Appendix B National Environmental Health Association Policy Statement on Microblading Policy Statement on Microblading Over the past 50 years, tattooing has evolved from a stereotyped subculture to commonplace. In the U.S., 21% of adults have a tattoo, which has increased from 16% in 2003 (Braverman, 2012). The use of permanent cosmetics, and more specifically microblading, has also risen in popularity during this time. Microblading is a relatively new type of permanent cosmetic procedure that falls under the definition of tattooing. Microblading is performed with a configuration of needles attached to a handle, often described as a blend between a scalpel and a fine‐tooth comb, to manually create small cuts that resemble eyebrow hairs that are then filled in with ink to achieve the appearance of fuller brows (Darby & Darby, 2016a; Food and Drug Administration [FDA], 2017). Environmental health professionals regulate tattoo procedures to protect public health. Not all states, however, classify microblading as a tattoo 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. Tattoos administered in unhygienic conditions can lead to a host of bloodborne pathogens such as hepatitis C and HIV, in addition to other common infections (Smith, 2003). These instances highlight the need to update requirements for microblading 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 abilities of environmental health professionals to ensure safe body art practices and protect public health. NEHA recommends the following for state, local, tribal, and territorial governmental agencies: • Classify microblading as tattooing as listed in the NEHA Body Art Model Code to increase regulation of the permanent cosmetic industry to improve public health and safety. • Adopt the NEHA Body Art Model Code into state and local laws. • Reclassify establishments that perform microblading tattoo procedures and permanent cosmetic procedures in the same category as other tattoo establishments so they fall under the jurisdiction of state and local health agencies. • Ensure that sterilization procedures can be monitored, sanitary practices can be established, and regulations will allow for uniform inspections to increase epidemiological surveillance to provide public health and safety. • Assure that regulatory agencies have the resources, training, and jurisdiction to conduct inspections of all microblading, permanent cosmetic, and other facilities that perform tattooing. • Hold microblading and permanent cosmetic procedures to the same sterilization, hygienic, training, and aftercare standards as other tattooing techniques. • Educate lawmakers and health agencies on the dangers of unregulated facilities and untrained or unlicensed personnel performing microblading and permanent cosmetic procedures on the public.
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