Infection Control Lapse

August 3, 2023

Infection control notification issued August 3, 2023 by local Health Unit

What is the risk?

Tools and piercing jewelry that are not properly cleaned and sterilized can cause skin infections from bacteria and may spread blood-borne infections such as hepatitis B, hepatitis C, and to a lesser extent, HIV. No infection or illness has been linked to this situation at this time.

Who is at risk?

Anyone who received piercing services from Melissa Charland (the operator) through Piercings by Melissa during the time period of February 25th until June 8th, whether at LUX Tattoo and Piercing or elsewhere.

Clients who received non-piercing services (e.g. tattoos) at LUX Tattoo and Piercings do not have any risk of exposure from this investigation.

What should I do?

If you are at risk of exposure, as described above, call 1-800-660-5853 ext 2222.

Below is the information package that has been sent to known clients at risk of exposure:

My piercing site didn’t have any infection or problems healing. Am I still at risk of exposure?

Piercing site infections and skin infections are primarily caused by bacteria. However, the risk of exposure that the Health Unit is concerned about are blood-borne infections from viruses: Hepatitis B, Hepatitis C, and to a lesser extent, HIV. These viruses do not cause skin infections. Because piercings go through the skin, there is a risk of transmission of blood-borne infections. In some instances, people who are infected with these viruses do not have symptoms until months or even years after infection. More information about these infections can be found on this webpage.

I saw my piercing tools were opened from sealed pouches. Am I still at risk of exposure?

You may have seen piercing tools that were in pouches used for sterilizing, including tape with heat-activated lines. Effective cleaning and sterilization is based on a number of factors beyond whether pouches were sealed or any single indicator such as heat-activated lines (for example, it also depends on whether adequate pressure was also reached, whether tools were packed properly into the sterilizer, etc.). These indicators of effective cleaning and sterilization are not obvious from looking at the reprocessed tool or its packaging. As a result, there is concern that all reusable tools may have led to a risk of exposure, even though they were processed using a sterilizer.

How did the Health Unit determine the time range of concern?

The Health Unit is using the date of February 25th, 2023 as the first date of potential exposure risk, because that is the date that the operator reports purchasing the sterilizer. Because the operator’s client records and cleaning and sterilization records are incomplete, we have not been able to further narrow the time range. It is possible that the second time that reusable tools were used (and therefore potentially exposed to a blood-borne pathogen) was after February 25th, but we have not been able to determine this date. Therefore, Health Unit has used a conservative date in assessing potential risk of exposure, out of an abundance of caution.

The Health Unit is using the date of June 8th, 2023 as the last date of potential exposure risk, because that is the date that we issued an order to Piercings by Melissa under Section 13 of the Health Protection and Promotion Act, which included a requirement to use only sterile single-use tools and pre-sterilized jewelry. The operator has not used reusable piercing tools since that time.

How did the Health Unit assess the risk?

The Health Unit’s assessment of the exposure was made with information from Piercings by Melissa, our inspection of the cleaning and sterilization processes used, and in consultation with Public Health Ontario. The following deficiencies in cleaning and sterilization were identified:

After obtaining this information, the Health Unit consulted Public Health Ontario, who is the provincial organization that provides scientific and technical advice to health units across Ontario. They provided a review of the risk assessment in this situation, as well as a review of the literature regarding the risk of blood-borne infection transmission.

Based on all the information the Health Unit gathered, we determined that tools and piercing jewelry were not properly cleaned and sterilized, and that clients should be notified of a potential exposure to blood-borne infections.

Has the Health Unit been inspecting this premises?

The Health Unit inspects on a regular basis all personal service settings such as piercing salons, tattoo parlours, nail salons, and others. LUX Tattoo and Piercing was previously inspected in November of 2022, and piercing services were not being offered at that time. Operators of personal service settings are required to notify the Health Unit before they change the services they provide. We became aware of piercing services being offered by Piercings by Melissa at LUX Tattoo and Piercing in June of 2023, several months after these services had already begun. The Health Unit conducted an inspection at that time, and identified deficiencies in cleaning and sterilization.

What requirements has the Health Unit placed on Piercing by Melissa’s services?

The Health Unit’s investigation has only identified inspection violations having to do with reusable tools and piercing jewelry that was sterilized on site. We have made requirements for Piercings by Melissa, including her services through LUX Tattoos and Piercings, to ensure compliance with public health guidance under Section 13 of the Health Protection and Promotion Act (HPPA). These requirements include using sterile single-use tools and pre-sterilized jewelry, which do not need to be cleaned and sterilized. No other inspection violations have been identified at this time that would prevent the operator from providing piercing services that comply with public health requirements. We are working with Piercings by Melissa and with LUX Tattoos and Piercings to ensure compliance with guidance regarding cleaning and sterilization, including minimizing the risk of infection transmission if they choose to use reusable tools in the future.

Information about IPAC Lapses

Resources about personal services procedures and blood-borne infections

Information about inspection of Personal Service Settings

Information about Beauty and Body Art Safety

The Health Unit has resources about beauty and body art safety to help you make informed decisions about services.