involves piercing the ear with a sterile, disposable, hollow needle that cleanly breaks the skin and removes unwanted tissue. This method decreases the likelihood of injury and infection as sterilization procedures are more in‐depth and there is not a high risk of blunt force trauma (APP, 2018). Ear piercing gun use should be limited to the ear lobe, where tissue damage is less likely to occur. In professional piercing studios, any nondisposable equipment is autoclaved, a process that uses heat, steam, and pressure to sterilize all nondisposable piercing tools between each use, killing most pathogens. In contrast, ear piercing guns cannot be autoclaved as they are usually made from plastic. Instead, piercing guns are simply wiped down with disinfectant between each use. Wiping down the external surfaces rarely eliminates all the bacteria outside the gun and cannot kill pathogens within the working parts of the gun. Blood from one client could easily contaminate another, leading to potential infection and transmission of diseases such as hepatitis or methicillin‐ resistant Staphylococcus aureus, which can live for extended periods of time on inanimate surfaces (CDC, 2008, 2018). Pathogens and disease can also be spread from client to technician, and from technician to client. Infection or injury are also likely to lengthen the healing time for piercings, which can already take months to completely heal. While ear lobe piercings typically heal in 6–8 weeks, cartilage and navel piercings can take anywhere between six months and one year if no complications occur. Ear piercing guns need to be regulated with the same sterilization standards as all other piercing establishments to alleviate these issues. Risk of infection is magnified by unsanitary workspaces that do not meet regulations or recommendations for general piercing studios. For any type of piercing, all surfaces should be nonporous and easily cleanable. These surfaces include floors, counters, chairs, and walls. Many ear piercing guns are used in unregulated procedures in mall stores or kiosks, which can emphasize comfort and appearance over cleanliness. In addition to limited separation from other areas of the store, ear piercing gun procedure areas might have pillows, sheets, or rugs. These surfaces are absorbent and could contain blood particles from multiple clients. A tuberculocidal disinfectant should also be used to regularly clean all surfaces. Lighting and washing are also important for hygienic workspaces. Body piercing and sterilization areas should all be adequately lit and contain hand sinks to facilitate proper hand washing practices. While ear piercing guns might seem easier to use, that does not make them less harmful. Training procedures at establishments using ear piercing guns should match their equivalents at professional piercing studios. Videos, demonstrations, and direct supervision are sometimes used to train employees to use ear piercing guns, although there is no specified training period (More et al., 1999). Employees at establishments that use ear piercing guns commonly do not have bloodborne pathogen training or do not follow appropriate aseptic techniques. Employees have also shown a lack of knowledge concerning potential complications from piercing procedures (Jervis et al., 2001). For example, employees at a mall kiosk in Oregon neglected to wash the bottle used to spray disinfectant onto earring studs, leading to an outbreak of Pseudomonas aeruginosa infections and several cases of auricular chrondritis. Four of the cases had to be hospitalized and undergo drainage surgeries (Keene et al., 2004). In contrast, most professional piercing studios require apprenticeships, typically lasting at least one year, before an employee can perform procedures individually (Grant, 2002; More et al., 1999). Increased regulation of ear piercing guns requiring standard sterilization, training, and workplace practices would alleviate injury and infection.
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