Volume 15 / Number 1 Winter 1997 UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY (UMDNJ) President Stanley S. Bergen, Jr., M.D. Vice President for Administration Celia Dorantes Abalos, Esq. Director, University Marketing Communications and Executive Editor Barbara Hurley HEALTHSTATE Editor Eve Jacobs Senior Editor Margaret Keenan Contributing Writer Merry Sue Baum Editorial Assistants Mamie Hargrove Mark O'Connell Advertising Representative and Photography Coordinator Doris Cortes Business Coordinator Patricia Staley Design McMillin Giacalone Thompson Design UMDNJ SCHOOLS: UMDNJ- New Jersey Medical School UMDNJ- New Jersey Dental School UMDNJ- Graduate School of Biomedical Sciences UMDNJ- School of Health Related Professions UMDNJ- School of Nursing UMDNJ- Robert Wood Johnson Medical School UMDNJ- School of Osteopathic Medicine UMDNJ'S HEALTH CARE FACILITIES AND CORE-AFFILIATED HOSPITALS: UMDNJ- University Hospital, Newark University Behavioral HealthCare Cooper Hospital /University Medical Center, Camden Kennedy Memorial Hospitals- University Medical Center, Stratford, Cherry Hill, Washington Township Robert Wood Johnson University Hospital, New Brunswick University HealthCare Corporation (UHC) is UMDNJ's statewide, integrated managed care network. UMDNJ is a member of University Health System of New Jersey,a consortium of the University and its major teaching hospitals. HEALTHSTATE is published three times a year by the University of Medicine and Dentistry of New Jersey. If you wish to reprint any material, contact the editor. Address correspondence to: Editor, HealthState, UMDNJ, Office of University Communications, Room 114, 30 Bergen Street, Newark, NJ, 07107-3000. For change of address, please enclose mailing label. Subscriptions are $10 a year. Make check payable to HealthState and mail to above address.

letters Striking a Nerve I found your article on body piercing informative and very well written. I was especially impressed that it was not reactionary and did not imply that those who have body modifications are "different" or part of a counter-culture. The article treated piercing objectively - as something kids of the '90s are doing and about which they should be informed and careful. A few days after I read it, I noticed that one of my students had an eyebrow piercing that was infected. Thanks to the article, I knew he should have it checked by a physician, so I suggested he do so and provided him with a copy of HealthState. I would also like to comment on the photographs, which I understand were done by a Mercer graduate. Besides being technically outstanding, they illustrate the intent of the article perfectly. These dramatic shots help the reader realize that these are humans, not just holes. Deborah Harvey Kell Assistant Professor of Mathematics Mercer County Community College I read with great interest your fall issue and the back-to-back articles on body piercing and tattooing. As they point out, New Jersey has no state laws regulating body piercing or tattoo parlors. These growing sub-culture industries are a dream for freewheeling entrepreneurs. Piercers learn their craft through unstructured hands-on training provided by other piercers; tattooists learn their trade through unofficial apprenticeships. Your readers may be interested to know that this lapse in governmental oversight has not gone unnoticed here in the state legislature. Alarmed by the potential health risks of unsanitary tattoo and body-piercing parlors, I introduced legislation to authorize the Public Health Council to regulate sanitary conditions in piercing and tattoo parlors. Assemblyman Anthony Impreveduto (D-Secaucus) has graciously signed on as a co-prime sponsor of the measure (A-547). Despite our efforts, this bill has languished in the Assembly Health Committee for too long. One of our frustrations throughout this drawn-out process has been the lack of serious public attention to this issue. Newspapers, magazines and television tend to glorify tattooing and piercing as a youth-oriented fad. Pop-music performers, actors, and professional athletes reinforce this trendy image. You are to be commended for shedding new light on these health issues. The articles provided us with new insights and information, all of which will strengthen our case for passing this bill in the legislature. Keep up the good work. The fall issue of HealthState demonstrates the important role the magazine performs in New Jersey, serving as a bridge between the medical profession and the community it serves. Assemblywoman Shirley K. Turner Associate Minority Leader, D-Lawrence As my family sat down to celebrate Rosh Hashanah - there were 17 of us -my 24-year-old daughter announced that she was thinking of having her navel pierced. I immediately handed her the fall issue of HealthState with its cover story on piercing. She read the article aloud. When she was finished, she decided to rethink getting pierced. The article also sparked some very interesting and lively

conversation around the table. Thanks for a well-written, informative article on this trend. It's important that people know what may be in store for them if they choose to have their bodies pierced. Barbara Azzati, RN Management Assistant Department of Urology, NJMS I found the articles on body piercing and tattooing quite interesting on a personal level, since I have a few tattoos and am interested in having my navel pierced. The most important point for me was weighing the risk factors involved in piercing the skin (which includes tattooing) and also the fact that once you have a tattoo, it is pretty much there to stay. My tattoos are an outward expression of part of who I am, but they are also tastefully done so as not to draw attention, especially in the office environment. I did want to share with those who may be considering body piercing a fairly new product on the market, magnetic earrings. The ones I have seen are the "stud" type which have a magnet in the front and in the back. This product gives people the opportunity to see how others react before deciding if they want to make the piercing permanent. There are limitations, of course, as to where these magnetic earrings can be tried. But for those considering multiple ear, nose, lip and even tongue piercing, this could be an inexpensive and certainly safer alternative. Patricia Lee-Szanyi UMDNJ The articles on body piercing and tattooing are of considerable interest. Could you provide a bibliography or some of your main sources, particularly those dealing with the historical aspects of these two subjects. Also, it is my understanding that pediatricians have small kits available to use in ear piercing. It would indicate that the American Academy of Pediatrics does approve ear piercing. Do you know if they have any policy at all regarding other popular piercing sites? Cornelius N. Stover, MD Hunterdon Orthopaedic Specialists, P.A. Clinton, NJ According to Terri Belongia, publications representative at the American Academy of Pediatrics, the academy has no policy on piercing. A kit called the Coren Disposable Ear Piercer contains an apparatus that pierces the ear and inserts the earring in one step. The distributor claims that 99 percent of sales are to the medical community - 50 percent to pediatricians and the rest to dermatologists and plastic surgeons. Call 1-800-343-2030 for details. References for the article included: "Modern Primitives," Re/Search Publications, 1990; "Infectious Complications of Tattoos," Gayle E. Long and Leland S. Rickman, Clinical Infectious Disease (1984)18:610-617; "The Art of New Zealand Tattoo," Anne Nicholas, Carol Publishing Group, 1994; and several books from the Tattootime series edited by D.E. Hardy, Hardy Marks Publications. I want to commend you for the informative, interesting way you address everyday topics. The extra copies of the fall issue that you sent us were greatly appreciated. It has led the Kearny High School Library Newsletter editor to interview a student who has multiple piercings and to cite your article. Antoinette Gisoldi Library Media Specialist Kearny High School

I applaud your effort in discussing such a timely topic as tattooing and body piercing. However, as a dermatologist I felt the articles did not stress strongly enough the possible adverse effects.Young adults reading them would probably not have been persuaded to think twice before getting a tattoo or a piercing. It's a very risky business, especially if done by an amateur. I know - I've seen the results. Judit O. Stenn, MD Clinical Assistant Professor, Department of Dermatology, RWJMS Shot Down There are several inaccuracies in the fall HealthState article, "Who's Calling the Shots?" It states that a booster for the chicken pox vaccine (Varivax) is given 11 to 12 years after the primary immunization. At this time, no booster is required. The article also says the CDC recommends that the older DPT be used for the fifth dose. That is incorrect. The acellular DPT can be used for all five doses. Also, the 12 to 15 month MMR is a primary immunization, not a booster. As a medical magazine, under the auspices of a medical center, please make sure that the information you convey is correct. Barbara Katz, MD Atlantic Coast Primary Care, P.C. Brick, NJ For amplification we consulted Richard H. Rapkin, MD, professor of pediatrics at UMDNJ-New Jersey Medical School. He provided these guidelines: 1) The new varicella (chicken pox) vaccine is recommended for administration to children 12 to 18 months old. If not given at that time, a single dose administered any time prior to age 13 is sufficient. (Many doctors will give the vaccine at 11 or 12 years of age to children in need.) After age 13, two doses are needed. 2) The new acellular pertussis (whooping cough) vaccine can be used in the primary immunization series (along with diphtheria and tetanus toxoids)- so called DTaP. That means all five doses of DTaP can replace the five-dose DTP series. 3) The measles-mumps-rubella (MMR) vaccine is given at 12 to15 months of age as a primary immunization. This is not a "booster." An MMR booster should be given to all children either at age 4 to 6, or before middle school or junior high school. Since there are many new vaccines in development and recommendations for administration are changing rapidly as new information is forthcoming, parents need to rely on their child's physician to keep them abreast of advances. P.S. Regarding your feature "Docs in Cyberspace," which appeared in the fall issue, you might be interested in an article by UMDNJ staff on Internet related health support: "The Internet Cafe: To Your Health," Wilson Library Bulletin, March 1995. L. Ratzan UMDNJ, IST-Telecommunications Cyberblooper A website address in the article "Docs in Cyberspace" was incorrect. To access the UMDNJ libraries' representative collection of links to Internet health science resources of all types: http://www3.umdnj.edu/~libcwis/med-int.html