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April 16, 2015

Connecting with the Community: Tattoo parlors & regulations

oaklandskylineSean P. McCarthy, owner of Jester’s Court Tattoo on Oakland Avenue, was glad to see Graduate School of Public Health faculty member Elizabeth Bjerke’s students in his shop this spring — even though they weren’t paying customers.

Bjerke is one of 10 current Robert Wood Johnson Foundation public health law fellows creating new curriculum offerings designed to provide innovative teaching nationally.

The fellowship gave her the impetus for a new multidisciplinary class, “Law and Public Health Practice,” which attracted students from public health, law, medicine and nursing. Consulting with the Allegheny County Health Department (ACHD) on areas of public health and regulatory concern, Bjerke decided the class would focus on whether tattoo parlors needed more oversight from the ACHD and, if so, what the best approach might be.

It seemed a perfect question for Bjerke’s students to tackle, since tattoo parlors are unregulated by the city, county or state, and the Jester’s Court owner welcomed the students’ attention.

Sean McCarthy works on a client earlier in his career.

Sean McCarthy works on a client earlier in his career.

“I’ve been interested in this issue since we opened our shop in 1991,” says McCarthy, who now has four shops. “That total absence of anything at all” by way of regulations or licensure — “it’s like the Wild West. Pennsylvania is the laughingstock” of the industry, he adds.

As the students in Bjerke’s course watched McCarthy and two colleagues work, “they were basically in shock, like most people are when they find there was nothing governing us at all,” he says.

Of course, McCarthy points out, today most tattoo artists use disposable tattooing equipment, with only a reusable handgrip that needs to be sterilized. He and his fellow artists hope that any licensing requirement put in place doesn’t impose an astronomical fee that might drive smaller, locally owned parlors out of business.

“I just want a grade A sticker on my front door, like a restaurant,” he says. “If the health department goes in and checks beauty parlors and barber shops, it’s ridiculous that we don’t get checked.”


Faculty member Elizabeth Bjerke

Faculty member Elizabeth Bjerke

Bjerke, director of Pitt’s JD/MPH program, says the new course “seemed like a logical fit for me. And as far as I can tell it is the first class in the nation to have both a multidisciplinary component as well as a practice-based program.”

During the course, students have been introduced to public health principles and public health law, including the regulatory process. They heard from Luann Brink, ACHD’s chief epidemiologist and deputy director, who instructed them on the agency’s scope of work and on how various health inspections work.

They examined tattoo parlor laws in different cities and states, studying the health outcomes of tattoo clients there and the economic impact of licensure and regulations.

Then they set out to survey Allegheny County tattoo parlors, reaching 60 of them.

The students have been analyzing their research findings and deciding how they will most effectively present those findings to the health department on April 23.

According to Bjerke, they will recommend:

• The formation of a Body Art Advisory Board to facilitate communication and collaboration between ACHD and tattoo industry stakeholders.

• The development of an internal resource bank on body art in Allegheny County to manage data, trends and other resources.

• The creation of an educational website for consumers to inform them about risks associated with tattooing and about proper aftercare practices.

• A marketing campaign to promote the website to targeted demographics, such as college campuses.

“The more you can get a community to buy into your proposal, the more you can get it adopted,” Bjerke says. The students, she adds, “do not believe regulating tattoo parlors would significantly improve the health and safety to consumers because regulations would primarily impact established parlors, which our research has shown … overall adhere to best practices.”

Bjerke purposefully did not have the students do the tasks they were most comfortable with, she noted; students other than law students, for instance, are drafting the model regulations. “I think that’s the way students will get the most out of this.”

The course, she concludes, “allows the students to develop communications skills and collaboration skills outside of their disciplines. And it allows the students to begin to develop a professional network. The Allegheny County Health Department gains insight into this problem area they have identified to address.”


Says ACHD’s Brink: “I thought that it was a good idea to be able to get an external impression of policies … to potentially move health policies forward in Allegheny County.” Seeing public health students teaming with students from law and other disciplines “was wonderful — they brought a lot of different perspectives from both the public health and the policy side.”

Allegheny County’s health department hasn’t evaluated the prevalence of injury or infection related to tattoo parlor visits. “And that would be very difficult to do,” Brink says, since they are unable to follow up with every customer. The department has received complaints accusing parlors of infection, “but nothing has been substantiated.

“To be honest, I am really not certain that they need regulations,” she adds, “or we would not be asking this question. There are really a lot of unknowns.” But, she allows, the lack of regulation “is surprising, if you take a look at it compared to, say, a hair salon … We’re excited to hear what the recommendations will be.”


In addition to assisting the county health department and the local tattoo shop industry, the course is aimed at providing a new type of educational experience. As part of her Robert Wood Johnson Foundation fellowship, Bjerke is creating a template for such a course to be adapted and adopted nationally: “Hopefully, this will help other professors to create interesting, valuable courses in public health law.”

—Marty Levine