Both colored and black inks may contain toxins associated with the development of lymphoma.
Tattoos have seen a significant surge in popularity over the last few decades. Today, tattoos adorn the skin of approximately 30% of the U.S. population, with European studies reporting similar prevalence rates above 20%. Most individuals decide on their first tattoo at a young age, resulting in prolonged exposure to the various chemicals tattoo ink contains. Despite this widespread practice, research on the long-term health effects of tattoos is still in its early stages.
Tattoo ink contains a complex mixture of both organic and inorganic color pigments, byproducts of pigment synthesis, and various additives. Colored ink also contains primary aromatic amines (PAAs) while black inks typically contain polycyclic aromatic hydrocarbons (PAHs), and inks of all colors can include metals such as arsenic, chromium, cobalt, lead, and nickel. Notably, several of these chemicals are classified as carcinogenic by the International Agency for Research on Cancer.
The tattooing process involves injecting ink into the skin through repeated punctures. This method effectively translocates ink particles to local lymph nodes, triggering a systemic immune response. Studies have shown that approximately 32% of the injected colors translocated within six weeks, with up to 99% potentially travelling to the lymph nodes over time.
For decades, clinical observations have documented pigmented and enlarged lymph nodes in tattooed individuals and have confirmed the presence of both black and colored inks, along with metal particles from needle wear. Lymph nodes, which house proliferating cells, are particularly susceptible to carcinogenic chemicals. There is mounting evidence that exposure to various environmental and chemical agents can disrupt the immune system, potentially playing a key role in the development of malignant lymphoma.
Globally, the incidence of malignant lymphoma has been on the rise with underlying causes remaining largely unknown. Given the concurrent increase in tattoo prevalence, understanding any potential association between tattooing and lymphoma is critical. To date, only one study by Warner et al. has examined tattoos as a risk factor for lymphoma, finding no significant increase in the risk of non-Hodgkin lymphoma among tattooed individuals. However, this study was conducted early in the mainstream adoption of tattoos and involved a relatively small sample size.
A recent population-based case-control study in Sweden again sought to investigate the potential link. Leveraging data from Swedish National Authority Registers, the study included individuals diagnosed with malignant lymphoma between 2007 and 2017. Researchers compared these cases with age- and sex-matched controls, examining variables such as tattoo presence, duration of exposure, and tattoo characteristics.
The team found that tattooed individuals had a 21% increased risk of overall lymphoma compared to non-tattooed individuals. This is the first large-scale epidemiologic study to suggest a possible association between tattoo exposure and lymphoma. The study also noted that tattoos received both shortly before and many years before the diagnosis were associated with an increased risk, indicating that exposure to ink contains enough chemicals to potentially play a role in both tumor initiation and promotion.
The findings underscore the need for further research to confirm the association between tattooing and cancer development, suggesting that the chemicals may contribute to the development of lymphoma specifically by disrupting the immune system. Additionally, the use of laser treatments for tattoo removal, which can convert pigments into carcinogenic compounds, warrants careful consideration and further investigation.
As tattooing continues to gain popularity, it is crucial to build a more solid understanding of their long-term health effects. This study provides an important step towards uncovering the potential risks associated with these inks and highlights the need for ongoing research to safeguard public health. If future research reveals the same findings, perhaps modifications can be made to the inks to make them safer.
Sources:
Tattoos linked to higher risk of malignant lymphoma, study finds
Tattoos and hematologic malignancies in British Columbia, Canada
Tattoos as a risk factor for malignant lymphoma: a population-based case–control study
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