Bloodborne Pathogens
Last month we discussed new and emerging pathogens and the importance of protecting yourself as a body art specialist. Although exposure to blood and body fluids by tattoo artists and piercers is relatively low, practicing universal safety precautions is extremely important in the body art industry. A single drop of blood could contain enough disease-causing organisms to cause significant illness. As a body art facility owner or employee, you have no idea what illnesses clients bring in through the front door. Although Hepatitis B is one the biggest viral concerns, other bacterial illnesses can be contracted during contact with small amounts of blood or body fluids during procedures. Depending on the bacterial or viral organism, the incubation period could be anywhere from 3 days to as long as 30 days or longer. That means when the organism is in your system, symptoms of the illness may not appear until days later. During this time, you’re shedding large amounts of the organism without showing symptoms. The Hepatitis B incubation period can be as long as 55 days so during this asymptomatic (no symptoms) period, large amounts of the HBV virus is active and available in your client’s blood during a tattoo procedure. There are more than 200,000 cases of HBV in the United states every year. According to the World Health Organization (WHO), an estimated 257 million people world-wide are living with a Hepatitis B virus infection. Because the Hepatitis virus can live outside the body for as long as seven days, conducting a procedure without using universal precautions can expose a tattoo artist to the virus and a serious illness can start the infection process very quickly.
Symptoms of bacterial and viral infections include nausea, vomiting, diarrhea and abdominal pain. Most of these illnesses go unreported and people do not visit an Urgent Care facility because symptoms usually go away with no need for treatment. If you do visit a medical facility, most doctors will assess the symptoms and decide to prescribe anti-biotics especially if the symptoms involve a fever. A prescription will most likely involve penicillin or a penicillin related drug. Let’s go back in history and take a quick look at the beginning stages of penicillin. Penicillin was considered a wonder drug and saved thousands of lives starting in the 1940’s. 
Prior to its discovery in 1928, there were no treatments for bacterial infections such as strep throat, tuberculosis and a wide variety of other bacterial infections. If you were lucky, your own immune system may have beaten the infection but that was tremendously rare, and most people died from bacterial infections. Simple cuts, scratches and abrasions almost always resulted in a slow, agonizing death.
Penicillin and its related drugs have been used for over 80 years and have triggered a very efficient defense mechanism in the bacteria they are used to treat. Production of the drug in the United States jumped from 21 billion units in 1943 to 1,663 billion units in 1944 to almost 7 trillion units in 1945. By March 1945 penicillin was distributed through the usual channels and was available to the consumer in his or her corner pharmacy. By 1949, the annual production of penicillin in the United States was 133,229 billion units and the price had dropped from $20 per 100,000 units in 1943 to less than ten cents.
Synthetic manufacture of Penicillin – photo credit: Wikimedia Commons
The cooperative efforts of American chemists, chemical engineers, micro-biologists, governmental agencies and chemical and pharmaceutical manufacturers placed penicillin on a fast track unlike any other drug at the time. As one scientist stated, “Too high a tribute cannot be paid to the enterprise and energy with which the American manufacturing firms tackled the large-scale production of the drug.” He added that had it not been for their efforts there would certainly not have been sufficient penicillin supplies by D-Day in Normandy in 1944 to treat the enormous casualties by both British and American soldiers during that invasion.
Although the discovery of penicillin was a true turning point in human history, even the sharpest and most creative scientists and micro-biologists did not anticipate the repercussions on a molecular level. Bacterial organisms have responded to our fight against them by mutating and protecting themselves against anti-biotics. The molecular fight has taken many years but it appears the tiny microbes are winning the battle and outsmarting our best medical efforts to control and kill them.
Next month, we will continue to discuss anti-biotic resistance due to the misuse of the drug once considered the wonder drug of all time.
In 1928, penicillin, the first true anti-biotic was discovered by Alexander Fleming, Professor of Bacteriology at St. Mary’s Hospital in London. Fleming began sorting through petri dishes containing colonies of staphylococcus, bacteria that cause boils, sore throats and abscesses. He noticed something unusual on one dish. It was dotted with colonies except one area where a blob of mold was growing. The zone immediately around the mold later identified as a rare strain of penicillin notatum, was clear. The mold had secreted something that inhibited bacterial growth. Fleming found that his mold “juice” was capable of killing a wide variety of harmful bacteria such as streptococcus, meningococcus and the diphtheria bacillus. Fleming wrote, “When I woke up just after dawn on September 28, 1928, I certainly didn’t plan to revolutionize all medicine by discovering the world’s first anti-biotic, or bacteria killer. But I guess that was exactly what I did.”
Last month we discussed government laws, regulations and ordinances that govern the day to day operations of a typical body art shop. We discussed the need for basic safety procedures that must exist in a body art shop to keep body art operators and customers safe. We also discussed how laws are enacted and the importance of government officials developing a working relationship with body art professionals in this law enactment process.
Medical waste facilities are much different than residential trash collectors. Residential trash collectors pick up residential waste and deliver it to an approved landfill for proper burial. Medical waste facilities are equipped with special disposal equipment and highly specialized machinery approved by that particular state. Each state medical waste facility must adhere to federal government regulations and be inspected from the time they are built to the time they are in full operation. They typically have controlled flame combustion equipment and other incineration devices such as rotary kilns and liquid injection incinerators capable of thermally breaking down solid waste and rendering it harmless. The specialized combustion equipment typically reaches temperatures of over 3000-degrees Fahrenheit and permanently destroys toxic, organic compounds by breaking their bonds and reverting them to constituent elements (elements to live) thereby removing their toxicity. The leftover material, carbonized ash, is then delivered to a special waste landfill which receives only these types of special waste.
