Loading...
Tattoo Ordinance Change Info Du~ ~ck~ MEMORANDUM August 9, 2004 TO: The Honorable Mayor and City Council Members FROM: Michael C. Van Milligen, City Manager SUBJECT: Request to Change Tattoo Ordinance Tanya Tigges has requested the City modify the existing Tattoo Ordinance to allow the practice if micro-pigmentation without a physician's supervision. Micro-pigmentation, also known as dermagraphics, permanent makeup/cosmetics, cosmetic tattooing, intradermal implants, and dermal pigmentation is tattooing. Micro-pigmentation technicians are not certified by a third party, but simply through the school in which the training was received. There are no state or federal certifications/licenses for this technique. Based on the recommendation of Dr. John Viner and Dr. Erin Kennedy, and the fact that micro-pigmentation is tattooing, it should require the same level of medical oversight and supervision since they are one in the same. If the requirement for physician oversight is not required for the practice of micro-pigmentation, it appears that it would also need to be removed as a requirement for general tattooing. The current City Ordinance states, "practice of tattooing be limited to physicians or osteopaths licensed in the state, or to individuals directly under their supervision." Public Health Specialist Mary Rose Corrigan is recommending that no change be made in the current City Ordinance. I concur with the recommendation and respectfully request Mayor and City Council approval. /%JJ 1{,7¡1~ Michael C. Van Milligen '- MCVM/jh Attachment cc: Barry Lindahl, Corporation Counsel Cindy Steinhauser, Assistant City Manager Mary Rose Corrigan, RN, Public Health Specialist "'> '" .. . D~ ~ck~ MEMORANDUM TO: Michael C. Van Milligen, City ~ FROM: Mary Rose COrriga~N, Public Health Specialist SUBJECT: Request to Change Tattoo Ordinance INTRODUCTION This memorandum is in response to Tanya Tigges' request to modify the existing Tattoo Ordinance to allow the practice of micro-pigmentation without a physician's supervision. BACKGROUND The City of Dubuque addresses the practice of tattooing under Section 23-2 of the City Code of Ordinances. In addition to being licensed as a tattoo establishment through the Iowa Department of Public Health, the City Ordinance requires that the "practice of tattooing be limited to physicians or osteopaths licensed in the state, or to individuals directly under their supervision." DISCUSSION Micro-pigmentation, also known as dermagraphics, permanent makeup/cosmetics, cosmetic tattooing, intradermal implants, and dermal pigmentation is tattooing. The micro-pigmentation procedures are performed by depositing pigment, or ink dyes, into the dermal layer of the skin with a specially designed motorized instrument and a sterile needle or group of needles. Micro-pigmentation is usually performed around the eyes, eyebrows and lips. Micro-pigmentation technicians are not certified by a third party, but simply through the school in which the training was received. There are no State or Federal certifications/licenses for this technique. Micro-pigmentation is often performed in physician practices, specifically by plastic surgeons or by technicians in physician- managed clinics. Dr. John Viner, MD, Medical Advisor for the City of Dubuque Health Services Department recommends that "cosmetic tattooing should be considered along with existing policies of tattooing in our community, by my perspective and recommendation. Medical supervision recommended." (See attached letter) Similarly, Dr. Erin Kennedy, MD, Plastic Surgeon in Dubuque stated that micro-pigmentation is tattooing and there are numerous risks involved in the process. In addition to potential allergic reactions with ingredients in the dyes used, there are risks to vision, lid inclusion, infection risk involving paraorbital cellulitis, sagittal sinus thrombosis, and possible vision loss. Dr. Kennedy believes any micro-pigmentation activity should be performed under the direction of a physician. She personally does not perform micro-pigmentation in her practice, nor does she intend to engage in this practice in the future. RECOMMENDATION Based on the recommendation of Dr. John Viner and Dr. Erin Kennedy, and the fact that micro-pigmentation is tattooing, it should require the same level of medical oversight and supervision since they are one in the same. If the requirement for physician oversight is not required for the practice of micro-pigmentation, it would also need to be removed as a requirement for general tattooing. Therefore, I recommend the physician oversight requirement for tattooing remain in the City Ordinance. However, if this requirement is removed, the City would not need any special ordinances nor provide oversight, and would simply direct tattoo establishment owners to obtain an Iowa Department of Public Health license. COUNCIL ACTION Please advise staff to either prepare a repeal of the current Tattoo Ordinance, Section 23-2, or leave it as is with the physician supervision requirement intact. MRC/cj " Dubuque Internal Medicine - Doctors For Adults" July 22, 2004 Dubuque [ute",al Medieine, P.c. 1515 Delhi Street, Suite 100 Dubuque, Iowa 52001-6389 5631557.9111 The Food and Drug Administration updated their position on 07/01/2004 regarding a cosmetic tattoo. They noted among other things that the color additives used in this procedure are not approved by FDA for tattoo use. These pigments are typically approved for printing and automobile pigments. Internal Medicine R. S. Bartsch, MD, J, M, Comptoo, M,D" FAc.P, W, J. Dal1, MD, M, J. Kirkendal1. MD, C. J, Konz, MD, p, J, Leeson, M,D,. FAc.P, R, W, Lengeling, MD, M, 0, Liaboe, M,D, C, A, Longo, M,D, A, G. Meurer, M,D, B, D, Moran, MD, G,M,Moran,M.D, D, K, Mozena, MD, K, E, Nelson, MD, G. v, Ridgley. ¡", M,D, H. A, Salas, M,D. R, W, Schope, M,D, D, L. Sorenson. M,D, J, p, Vin". M,D" FAe.P, Travel Medicine R. J. Fairley, M,D" M,P,H, Cardiology e. A, Longo. MD, T, W, Marbn. M,D" FAe.e. Endocrinology R, A, lve"on, MD,. FAe.P, D, M, Putz.MD, Gastroenterology I. M, Koontz, MD, R, W, Lengeling, M,D, Infectious Diseases J, p, Vin". M,D" FAe.P, Medical Oncology M, E, Hem1ann, MD, D, W, Zenk. M,D, Nephrology D, M, Ringold, MD, J, E, Whalen. MD, Nenrology R, S, Sims. M,D, Pulmonary Medicine R, W, Schope. MD, Medical Director R, J, Fairley. MD., M,P,H, Mrs. Mary Rose Corrigan Dubuque Health Department 1300 Main Street Dubuque, Iowa 52001 Dear Mrs. Corrigan: The question has been raised about the health safety of micro pigmentation tattoo. This is a cosmetic tattoo which involves subcutaneous pigment introduction by needle. Of course, this is a facial procedure, induding around eyes. The City of Dubuque requires medical supervision for tattoo application. I have checked with the American Medical Association policy regarding this procedure. The AMA H-440.909 "Regulation of Tattoo Artists and Facilities" recommends State regulation. AMA policy H-440.934 expresses concern for the sterilization of instruments in noncommercial enterprises, such as tattoo parlors because ofthe danger of blood infected contaminated fluids. The FDA sites six specific problems with cosmetic tattoo. I believe that most important from the public health standpoint is the danger of infection and they specifY hepatitis, by which they mean hepatitis B and C. The Red Cross Policy is that an individual cannot donate blood for one year after this tattoo procedure which is in reference to this hepatitis risk. There is also a notable case in the popular press of an actress who is hepatitis C infected due to tattoo exposure. Page 2 Mrs. Mary Rose Corrigan Dubuque Health Department Dubuque, Iowa 52001 07/22/2004 I do not want to discount the other five points referred by the Food and Drug Administration update. Removal problems are difficult with cosmetic tattoos. Allergic reactions to dyes and pigments are not uncommon. Granuloma development is also a frequent problem. Keloid development, either with the original tattoo or with removal of tattoo is a situation of which the dermatologists are well aware. An added problem from cosmetic tattoo has complication in magnetic resonance imaging. Apparently, there is metal!ic content in pigments which can be disrupted or moved in the presence of the strong magnet of MRI scanning. Patient dissatisfaction is not unusual with cosmetic tattooing due to fading and distortion. Cosmetic tattooing should be considered along with existing policies of tattooing in our community, by my perspective and recommendation. Medical supervision recommended. Sincerely, ).,~' John P. Viner, M.D. JPV/rs Chapter 23 HEALTH AND SANITATION ARTICLE I. IN GENERAL Sec. 23-2. Tattooing: (a) (b) (c) Definitions: For the purpose of this Section, the following words and phrases shall be construed as follows: (1) Tattoo Artist: Any person engaged in the practice of tattooing. (2) Tattoo Establishment: Location where tattooing is practiced. (3) Tattooing: To puncture the skin of a person with a needle and insert indelible permanent colors through the puncture to leave permanent marks or designs. Prohibition: The practice of tattooing shall be limited to physicians or osteopaths licensed in the State, or to individuals directly under their supervision. Registration: Tattoo establishments and tattoo artists shall register annually with the City Health Services Division and indicate the physician or osteopath under whose supervision they are operating. (1976 Code, § 18-2; Ord. 17-96, § 1,3-18- 1996)