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Brussels, 17 July 2003

EU research investigates health risks of tattoos and body piercing

The fashion for tattoos and body piercing is growing in Europe, along with concerns about the health risks associated with them. But the knowledge about the chemical structure, identity, and toxicological profiles of a large number of dyes used in tattooing is mostly lacking. In this light, the Commission is collecting and assessing all necessary information to establish a common knowledge basis. EU research results released today present a comprehensive overview of possible health hazards and exposures associated with tattoos and piercing. When health standards are disregarded, these practices can bring about viral infections such as hepatitis, HIV; bacterial and fungal infections; allergic reactions such as skin irritation and urticaria; malignant lesions such as melanoma; leprosy and other devastating diseases. The Commission study identifies substances and materials associated with adverse health effects and recommends the development and use of safe, pure and sterile substances and materials.

European Research Commissioner Philippe Busquin said: “If people want to tattoo or pierce their bodies, we would like them to do so with proper health and safety guarantees. I hope the results from our EU research will raise awareness of the hazards associated with this practice and encourage practitioners in the tattooing profession to respect safety requirements, and policy makers across Europe to take appropriate steps to address this issue”.

A widespread problem

Up to half of piercings can lead to acute infections requiring medical or even clinical treatment. Two cases of death after piercing have been reported in Europe since the end of 2002. Existing regulations in EU Member States are mostly limited to prescribing hygiene practices such as the use of gloves and the sterilisation of needles. They do not tackle the issue of sterility of materials, dyes and colours, their purity, or the need for a proper toxicological and risk evaluation.

To address this issue, the Commission is working with the Council of Europe, which has prepared a resolution on “tattoos and permanent make-up”. The Commission also invites Member States to step up their efforts in this area and take appropriate action. Experts from Member States participated in the technical working group that drafted the Commission study released today, reviewing currently available information and proposing recommendations to foster monitoring, awareness raising and risk assessment.

Preliminary results of the study published today were discussed at a recent workshop in Ispra (Italy). Scientists, medical professionals, representatives of public administrations, practitioners and stakeholders from the piercing/tattooing industry agreed that action is needed, and called for the respect of safety standards and for enhanced monitoring across Europe.

Would you inject car paint into your skin?

Materials used in tattooing are administered directly into the skin. Because of the anticipated high life-long exposure to the chemicals used in tattoos or in piercing posts, chemical substances used have to meet strict requirements concerning purity, sterility and safety.

But except for a limited number of dyes and colorants that have been approved for use in cosmetics, most chemicals used in tattoos are industrial pigments originally produced for other purposes, such as automobile paints or writing inks, and have little or no safety data to support their use in tattoos.

Health effects of tattooing and piercing

As a result, a number of adverse health effects and infectious diseases associated with tattoos have been reported, such as:

  • Viral infections such as hepatitis, HIV, and cutaneous infections;

  • Bacterial infections such as impetigo, toxic shock syndrome, tetanus, venereal ulcer, tuberculosis and leprosy;

  • Fungal infections such as sporotrichosis and zygomycosis;

  • Allergic reactions such as cutaneous irritation and urticaria;

  • Granulomateus/lichenoid reactions;

  • Pseudo-lymphomas;

  • Lymphadenopathy;

  • Sarcoidosis;

  • Malignant lesions such as melanoma and skin cancer;

  • Behavioural changes;

  • Other skin diseases such as psoriasis, photosensitisation, phototoxicity and photogenotoxicity.

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