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Hepatitis C and Body Piercing

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Understand the concern and risks associated with body piercing.
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Although tattoos are a known risk factor for acquiring Hepatitis C, many fail to consider body piercing as having an equal potential for viral transmission. Government agencies are recognizing the increasing popularity of body piercing and its associated risks. Being familiar with the Hepatitis C-related risk for piercing and, more importantly, knowing how to proceed safely with this trend, can save you or those you care about from acquiring or spreading Hepatitis C infection.

Why the Concern

In over 40 percent of Hepatitis C cases, infected individuals cannot identify the source for their infection. Unlike many other blood-borne viruses (like HIV), virtually any source of blood or blood products seems to be capable of carrying the Hepatitis C virus, even if the source is indirect – like a piercing gun.

According to occupational exposure statistics, Hepatitis C is approximately seven times more infectious than HIV. As the most common chronic blood-borne infection in the United States, the concentration of Hepatitis C virus in a drop of infected blood is exponentially higher than the concentration of HIV in a drop of infected blood. To compound its high level of contagion, the Centers for Disease Control confirm that Hepatitis C may survive on surfaces outside the body for up to four days. Because of Hepatitis C’s high concentration in blood and the length of time the virus can survive outside the body, extreme care must be taken with any practice involving even infinitesimal amounts of blood.

When it comes to body piercing, its popularity is rising steadily among young adults. A survey of more than 600 undergraduate college students found that 55 percent had at least one piercing in a body area other than their ears. Julie R. Hollberg, MD and colleagues of the Center for Digestive Care in Ypsilanti, Mich, also reported that, of those with piercings in areas other than the ears, approximately 60 percent reported sharing their body-piercing jewelry with friends.

The Risk

When it comes to body piercing, a risk of Hepatitis C transmission exists if any instrument is either not sterilized or disinfected, or is inappropriately used between clients. The Centers for Disease Control recommends that single-use instruments intended to penetrate the skin be used once, then disposed of properly.  Reusable instruments or devices that penetrate the skin and/or contact a client’s blood should be thoroughly cleaned and sterilized between clients. Any less of an effort harbors a possibility of transmitting the highly contagious Hepatitis C virus.

A blossoming concern on Hepatitis C transmission is the sharing of body-piercing jewelry. When pierced, some body locations take longer to heal than others. Until a piercing is completely healed, microscopic traces of infected blood can survive on the jewelry and then transmit the virus to the next wearer. Reports across the U.S. are emerging that demonstrate this type of jewelry sharing to be a source of Hepatitis C virus acquisition. Dr. Hollberg’s study of undergraduate college students highlights the need for education on the dangers of sharing body-piercing jewelry.

Pick Your Piercer Wisely

Johns Hopkins microbiologist Dr. Robyn Gershon points out that many piercings are done at rock concerts, in the backs of stores, or even out of vans – unsanitary conditions far from the reach of state health laws. While most warnings about piercing risks simply advise seeking a reputable business, The Association of Professional Piercers gives us the solid information needed to choose a piercer aware of blood-borne pathogens:

  1. See Their Autoclave – An autoclave is a device that sterilizes the jewelry, tools and equipment necessary to perform piercings. The most effective units use a combination of steam and pressure. Dry heat is NOT considered appropriate for sterilization.
  2. Spore Test Results – A spore test is the only way to know that an autoclave is working properly. Biological indicators test the autoclave’s ability to kill even the most dangerous and resistant organisms such as HIV, hepatitis, etc. The business should keep recent results on file and be willing to show them to you.
  3. Piercing Setup – Ask if you can watch the piercer set up for a session and be in the room when they set up for yours. The piercer should first wash and glove their hands. The equipment should be sealed in individual sterilized packages and placed on a tray. The piercer should change gloves if he or she touches anything in the room other than you and the sterile equipment. All needles should be in individual sterile packages and should be opened while you are present. NEVER let a piercer use a needle on you that was soaked in a liquid. All needles should be disposed of in a sharps container (usually a small red box marked “biohazard”) after they have been used on a single client.
  4. Licensed – In most cases, a license to operate means that the business meets minimum requirements and has passed some sort of inspection. To find out if your area has established standards and inspections, call your local Health Department. If a business is operating unlicensed in an area where licenses are required, report them to your local health department or city business license division.
  5. Using Ear Guns – A number of states have made it illegal to use a gun on body piercings. Most ear guns can’t be sterilized in an autoclave and therefore can potentially transmit Hepatitis C. Even if the antiseptic wipes used were able to kill all pathogens on contact, simply wiping the external surfaces of the gun with an antiseptic does not kill pathogens within the working parts of the gun. Blood from one client can aerosolize, becoming airborne in microscopic particles, and contaminate the inside of the gun. The next client’s tissue and jewelry may come into contact with these contaminated surfaces. Many medical reports acknowledge the possibility of transmitting Hepatitis C with ear guns.

Whether you are Hepatitis C positive and are being conscientious about its spread, or want to protect yourself or others from acquiring this virus, being educated on the risks involved with body piercing will benefit everyone partaking in body piercing. Since the practice of body piercing has only risen over the years, the public needs to know what to look for when choosing a hygienic piercer and the dangers of ear guns and jewelry sharing. As more information is disclosed about the infectivity of Hepatitis C and safe body piercing practices, legislation assuring protection to those wishing to adorn their body with studs, hoops, barbells or rings will be adopted nationwide.

References:

www.all-about-hepatitisc.com, Tattooing and Body Piercing, Schering Corporation, 2007.

www.cdc.gov, Can I get HIV from getting a tattoo or through body piercing?, Centers for Disease Control and Prevention, 2007.

www.cdc.gov, FAQ: Viral Hepatitis, Centers for Disease Control and Prevention, 2007.

www.dochemp.com, Tongue Bars, Rings, Is it Worth Dying For?, C. David Hemp, DDS, Inc., 2007.

www.epi.burnet.edu.au, Hepatitis C Virus and Body Piercing, Burnet Institute, 2007.

www.gazetteonline.com, Senate votes to ban under-18 body piercings, Gazetteonline, April 2007.

www.hcvets.com, Concerns about body piercing get more than lip service, The New York Times, 2007.

www.hepatitis-c.de, Hazards of Body Piercing, Johns Hopkins University, 2007.

www.medpagetoday.com, ACG: Students Risk HCV by Sharing Body-Piercing Jewelry, Jeff Minerd, MedPage Today, LLC, 2007.

www.pediatrics.aapublications.org, Transmission of Hepatitis C Through Swapping Body Jewelry, A. Rebecca Daniel, MD, Thomas Sheha, MD, Pediatrics, November 2005.

www.safepiercing.org, Choosing a Piercer, Association of Professional Piercers.

www.safepiercing.org, What is the APP Position

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