CHAPTER 22PRACTICE OF TATTOOING64122.1(135) Purpose. The purpose of this chapter is to stipulate the permit and operational requirements for tattoo artists and tattoo establishments.Related ARC(s): 7982B64122.2(135) Definitions. For the purpose of these rules, the following definitions shall apply:
"Aftercare" means written instructions given to a client, specific to the procedures rendered, on care for the tattoo and surrounding area and guidance on when to seek medical treatment.
"Department" means the Iowa department of public health.
"Director" means the director of the Iowa department of public health.
"Disinfectant" means a U.S. Environmental Protection Agency (EPA)-registered antimicrobial product that is applied to surfaces to destroy microorganisms that are living on the surface but not necessarily bacterial spores.
"Imminent health threat" means a condition or conditions that exist in a tattoo establishment and require immediate action to prevent endangering the health of people.
"Impervious" means nonporous, impenetrable, smooth, and washable.
"Inspection agency" means the department or a city, county or district board of health that has executed an agreement with the department pursuant to the authority of a city, county or district board of health to inspect tattoo establishments and enforce these rules. The authority of a city, county or district board of health is limited to the geographic area defined in the agreement executed with the department. Within the defined geographic area, the city, county or district board of health is the “local inspection agency.”
"Mobile tattoo unit" means a mobile establishment or unit that is self-propelled or otherwise movable from place to place, is self-sufficient for utilities such as gas, water, electricity and liquid waste disposal, and operates at a fixed location where a permitted artist performs tattooing procedures for no more than 14 days in conjunction with a single event.
"Residential dwelling" is a place or structure intended to be occupied as a residence.
"Single use" means intended for one-time use and disposed of after use on a client. Single-use products or items include, but are not limited to, cotton swabs or balls, tissues or paper products, paper or plastic cups, gauze and sanitary coverings, disposable razors, tattoo needles, scalpel blades, stencils, ink cups, and protective gloves. Cloth towels and linens are not included as “single use” and are prohibited.
"Sterilization" means a process resulting in the destruction of all forms of microbial life, including highly resistant bacterial spores that demonstrate tuberculocidal activity.
"Tattoo artist" means any person, including a permanent color technologist, engaged in the practice of tattooing within the state of Iowa.
"Tattoo establishment" means the building or portion of the building designated by the owner where tattooing is practiced.
"Tattooing" means to puncture the skin of a person with a needle and insert indelible permanent colors through the puncture to leave permanent marks or designs. “Tattooing” includes permanent color technology that is the process by which the skin is marked or colored by insertion of nontoxic dyes or pigments into the dermis portion of the skin so as to form indelible marks for cosmetic purposes. “Tattooing” does not include applying a tattoo for radiological purposes.
"Temporary establishment permit" means a permit issued by the department to perform tattoo procedures at a temporary event.
"Temporary event" means any place or premises operating at a fixed location where a tattoo artist performs tattooing procedures for no more than 14 days consecutively in conjunction with a single event or celebration to which the general public is invited.Related ARC(s): 7982B, 2656C64122.3(135) General provisions. 22.3(1) Tattoo artists and tattoo establishments that fail to meet the requirements of Iowa Code section 135.37 or these rules shall be guilty of a serious misdemeanor. 22.3(2) No person shall tattoo any person under the age of 18. Violators shall be guilty of a serious misdemeanor. 22.3(3) No person shall engage in the practice of tattooing without first applying for and receiving a tattoo artist permit from the department. 22.3(4) Tattoo artists and tattoo establishments that are in compliance with Iowa Code section 135.37 and these rules are not relieved from the requirements of any other applicable state laws or local ordinances. 22.3(5) Tattooing shall be practiced only in facilities that have applied for and received a tattoo establishment permit from the department. 22.3(6) Notwithstanding local zoning codes, where zoning codes exist, tattooing shall not be practiced in a residential dwelling, inclusive of an attached garage. Beginning January 1, 2010, all new tattoo establishments must be in a building that is zoned commercial where zoning ordinances exist. A waiver shall be granted to any tattoo establishment which is in a residential dwelling and which has been operating continuously since being granted a permit prior to January 1, 2010. 22.3(7) Tattoo establishments shall be inspected annually.Related ARC(s): 7982B, 2656C64122.4(135) Sanitation and infection control. 22.4(1) Tables, chairs, and other general-use equipment in the tattoo area shall be constructed of impervious, smooth and easily cleanable material. 22.4(2) A sink for hand washing supplied with potable hot and cold running water under pressure to a mixing-type faucet shall be easily accessible in the tattooing area. Hand-washing facilities shall be supplied with liquid soap and single-use towels or hand dryer. 22.4(3) Easily accessible toilet facilities with a sink for hand washing must be available for employee use and patron use. 22.4(4) The tattoo establishment shall have an area of at least 300 square feet and shall be adequately lighted and ventilated. 22.4(5) Floors in the tattoo area shall be finished with an impervious, smooth, washable surface. 22.4(6) The entire premises and all facilities used in connection therewith shall be maintained in a clean, sanitary, vermin-free condition and in good repair. 22.4(7) All refuse shall be stored in rigid containers with plastic liners which are emptied at least once each business day. 22.4(8) Closed cabinets or containers shall be exclusively used for the storage of instruments, dyes, pigments, stencils, tattoo machines, and other equipment. 22.4(9) The following prohibitions apply to tattoo establishments: a. Smoking shall not be allowed pursuant to Iowa Code chapter 142D. b. Consumption of food or drink shall not be allowed in the tattoo area. c. The owner or tattoo artist must not use, consume or serve intoxicating beverages or controlled substances on the establishment’s premises. d. The owner or tattoo artist must not allow any other person to use, consume, or serve intoxicating beverages or controlled substances on the establishment’s premises. e. The owner or tattoo artist shall not in any manner possess or distribute or allow any other person to possess or distribute intoxicating beverages or controlled substances on the establishment’s premises. f. The tattoo establishment owner shall not allow a tattoo artist who is not currently permitted in the state of Iowa to tattoo in the establishment. 22.4(10) No animals, except service animals, shall be permitted in a tattoo establishment. Aquariums containing fish shall be allowed in waiting rooms and non-tattoo areas.Related ARC(s): 7982B, 2656C64122.5(135) Equipment. All equipment shall be maintained in a clean and sanitary condition. 22.5(1) Cups to hold ink or dye shall be for single-patron use. Any ink or dye, once dispensed into an ink cup, must be disposed of immediately following use. 22.5(2) Any dye or ink in which needles were dipped shall not be used on another person. 22.5(3) All tubes, tips and grips used for the tattoo procedure which are not sterile, not for single-patron use, and not disposable shall be physically cleaned with a detergent according to manufacturers’ recommendations and then steam-sterilized or dry-heat sterilized before use on another patron. 22.5(4) Steam sterilization shall be at 250 degrees Fahrenheit (121 degrees Celsius) for 15 minutes at a minimum pressure of 15 pounds per square inch. Steam sterilization is the preferred method of sterilization. 22.5(5) Dry-heat sterilization shall be at 350 degrees Fahrenheit (170 degrees Celsius) for one hour. 22.5(6) All instruments must be sterilized on site. All instruments to be sterilized shall be placed in closed pouches. The pouches must be dated effective for 30 days, after which the instruments must be resterilized and the pouches redated. 22.5(7) Sterilizers shall be monitored monthly for spores of Bacillus subtilis, and records of results shall be maintained for three years. 22.5(8) Each tattoo establishment shall maintain written procedures to follow in the event of positive spore tests. a. In the event of a positive spore test, materials processed in that sterilizer, dating from the sterilization cycle having the positive biological indicator to the next cycle showing satisfactory biologic indicator challenge results, must be considered nonsterile and must be reprocessed before being used. b. A sterilizer that has received a positive spore test must be immediately removed from service. c. Prior to putting a sterilizer that has received a positive spore test back into service, the owner must ensure that there is evidence of one negative spore test. d. The owner must notify the inspection agency of a positive spore test within 24 hours of receiving the test result. 22.5(9) Each tattoo establishment shall be equipped with a puncture-resistant, leakproof container designated for disposal of used needles and other sharps. The container shall be red and labeled with the “biohazard” symbol and shall be closeable for handling, storage, transportation and disposal. A written plan for disposal shall be maintained in the establishment. 22.5(10) Any bottles of solution shall be labeled as to contents and used according to manufacturers’ directions. 22.5(11) Razors for removal of unwanted hair shall be for single-patron use and shall be disposable. If electric razors are used to remove unwanted hair of the patron, the clippers shall be cleaned with a brush and fungicidal/tuberculocidal disinfectant spray. 22.5(12) Topical ointments shall be prepared for single-patron use.Related ARC(s): 7982B, 2656C64122.6(135) Procedures. 22.6(1) Each tattoo establishment shall establish a written standard operating procedure (SOP), which shall include the process for setup and tear down of tattoo procedures. The SOP shall focus on procedures of hygiene and cross-contamination control. 22.6(2) For privacy purposes and at the patron’s request, there shall be in place or readily available a panel or other barrier of sufficient height and width to effectively separate the patron from any unwanted observers or waiting patrons. Panels or other barriers shall be nontransparent and may be fixed or movable, rigid or flexible. 22.6(3) Tattoo artists shall scrub their hands thoroughly before beginning the tattoo procedure. Tattoo artists shall dry their hands with individual single-use towels or hand dryer. 22.6(4) Tattoo artists shall wear clean garments when performing tattoo procedures. Tattoo artists shall wear disposable latex, nitrile, chloroprene, or vinyl gloves during the tattoo procedure. Gloves shall be changed after each tattoo. Tattoo artists shall wash their hands before and after each tattoo procedure. 22.6(5) All items with which the gloved hands of the tattoo artist would normally come into contact during the tattooing procedure shall have appropriate barrier films covering them. These items include, but are not limited to, clip cords, squeeze bottles, seat adjustment controls, power control dials or buttons, and work lamps. 22.6(6) The skin area to be tattooed shall first be cleansed with soap and water. Single-use towels or sponges (gauze) shall be used during the cleansing procedure. 22.6(7) Before placing the tattoo design on the patron’s skin, the tattoo artist shall prepare the skin with 70 percent ethyl or isopropyl alcohol solution or an equally effective antiseptic or antimicrobial. 22.6(8) Tattooing shall not be performed on any area where there is evidence of skin infection, irritation, or abnormalities. 22.6(9) After the tattooing is completed, the tattoo artist shall: a. Apply an adequate dressing or bandage to the tattoo area. b. Provide to the persons tattooed printed aftercare instructions regarding tattoo care during the healing process. c. Thoroughly clean the machine head with an acceptable disinfectant and spray an acceptable surface disinfectant over the work area during the clean-up procedures before the area is set up for the next tattoo procedure.Related ARC(s): 7982B, 2656C64122.7(135) Permit issuance and renewal. The following criteria shall apply to application for a permit to practice as a tattoo artist or as a tattoo establishment. 22.7(1) Online or paper applications. a. An applicant shall complete either an online application or a paper application according to the instructions contained in the application. b. Paper applications are available to download at http://www.idph.iowa.gov/Tattoo or may be obtained from the tattoo office by writing to Tattoo Program, Iowa Department of Public Health, 321 East 12th Street, Des Moines, Iowa 50319-0075; or by calling (515)242-6337. c. Fees. In order to be processed, each application must be accompanied by the appropriate fee as determined in the fee schedule listed in subrule 22.8(2). All fees are nonrefundable. An application that includes insufficient or incorrect fees shall be considered incomplete. d. A paper application shall be accompanied by the appropriate fee payable by check or money order to the Iowa Department of Public Health. e. Online application fees shall be paid by credit card only. f. If the applicant is notified that the application is incomplete, the applicant must contact the tattoo office within 90 days. Incomplete applications shall be considered invalid and after 90 days shall be destroyed. 22.7(2) Documentation of medical conditions and criminal convictions related to the practice of the profession shall include a full explanation from the applicant. No application shall be considered complete until the applicant responds to any program requests for additional information regarding the applicant’s medical condition or criminal conviction. 22.7(3) All permits expire on December 31 for the year issued. Permits shall be renewed annually. The applicant shall submit a completed application, supporting documentation and renewal fee by December 1. The permit holder must have a current permit in possession before performing tattooing. An applicant who submits a renewal application after December 1 will be required to pay an additional $25 for each month delinquent. 22.7(4) The permit holder is responsible for renewing the permit prior to its expiration. 22.7(5) A permit which has not been renewed within 90 days of the permit expiration date will automatically be deactivated. There will be a $25 reinstatement fee charged for reactivating a permit. This reactivation fee will be in addition to the renewal fee.Related ARC(s): 7982B, 2656C64122.8(135) Fees. 22.8(1) All fees are nonrefundable. 22.8(2) Fees for all initial and renewal applications are as follows: a. Tattoo artist - $75. b. Tattoo establishment - $100. c. Temporary tattoo establishment: (1) 0 to 10 participating artists - $100. (2) 11 to 100 participating artists - $200. (3) 101 or more participating artists - $300. d. Mobile tattoo unit - $100. e. Mobile tattoo event - $25 per event. f. Tattoo establishment change of ownership - $25. g. Tattoo establishment change of location - $25. h. Mobile tattoo unit change of location - $25.Related ARC(s): 7982B, 2656C64122.8(135) Tattoo establishment permit requirements. 22.8(1) No tattoo establishment shall be operated in the state without having a permit to operate issued by the department. Permits shall be posted in a conspicuous location in the tattoo establishment. 22.8(2) Each person acquiring or establishing a tattoo establishment shall apply for a permit prior to beginning operation and shall submit a floor plan of the establishment with the application. 22.8(3) A permit to operate shall be issued to a new establishment when the department or its representative has successfully completed an on-site inspection. 22.8(4) Tattoo establishment permits are nontransferable. 22.8(5) Client records. A tattoo establishment shall retain a record of all persons who have had tattoo procedures performed at the establishment. a. Records shall include the client’s name and date of birth, copy of client’s identification, date of the procedure, name of the tattoo artist who performed the procedure(s), and signature of client. b. Records shall be retained in a confidential manner for a minimum of three years and shall be available to the department and the inspection agency upon request. 22.8(6) Change in ownership. Within 30 days of a change in ownership of a tattoo establishment, the new owner shall submit a change in ownership application and fee for a new permit. When a change of ownership occurs, an on-site inspection must be completed by the inspection agency before a permit to operate will be issued. The new permit must be posted in a conspicuous location in the establishment. 22.8(7) Change in location. Within 30 days of a change of location of a tattoo establishment, the owner shall submit a change of location application and a fee for a new permit. When a change of location occurs, an on-site inspection must be completed by the inspection agency before a permit to operate will be issued. The new permit must be posted in a conspicuous location in the establishment.Related ARC(s): 7982B, 2656C64122.9(135) Tattoo artist permit requirements. 22.9(1) No person shall perform tattooing without a current permit to operate issued by the department. Each person shall apply for a permit prior to beginning operation. 22.9(2) Each permit issued shall be in effect solely for the tattoo artist named thereon and shall remain with the tattoo artist upon change of employment. Tattoo artist permits are nontransferable. 22.9(3) An applicant for a tattoo artist permit shall be at least 18 years of age and must submit government-issued documentation to show proof of attaining the age of 18 years. 22.9(4) An applicant must show proof of a high school diploma or high school equivalency diploma. (Note: Tattoo artists granted a permit prior to January 1, 2010, will not be required to obtain a high school diploma or high school equivalency diploma.) A degree from an accredited college will be accepted in lieu of a high school diploma or high school equivalency diploma. 22.9(5) Upon initial application and permit renewal application, a tattoo artist must possess and show proof of current certification of American Red Cross or equivalent nationally recognized certifications for blood-borne pathogens and standard first aid. 22.9(6) Permits shall be posted in a conspicuous place in the tattoo establishment.Related ARC(s): 7982B, 2656C64122.10(135) Temporary establishment permit requirements. 22.10(1) A person who wishes to obtain a temporary establishment permit for a temporary event must submit a temporary tattoo establishment application form, a floor plan of the facility, promotional documentation for the event, and the appropriate fee at least 30 days prior to the event. Fees shall be based on the number of participating tattoo artists. The application shall specify the following: a. The purpose for which the permit is requested. b. The period of time during which the permit is needed (not to exceed 14 calendar days per event). c. The fulfillment of tattoo artist requirements as specified in 641—22.10(135). A list of participating tattoo artists shall be sent to the tattoo program no later than one week prior to the event. d. The location at which the temporary event will be held. 22.10(2) The temporary event must be inside a permanent building. 22.10(3) The temporary establishment shall comply with the following: a. Conveniently located hand-washing facilities with liquid soap, single-use towels or hand dryers and potable hot and cold water under pressure to a mixing-type faucet shall be provided. Drainage in accordance with local plumbing codes shall be provided. b. A minimum of 80 square feet of floor space shall be provided for each booth. c. There shall be sufficient lighting where the tattoo procedure is being performed. d. All tubes, tips and grips used for the tattoo procedure that are not single use must be properly sterilized and dated 30 days or less prior to the date of the event. Evidence of a spore test performed on the sterilization equipment must be dated 30 days or less prior to the date of the event. Single-use, prepackaged, sterilized equipment obtained from reputable suppliers or manufacturers will be allowed. e. Tattoo artists must properly clean and sanitize the area used for tattoo procedures. f. Floors of the tattooing area(s) shall be smooth and impervious or be covered with an impermeable barrier. 22.10(4) The facility where the temporary event will be held must be inspected by the designated inspection agency and be issued a permit prior to the performance of any tattoo procedures. A $50 inspection fee for each booth shall be made payable to the inspection agency. 22.10(5) No animals, except service animals, shall be allowed in the temporary establishment at any time. 22.10(6) Temporary establishment permits issued under the provisions of these rules may be suspended by the department for failure of the holder to comply with the requirements of these rules. 22.10(7) Temporary establishment permits and tattoo artist permits shall be posted in a conspicuous place in the temporary establishment.Related ARC(s): 7982B, 2656C64122.11(135) Mobile tattoo unit permit requirements. Effective September 7, 2016, no new mobile tattoo units will be permitted. (Note: Mobile tattoo units granted a permit prior to September 7, 2016, may continue to operate with a current permit provided they remain compliant with the rules of this chapter.) 22.11(1) Mobile tattoo unit permits shall be in compliance with all of the following requirements: a. No mobile tattoo unit shall be operated in the state without having a permit to operate issued by the department. b. All tattoo artists working in a mobile tattoo unit must have a permit and must comply with the permit requirements of these rules. Artist permits shall be posted in a conspicuous location in the mobile tattoo unit. c. Mobile tattoo unit permits shall be posted in a conspicuous place in the mobile tattoo unit. d. Mobile tattoo unit permits are nontransferable. e. Change in address location. Within 30 days of a change of address of where the mobile tattoo unit is housed, the owner shall submit a new application and a fee for a new permit. f. Inspections will be conducted by the local jurisdiction in which the mobile tattoo unit is housed. Out-of-state mobile tattoo units must have a current Iowa mobile tattoo unit permit and will be required to have an annual inspection. 22.11(2) Mobile tattoo units and tattoo artists working from a mobile tattoo unit shall also comply with all of the following requirements. a. Mobile tattoo units are permitted for use only at temporary events lasting 14 calendar days or less. Permits must be obtained at least 14 days prior to the event, and no tattoo procedures shall be performed before a permit is issued. Promotional documentation of the event must be included with the application. Permit holders are responsible for compliance with all other local regulations including but not limited to zoning and business license requirements. b. The mobile tattoo unit shall be maintained in a clean and sanitary condition at all times. Doors shall be tight-fitting. Openable windows shall have tight-fitting screens. c. Mobile tattoo units must meet the sterilization requirements in accordance with 641—22.5(135). d. Mobile tattoo units shall be used only for the purpose of performing tattoo procedures. No habitation or food preparation is permitted inside the vehicle unless the tattoo work station is separated from culinary or domicile areas by an impervious floor-to-ceiling barrier. e. Mobile tattoo units shall be equipped with a hand sink for use of the tattoo artist for hand washing and preparing the client for the tattoo procedures. (1) The hand sink shall be supplied with hot and cold running water under pressure to a mixing-type faucet, as well as liquid soap and single-use towels in dispensers or hand dryer. (2) An adequate supply of potable water shall be maintained for the mobile tattoo unit at all times during operation. (3) The source of the water and storage of the tank(s) shall also be identified. f. All liquid wastes shall be stored in an adequate storage tank with a capacity at least 15 percent greater than the capacity of the on-board potable water supply. Liquid wastes shall be disposed of at a publicly owned treatment works site approved by the department of natural resources (IDNR). g. Restroom facilities must be available at the temporary event or within the mobile tattoo unit. (1) A hand sink must be available within a reasonably acceptable distance from the restroom. (2) The hand sink shall be supplied with hot and cold running water under pressure to a mixing-type faucet, as well as liquid soap and single-use towels or hand dryer. (3) Restrooms must be adequately ventilated. h. All tattoo artists working in a mobile tattoo unit must have a permit and must comply with the permit requirements of these rules. Permits shall be posted in a conspicuous location in the mobile tattoo unit. i. No animals, except service animals, shall be allowed in the mobile tattoo unit at any time.Related ARC(s): 7982B, 2656C64122.12(135) Agreements. The department may enter into agreements with the local boards of health to provide inspections and enforcement. An inspection agency shall:
- Ensure that its inspectors will meet the educational requirements of 641—22.15(135).
- Provide inspections of all tattoo establishments within the contracted area.