Appendix A National Environmental Health Association Policy Statement on Ear Piercing Guns Policy Statement on Ear Piercing Guns In the U.S., approximately 83% of the population has their earlobes pierced and 14% has a piercing outside the earlobe (The Academy of Responsible Tattooing, 2018). Commonly regulated separate from other piercing techniques, ear piercing guns are frequently used to pierce the ear lobe, outer ear, and other areas of the body despite their inability to meet the same sterilization requirements as other piercing methods. This inability increases health risks such as infection, disease transmission, and tissue damage, including cartilage shattering (Centers for Disease Control and Prevention [CDC], 2008, 2018; Keene, Markum, & Samadpour, 2004), as well as potential hospitalization in severe cases (Cicchetti, Skillman, & Gault, 2002; Margulis, Bauer, & Alizadeh, 2003). Environmental health professionals regulate piercing procedures to protect public health. Not all states,however, classify the use of ear piercing guns as a piercing procedure and it can be exempt from these regulations. This situation creates an environment that allows for insufficient hygiene standards that have been shown to produce greater rates of infection, complications, and disease transmission. These discrepancies highlight the need to update requirements for ear piercing guns and limit their use to the ear lobe to protect public health and safety. The National Environmental Health Association (NEHA) advocates for national, state, and local policies, regulations, research, and resources that will enhance the ability of environmental health professionals to ensure the practice of safe body art procedures to better protect public health. NEHA recommends the following for state, local, tribal, and territorial government agencies: • Classify establishments that use ear piercing guns in the same category as body piercing facilities and enforce body piercing and biomedical waste regulations on these establishments as governed by state and local health jurisdictions. • Ensure that sterilization procedures can be monitored, sanitary practices can be established, and regulations will allow for uniform inspections and improve consumer health. • Hold the use of ear piercing guns to the same standards as other piercing techniques. As stated in the NEHA Body Art Model Code, “individuals who perform piercings with a pre‐sterilized, single‐use, stud‐and‐clasp ear piercing system must adhere to [general body art] regulations • Educate lawmakers and health agencies on the dangers of unregulated facilities and untrained personnel using ear piercing guns on the public. Piercings performed with ear piercing guns that cannot be fully sterilized might result in serious infection, tissue damage, and disease transmission. These issues can be exacerbated with untrained staff in unregulated facilities. • Ensure that regulatory agencies have the resources, training, and jurisdiction to conduct inspections of all piercing facilities, including those that use ear piercing guns. • Hold establishments using ear piercing guns to the standards outlined in the NEHA Body Art Model Code. and meet the requirements of a body art practitioner.” • Limit the use of ear piercing guns to the ear lobe.
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