Tattooing regulations in U.S. States, 2011.

Tattooing's popularity has led to regulatory concerns because medical complications linked to unsanitary practices can have a lasting health impact. The authors' study sought to determine whether existing state tattooing laws and regulations (rules) effectively protect public health. A 10-item checklist was created for each of three types of rules (sanitation, training, and infection control) identified as having the greatest public health impact. State rules were classified as effective if the state scored > or = 7 on all three categories, moderate if > or = 4 in all three categories, minimal if < 4 in one or more categories, and ineffective if < or = 2 in all three categories. Forty-one states have at least one state statute regulating tattooing practice. On the basis of the authors' study criteria, 36 states regulate sanitation effectively; 15 states regulate training effectively; and 26 states regulate infection control effectively. Fourteen states meet the criteria for regulating all three categories effectively. Specific rules vary substantially by state. Public health agencies should encourage states to adopt and enforce effective, evidence-based tattooing rules.