Jailhouse Tattooing
Every prison and jail I ever
visited, and there have been many in my four decades as a sanitarian, tattooing
is prohibited. Universally its practice is
punishable by lock-up and loss of privileges.
The reasons for the prohibition are fairly universal and include:
A tattoo gun can be used as
a weapon. A sewing needle, paper clip, piece of guitar string or purloined
needle from the infirmary placed inside the shaft of a ballpoint pen and
fortified for stability by being taped to popsicle sticks, a toothbrush handle,
spine of a comb or a plastic eating utensil can certainly inflict considerable
harm.
Certain tattoos foment
friction. Prison and street gang tattoos
and racial hatred symbols such as swastikas or a KKK cross are blatant provocations
to incite violence.
Operating a mushfake tattoo gun
that uses electric house current is inherently dangerous. It poses both an
electrical shock and fire hazard. Even
if the original equipment used to construct the gun was UL listed, once the electrical
appliance is compromised it is dangerous and its safety can no longer be
ensured. Additionally, using a light
bulb or fluorescent light socket for the power source in the absence of an
electrical outlet, or using an outlet that is not GFI protected can disrupt
electrical service by blowing out circuits and potentially causing serious
injury to “jailhouse electricians”, the tattoo artist and the customer.
As serious as the security, inmate
management and safety arguments are, they pale in the face of the spread of
communicable diseases, particularly Bloodborne diseases such as Hepatitis B and
C, and HIV which may be contracted through an infected needle, infected ink and
by the infected artist. Sterility and
infection control is not part of the jailhouse body art culture. As professionals in corrections, sooner or
later we have to address this problem … preferably sooner.
But first, to put the
correctional communicable disease picture as it relates to tattooing in context
of public health, societal and economic realities, consider the following:
Rates of many diseases are
higher for the incarcerated than for the total
Approximately 1.4 million of
the 9 million individuals released annually are infected with Hepatitis C. This number represents about 30% of our total population
who have this disease. While this figure
is dramatic, it is hardly surprising.
Most of those who are incarcerated are there because of injecting drugs,
sex work, and violence. These behaviors
lead to infection with blood-borne or sexually transmitted diseases. And just because they are behind bars does
not mean that they discontinue the behaviors that put them there in the first
place. The high risk practices continue,
but without the protection that people might have had on the streets (syringes,
needles, bleach, condoms or latex barriers are considered contraband). In fact, there is epidemiological evidence
that tattooing is the most prevalent risk-related activity among the
incarcerated and that it involves greater numbers of inmates than does
injection-drug use. While tattooing is
relatively safe against infection when performed in the outside world, it could
perhaps be the primary means of Hepatitis C and HIV transmission in our
correctional facilities.
When all communicable diseases
are considered, statistically we can predict about half of all individuals who
were incarcerated at one time or other will die early from a disease they
caught behind bars. About a quarter of
sentenced inmates will contract Hepatitis C while incarcerated. The cost to society is staggering. While all Bloodborne diseases are
catastrophic, Hepatitis C is
probably the worst. There is no
cure. Like HIV infections, the cost for
palliative care can easily exceed $150,000 per individual.
Finally, we need to consider that
tattooing inside prisons is an important part of the correctional social
structure. I am told that it gives
individuals some sense of self and control of their identity. About one half of all prisoners are tattooed
while behind bars. Removing tattooing
from our jails and prisons simply isn’t going to happen.
Recognizing these realities leaves us with two
options: we can either accept the prison experience, or we can allow safe
tattoo studios to be set up inside our facilities. If we choose the latter, our investment will
be far less than our current spending on medical care and risk to the public
health. Tattoo safety is one of the
easiest, least costly and most obvious ways to reduce needless danger to
prisoners.
In 2005
Correctional Service Canada began such a program in six of its federal
prisons. While it is too soon to learn
of any positive epidemiological data from this initiative, it is easy to see
how control can prevent disease.
There are
restrictions on the tattoos permitted (no gang tattoos for example), and
prisoners would have to pay for the cost of their tattoos out of their own accounts
to cover the cost of the needles, ink and disposable gloves and razors. Inmates
are charged five dollars for a two-hour session with trained inmate tattoo
artists who do their work using established infection control practices and
operate under the same guidelines as a licensed tattoo parlor.
Not surprisingly, the
facilities are quite similar to our barber shops; the only significant addition
is an autoclave to sterilize equipment and installation of hard disinfectable
surfaces. There are several model
ordinances available through the internet that provides detailed facility and
management guidance.
From an environmental health
standpoint, the minimum requirements for tattooing facilities include:
Operations shall include
the following:
Skin
preparation, Hand washing and Hygiene requirements:
Proper
handling and disposal of needles, other sharp instruments, blood, other body
fluids, and contaminated products must follow the Occupational Exposure to Bloodborne Pathogens
standard. Basically, these are the same procedures used
in existing clinics.
Establishment
of a tattoo facility inside the walls is neither difficult nor costly and
Infection Control Policies and procedures are virtually identical to those
applied to any clinic or medical receiving area.