A colleague quoted me and made this little sticker to inform clients.
To say the least, Brian knows what he’s talking about. This is great information to know for those of you who don’t already!
Because Brian Skellie Said So
I am not a piercer, but as a microbiologist, I have a few questions about this. If you’re using the autoclave correctly, everything should be killed. Nothing is going to ‘grow back’ after a proper autoclave session. (There are a very few microbes that are resistant to normal autoclave settings, but these are rare and highly controlled in the labs they’re studied in, the chances of them appearing on a average person’s jewelry is extremely low). And I’m not quite sure how ‘protein residues’ could possibly cause a bacterial/fungal/viral infection? Perhaps leftover toxins that are produced by certain microbes (i.e. S. aureus, a common skin microbe, can produce a toxin) could cause damage but it wouldn’t be an actual infection. And the vast majority of those toxin proteins (including the S. aureus toxin) are destroyed by the heat and pressure of the autoclave.
The only one of these that kind of makes sense is prions since as far as I know those are extremely difficult or impossible to decontaminate. But prions (the causative factor of ‘mad cow disease’, among others) are only spread through contaminated brain tissue, so I would think the likelihood of them appearing on a piercing would be extremely low.
Not that I’m saying buying used body jewelry is a good idea. I personally would never want to buy used jewelry. But the scientific inaccuracies here don’t really inspire confidence in the piercer. If I saw this at a studio I went to get pierced at, I would turn around and walk right back out the door.
Hello microbiologist friend smartsexyscientist :)
These points were reduced from a much more involved conversation in the context of describing why sales of used body jewelry is an untenable business practice, and to discourage professionals from considering their autoclaves infallible. At a piercing studio, you wouldn’t want to have to question if someone had previously worn your jewelry or if it was new and safely handled prior to cleaning and sterilization.
If it is not clean, it can’t be sterilized.
A colleague cherry picked quips to keep it simple for a lay person to understand . As easy as it may be to pick it apart, it is clear that you got the message, and as a person who describes some understanding of steam sterilization, you already understand that an autoclave process should be effective against most pathogens. Prions are one harmful known protein type that are not destroyed by steam sterilization, and require more harsh means for removal from a surface. They are most often spread through contaminated brain and spinal tissue, but also through other kinds of nervous tissue, such as the tongue.
Another part of the problem when it comes to body jewelry is that the autoclave operator most likely does not have a background in clinical microbiology and infection prevention, and may not have optimal equipment to clean and sterilize jewelry. Most of the autoclaves used in North American piercing studios do not have dynamic air removal such as a vacuum or pressure pulsing system. They rely on gravity displacement and can not adequately sterilize hollow, porous or wrapped loads, which results in regrowth.
I do not condone appeal to authority, even when I’m the alleged authority. I am a person very interested in the specifics of “how clean is clean enough,” and to this end continue to study and participate in the related workgroups in the ASTM F04.15 subcommittee on on Material Test Methods.
We’ve been working on the problem of reliable validation for surgical implant reuse for philanthropic purposes for over a decade. For example, pacemakers can be still functional for years after explanted from a deceased individual. The concerns for failure are due to both infectious material (protein, bacterial, fungal and viral) that resists autoclave processes inside crevices and hollow or porous spaces, and endotoxin and pyrogen residues that can cause rejection, even without infection.
Biofilm and denatured proteins that can prevent effective decontamination are known problems with body jewelry. More on this subject here.
References of interest:
ASTM F2847 - 10 Standard Practice for Reporting and Assessment of Residues on Single Use Implants
WK32535 New Practice for Establishing Limit Values for Residues on Single use Implants
WK33439 New Guide for Standard test soils for validation of cleaning methods for reusable medical devices
I support the establishing evidence based standards for decontamination and sterilization of medical device and other surgical implants for reuse, if it can be done safely and consistently. Once that sort of process is standardized in medicine, then it might be applied to body jewelry. This shouldn’t be impossible, and may be forthcoming. A promising note is that there are processes to clean bone and tissue for allograft and implant from exogenous sources, such as cadavers, into patients in need. These sorts of things under clinical investigation may result in the standards we need for reprocessing body jewelry.
Until implants can be safely reused under routine conditions, we should not reprocess previously worn body jewelry for anyone but the original wearer’s own personal reuse.