Tattoo Artists Need Closer Monitoring, Study Says

Tattooing is associated with a higher risk of hepatitis C, Canadian researchers found in a newly published review and meta-analysis of studies from 30 countries.

Individuals with multiple tattoos over large swaths of skin were at a higher risk of contracting hepatitis C, said lead author Dr. Siavash Jafari of the University of British Columbia (UBC). Bigger tattoos require more punctures for injecting indelible ink and have a higher chance of infection from contaminated needles, he said. Tattoo devices pierce the skin 80 to 150 times per second during the application of a design.

Of 124 studies included from a comprehensive search of case-control, cohort or cross-sectional studies published prior to November 2008, 83 were included in the meta-analysis.

"The pooled odds ratio (OR) and 95 percent confidence interval (CI) of the association of tattooing and hepatitis C from all studies was 2.74 (2.38-3.15)," Jafari and colleagues reported. "In a subgroup analysis we found the strongest association between tattooing and risk of hepatitis C for samples derived from non-injection drug users (OR 5.74, 95 percent CI 1.98-16.66)."

"Since tattoo instruments come in contact with blood and bodily fluids, infections may be transmitted if instruments are used on more than one person without being sterilized or without proper hygiene techniques," Jafari said in a UBC statement. "Furthermore, tattoo dyes are not kept in sterile containers and may play a carrier role in transmitting infections. Clients and the general public need to be educated on the risks associated with tattooing, and tattoo artists need to discuss harms with clients."

In Vancouver, enforcement of health regulations could be stricter, said Erin Lawrence, manager of an Adrenaline tattoo parlor. "There are just so many different techniques for cleaning different things," she said. "[Inspectors] never come in and actually watch us clean; they just make sure you have everything. There's a difference between looking clean and actually being clean."

The full report, "Tattooing and the Risk of Transmission of Hepatitis C: A Systematic Review and Meta-Analysis," was published in International Journal of Infectious Diseases (doi:10.1016/j.ijid.2010.03.019).