Health and Hygiene Regulations and Requirements

Proper hand washing, use of clean and/or sterile instruments, safe waste disposal, safe procedures and clean premises all contribute to preventing the transmission of infections.

Adhering to health and hygiene requirements is not only important for the safety of yourself and your clients – compliance is required by your Insurer in the event of a claim under your policy.  In addition, failure to ensure a procedure is carried out in accordance with the relevant code commits an offence under regulations.

The information provided below is intended as a guide only.  Specific reading of the relevant standards and guidelines and/or liaison with your local Environmental Health Officer are advised.

Skin Penetration 

Skin penetration is a procedure in which the skin is cut, punctured, torn or shaved or the mucous membrane is cut, punctured or torn

All persons who perform skin penetration procedures and the premises in which these procedures are performed are required to comply with the provisions of 

Auckland Council Health and Hygiene Bylaw & Code of Practice 2013.

 The Code of Practice & Bylaw specifies the minimum standards that must be adhered to in order to minimize the spread of infectious disease.  It provides for specific measures that must be implemented regarding hand washing, the use of personal protective equipment or clothing and the handling and disposal of sharps and other contaminated materials.

Standards for Premises

All floors, floor coverings, walls, ceilings, shelves, fittings and other furniture shall be constructed of materials suitable for the procedures undertaken and shall be kept clean and in good repair.  Surfaces that come into direct contact with a client’s skin or mucous membranes must be smooth, impervious and in good repair.

All operators shall ensure that a hand basin supplied with hot and cold water, soap and paper towels is available in the immediate area where skin penetration procedures are undertaken and that all waste is stored and disposed of in a manner that complies with the local government requirements.

For new premises or premises that are undergoing refurbishment and approved hands-free type of basin supplied with hot and cold water through a single outlet shall be installed in the immediate are where skin penetration procedures are to be undertaken.  The hand basin shall be supplied with soap and disposable paper towels.

Where it is not practical or desirable to install permanent plumbing fixtures, a free-standing hand washing station designed to meet hand washing regulations without the need for plumbing can be considered.  These units are entirely self-contained, hygienically holding fresh and wastewater in a container within so no plumbing is required.

Twin sink options are also available to enable hand washing and equipment cleaning within the same unit.

Workspace/Preparation Area

A workspace or preparation area shall be separate from the client treatment or work area.  The workspace shall have a cleaning area separated from the preparation area.

There should be good lighting and ventilation.

There should be sufficient bench space to accommodate the necessary equipment (e.g., steam sterilizer).  All appliances should be positioned and stored safely to minimize the risk of an injury.  All work surfaces should be smooth and impervious.

All floors should be impervious and non-slip.

For home operators, some local Government Authorities (Councils) may allow an existing laundry or bathroom sink to be used as the designated sink for cleaning and decontaminating equipment, particularly if the activities are confined to tweezing and waxing.  

Cleaning

All floors, floor coverings, ceilings, shelves, fittings and other furniture shall be regularly cleaned and maintained in good repair.  A cleaning and maintenance schedule shall be written and available upon request by an Environmental Health Officer.

When not in use, cleaning equipment should be kept clean and dry.  Buckets shall be clearly identified for their purpose.  Buckets should be emptied after use, washed with detergent and hot water and stored dry.  All equipment used for cleaning shall be stored separately from any appliance.

Work surfaces shall be cleaned before and after each Client session.  Trays used to hold and carry instruments shall be sterilized before use.

Hand Washing/Sanitisation

Cleaning hands is the single most important factor in preventing infection (after cleaning and sterilising equipment) and cannot be overstated.

The purpose of washing hands is to reduce any microorganisms that may be present.  Unless the fingernails are visibly dirty, a nailbrush should not be used because it may cause breaks in the skin during vigorous brushing.  Obvious dirt under the nails must be removed.

Good hand-washing facilities are essential and should be located within the treatment area. 

When to Wash Hands

• Before and after contact with each client
• After contact with blood or body fluids
• Before and after using gloves
• After using a tissue or handkerchief
• After smoking
• After going to the toilet
• Before and after eating
• After answering the phone or touching any potentially contaminated objects

Unbroken skin is the best defence because if provides the perfect barrier against infection.

1. Nail brushes are not recommended for scrubbing hands as they may cause damage to skin.
2. Cuts and abrasions on hands shall be covered with a water-resistant dressing which should be changed as necessary or when the dressing becomes soiled.
3. Technicians with weeping cuts, abrasions or dermatitis should not come into direct contact with clients.

Hand Washing

• First wet hands with warm running water, use liquid soap (one pump measure is sufficient), then rub hands vigorously for a minimum of 15 seconds.
• Wash hands all over including:
• Backs of hands
• Wrists
• Between fingers
• Under fingernails
• Rinse hands well.
• Pat dry hands thoroughly using a paper towel.

Linen

Paper towel, paper strips, couch roll or clean linen are recommended and must be changed between Clients.  Soiled linen, towels and protective clothing should be placed in a washable, leak-proof receptacle, and laundered using hot water (70-80°C) and detergent.  All clean linen, towels and clothing must be stored in a clean environment to reduce contamination.

Waste Disposal

All bins used for waste must have a close-fitting lid and be lined with plastic that can be sealed for disposal.

Disposal of Contaminated Waste

Contaminated waste, such as blood-stained swabs, used wax strips, cotton wool and gloves must be placed into a plastic bag-lined washable bin with a close-fitting lid marked ‘contaminated waste’.

Disposal of General Waste

All general waste, such as papers and powdered pigments, should be placed into a plastic bag-lined washable bin with a close-fitting lid marked ‘general waste’.  General waste can be disposed via normal refuse collections.  Bins should be regularly emptied and washed.

Animals

As a general rule animals should not be allowed in places where personal appearance services are provided as they may be a potential source of infection.  Animals are generally prohibited in areas where skin penetration procedures are undertaken.

However, the rights, needs, and circumstances of people with disabilities and special needs should be considered.  A person with a disability who relies on a guide, hearing or assistance dog to reduce the persons need for support may be accompanied by the guide, hearing or assistance dog.

Dispensing Products

To avoid contamination, you must ensure any make-up, fluid, cream, ointment or similar substance is removed from its original container/tube (including self-dispensing pumps) using a clean disposable applicator.  Leftover creams, ointments and similar substances must not be returned to the original container and must not be used on any other client.  Applicators used for dispensing must not be re-dipped into the original container and must be discarded after each client.  Single use applicators are recommended.

Pumps/spray bottles/nozzles

Pump outlets, bottles and nozzles are a potential source of contamination, particularly due to the buildup of contents around the outlet.  Nozzles should be cleaned frequently and dried before being replaced.  Wash bottles and nozzles in warm water and detergent, rinse them under hot running water, and dry them using a lint-free cloth, before refilling the bottle or replacing the pump/spray nozzle.  Pump/spray bottles should never be topped up.

Special Requirements

1. Wax reused between clients should be thermally disinfected (for the purposes of this paragraph thermally disinfected means reused wax that has been treated at a temperature of at least 130°C for a minimum of 20 minutes).
2. All non-invasive appliances such as tweezers and nozzles used for beauty treatments should be rinsed in tepid water, immersed in detergent and water and scrubbed under water with a clean scrubbing brush.
3. Following cleaning, appliances should be dried and stored dry.  They should not be stored by soaking in disinfectant.
4. Depilatory waxes shall be poured or removed from stock using a new clean spatula or ladle and placed into a clean container prior to each Client treatment.  If more wax is required, a new spatula shall be used.  (A new ladle is not required providing the ladle does not come into contact with any material that is in use on the client).  Disposable spatulas and containers shall be discarded into an appropriate waste receptacle after use.  Reusable containers shall be cleaned and disinfected between each client.
5. Dye, pigments, solutions used in skin penetration shall be poured or removed from stock using a new clean spatula or ladle and placed into a sterile container prior to each client treatment.  If more dye, pigment, solution is required a new spatula shall be used.  (A new ladle is not required providing the ladle does not come into contact with any material that is in use on the client).  Disposable spatulas and containers shall be discarded into an appropriate waste receptacle after use.  Reusable containers shall be cleaned and disinfected between each client.

Cleaning, Disinfection & Sterilisation

Before re-using instruments, you must clean or decontaminate them to minimise the risk of infection.  Some instruments may also need to be disinfected or sterilised – see the following Process Chart.

What is Cleaning?

Cleaning is the mechanical removal of foreign material from objects, usually with a suitable detergent and water, using hand scrubbing with a brush or other suitable device.  Cleaning is an essential element to any effective infection control procedure and reduces organic matter that contributes to the creation of bacteria and viruses but does not kill bacteria or viruses.

Cleaning Instruments

Use for all instruments or parts of instruments that can be immersed in water.

• When cleaning instruments, wear intact and water-resistant rubber or plastic gloves.
• Rinse the instrument in luke-warm water to remove visible substances.
• Dismantle the items where necessary.
• Ensure equipment used to clean instruments is clean and in good condition.
• Fully immerse the instrument, where practical, in warm water and suitable detergent, and scrub with a clean brush or other suitable device, paying particular attention to the interior surfaces.  In the case of tubes, the brush should pass completely through the tube in one direction.  Alternatively, a dedicated dishwasher can be used.
• The formation of potentially hazardous aerosols is minimised when the scrubbing action is performed under water, OR by agitation using an ultrasonic cleaner.  Use ultrasonic cleaners in accordance with manufacturer’s instructions.
• Rinse the instrument in running hot water.
• Dry instruments with a clean non-linting cloth.
• Wash hands before and after cleaning instruments.

Items that cannot be fully immersed should be wiped overusing a lint-free cloth dampened in warm water and detergent, then rinsed and dried.  A 70% ethanol alcohol solution should then be used to chemically disinfect the item.

Drying Instructions/Equipment

Do not dry items in the ambient air (for example, on a bench) because this will allow airborne contamination.  Equipment wiped over with a 70% alcohol solution should be wiped dry before storage.  Use a lint-free cloth to dry items.  Paper towelling is not appropriate because it is not lint-free.

Do not handle cleaned items or packaging materials if a hand cream/lotion has been recently used, wash hands first. Hand creams/lotions, especially oil-based ones, will leave marks that may attract contaminants and provide an impenetrable barrier to steam.  Once items are dry, they may be handled with clean, ungloved hands.

What is Disinfection?

Disinfection is the process of destroying pathogenic microorganisms and removes most organisms present on surface except bacterial resistant spores.  Disinfectants are antimicrobial agents that are applied to non-living object to destroy microorganisms that are living on the objects.

Instruments used on intact skin may be washed and stored in a dry place, but instruments that penetrate the skin must undergo cleaning and sterilisation.  The use of disinfectants does not replace the need for good cleaning practices, and all items/equipment/surfaces must be thoroughly cleaned before disinfection.

Disinfectants should be used only when equipment for the environment is contaminated with blood or other body substances however items that can be, must be sterilised after cleaning.  Detergent solution is sufficient for cleaning off perspiration, for example.

Disinfection Processes

Chemical disinfection should be used only for items for which sterilisation and thermal disinfection are not suitable – for example, times unable to be immersed in water (thermal) or unable to withstand high-pressure gradients (sterilisation).  Items that can be fully immersed but are unable to withstand high-pressure gradient may be disinfected in a suitable chemical disinfectant solution if necessary.  Thermal disinfection is recommended for items that can be immersed but are not required to be sterile at the time of use.

Items of equipment should be immersed in a chemical disinfectant solution only for the time specified by the manufacturer.  They should be removed and rinsed with distilled water before being dried and stored.  Chemical disinfectant solutions should be discarded immediately after use.  The container should have a close-fitting lid.  Spray bottles are not a suitable method of disinfecting equipment because the aerosols produced do not come into contact with all parts of the equipment.

Thermal Disinfection

Thermal disinfection uses heat and water (moist heat) at temperatures that destroy most organisms.  It is the most cost-effective and efficient method of disinfection.  It is only suitable for items that can be fully immersed in water at high temperatures.

All items must be fully immersed for the entire time once the water boils.  Additional items must not be added during this boiling stage.  Temperature of the water should be 80°C and items boiled for 10 minutes.

Chemical Disinfection

All items that can be fully immersed in water may be disinfected in a chemical disinfectant solution.

• All items should be cleaned and dried before chemical disinfection.
• Fully immerse items for the time specified by the item/equipment and chemical manufacturer, then rinse with distilled water and dry with a lint-free cloth.
• Wipe over non immersible items with a 70% alcohol solution, then dry them using a lint-free cloth.
• It is essential to dry items fully after cleaning (before either wiping or immersing the item in a chemical disinfectant) because any moisture will dilute the solution, making it ineffective.  Wiping instruments with disinfectants before use does not sterilise them.  Instruments must not be stored in disinfectants before or after cleaning or sterilising.

Suitable Equipment Disinfectants

Suitable disinfectants are those with the following strengths:

70% w/w ethyl alcohol

80% v/v ethyl alcohol

60% v/v isopropyl alcohol

Observe the use-by dates on all disinfectants, including those on decanted containers.

What is Sterilisation?

Sterilisation is the complete destruction of all forms of microbial life, including transmissible agents such as viruses, bacteria, fungi and spore forms.  All reusable equipment used in procedures involving contact with normally sterile areas of the body or contaminated with blood or body substances shall be cleaned and sterilised before being reused on another client.  Equipment shall be sterilised by one of the following methods:

Steam under pressure (moist heat) sterilisation – Autoclaving

• The manufacturer’s recommendations shall be followed to ensure the effective and safe use of steam sterilisation equipment.
• To ensure correct operation, steam sterilisation equipment shall be regularly tested and calibrated.  If the temperature of the steam inside the steam steriliser exceeds 137°C, or the pressure of the chamber is lower than it should be, the steam will not be able to kill all microbes in the chamber.
• All sterile equipment shall be packaged and wrapped to maintain sterility.  Where equipment is steam sterilised and stored for later use, labelling shall be included in or on the package to distinguish packages that have been sterilised.

Dry Heat Sterilisation

• Appliances shall be maintained in a dry air steriliser at 160°C for a minimum of one hour plus penetration time. This is a sterilising time, which commences when the equipment to be sterilised reaches the required temperature.
• The manufacturer’s recommendations shall be followed when operating a dry heat sterilisation system.
• All items are subjected to sterilisation shall be packages and wrapped to ensure sterility.

Note: Dry heat can damage some equipment, particularly those with moving parts and sharpened points or edges.