discussionsstart as soon as possible so students canbegin thinking about their decisions. In-troducing the topic demonstratesproactivity in the situation, even thoughyou may not like the procedure. Remem-ber, students will still talk about piercingwith your health-oriented discussion; theirdialogue will be better informed. Avoidscare tactics. While the content should bepresented in a manner that appreciates theteenager’s belief in the right to have thepiercing, the information should also en-courage the adolescent to think of them-selves as a growing and changing person,with power to discuss, contemplate andmake informed decisions.

Initiate conversations with students re-garding personal observations and seekinsights of other teachers, counselors andschool nurses. Support the casual conver-sations of students when they talk aboutbody piercing. School nurses should seekopportunities to visit studios to share in-formation with body piercers about steril-ization of the instruments they use and theincreased risk for spreading blood-bornediseases, such as hepatitis B and HIV/AIDS to themselves and to their clients,if they do not follow standard preventivepractices.

This article represents whatthe mainstream public thinkregarding piercing.

Greenlake Tatto &piercing wants YOU!!!Full time piercer for outstanding shop

in metro Seattle. APP member, Min. 3yrsexperience, benefits available. Fax oremail resume + references to:

richard@eclipseinkFax 425-745-5656 Attn: RichardFax 206-706-3100 Attn: Richard

Visit Seattle andmake Money!!!

Guest piercer, Min. 3yrs Experiencewith references to work in outstandingshops for up to 6 weeks. Housing help apossibility. APP member. fax or email re-sume + references to:richard@eclipseink.com.

Fax 425-745-5656 Attn: RichardFax 206-706-3100 Attn: Richard

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Association of Professional PiercersThe Point872 N. High St.Columbus, OH 43215