According to the CDC, Ebola is the biggest threat to health care workers and their families, and air travel workers. That's because until recently Ebola outbreaks had been pretty well restricted to a few countries in Africa. Most of the people who had interactions with those infected were usually their caretakers, medical personnel. When someone who is infected tries to travel (usually because they don't realize the severity of their illness and believe they just have a cold or flu), travel personnel become the next most likely to become infected as they are the ones in the most contact. I can recall from my own experience traveling about a year ago. I had started exhibiting flu like symptoms the night before, after waiting in an Emergency Room while my niece was treated for some bug that we probably jokingly told her at the time was Ebola. Up until recently I'm not even 100% sure that I knew Ebola was a real thing and not a fictitious virus made up by Hollywood for movie purposes. The next morning I had an early flight home to Los Angeles, and although my symptoms had increased to extremely uncomfortable levels I knew I had to be back home. I could not simply stay away because I had a fever and felt fatigued and needed to be close to a restroom at most times. I got on the flight, and for the first time in my life used one of those little wax lined bags they keep in the seat pocket. I never vomit. Ever. So you can imagine my dismay and slight confusion. My first instinct was to ring the bell for the flight attendant, while I sat there in shock and embarrassment hoping to God I had contained the smell and spared the strangers in the surrounding seats. I felt clammy, I was extremely tired and uncomfortable, there was turbulence (which probably helped hide my illness and just made me seem like I had motion sickness), I wanted to be 10 years old and have someone wait on me and tell me I'd get better soon. I didn't know what the attendant would do, but I thought maybe she could at least give me a napkin or a wet wipe. I didn't blame her for just instructing me to go to the bathroom. It wasn't her mess to clean up, I wasn't her child. But now in the light of this Ebola outbreak, I realize just how incredibly smart that was for her not to get close or touch anything near me. I'm sure they are taught this in flight attendant school. Surely it is part of their Standard Practices for executing their job duties. Unfortunately, nobody knows what I touched or did once I was in the restroom. Nobody knew I was a body piercer that typically has a handwashing ritual in every place he goes that he has very little direct contact with any public surfaces. I could have been the average Joe and spread trace amounts of my sickness all over the restroom in microscopic proportions, unwittingly infecting the next few people that use the same restroom until we landed and *hopefully* a crew disinfected the restrooms. I'm not even sure how frequently airplane restrooms get disinfected. It was a simpler time only a year ago.
Two imported cases have brought Ebola to the United States - one of which being fatal already - where two more reported cases have been locally acquired. There has been a lot of opinion and speculation on the current state of preparedness in the US, and the potential likelihood of a mass outbreak happening here. We all want someone to blame when we no longer feel safe. We have lived such a life of privilege and luxury as contemporary humans in a modern society, we tend to think it preposterous that we should be responsible for our own part in our survival and well being. And we tend to relax a lot on the rules established for the good of humanity. This can be proven very easily in the case of Ebola in America. While health care workers point blame at hospitals for not supplying correct precautionary equipment to treat Ebola patients, the Occupational Safety and Health Administration released a newly updated Fact Sheet on Ebola. This fact sheet is designed to helped limit occupational exposure to the viruses that cause Ebola. The problem is, NONE OF THIS INFORMATION IS NEW. Let me clarify, none of this information is new information for reputable body piercing establishments. All of the precautionary practices and equipment recommended should already be in place at your local body art facility, or else you should immediately STOP GOING THERE. And this has been standard operation since before Ebola was on our radar. Maybe not before the outbreaks of the 1970s in West Africa, but definitely since the beginning of Anomaly's history over 10 years ago. Let's take a closer look at some of the OSHA recommendations to see what I mean...
- Immediately clean and disinfect any visible surface contamination from blood, urine, feces, vomit, or other body fluids that may contain Ebola virus. One of the good habits of asepsis is making sure that contamination is taken care of immediately. Long before Ebola was a concern, Anomaly instated practices that specifically do this very thing.
- After disinfecting and removing bulk material, clean and decontaminate the surface using [a suitable] disinfectant. Anomaly has been concerned with limiting any potential spread of infectious matter since our inception, not just Ebola, and for that reason we have always employed the best disinfectants on the market. We choose to use the ones that are least damaging to our environment whenever effective. Products like SciCan Optim 33TB which has a very short one minute contact time for effectiveness against non-enveloped viruses. Possibly the shortest contact time for effectiveness available.
- Ensure adequate ventilation in areas where workers are using disinfectants, including by opening windows and doors, or using mechanical ventilation equipment. Anomaly incorporates the use of UV air filters and cleansers in our procedure room.
- Use appropriate protective equipment: Nitrile gloves, fluid impermeable gowns, goggles or face shields, and face masks that cover the nose and mouth. Anomaly has always used liquid proof aprons and sleeves, full facemasks including eye shields, and the best Nitrile exam gloves on the market for cleaning and disinfecting in our studio. To take it one step further, almost exactly one year ago we incorporated a "fully disposable" business model that does not disinfect or reuse any critical implements or tools. Meaning even though we have a functioning autoclave sterilizer, we still do not reuse tools or items from one client to another like most studios.
- Avoid cleaning techniques, such as using pressurized air or water sprays, that may result in the generation of bio-aerosols (aerosolized droplets containing infectious particles that can be inhaled). Anomaly uses disinfectant wipes that are impregnated with Optim 33TB for most of our hard surface disinfecting. The contact time for this product to be effective is astonishingly only one minute, beating many other products by about ten full minutes yet still remaining safer for the environment. Since we use products only in wipe form or waterpick style spray bottles, the hazards of bio-aerosols are practically eliminated. Products in spray bottles that mist like glass cleaners, for example, or hard sprayers, can kick up particles of potentially harmful materials that are then spread around to surfaces thought to be clean, or inhaled into the body. Our studio also does not reprocess tools, so equipment like ultrasonic cleaners that create additional bio-aerosols, are not employed in our studio.
- It may be necessary to dispose of contaminated objects with porous surfaces that cannot be disinfected. As mentioned previously, our studio operates on a disposable implement basis. We keep critical tool and equipment usage to a minimum, and dispose of used objects like clamps, pliers or tapers, never allowing them to come in contact with more than one client. In terms of Ebola, this means clients as well as employees are spared potential infection from used tools. Reprocessing tools can be a big risk for employees of studios and must be done in a very specific order with very specific materials. We are proud to have eliminated that risk, making our work environment a little safer for our employees and our clients. Even if it does cost more to function this way.
- Employers must ensure that they comply with OSHA’s Bloodborne Pathogens standard, 29 CFR 1910.1030, to protect workers who may be exposed to blood or other potentially infectious materials. The Bloodborne Pathogen standard mentioned here is the EXACT same standard that body art facilities are required to follow in order to operate in the State of California. This standard is established to help protect employees from contracting any number of potentially harmful diseases from body fluids. It is refreshing to know the same standard is fully effective for Ebola, but once again we have been following this for the last decade since our studio opened. EVEN BEFORE IT WAS A STATE LAW. And as required by law, we update our training annually.
It happens to us all at some point in our lives. For many of us, that means an incorrect number on a spread sheet or an extra character typed in a line of code, or forgetting to tie the trash can liner tight so that heavy items don't suck the bag inside. But if your "every day" is in a health care setting, the smallest mistake at the wrong time could lead to serious complications. We read stories of surgeons accidentally leaving tools inside patients, operating on the wrong side of the body, or using skin preps the patient has an extreme allergy to. None of these things were done out of malice, in fact quite the opposite. Out of the desire to help save and heal someone. Yet "accidents will happen" Elvis Costello says. And even beyond the simple fact that we all make mistakes as flawed humans, consider also how many thankless hours medical professionals spend at work and on call. It's truly an inspiration that anyone chooses to do it for a lifetime. But imagine also if mistakes were made during the training of said individuals. What if certain practices meant to keep them safe were not expressly pointed out to be as important as they are. Surely a nurse or doctor or other worker wouldn't even realize that some break in their aseptic technique - from a lack in understanding just how important that one thing is - is the weakest link in a chain of protection from what could be the next big outbreak. Imagine if an error in accounting at the hospital did not budget enough for the protective equipment needed to handle serious issues. That doesn't stop potentially infected people from requiring treatment. Imagine what an error or a typo in supply orders could do. I've seen piercers and nurses who don't even wash their hands effectively. It's not that they want to get sick or spread illnesses. It's usually that they either don't know better or they have become so complacent relying on the rest of their protective equipment and fancy sterilizer to do the work and make them seem "clean", they forget that HANDWASHING IS THE FIRST STEP in breaking the chain of infection. The first line of defense in protection.
Speaking of piercers, one of my oldest and dearest friends recently asked me how I make sure my employees follow practices and protocols like those outlined in this blog. In other words, what sets my studio apart from the many others as well as the many clinics and health care settings where illnesses are often contracted instead of stopped (remember the story I told about getting sick on the airplane? I contracted my stomach bug from a hospital Emergency Room, sitting in the waiting room the whole time). My friend's question really made me think. Why am I not as concerned about my health in my studio? Why do clinical settings worry me more? And a few ideas hit me almost immediately. First, I know the cleaning regimen for my studio and the protocols and products used. Most of the time I am the person doing the cleaning, at least in the critical areas like procedure rooms for sure. Secondly, I oversee the training of my employees when it comes to these procedures, and I don't skimp on getting the best product for the task. Third, our studio handles minimally invasive procedures people are electing to get of their own free will. Meaning the clients are in good health, and we have no limit on the amount of time needed to do the procedure correctly and to minimize potential contamination. We don't do anything that is life saving (although some people may feel emotionally at times that it has been life changing), we do not ever have a true emergency. We are not rushed to resuscitate a client or to stop a fountain of severed artery. We are merely piercers and that affords us the ability to slow down and do things with precision every time. Fourth, we don't create much waste. We use the least amount of materials needed for a single piercing, we do not reuse any critical items, and we rarely see very much residual bleeding or other body fluids present during our procedures. I'd hate to jinx myself, but it's been years since a client has vomited from excitement or nervousness. Years. Lastly though, and this is the biggest one, I don't hire anyone who doesn't have the drive to be the absolute best piercer possible. I don't settle for piercers who are too lazy to do things right. Anomaly has a tradition of piercers who want to continually learn and grow and strive to be the best. This mentality keeps our piercers fresh and hungry to do things right every time. It also keeps us constantly re-evaluating how we are doing things and evolving our procedures and approaches. We don't need to be threatened by the negative media scare of Ebola, we have the positive desire stay on the forefront of our industry and to keep all of our employees and clients safe and healthy. And all of this at an extremely competitive price when you take into account our much higher cost of doing business the right way. But I have always said my clients are a part of my life, I believe they all deserve the best. Thank you once again for your time and your thoughts. I truly appreciate all the feedback I get from these blog entries. As always you may reach me at anomalyart@gmail.com if you have any further questions or suggestions.
Wado (Thank You),
-Brett Perkins
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