The Hygiene Guidelines for Sex Businesses and Sex Workers were revised extensively in 2018. The English translation was published April 2019.

The cleaning schedules from this guideline can be downloaded here as a Word document.

 

1 Introduction

This introduction specifies for whom these guidelines are written and what the purpose of the hygiene requirements is. It also explains why hygiene is important. You can also find a readers’ guide here.

What is the aim of these guidelines?

These Hygiene Guidelines set out standards and advice that can limit the spread of infectious diseases such as sexually transmitted infections (STIs). By adhering to these standards and advice, hygiene requirements that may be imposed at the municipal level will also be met. You can also include these hygiene guidelines in your business plan.

Who are these hygiene guidelines for?

These hygiene guidelines are intended for:

  • Managers and owners of sex businesses In these hygiene guidelines, the term 'sex businesses' refers to all commercial spaces where sexual activity takes place. This includes:
    1. businesses where sex workers engage in sexual activity, such as sex establishments, brothels, window prostitution, prostitution hotels, sex clubs and private houses;
    2. businesses that facilitate sexual acts (without the presence of sex workers). This includes sex saunas, erotic massage parlours, SM studios, sex cinemas, sex theatres and swingers' clubs.
  • Self-employed and ‘opting-in’ sex workers These hygiene guidelines are based on the assumption that an independent sex worker and sex workers who work on an ‘opting-in’ basis work as freelancers and that there is no employer-employee relationship. It is assumed that the freelancer and the client (landlord/manager/owner) will reach agreements regarding the implementation of the advice and standards outlined in these guidelines. These guidelines will use the term 'independent sex worker' in order to refer to these categories. This also includes sex workers who work on an opting-in’’ basis.

Responsibilities

The manager or owner of a sex business is an employer if he or she employs staff. The manager/owner is obliged to ensure that his or her employees (e.g. bar staff and cleaning staff*) can work hygienically. This means, among other things, that the manager/owner provides appropriate personal protective equipment free of charge. The manager/owner also keeps employees informed regarding hygiene measures. If it comes to the notice of the manager/owner that an employee is conducting himself/herself in a way that is not hygienic, the manager/owner must take action. This could involve talking to the relevant employee about this issue, for example.

The landlord/agency must, in accordance with the Working Conditions Act, reach agreements with the independent sex worker to ensure that he/she can work safely. This may include reaching agreements regarding who is responsible for the availability of condoms, towels and cleaning materials. But also regarding who is responsible for cleaning the rooms and any objects used during sex.

Due to their respective responsibilities, both the managers and owners of sex establishments and independent sex workers should read these guidelines. However, some sections are more relevant for sex workers while other sections are more relevant for the managers and owners of sex businesses, irrespective of whether sex workers are present.

  • Section 2 ‘Safe sex and personal hygiene' is intended for anyone who engages in sexual activity and anyone who is responsible for informing sex workers and employees about hygiene and safe sex.
  • Section 3 'Cleaning and disinfecting rooms and objects' is important for anyone who is (ultimately) responsible for cleaning of rooms, furniture and objects used during sex.
  • Section 4 ‘Building and facilities’ is aimed particularly at the managers and owners of sex businesses.
  • Section 5 'Information and rules of conduct' is important for both sex workers and managers or owners.

* If an external cleaning contractor is used, the operator/owner of the sex business has to inform the contractor about these hygiene guidelines. However, the operator/owner remains responsible for ensuring a safe working environment for sex workers.

Hygiene and pathogens

During sexual activity, sex workers and clients may become infected by STIs such as chlamydia, syphilis, gonorrhoea, hepatitis B, hepatitis C or HIV. Employees, such as cleaners, may also become infected during the course of their work. This can happen by, for example, touching an object which has semen on it. Chlamydia, syphilis and gonorrhoea are caused by bacteria, hepatitis B and C and HIV by viruses. If you become ill due to bacteria, fungi, parasites or viruses, this is known as an infectious disease. Good hygiene can prevent the spread of these pathogens.

Bacteria and viruses are invisible to the naked eye. They can be found everywhere: on the skin, in body fluids such as semen and blood, in lubricant or massage liquid after use, on furniture and objects, in the air, in water, on and in food. The majority of bacteria and viruses are harmless or even useful to humans, but some can cause diseases.

These pathogens can spread from one person to another through bodily contact. If they then multiply, they can cause illness. Whether exposure causes an infection depends on various factors:

  • the amount of pathogen(s) required to infect a person;
  • how easily the pathogen makes people ill;
  • the person's physical condition; while one person may become ill, another may just feel unwell and a third person may have no problems at all.

How are pathogens spread?

  • via the hands;
  • via body fluids (including semen, blood, saliva, vomit, faeces, urine, vaginal fluid);
  • through the air (e.g. droplets expelled when coughing, flakes of skin or dust);
  • via objects (sex toys, chairs, door handles and other objects that people touch with their hands);
  • via food and water;
  • via animals (pets, pests).

Regulations and permits

The municipality decides whether a sex business requires a permit. As part of the application process, the municipal public health service (GGD) may be asked to assess the hygiene of a sex business. The inspectors of the GGD will then check whether the business complies with the hygiene requirements set out in these guidelines. The General Municipal Bylaw (APV) of a municipality may state that the GGD, or another inspector appointed by the municipality, will continue to monitor hygiene on a regular basis after the permit is granted.

These guidelines refer to legislation such as the Buildings Decree and the Working Conditions Act. No references are made to the forthcoming Regulations of Prostitution and Combating Abuses in the Sex Industry Act (Wrp). At the time when these guidelines were being revised, it was still unclear which rules would be incorporated into this act and when the act would take effect.

Readers’ Guide

Hygiene standards are included in sections 2, 3, 4 and 5.

Hygiene standards

  • The hygiene standards are shown in a yellow box. These are the minimum requirements for a good hygiene policy.

Compliance with the hygiene standards in these sections may be verified by the GGD when issuing permits. You may only deviate from these standards if you apply a comparable or better alternative. The inspector of the GGD will determine whether a method, procedure or resource is a comparable or better alternative.

Advice

  • Tips and advice are shown in italic text in a grey box. You do not have to follow this advice. However, doing so will ensure that you are working more hygienically.

Where the text refers to the ‘GGD’, this refers to your specific locality. Please visit www.ggd.nl for the contact details for your local municipal public health service.

In the annexes, you will find some examples for cleaning schedules and instructions for hand hygiene, ready to print for immediate use. At the back of the guidelines, there is an overview of additional information and a glossary

2 Safe sex and personal hygiene

Why? Safe sex and personal hygiene help to reduce the risk of sexually transmitted infections (STIs) and reduce contact with other pathogens.

Who for? The standards and advice in this section apply to both the managers and owners of sex businesses and to sex workers. Managers and owners are responsible for informing sex workers and employees about hygiene and safe sex.

2.1 Hand hygiene

Why? One of the most common routes by which pathogens are spread is via the hands. The risk of infection is reduced by cleaning hands at the right time and in the right way.

How? Wash your hands with soap and water.

Hygiene standards

  • Wash your hands;
    • before and after any sexual contact or massage;
    • if there are body fluids such as semen, pre-ejaculatory fluid, vaginal fluid or blood on your hands;
    • if there is any lubricant or massage liquid on your hands;
    • after using the toilet;
    • before and after preparing food or eating;
    • after disposing of gloves;
    • after doing any cleaning work;
    • if your hands are visibly dirty.
  • Wash your hands according to the instructions provided in annex 2.

Advice

  • In cases where there is an increased risk of the transmission of STIs, such as in men who have sex with other men (MSM) or blood contact due to fisting an unknown sexual partner, after washing your hands and drying them thoroughly, you can also choose to disinfect them. This further limits the number of pathogens which may not have been removed by washing. Only use hand sanitisers that have been authorised by the Board for the Authorisation of Plant Protection Products and Biocides (Ctgb). See section 3.4 for further information. Disinfect your hands according to the instructions in annex 2.
  • If you work as an escort, only make appointments in places where you can wash your hands with soap and water. Always take a bottle of hand sanitiser with you to be on the safe side. Do not use hand sanitisers when your hands are visibly dirty; this reduces the effectiveness of the sanitiser. Wash or disinfect your hands according to the instructions in annex 2.

2.2 A clean body

You can get STIs from pathogens present in semen, pre-ejaculatory fluid, vaginal fluid, blood and mucous membranes. Pathogens can also survive for some time outside the body. This means that you can get STIs through body fluids present on your hands or skin. You can also become infected through body fluids on other materials - on a mattress or towel, for instance. Or because body fluids are present in used lubricant or massage fluid. For this reason, please observe the standards in section 2.1, as well as the following standards:

Hygiene standards

  • Take a shower every day.
  • Wash your lower body with water after vaginal or anal sex. Do not use soap or other products to rinse your vagina.
  • If the condom tears or slips off, do not rinse the inside of your vagina and anus since this increases the chance of an STI*. If the condom tears or slips off during vaginal sex, try to urinate and wash the outside of your vagina with water. Contact your general practitioner (GP) or the STI outpatient clinic of the Municipal Public Health Service (GGD)to assess whether any additional examination and/or treatment is needed.
  • Use clean bed linen or a large towel for each client, so that the client's body does not come into contact with the sheets. Put the towel with the dirty laundry immediately after you have finished having sex.
  • If the client does come into contact with the sheets, change the sheets after that client.
  • Any other items of laundry that have been used by the client, such as a bathrobe or towel, should also be put with the dirty laundry immediately after use.

* If the condom tears or slips off during sex, or if you have unsafe sex, there will be sperm in your vagina or anus. If you rinse, you can actually push the sperm deeper into your body. This increases the risk of an STI or pregnancy.

Advice

  • If possible, ask the client to shower or wash with soap and water before sex or a massage. Make sure that flannels, sponges and other personal cleaning materials are not shared.
  • If you rinse the inside of your vagina and anus after sex, do this with lukewarm water. Soap dries out mucous membranes. This makes you more susceptible to STIs and fungal infections. You can use soap when washing your skin.
  • If you shower frequently (for example, after every client), remember that your skin may become dry. This means it is essential to take good care of your skin.
  • If it is possible to rinse anally on location, use a separate disposable attachment. Discard the attachment immediately after use.
  • If you are working as an escort, make appointments in places where you can wash your lower body after vaginal or anal sex and where clean bed linen is available. See the Mantotman website for more information about anal douching for male escorts.
  • There is additional advice regarding neovaginas (after gender realignment surgery), such as rinsing at least once a week, avoiding possible irritants and applying special oil after rinsing. See the Soa Aids Nederland website for more information.

2.3 Hygiene regarding sex toys and other objects

STIs can survive outside the body for some time. For example, when body fluids are present in used lubricant or massage fluid. This means it is important to take care with objects and surfaces where body fluids are present or where lubricant or massage fluid is present. When body fluids enter the mouth, anus or vagina or come into contact with a wound or abrasion, you or your client risk contracting an STI. This relates to the mattress and cover, sex toys (vibrators, dildos), objects that you have used during sex (BDSM equipment, speculum) or rinsing equipment for vaginal and anal douching.

Hygiene standards

  • Prevent contamination via sex objects by doing one of the following:
    • Clean and disinfect the toys and objects where body fluid, lubricant or massage solution are present immediately after using them with a client. Section 3.3 explains when disinfection is required and section 3.4 explains which products should be used to do this; or:
    • Put a condom around the toy or the object if it is not too big for this. Tie a knot in the open end of the condom (at the bottom of the toy or object). Use a new condom for each client. Discard the condom immediately after use. Then wash the toy with soap and water. If the sex toy does come into contact with body fluids, lubricant or massage fluid, for example when removing the condom, then it will need to be cleaned and disinfected; or:
    • Use disposable materials. Dispose of these immediately after use with one partner. Disposable razors, disposable speculums and disposable douching equipment are all available.
  • Keep dirty sex toys and objects separate from clean items. This prevents the clean items from getting dirty.
  • Clean any surfaces where body fluids, lubricant or massage fluid are present, such as the mattress cover. Then disinfect the areas where liquids were present. Section 3.3 explains when disinfection is required and section 3.4 explains which products should be used to do this.

Advice

  • Only use your own sex toys. Make sure they are cleaned and disinfected before use. Do not use any sex toys that the client brings - this is not recommended. If you do use the client's sex toys, clean and disinfect the sex toy before use. Wear disposable gloves when you clean the toy.
  • Do not share sex toys with the client. This means, do not both use the same toy - this is strongly discouraged. If you do share sex toys with the client, use protection (a condom on the sex toy) and replace the condom each time a different person uses the toy.

2.4 Condoms and lubricants

Why? To prevent infection with STIs.

Which condoms? It is best to use latex condoms or condoms made of polyurethane. Both latex and polyurethane condoms are suitable for vaginal, anal and oral sex.

The skin of a neovagina (after gender realignment surgery) may become sore or irritated. For a neovagina, it is advisable to use polyurethane condoms with a lubricant based on grease or oil. If you still prefer to use a water-based lubricant or silicone-based lubricant, rinse your neovagina after sex (see the Soa aids Nederland website for more information).

General

Hygiene standards

  • Ensure that lubricants and approved condoms are available in or near the areas where sexual activity takes place.
  • Only use lubricants that are actually sold as lubricants. Never use hand cream, baby oil or other products as a lubricant.
  • With latex condoms, only use water-based or silicone-based lubricants and massage liquids. Condoms may tear because latex dissolves in oil and grease.
  • Only use lubricants and massage fluid based on oil or grease in combination with polyurethane condoms. Polyurethane condoms are resistant to oil and grease.
  • Use latex-free condoms if the sex worker or the client has an allergy to latex.
  • Always use a condom and enough lubricant during vaginal and anal sex. Also use a condom during oral sex or deep-throat sex and a dental dam when licking or rimming a partner’s vagina or anus. Never swallow semen, pre-ejaculatory fluid, vaginal fluid, blood or excrement.

Advice

  • Use the right size of condom. A condom that is too tight is more likely to tear and a condom that is too loose is more likely to slip off.
  • Buy lubricants in disposable packaging. Use a new package for each client.
  • Use enough lubricant during both vaginal and anal sex. Apply the lubricant to the condom and on and inside the vagina or anus. During sex, if you notice any discomfort, apply more lubricant. The more discomfort there is, the greater the chance of the condom tearing or slipping off and damage to your skin, and the higher the risk of transmitting an infection.
  • If you work as an escort, make sure that you take everything you will need for safe sex with you. Take materials such as condoms, lubricants, massage liquids, dental dams and gloves with you.

Condoms

Hygiene standards

  • Only use condoms that have a CE logo on the packaging (see illustration)*.
    logo CE-markering
  • Do not use condoms after the expiry date shown or condoms with damage to the packaging.
  • Make sure that the condoms do not contain nonoxynol 9.**
  • Follow the instructions for using the condom.
  • Store condoms in their original packaging in a dry, dark place at room temperature. Do not place them in the refrigerator or on the windowsill. Do not store condoms near sharp objects.

* It is illegal to use condoms without this logo. The logo indicates that the condom and the packaging comply with European standards.
** Nonoxynol 9 is sometimes added to condoms as a spermicide. However, nonoxynol 9 also damages the mucous membrane inside the vagina. This increases susceptibility to STIs and other infections. The packaging indicates whether nonoxynol 9 is added.

Advice

  • Replace the condom after 15 minutes of sex. When you use the same condom for an extended period, it can dry out. This increases the chance of the condom tearing or slipping off.

2.5 STI research

Sex workers are advised to get tested for STIs regularly. This can be done at your GP or at the STI outpatient clinic of the GGD in your local area. Get tested four times a year. STIs can lead to health problems if they are left untreated. It is also possible that you may not experience symptoms of an STI immediately, but only later.

Most STIs can be treated. However, some STIs do not show up for two to three weeks. So it is possible that you will have to be tested for HIV, syphilis and hepatitis B at a later date and, if you are an MSM sex worker, also for hepatitis C. Get tested if you notice any symptoms (such as itching, pain, an unusual discharge or skin lesions) or if the condom tore or slipped off during sex.

Are you worried that you or a client might have an STI? Stop working and have a check-up for STIs with your GP or the GGD. Lesions, blisters or warts on your client’s genitals may be an indication of an STI.

If you or your client have a piercing in the mouth or the genitals which has not fully healed, do not have sex. There is a higher risk that you or your client will catch or pass an infection. You can recognise new piercings from red or swollen skin around the piercing, or from pus, blood or scabs around the piercing.

2.6 Vaccination against STIs

You can be vaccinated against hepatitis A and hepatitis B. These vaccinations do not protect you against other STIs such as chlamydia or HIV. It therefore remains important to use a condom. You can get vaccinated at the GGD, for example. Vaccination against hepatitis B is free for sex workers.

2.7 Working when you are ill

If your symptoms include vomiting or diarrhoea, do not work. There is a high risk that your client will also become ill. Preferably, do not work if you are sick. This will prevent you from transmitting pathogens to other people such as your clients.

2.8 Working when you are menstruating

STIs can be transmitted through menstrual blood during your monthly period. It is therefore preferable not to work during your period. If you want to work anyway, use a sponge that is specifically intended for use during menstruation. These sponges do not protect you against STIs, so a condom is still needed.

2.9 Shaving clients

Some clients want to be shaved. This can lead to small skin abrasions. STIs can be spread via any bleeding from these abrasions. Sometimes these abrasions are so small that you cannot see them. However, some bleeding can still occur. Always stick to the following standards when shaving clients:

Hygiene standards

  • Ask clients who want to be shaved to bring their own razor or use a disposable razor. Use a new razor for each client.
  • Dispose of disposable razors immediately after use in a needle container with the UNUnited Nations  logo (see illustration). Never dispose of razor blades in a regular rubbish bag or bin. Those who collect or transport this rubbish may cut themselves.
    logo UN-keurmerk
  • If you notice that your client has a skin wound or abrasion, follow the steps in section 2.10.

2.10 Wounds or abrasions

If you have a wound or abrasion and another person’s body fluids come into contact with that wound, there is a higher chance of becoming infected with an STI. But there is also a risk if the other person has a wound or abrasion: you can get infected if blood from another person ends up in your vagina, anus or mouth. So take action immediately if you or your client gets a wound or abrasion.

A graze or scab does not pose such a risk, because these are not open so there is no bleeding.

Skin wounds and abrasions

Hygiene standards

  • Do not touch the blood or body fluids of another person with your bare hands. Use disposable gloves for this.
  • Allow the wound to bleed. Then rinse the wound with clean lukewarm water.
  • Apply a plaster or gauze to the wound.

Wounds in mucous membranes (the inside of the mouth, vagina and anus)

Hygiene standards

  • Rinse the area with water. Do not use soap. Soap dries out your mucous membranes, increasing the risk of STIs or a fungal infection.
  • If and you or your client accidentally get semen, pre-ejaculatory fluid, vaginal fluid or blood from the other person in an open wound or abrasion, rinse and treat the wound as described above. Then call or visit your GP or the GGD immediately. Explain that body fluids from another person have come into contact with an abrasion. The GP will let you know what steps you should take.
  • Make sure you have the telephone numbers of your GP and GGD in your telephone.

2.11 Fisting

When fisting, there is a chance that the vagina or anus may tear and bleed. If you fist your client when you have small wounds or abrasions on your hands, such as torn skin next to a fingernail, you run the risk of becoming infected with an STI. Follow these steps in order to minimise the risk of infection.

Hygiene standards

  • Make sure your nails are short and without sharp edges.
  • Wear a glove on the hand used. Only use gloves with the following logos and images on the packaging: CE marking and standard EN 374 suitable for micro-organisms (see illustrations).
    logo's CE + EN 374
  • Use a new glove for each client, and fresh lubricant.
  • Stop if there is bleeding from the anus.
  • Ask the client to rinse anally before fisting.

2.12 Golden shower and scat

Sometimes, for example with a golden shower, urine may be swallowed. Urine is usually sterile. This means that it does not contain pathogens. However, when someone has an STI, blood can come out with the urine, and the STI can be transferred to anybody who drinks the urine.

Excrement contains many bacteria and viruses, so it is not safe to eat during scat sex. Bacteria may also be transmitted through (small) wounds or abrasions.

Hygiene standards

  • Do not drink urine if you see or suspect that it contains blood.
  • Never eat your client's excrement.
  • Make sure that excrement or urine with visible blood never comes into contact with skin wounds or abrasions.

2.13 Activities that can damage or pierce the skin

Some sexual activities involve piercing or damaging the skin, inserting a catheter or injecting a fluid. These hygiene guidelines do not relate to the safety risks or regulations that may be relevant during such activities.

If you and/or the client engage in activities that involve piercing or damaging the skin, make sure that all materials used are sterile and that the method used is hygienic. You can find more information about this in the Hygiene Guidelines for Piercing issued by the National Centre for Hygiene and Safety (LCHV).

3 Cleaning and disinfecting

Why clean? Cleaning reduces the chance of illness. Dirt and dust can contain pathogens. Cleaning reduces the amount of dust and dirt present. This can include vacuuming or mopping. Most of the pathogens in the dust and dirt are usually also removed using these methods.

Why disinfect? Disinfection eliminates any pathogens still present after cleaning. Pathogens may be contained in body fluids such as semen and blood. Even after cleaning, residues of body fluids may still be present, meaning that pathogens may also still be present. This is why disinfection is necessary.

Who for? For everyone who has (overall) responsibility for cleaning and disinfecting areas where sexual activity takes place or cleaning the objects used during sexual activity. This primarily means the managers or owners of sex businesses and independent sex workers. The manager or owner of the sex business must notify those responsible for cleaning, including any external cleaning contractors, of the standards and advice set out in this section, so that they can work hygienically.

3.1 Cleaning rules and techniques

General rules

Hygiene standards

  • Use ‘dry’ methods of cleaning first (e.g. dusting or vacuuming) and then ‘wet’ methods (e.g. using a damp cloth or mop).
  • Start with the cleanest areas and move to dirtier areas. Start high and work your way downwards.*
  • Only clean using substances that are actually sold as cleaning products, such as all-purpose cleaner fluid. Follow the instructions on the packaging when using cleaning products.
  • Wear disposable gloves when cleaning. Only use gloves with the following on the packaging: CE marking and standard EN 374 suitable for micro-organisms.
    logo's CE + EN 374
  • Wash your hands after removing the gloves and disposing of them. Wash your hands according to the instructions in annex 2.
  • Also wash your hands:
    • if there are body fluids such as semen, pre-ejaculatory fluid, vaginal fluid or blood on your hands;
    • if there is any lubricant or massage liquid on your hands;
    • after using the toilet;
    • before and after preparing food or eating;
    • if your hands are visibly dirty.

* If you start in the less dirty areas, you can prevent your cleaning materials from becoming dirty too quickly. So start in the communal area, for instance, and then move to the areas used for sexual activities, and finish with the toilet and bathroom areas.

Using cleaning materials

Hygiene standards

  • Use fresh soapy water every time you clean.
  • Replace the water when it becomes visibly dirty.
  • Dispose of the water when you have finished cleaning.
  • Replace the cleaning materials when they are visibly dirty.
  • Wash cleaning materials such as mops and cloths after every use at 60°C. Then hang them up to dry or dry them in a tumble dryer. You can also choose to use disposable materials; discard these immediately after use.
  • Never leave wet cleaning materials in buckets after using them; this prevents pathogens from multiplying.
  • Hang up brooms, squeegees and other cleaning equipment and materials. Do not leave these on the floor. Hanging them up means that they can dry more quickly.
  • After use, rinse all used buckets with clean soapy water. Dry the buckets by turning them upside down.
  • Use clean materials every day.
  • Store cleaning materials in a separate cabinet that is clean. Also, store cleaning products in this or another cabinet.
  • Replace the filter and dust bag of the vacuum cleaner as often as the manufacturer recommends.
  • When mopping, use different buckets for clean and dirty soapy water. Clean the mop in the bucket of clean soapy water and rinse it in the other bucket. This will keep the water cleaner for a longer period.

Using microfibre cloths

When microfibre cloths are used in the right way, they absorb dirt and pathogens better than regular cloths. You can use microfibre cloths both dry and wet. Moist microfibre cloths work a little better.

Hygiene standards

  • If you use microfibre cloths, follow the manufacturer’s instructions. You can find these instructions on the packaging or on the manufacturer’s website.
  • Replace the microfibre cloths after 150 washes, or earlier if indicated on the packaging.

3.2 Using a cleaning schedule

Hygiene standards

  • Work according to a cleaning schedule. The schedule describes how often you clean each area, and which cleaning agents and materials to use.
  • An example of a cleaning schedule is provided in annex 1. Of course, you can clean more often than indicated in this schedule. Cleaning less often, or differently to the way described in the standards, is only allowed for a good reason (for example because an area is rarely used).

Advice

  • Tick off the cleaning work as you go. This allows you to see what has not yet been done more easily. This is particularly useful when cleaning is done by several people.

3.3 Disinfecting surfaces and materials

Disinfection after cleaning is necessary whenever body fluids such as blood or semen have come into contact with an object (such as a sex toy, swing, sling, etc.) or a surface (table, bench, chair, bath). Body fluids may also end up on objects or surfaces via lubricant or massage oil. Disinfection eliminates any pathogens that are present.

Try to prevent any pathogens from ending up on objects or surfaces, wherever possible. You can minimise this risk by:

  • using a condom for sex toys;
  • placing towels or waterproof sheets on beds or upholstered furniture.

Disinfection is only necessary in the areas of objects and surfaces that body fluids have come into contact with or that lubricant or massage fluid have come into contact with. There is no need to disinfect the entire surface.

Hygiene standards

  • Only disinfect after cleaning and once the surface is dry. Disinfectants do not work when an object or surface is still dirty, wet and/or dusty.
  • Sex toys and other sex objects (such as vibrators, dildos, sex dolls and BDSM material) should only be disinfected after cleaning and only when they have come into contact with body fluids, lubricant or massage liquid. Disinfection is not necessary if the toy is used with a condom and no body fluids have come into contact with it (when removing the condom for example). The toy should always be cleaned after use.
  • Other objects and surfaces that have come into contact with body fluids, lubricant or massage fluid: clean first and then disinfect the area where the substance in question ended up.
  • Keep clean and dirty sex toys separately.

Advice

  • Grease leather articles after you disinfect them. Leather can be damaged by disinfectants. By greasing the articles after you have disinfected them, you will protect the leather.
  • Wear gloves that are resistant to disinfectant when disinfecting.

3.4 Which disinfectants can be used?

On the Ctgb’s website (Board for the Authorisation of Plant Protection Products and Biocides), you can find out which biocides can be used for disinfecting in their database. The NVZ (Dutch Association of soap and disinfection suppliers) also has a list of suitable disinfectants that have been approved by the Ctgb.

If you have any questions about disinfection, contact a specialist cleaning company or the GGD. If there is an outbreak of an infectious disease, always contact the GGD.

Hygiene standards

  • Only use a disinfectant that has been authorised by the Ctgb. Check the latest instructions for use to ensure that the product:
    • is suitable for the 'material' (e.g. hands, sex objects* or hard surfaces) that you want to disinfect; and
    • is effective against bacteria and viruses.
  • Always use disinfectants according to the manufacturer’s instructions.

* Check the care instructions or ask the supplier which approved disinfectants are suitable.

3.5 Dirty laundry

Dirty laundry may be contaminated with pathogens. For this reason, always apply the following standards:

Hygiene standards

  • Collect and transport dirty laundry in a closed laundry basket or plastic bag.
  • Do not press the air out of a plastic bag filled with laundry (to make the bag easier to close); pathogens can also spread through the air.
  • Place sheets and pillowcases in the dirty laundry after every client if clients were not lying on a clean towel.
  • Do you place a clean towel on the bed for each client? If so, only the towel needs to be washed after each client. Change the sheets and pillowcases after each rental period or immediately if these are visibly dirty or wet. If rooms are not rented out, change them at least once daily.
  • Wash dirty laundry daily.
  • Wear disposable gloves when handling dirty laundry. Only use gloves with the following on the packaging: CE marking and standard EN 374 suitable for micro-organisms.
    logo's CE + EN 374
  • Wash your hands after removing the gloves.
  • Use a complete wash cycle. Wash at 60°C if blood or other body fluids are on the laundry. If the laundry cannot be washed at 60°C, follow the washing instructions. Dry the laundry in a tumble dryer or iron it.* 
  • Wash other laundry according to the washing instructions.

* The heat of the tumble dryer or iron will eliminate any remaining pathogens.

3.6 Waste disposal

Waste can be a source of pathogens and can attract pests. Ensure that the storage and disposal of waste meet the following standards:

Domestic waste

Hygiene standards

  • Use bin liners in all waste bins (with the exception of smoke-protection waste bins).
  • Empty the waste bins in the building at least once a day (or several times a day if they are full) and after each rental period. Close the bags properly and store these in a separate storage area in closed waste containers.
  • Do not press the air out of full bags of waste (to make the bag easier to close); pathogens can also spread through the air.
  • Wear disposable gloves when closing the rubbish bags. This prevents any body fluids from coming into contact with your hands. If body fluids do end up on your hands, follow the standards and instructions for hand hygiene in section 2.1.
  • Do not place waste bags next to waste containers. Make sure that the waste is collected before a container is full.
  • Ventilate the storage site and keep it clean and sealed, so that no rats or other vermin can reach it.

Sharp objects

Dispose of sharp objects, such as razor blades and needles, in an appropriate container. This minimises the risk that those who collect or transport the rubbish may cut themselves.

Hygiene standards

  • Dispose of sharp objects (such as razors) immediately after use in a needle container with the UNUnited Nations  logo (see illustration). Do not dispose of these with regular waste.
    logo UN-keurmerk
  • Replace needle containers when the contents reach the maximum fill line. Close the lid and hand over full needle containers for disposal.

You can only return full needle containers to collectors with a VIHB number. The contact details of collectors with a VIHB (transporters, collectors, dealers and brokers of waste substances) number can be found on niwo.nl.

4 Design and layout of business premises

Why? Keeping your business premises clean is an important part of preventing the spread of pathogens. The layout and design affect the ease with which this is possible. For example, smooth walls are easier and quicker to clean than walls with a rough texture.

Who for? The standards and advice regarding the design and layout of business premises are aimed particularly at the managers and owners of sex businesses.

The Buildings Decree includes a number of requirements for the design and layout of buildings. Municipalities may impose additional requirements regarding the premises of sex businesses. Always comply with the requirements of the municipality, even if those requirements deviate from the standards and advice set out below.

4.1 General standards

Hygiene standards

  • Ensure that cleaners can access all parts of the premises. Avoid difficult-to-reach corners and surfaces.
  • Make sure that furniture and other surfaces are made of a material that is easy to clean. Repair any damage immediately.
  • Ensure that sufficient cleaning materials, cleaning products and personal protective equipment are available so that the standards outlined in section 3 can be met.*
  • Make sure there is enough light for cleaners to work properly and see the results of their work.
  • Ensure good ventilation in all areas. Install ventilation grilles or windows that can be opened, for example.
  • Ventilate all areas 24 hours a day.**
  • Air all areas at least once a day for about 15 minutes.
  • Ensure the presence of at least one first aid kit that meets the guidelines of the Oranje Kruis.

* If you use an external cleaning contractor, agree who is responsible for providing these materials.
** N.B. airing is not a substitute for ventilation; both are necessary.

Advice

  • Have an expert (authorised cleaning company) provide training for those responsible for cleaning the premises.
  • Hire a professional cleaning company to clean the premises.
  • Check the expiration date of the materials in the first aid kit at least once every three months, and replace any materials that are past their expiration date.

4.2 Areas where sexual activity takes place

Places where sexual activity takes place include rooms where prostitutes work with clients, dark rooms, sex cinemas and relaxation cabins. Pathogens may be present in these areas in residual lubricant, or semen or blood stains on the furniture and walls, for instance.

Ensure that these areas meet the following standards:

Hygiene standards

  • Use mattress and pillow covers that do not absorb moisture. This ensures that they can be cleaned more easily.
  • Make sure that objects and surfaces which come into contact with lubricant, massage liquid and/or body fluids are made of a material that does not absorb moisture and is easy to clean and disinfect. This includes the floors, walls, beds, bed frame, chairs in film cabins and glory holes.
  • In or close to the area, ensure that there is an easily cleanable washbasin with hot and cold running water, a soap dispenser and disposable paper towels. Towels made of fabric can only be used if a clean towel is provided after each use.
  • Place a waste bin in the area where sexual activity takes place and use a bin liner.
  • Place disposable paper towels and cleaning and disinfection products in or near the area. This enables sex workers or clients to clean chairs or other objects before and after use, and to disinfect them if necessary.
  • Make sure that there are condoms with a CE logo and lubricant in or near the room where sexual activity takes place. Detailed information about condoms and lubricants can be found in section 2.4.
  • In rooms that clients can use together for sexual activity (for example, relaxation cabins), condoms, disposable paper towels, a waste bin with bin liner and cleaning and disinfection products should always be provided in the room itself.
  • If sharp objects such as razor blades are disposed of in an area of the premises, a needle container with the UNUnited Nations  mark should be provided in that area.
  • It should be possible for users to illuminate the area, using a dimmer switch for example.

Advice

  • Purchase lubricants in disposable packaging, so that a new package can be opened for each sexual activity and each package is used only once.
  • If it is possible to rinse anally on location, ensure that disposable attachments are available for single-use only. Discard the attachment immediately after use.

4.3 Toilets

The toilet area should be easy to clean. This is only the case if walls and floors are smooth and do not absorb moisture. Moisture is the perfect breeding ground for pathogens. Every person who uses the toilet should be able to wash their hands afterwards. For this reason, please observe the standards:

Hygiene standards

  • Ensure that the toilet and toilet area are laid out by following the Buildings Decree; for example, the room has smooth walls and floors that do not absorb moisture.
  • Ensure that there is a washbasin with hot and cold running water, a soap dispenser and disposable paper towels. Towels made of fabric can only be used if a clean towel is provided after each use.
  • Place a waste bin in the area where sexual activity takes place and use a bin liner.
  • Provide enough toilet paper.

Advice

  • Place special containers for sanitary towels and tampons in the ladies' toilets.

4.4 Showers and bathroom

Sex workers and their clients must be able to wash and shower before and after sex.

Hygiene standards

  • Ensure that the shower, shower area and steam room are constructed in accordance with the Buildings Decree (for example, the room has smooth walls and floors that do not absorb moisture).
  • Make sure there is at least one shower facility.

4.5 Saunas, steam cabins, pools and bubble baths

STIs can be spread through semen, blood or other body fluids in the bath (water). It should therefore be possible to clean pools, baths and sauna facilities thoroughly. If you provide bathing facilities, you must comply with the Bathing Establishments and Swimming Facilities Hygiene and Safety Act (WHVBZ) and the associated Decree (BHVBZ).

Hygiene standards

4.6 Kitchen

Hygiene standards

  • If you have a kitchen where food is prepared for clients, you need to follow the Hygiene Code for Food Safety.
  • If you have a kitchen that is used only by sex workers and staff members, make sure that the kitchen at least meets the standards described in section 4.1 and that there is a sink with running water, a soap dispenser, a waste bin and disposable towels.

4.7 Prevention of legionella

Legionella is a bacterium that can cause a lung infection. People can become ill by inhaling very small water droplets in which these bacteria spread from place to place. Jacuzzis and showers are examples of the way in which the bacteria can spread.

If your sex business has bathing facilities with a water surface area of at least 2m² and a depth of 0.5 metres or more (such as a jacuzzi), it is mandatory to implement legionella prevention measures for the plumbing system and for any jacuzzis on the premises. Visit the website of the Government of the Netherlands to check if you are required to comply with regulations regarding legionella prevention.

Hygiene standards

  • Visit the website of the Government of the Netherlands to check if you are required to comply with regulations regarding legionella prevention. In case you are required to comply, you must implement the necessary measures.

Advice

  • In order to comply with legal regulations, a risk analysis must be carried out and a management plan drawn up. Have this done by a specialist. For plumbing systems, it is mandatory to have the work carried out by a BRL 6010-certified company. For jacuzzis it is also advisable to use a BRL 6010-certified company with specialist knowledge of bathing installations.

5 Information and rules of conduct

Who for? The information in this section is important for everyone. These standards relate to the managers and owners of sex businesses, but the information is also relevant for sex workers.

5.1 Information

There is a great deal of information available for sex workers about STIs, safe sex and hygienic working methods. For example, Soa Aids Nederland provides various leaflets for sex workers. You can download these in a range of different languages or order them in the Soa Aids Nederland webshop.

Hygiene standards

  • Make sure that informational materials about STIs and safe sex are available for sex workers, clients and visitors. For an overview of the various information resources available, see Extra information.
  • Make sure that you have the telephone numbers of your GP and the local GGD on your telephone. See www.ggd.nl for the contact details of the GGD in your area.
  • Always allow health officials from the GGD to enter the premises. Allow sex workers the opportunity to talk only with these advisers.

Advice

  • For sex workers who work as escorts, Soa Aids Nederland has published a special leaflet entitled Call Me. This provides information for escorts on how to work safely and hygienically. For MSM escorts, there is the Mantotman website provided by Soa Aids Nederland, GGD Amsterdam and GGD Rotterdam. This also provides information about safe sex and STIs, among other subjects.
  • Advise sex workers to get vaccinated against hepatitis A and hepatitis B. The hepatitis B vaccination is free of charge for sex workers.
  • Sex workers are advised to get tested for STIs. Encourage them to get tested if a condom tears or slips off during sex or if they have any unusual physical symptoms.
  • Compile a list of the contact details of support services, advocacy organisations and stakeholder groups (such as the police and the tax authority).

5.2 Rules of conduct

Practising safe sex reduces the risk of STIs. Sex education is the first step towards safe sex practices. But knowledge is not enough on its own. Sex workers must feel able to work safely, and not feel inhibited about insisting on safe sex. They should not be afraid to refuse clients, decline to take part in certain activities or get tested for STIs. Setting ‘house rules’ for clients, and displaying these prominently, can help in this regard.

Hygiene standards

  • Clients should be made aware of the following rules of conduct:
    • Sex workers can always decline to work with a particular client or engage in a particular form of sexual activity.
    • Only safe sex is allowed. You may never force sex workers into unsafe sex.
    • Clients, managers and owners must never force sex workers to drink alcohol or use drugs.
  • Display the house rules in a place where clients will see them.

Advice

  • If you have video cabins or other private areas where clients engage in sexual activity, ask them to clean the cabins themselves after use.
  • Translate your house rules into different languages so that all sex workers and customers can understand them.
  • Include the house rules on your website.

Annexes

Annex 1. Cleaning schedules

This annex provides some examples of cleaning schedules. Not everything in the schedules may be applicable in your situation; you can change the schedules to suit your situation.

Where the standards mention how often cleaning should take place, this should be adhered to. Of course, you can clean more often than the schedule states, but if you want to clean less often or use a different method, you can only do so if you have a good reason (for example: a particular area is temporarily out of use).

One standard that should always be applied is: always clean immediately whenever an object or area is visibly dirty. This applies to all rooms, surfaces, appliances and objects mentioned in the cleaning schedule.

The other cleaning frequencies mentioned are advisory.

These schedules are shown on separate pages, so you can print them out more easily. You can display them in the cleaning cupboard, for example.

The cleaning schedules from this guideline can be downloaded here as a Word document.

Annex 2. Instructions for hand hygiene

Pathogens are everywhere: on door handles, tables, telephones and other objects, devices and materials. One of the most common routes by which pathogens are spread is via the hands. By washing your hands, you reduce the chance that you or someone you work with will become ill.

For correct hand hygiene procedures, please follow the standards and instructions for hand hygiene set out below.

  • Wash your hands with (liquid) soap and water:
    • before and after any sexual contact or massage;
    • if there are body fluids such as semen, pre-ejaculatory fluid, vaginal fluid or blood on your hands;
    • if there is any lubricant or massage liquid on your hands;
    • after using the toilet;
    • before and after preparing food or eating;
    • after disposing of gloves;
    • after doing any cleaning work;
    • if your hands are visibly dirty.
  • When your hands are not visibly dirty or sticky, a hand sanitiser can be used instead of soap and water.
hand hygiene

Download the schedule Instructions for hand hygiene here.

More information

Also check the website of your Municipal Public Health Service (GGD) for information relevant to your area. You can search for a GGD location near you at https://www.ggd.nl/.

Glossary

bacteria

An organism that cannot be seen with the naked eye. Bacteria are made up of one living cell without a cell nucleus. People have billions of bacteria inside them, but these are usually harmless and do not cause disease. Some bacteria can cause illness and diseases in humans. Some examples of bacteria that make people ill are: E. coli, Salmonella, Chlamydia, Neisseria gonorrhoeae (gonorrhoea) and Treponema pallidum (syphilis).

BDSM

A sexual preference and a form of sexual expression that involves imposing physical restrictions by mutual consent, intense physical stimulation, fantasies about domination and submission, and role play games that involve power.

Biocide

A substance that kills organisms. A disinfectant is an example of a biocide.

Chlamydia

A sexually transmitted infection caused by the bacteria Chlamydia trachomatis. The bacteria can be transmitted through unprotected sexual contact or during pregnancy from mother to child. Chlamydia is the most common bacterial STI in the Netherlands.

Ctgb

Board for the Authorisation of Plant Protection Products and Biocides The public body that assesses whether certain products are safe and decides whether a product can be sold and used in the Netherlands.

Dark room

A dark room where people can have sex together. This may or may not involve payment. There may be various facilities in or near the dark room, such as a video area or a relaxation cabin.

Disinfection

The elimination of pathogens using a specially designed disinfectant.

Fisting

A sexual practice where the fist is inserted into the vagina or anus.

Glory holes

A hole made in a wall or partition, intended for sexual activity to occur or be observed.

Golden shower

 A sexual practice where one person urinates on another person. It may involve swallowing the urine.

Gonorrhoea

A sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae. The bacteria can be transmitted through unprotected sexual contact (including contact with the hand or fingers) or during pregnancy from mother to child.

Hand sanitiser

A liquid that eliminates pathogens on the hands. When hands are not visibly dirty or sticky, a hand sanitiser can be used instead of soap and water.

Hepatitis A

Liver infection caused by the hepatitis A virus. The virus is usually transmitted via contaminated food or water.

Hepatitis B

Liver infection caused by the hepatitis B virus. The virus is transmitted via body fluids, including during sexual contact. Vaccination against hepatitis B is included in the National Immunisation Programme.

Hepatitis C

Liver infection caused by the hepatitis C virus. The virus is usually transmitted via contaminated blood.

HIV

Human immunodeficiency virus. This virus can cause AIDS.

Hygiene

Actions and methods that ensure that people and animals remain healthy by minimising the number of pathogens. This can be done by removing pathogens, control them or isolating a particular source of infection.

Infectious disease

Disease in humans or animals that are caused by one or more pathogens such as bacteria, viruses or fungi.

Body fluids

Semen, pre-ejaculatory fluid, vaginal fluid, blood, vomit, mucus, urine and excrement.

Airing

Opening all the windows and doors in a room or building for a short time (around 15 minutes). This allows fresh air into the room without allowing too much heat to escape.

MSM

Men who have sex with men.

Needle container

Refuse container designed specifically for sharp objects such as needles and razor blades. When used correctly, needle containers ensure good protection against cuts and injuries from sharp objects that have been disposed of.

Neovagina

A constructed vagina for trans women who have undergone complete sex reassignment surgery.

NVZ

Trade organisation for manufacturers and importers of cleaning and disinfection products.

Opting-in

A quasi employee-employer relationship, as defined by the Netherlands Tax Authority. The legal relationship is that between a client and service contractor, but the client does deduct income tax/social insurance premiums and the Healthcare Insurance Act contributions from the service contractor’s income.

Parasite

Organism or virus that survives and multiplies at the expense of another organism, which it lives with (the host). Scabies (crabs) and Trichomonas are examples of parasites.

Scat sex

Sex which involves playing with human excrement.

Rimming

Licking the anus.

Fungus

Organism with a cell nucleus. A fungus may consist of one cell, or of multiple cells (such as mushrooms). Candida, for example, is a yeast-like fungus that is often found in humans and can cause illness.

Cleaning

Removing dust and dirt, using a vacuum cleaner or mop, for example.

STI

Sexually transmitted infection. Examples of STIs include HIV, chlamydia, syphilis and gonorrhoea. Most STIs are caused by bacteria or viruses.

Syphilis

A sexually transmitted infection caused by the bacteria Treponema Pallidum. The bacteria can be transmitted via unprotected sexual contact, blood contact, blood transfusions with infected blood, or during pregnancy from mother to child.

Safe sex

Sexual activity that involves precautions to prevent the transmission of pathogens.

Ventilation

Ventilation involves a constant flow of fresh air into an interior space, using a vent, an open window or a mechanical system for example.

Virus

Usually much smaller than even the smallest bacterium. Contains genetic material within a protective layer. Cannot reproduce on its own and needs a host to do this, such as a human cell or a bacterium. Viruses can lead to serious illness. Examples of viruses are the flu virus, cold viruses, HIV, the various forms of hepatitis, and herpes.

Pathogens

Bacteria, viruses, fungi, yeasts and parasites that can cause disease.

Publishing information

The Hygiene Guidelines for Sex Businesses and Sex Workers were revised extensively in 2018 (English translation: early 2019). The following municipal public health services and organizations have contributed to the 2018 revision:

  • GGD Amsterdam
  • GGD Brabant-Zuidoost
  • GGD Gelderland-Zuid
  • GGD Haaglanden
  • GGD Hollands Midden
  • GGD Hollands Noorden
  • GGD Limburg Noord
  • P&G292
  • PROUD (union formed by sex workers)
  • Soa Aids Nederland
  • SOR Amsterdam
  • Vereniging Exploitanten Relaxbedrijven (VER)
  • VGGM

 

The Hygiene Guidelines for Sex Businesses and Sex Workers are published by:
National Institute for Public Health and the Environment
National Centre for Hygiene and Safety
Postbus 1 | 7200 BA Bilthoven
E-mail: lchv@rivm.nl 
Web: www.lchv.nl