Smart Body Art

Do tattoos & piercings carry an increased HCV risk?
by Larry Buhl

In the U.S., an estimated thirty-six percent of people under thirty have tattoos, according to the International Journal of Infectious Diseases. Now that tattoos and piercing are becoming more commonplace, there’s an increased focus on risk prevention from the needles used for the creations. We’ve covered a public service campaign, “Be Smart With Body Art” [December 2010], that warns youth of the risk of exposure to the hepatitis C virus (HCV) from unsafe tattooing procedures.

It makes sense that anything that requires piercing the skin would carry a risk of infection. Tattoos require the skin to be pierced by a needle and injected with tiny amounts of ink, and each injection brings the needle into contact with blood. Just one puncture can expose blood to microbes (bacteria, viruses) carried by others, including hepatitis B, hepatitis C, and even HIV.

But research shows that the risk from body art comes from unregulated environments, such as homes and prisons. A new survey underscores this research, concluding that body modifications done in professional studios under sterile conditions carry no evidence of increased transmission risk, according to a recent study published in Clinical Infectious Diseases.

Rania Tohme and Scott Holmberg from the CDC performed a critical review of previous studies in an effort to sort out conflicting findings in the medical literature.

The authors evaluated the risk of HCV infection from tattooing and piercing following the Meta-analysis of Observational Studies in Epidemiology, or MOOSE, guidelines. They identified 293 articles and abstracts measuring risk factors for HCV and tattooing or piercing, published in all languages between 1994 and July 2011, then narrowed those published papers to ones that controlled for other HCV risk factors, leaving sixty-two articles eligible for analysis.

The authors found that there was no definitive evidence for increased risk of HCV infection when tattoos and piercings were done in professional settings, and that the risk of HCV infection was significant overall when tattoos were done in prison or by friends (a nearly four-fold higher risk).

“To date, there is no definitive evidence that such infections occur when sterile equipment is used,” the researchers wrote, adding that no outbreaks of HCV infection have been detected in the United States that originate from professional tattoo or piercing parlors.

“In addition, recent cohort and case-control studies including samples from the general population or blood donors in developed countries did not show an increased risk of HCV infection with body or ear piercing,” the authors said.

Safe Body Art Guidelines
The American Association for the Study of Liver Diseases offers guidelines for safe body art:
• The artists should be licensed by the state they’re operating in.
• Needles and ink containers should only be used by a single person.
• Tattoo artists should keep daily logs of the tubes they use.
• Tools that make contact with blood should be sterilized.
• Artists should wear single-use latex gloves.
• The parlor should proudly display Department of Environmental Health test results.

Customers can ask to see the sterilization process at any studio or parlor. The equipment used to sterilize needles and all other tools should be similar to those used in dental offices (you can ask your dentist how equipment is sterilized before getting that tattoo or piercing).

“Tattoo and piercing parlors need to be educated about and monitored for use of proper infection control procedures to avoid isolated cases of HCV infection and other infections,” the authors concluded.

Larry Buhl is a freelance journalist and screenwriter living in Los Angeles.

June 2012