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Do you want a tattoo? Think again.


The popularity of body tattoos is on the rise. While having a tattoo goes back to ancient traditions of ethnic identity, and membership to organisations with at times dubious practices, nowadays having a tattoo is a meaningful distinctive hallmark that defines who we are and our relationship to others. A tattoo signifies the loss of a loved one, or the bond to our children and lovers. It also reflects our ideals, the faith we belong to or any essential activity in our lives that make us who we are.

In Australia, there has been a spike in the number of tattoos. Over 4 million people (one in 5 Australians) have ink injected under the skin. Approximately 27% Australians with tattoos will regret, having a tattoo with 15% considering tattoo removal (The McCrindle Blog 2016). 
 
Because this activity is not yet fully regulated, it brings along a number of potentially unpleasant legal issues:
 

Health impact of potentially toxic substances


Recent studies in Australia have shown that 49 different inks used for tattoos contain up to 89 different chemicals. Out of these only 49 comply with European standards (ABC 2016). Molecules defined as polycyclic aromatic hydrocarbons (PAHs), may increase the risk of cancers and are found in 20% of the inks analysed. Of additional is concern is the role of metals such as barium, copper, mercury and colourants whose potential as health hazards has not been sufficiently addressed. Substances in the categories of iron oxide, mercury, aluminium and manganese may also trigger allergic reactions and are mostly found in red inks. Also, their long term toxic consequences are not known.


Bacterial and viral Infections


Although the practice of tattoos has become more regulated from a hygiene perspective, the risk of acquiring local and systemic infections in recipients amounts to a significant proportion. A 2010 German study in a sample of 3,411 study participants, reported a 67% complication rate in tattooed people with 7% at systemic level and 6% with persistent issues (Klügl, I et al, 2010). Bacterial infections are mostly caused by staphylococci, streptococci and mycobacteria while viral infections includes Herpes simplex, viral warts, hepatitis B and C. It is notorious that HIV infection is an additional risk for the individual being tattooed if blood contamination has occurred.

In July 2014, the Food and Drug Administration in the US released the following recall:
White & Blue Lion, Inc. in the City of Industry, CA is recalling all lots of tattoo Inks and tattoo needles due to pathogenic bacterial contamination. Use of these products may cause bacterial infection and can lead to sepsis, a potentially life-threatening complication of an infection. As of an extra precaution, we are also recalling all tubes and ink cups as well.

The use of this ink lead to a lawsuit by two tattooists in California after the procedure self-applied, caused acutely severe pain and infections requiring antibiotic treatment, as well as permanent scarring and skin damage from the contaminated ink. The plaintiffs received US$ 75,000 in damages and accused White & Blue Lion for negligence of selling contaminated ink.

Regulating tattoo parlours and client protection

 
Both in the US, and in Australia since 2014 the practice of tattooing is increasingly regulated to prevent health complications, thus protecting the individuals receiving the tattoo. Also, the tattoo artists’ intellectual property is protected from copy-right infringement as a tattoo is considered a form of art that should not be reproduced without permission. Prominent is the case from 2011 on the digital reproduction of the boxer Mark Tyson’s facial tattoo on the actor Ed Helms’ face in the Hang over Part II that ended up in a compensation settlement from Warner Brothers Entertainment. Parlours should also be protected from any lawsuits from their clients should any complication arise.
 
Nowadays, most states in the US require tattoo parlours to be licenced and carry insurance. What are the fundamentals of an injury claim? This includes instances where a parlour does not meet standards of care or in the case of an injury. But demonstrating that any injury or infection is due to the parlour’s responsibility is not an easy task.  The plaintiff should demonstrate that the ink used has been contaminated, the needles were not clean and provide testimony by a medical specialist. For the safety of both parties, it is recommended to establish a written agreement with the parlour prior to giving a tattoo or any other form of body mark, whereby information is provided about the details of the procedure and the method used to include information on how to care for the skin area involved (Lawstuff 2014). 


Tattoo removal


Removing tattoos is not always satisfactory or without pain and risks. Traditional procedures such as dermabrasion and surgery have been most entirely replaced by laser surgery. Infrared coagulation tattoo removal is another method based on heat generated by infrared light but carries a higher risk of burns. Today high powered laser devices are mostly employed, theoretically following specific regulations, as they present a high risk of causing serious burns, scarring and even blindness. Several treatment sessions are required for tattoo removal but some colours are difficult to eliminate completely. It is paramount that such devices are only used by professionals (dermatologists and plastic surgeons) but their commercial readiness makes them available to nonspecialised individuals.
 

When a tattoo causes discrimination

 
A visible tattoo may become a discriminatory issue in the workplace.  In NSW, the anti-Discrimination Act states that discrimination as ground of race is unlawful and a tattoo may be considered as a cultural heritage of a specific race. Therefore, the requirement to cover the tattoo may be in breach of the legislation. In Victoria, the Equal Opportunity Act 2010 prevents discrimination based on “physical features”. In this regard, tattoos are regarded as physical feature in Victoria from the Jamieson v Benalla Golf Club Inc (2000) VCAT 1849, 30 September 2000, which may affect any future case in the State.

The Australian Human Rights Commission established that Employers will sometimes set rules regarding the appearance of their employees in the workplace. However, it is important to ensure that any proposed rules that affect people with tattoos do not amount to discrimination.
 
Example: An employer had a policy to refuse to hire any workers with visible tattoos, even for roles that involved no customer contact. A Maori job applicant who had a tattoo for reasons connected to his ethnic origin was not hired because of his tattoo. This could be racial discrimination.

Introducing Dr Divy Dua, Oncology and General Medicine

Lex Medicus is proud to partner with Dr Divy Dua, a Medical Oncologist with extensive clinical experience in both oncology and general medicine to inform his expert medical opinion.

Dr Dua is a Fellow of the Royal Australasian College of Physicians with specialty training in medical oncology and general medicine. He has  work experience across  India, UK and Australia . He believes in a multidisciplinary approach to cancer care. With special interests in lung and genitourinary cancers, melanoma and drug development, Dr Dua supports these interests with research, teaching and publications.

Dr Dua has worked overseas and around Australia as an Oncologist and is now working with Lex Medicus in the South Yarra suites to provide his expert independent medical opinion for general medicine and in clients with oncological impairment.

To book a client with Dr Dua, please contact Lex Medicus reception on: (03) 9827 8093 or lexmedicus.com.au.
Book now

Wine and Pain Seminar, 9 February 2017

Our popular seminar series continues in 2017, with our Pain Specialist, Dr Peter Blombery, presenting on Chronic Pain followed by an Italian Wine tasting by Sommelier James Ahearn.

 
DATE: Thursday 9th February
TIME: 6:30pm - 8:30pm (Seminar to commence 6:45 sharp)
VENUE: Suite 1202, 9 Yarra Street, South Yarra VIC 3141
TOPIC: Clinical and Medico-Legal Aspects of Chronic Pain
PRESENTERS: Dr Peter Blombery
COST: $50 donation or more to Royal Children's Hospital Foundation

You may be eligible to attend CPD/CLE points by attending this seminar.
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Lex Medicus asks that each attendee donates $50 or more to support the Royal Children's Hospital in order to attend Wine and Pain.
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