Public Health (Wales) Bill: Tattooing, body modification and intimate piercing

Article by Amy Clifton, National Assembly for Wales Research Service, In Brief blog. On Tuesday, 8 December 2015 the Assembly will debate the Public Health (Wales) Bill in Plenary. The Health and Social Care Committee, tasked with scrutinising the legislative proposal, issued a Report on the Bill last week and made a number of recommendations and suggested amendments. At the start of the consultation, the Assembly's Outreach team conducted a national survey to ask the people of Wales what they thought of the Welsh Government proposals relating to e-cigarettes, special procedures and intimate piercing. Much of the attention surrounding the Public Health (Wales) Bill has focused on e-cigarettes. However another interesting area of the Bill concerns special procedures and intimate piercing (Parts 3 and 4 of the Bill). Special procedures The Bill as drafted would create a mandatory licensing scheme for practitioners and businesses carrying out special procedures in Wales. The special procedures currently included are acupuncture, electrolysis, body piercing and tattooing, although the Bill would also allow Welsh Ministers to amend this list through secondary legislation. Many stakeholders indicated in their evidence to the Committee that there is currently a significant lack of quality control within the tattoo and piercing industries. The Committee heard alarming reports that many procedures are being done by people with little, if any, knowledge of anatomy, infection control or healing processes. Stakeholders also highlighted additional procedures they believe should be included the Bill. These included body modification (scarification, dermal implants, branding and tongue splitting), injection of liquid into the body (botox or dermal fillers), and laser treatments (tattoo removal or hair removal). The Assembly Outreach team made a short video, interviewing practitioners across Wales: https://www.youtube.com/watch?v=xsUHPEWTaxU&feature=youtu.be Tattoo artists in the video express particular concern about branding, scarification, ‘extreme body modification’ (such as tongue splitting and penis splitting) and dermal implants. They explain that scarification (where a section of the skin is removed to leave a scar) is often performed dangerously. The tattooists also say that branding is being done with blowtorches and bent coat hangers, and adapted soldering irons, and describe concerns about dermal implants, such as inserting horns and stars under the skin:

Inserting foreign objects into your body is not a good thing without some sort of legislative weight behind it to say, ‘That’s unsafe’, or, ‘Is the material safe?’ or ‘Has it been checked?’; ‘Is it sterile? Have you autoclaved it before you put it in there? Where did you get it from? Has this come out of a five-penny ball machine round the corner?’

Intimate piercing The Bill proposes to set an age restriction of 16 years old for intimate piercing. It defines the intimate body parts as the anus, breast, buttock, natal cleft, penis, perineum, pubic mound, scrotum and vulva. Whilst there is support for the principle of an age restriction, many stakeholders believe that 18 would be a more appropriate minimum age limit for intimate areas. For example, the Chartered Institute of Environmental Health (CIEH) believes that 18 would be a more appropriate age restriction, as this is in line with the minimum age for tattooing, and reflects the level of maturity needed to make such decisions. Stakeholders also reasoned that an individual aged 16 is still growing and therefore the risk of damage to skin is greater. It was also noted that intimate body piercings require a higher standard of aftercare than tattoos, as they are potentially more susceptible to infection. Dr Ncube supports a higher age limit, noting that there are long term implications with genital piercing. He gave a case study example of a father with a genital piercing, who was playing with his daughter, and his daughter accidentally kicked him.

The trauma that was caused by the genital piercing resulted in the formation of gangrene in his penis. It’s a condition called Fournier’s condition. Because of that, the scarring that occurred was profound. So, genital piercing is attended with considerable risks, and it’s not just the piercing alone that is important, but it’s the long-term implications of it.

There was also a strong message from stakeholders, including Public Health Wales, that tongue piercing should be included in this part of the Bill, with witnesses describing a high risk of complications, harm and infection. Plenary debate You can watch the debate on the Public Health (Wales) Bill live on senedd.tv or catch-up at a later date. For more information on the work of the Committee, visit their website on www.assembly.wales/seneddhealth