Infection risk from blood splatter to eye

[15bucks]

I know a tattoo artist who came to me with some questions about his risk of infection by tattooing HIV+ individuals. Specifically, he recently tattooed two people who he knows to be HIV+.  He works in a very clean shop and takes the utmost care to prevent any possibility of exposure to or transimission of any disease.  The tattoos went as normal, but he said that at one point he was looking closely at the tattoo while working on it and he felt like tiny bit of spray from the tattoo may have hit him in the eye.  Tattoo spray is incredibly fine and anything that would have come off it couldn't be any bigger than the tip of a pen (probably more like the tip of a pin).  Since then he's been worried about possible transmission via the eye since he takes precautions in every other way.

In my research on the topic I felt like his chances of contracting HIV in this way are next to nothing as most cases of transmission via the eye involve a larger volume of blood splatter, but he still wants more reassurance.  Does he have any risk of contracting HIV in this way?

I also found that cases of hepatitis infection via the eye was more likely given its higher viral load in general.  Does my friend have risk of contracting other hepatitis or something else by a miniscule splatter to the eye?  (Sorry to sneak in another disease, but it's the exposure via the eye that is at the heart of his concerns.)

Thank you for any help.

[Willl]

There was a case I read where a lab technician became infected by not following procedure, after he had been warned previously about this. He was not wearing face protection and not using the correct tool for removing tops to vials (apparently there is a tool for this). He pulled the top off of a vial with his fingers and reported feeling a drop go into his eye. The article also stated he did not wash his eye after but rather blinked and rubbbed it instead.

[15bucks]

We're actually in a location that has some of the strictest health regulations for tattooing that I'm aware of regionally and my friend is in total compliance since he loves his job and wouldn't want to lose it nor would he ever risk someone else's health.  The truth is that these rules are designed to protect the customers so the idea of protecting the tattoo artists is somewhat novel.  The rule of the shop has always been to treat everyone like they are infected, but eye transmission has never been something to come up in tattooing as far as I can tell.  Thus the need for outside counsel.

I actually suggested goggles too, but given the nature of the work they would have to be damn good ones where he could still see his work very clearly.  I will go shopping asap.

Thanks for the help though I wish there was more information.

[H. Hunter Handsfield, M.D.]

The risk undoubtedly is low, but to my knowledge no specific data are available.  You are right that the risks of B and C (but not A) are much higher than those of HIV.  But the risks are not zero for HIV or any blood borne infection.  Anybody who has any chance of facial spatter with blood or body secretions in the course of his or her work should be wearing mask and goggles.  Depending on the laws in your tattoo artist's state, this may be a legal requirement, and for his employer to provide the equipment and enforse its use--for all customers, not just those known to have a particular blood borne infection.  Your friend also should be immunized against HBV.  Your friend ought to phone his local or state health department to learn their recommendations and/or requirements.

Bottom line:  Very low risk, but the precautions nevertheless are reasonable.

HHH, MD