Departments: Health
The Piercing Reality of Body Art

The popularity of body art is on the rise, yet most students, school staff, and parents remain unaware of the serious consequences and health risks associated with it. Vicki Harrison of the NEA Health Information Network recently spoke with Myrna Armstrong, a professor at the Texas Tech University Health Sciences Center School of Nursing, about the body art phenomenon.

What is body art?
Tattoos are indelible markings of pigment placed under the skin.

Piercing involves the penetration of the body--the most commonly pierced areas of the body are the ears, nose, eyebrow, tongue, chin cleft, nipple, navel, and genitals--by a large needle to insert jewelry.

Tattooing and piercing are the most popular types of body art, with between 15 to 20 percent of students having one or the other.

Branding, implants, and scarification are more extreme and dangerous types of body art that are slowly emerging. Branding involves creating scars on the skin by striking hot pieces of metal against the body. Scarification involves cutting patterns deeply enough in the skin to create a permanent scar.

Implanting is the insertion of metal or plastic pieces of jewelry under the skin.

Why is body art popular?
Despite the potential for pain and inherent health risks, young people regard body art as a form of self-expression. When their parents were growing up, a tattoo or piercing was a sign of deviancy. To members of this generation, it's a way to assert themselves and feel unique. And it's difficult for them to understand why their parents get so upset about it.

Who's doing body art?
Body art attracts adolescents from all socioeconomic backgrounds and levels of academic achievement. In one study I conducted, 65 percent of the adolescents with tattoos were students with A and B averages.

The average age for the first tattoo was 14. The youngest tattoo enthusiast I've encountered was eight.

It's not too early to start talking about body art with children in second or third grade. Children today are exposed to body art at a very early age. They have temporary tattoos as toys, and even Barbie almost had a butterfly tattoo until parents objected.

How safe is body art?
It depends on how and where it's done and by who. Tattoos and piercings are done in studios, but they're also frequently done in flea markets, concerts, house fronts, cars, and vans. It's not unusual for adolescents to pierce or tattoo themselves or their friends, especially younger students who don't have the resources or parental consent that most reputable artists require for anyone under the age of 18.

Students learn from their friends, the Internet, or just get very creative on their own. Amateur brandings might be done with a red-hot coat hanger or paper clip. Amateur tattooing might be performed with crude instruments such as pencils, pens, and straight pins, using pigments such as charcoal or mascara.

Branding and scarification are extremely dangerous practices, bordering on self-mutilation. Implanting is officially considered surgery and should never be done.

Half of the states do not have health regulations governing tattooing, and only about 15 have regulated body piercing. Nationwide, there are no training requirements for these artists.

In order to find a good, responsible artist, adolescents and their parents should shop around, visit studios, and observe an artist's techniques. When shopping for a body piercer, go someplace that uses a simple, sterilized needle to complete the procedure.

What are the health risks?
Perhaps the greatest risk associated with tattooing and body piercing is the potential for the transmission of Hepatitis B, a virus that can survive on blood-contaminated surfaces for a couple of months. This is why sterile instruments and environment are so critical.

HIV transmission is also a possibility, but the risk is not as great because the virus dies at room temperature.

Body piercings are very prone to bacterial infections, because they they are often not cared for properly and are often in high-bacteria areas.

Piercings in the cartilage of the upper ear can easily become infected because of bacteria in hair and the pressure applied while sleeping. Navel piercings have a 45 percent infection rate because hygiene is generally poor in that area. The friction of tight clothing like waistbands also creates a moist environment where bacteria thrive. It can take nearly a year for a navel piercing to heal sufficiently.

Adolescents must understand that if they do a body piercing, they need to maintain a continual regimen of post-piercing skin care.

Other health concerns are allergic reactions to the non-FDA-approved pigments used for tattooing and the threat of second- or third-degree burns during branding.

What can school staff do?
Give students as much information as possible. Provide non-judgmental guidance and encourage adolescents to take their time in making a decision about body art.

Talk with students, but don't use scare tactics. Just be realistic. Ask them to consider future conse-quences, such as how a visible marking might affect future education or employment plans. Visit studios in your community.

In addition to safety and care issues, school nurses face the challenge of carrying out expectations of their administration, notes Lynne Kelly, RN, MSN, a clinical instructor of nursing at Texas Tech and a former school nurse. But because body art's mainstream popularity is a more recent phenomenon, few school policies exist on the topic.

So questions arise for school nurses: How much leeway do they have on the preventive end? Can they educate students about body art? Can the topic be included in the school's health curriculum?

Some school districts view talking about body art as a way of promoting it. But when school nurses are permitted to educate students before they go through with a procedure, students will become aware of the risks and know what's safe. School nurses need to educate administrations and ask for guidance and support.

Body art is growing more and more popular. It's important to have a dialogue about it in every school.

Resources

• A Tattoo?...You. Teens Talking to Teens, an eight-minute video, discusses the risks, the procedure, and tattoo removal. Available with an accompanying study guide for $55 from the Texas Tech University Health Sciences Center School of Nursing, 806/743-2002.
• Taking Care of Body Piercings, a brochure, lists risks, tips for healing, and what to look for in a piercing salon. Body Art: Self-Test asks the reader to ponder: Why do I want it? Is it safe? Will I regret it? Other titles include Getting What You Want from Body Art, Body Art: Incredible Facts, and Tattoos: Incredible Facts. Each title, $16 for 50 copies from ETR Associates 800/321-4407 (www.etr.org).

Firming a Resolution 'To Do Something for Me'

Students at Virginia's Woodbridge Senior High School will see less of school staff this year--an on-site, after-school weight-loss program has helped staff get in shape.

"January is such a perfect time to begin a weight-loss group," says ninth grade special ed teacher Myrna Thumher. "So when our vice principal asked if we were interested in forming one last January, I jumped on the idea immediately."

Since then, Thumher, pictured front, second from left, and 17 colleagues have met every Friday after school to weigh in, learn weight-loss strategies, and support one another's progress. Diet talk now dominates lunch-time conversations in the staff lounge.

"I hadn't really run or dieted in a couple of years," says Thumher, who has been spurred on to dieting by others in the group and a firm resolve that "I needed to do something for me."

Thumher has lost 25 pounds since she started in the program. Personal commitment is certainly critical to dieting success, she says, but enlisting practical support from others is equally important.

"I haven't had to do it alone," Thumher points out. "I talked to everyone and asked for help."

Thumher's friends run with her at school and on neighborhood streets. She has instructed her husband not to buy chocolates on Valentine's Day. And her students remind her to fill her ever-present water bottle during the day if they see it empty.

Of the original members of Thumher's weight-loss group, a third met their lifetime weight loss goals during the year. One added benefit: Thumher's husband, who helped her train, lost 20 pounds to boot.

Thumher, 53, has literally gone the extra mile in her shape-up effort.

When a group member challenged Thumher to train for and race two high-profile marathons, Thumher did so--raising $3,500 for the Leukemia Society in a June Rock and Roll Marathon in San Diego and finishing the 26.2 mile Marine Corps Marathon in just under six hours.

"As teachers, we tend to lose sight of our own needs and put everyone else's first," says Thumher, who notes that losing weight and feeling fit need to be moved closer to the top of educators' must-do lists.

Easy Steps
Have a New Year's resolution that includes "losing weight"? Try high school teacher Myrna Thumher's 10 tips for dieting success.

1. Set small goals. Calculate 10 percent of the weight you want to lose and focus on reaching that interim goal a bit at a time.
2. Be prepared. If you're starting a new program, read materials thoroughly, and load your fridge and cupboards with good-for-you foods you can eat.
3. Out of sight, out of mind. Keep food triggers out of easy reach by packing them up and putting them elsewhere.
4. Seek variety. Purchase cookbooks, try new low-fat recipes, and exchange ideas with other dieters.
5. Don't skip meals. Instead, eat smaller portions to avoid becoming overly hungry.
6. Get moving. Take steps instead of elevators. Park the farthest space away from entrances. Fifteen minutes of activity a day makes a difference.
7. Make H20 a habit. Carry drinking water around with you all the time, even at bedtime.
8. Enlist support. Find cheerleaders whom you can depend on to encour-age you and share your success.
9. Communicate needs. Donuts in the break room? In-laws forcing dessert? Share your goals with coworkers and family and politely ask that they not sabotage your plans.
10. Reward success. Treat yourself to a movie. Indulge in a manicure. Avoid rewarding yourself with food that can add unwanted pounds.

Quick Tip

By Kim Fischer

"When in training, make sure you've got room in your shoes. Feet--especially a new runner's feet--grow. Buy comfortable shoes, opting large, if you can. Luckily, my shoes and I squeaked by when I grew a half size. Wish I could say the same for my favorite black pumps.

"Some runs will be great and some will be awful. Do them anyway. If you're consistent, you'll improve.

"Enlist a friend. Going through an event like a triathlon alone--especially for first-timers like me--makes it especially scary. Even swapping stories is valuable. You'll probably need to talk about the good days and the sore calves more than your family needs to listen to you."

--Kim Fischer, eighth grade English teacher, McKinley Middle School, Kenosha, Wisconsin, competed in her first Mrs. T Sprint Triathlon (half-mile swim, 15-mile bike ride, and 5K run) last August.

From the NEA Health Information Network

• Sexual Health
  The NEA Health Information Network has just released Sexual Health: The Role of School Personnel, a two-sided fact sheet that provides a concise overview of the role school personnel play in the sexual health of their students. It explains why sexual health is an issue for all educators and highlights important statistics and key strategies for school staff to incorporate into their classrooms and schools. Copies of the free fact sheet can be ordered online at www.neahin.org or by calling NEA HIN's automated hotline at 800/718-8387.

• Assault Prevention
  Drawing the Line: A Guide to Developing Effective Sexual Assault Prevention Programs for Middle School Students offers practical information about the characteristics of promising programs. The guide discusses dealing with disclosures of abuse, taking an age-based approach to devising curriculums, and avoiding program implementation pitfalls. This 55-page resource, published by the American College of Obstetricians and Gynecologists as part of its National Rape and Sexual Assault Prevention Project, is free. To order, visit www.acog.org.

• STD Prevention
  The National STD and AIDS Hotlines Classroom Calls Program, a free and confidential service, gives students and educators an opportunity to ask tough questions about HIV and other sexually transmitted diseases in their own classroom, through speakerphone. The service is available anywhere in the United States, Puerto Rico, or the Virgin Islands and can be conducted in English, Spanish, or TTY for the deaf or hard of hearing. For more information, call the Centers for Disease Control and Prevention National STD and AIDS Hotlines at 800/342-2437 or 800/227-8922. The toll-free hotlines are also available 24/7 for one-on-one callers to discuss HIV- and STD-related questions and concerns.