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Blando JD, Guigni BA. Potential chemical risks from tattoos and their relevance to military health policy in the United States. J Public Health Policy 2023; 44:242-254. [PMID: 36914711 PMCID: PMC10232601 DOI: 10.1057/s41271-023-00403-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 03/16/2023]
Abstract
We summarize and consolidate disparate sources of information about the practice of tattooing and its potential implications for military population health and policy. Each branch of the United States military has policies about tattoos for service members, but these have varied over time and do not cover health protection. The number of veterans receiving disability payments and the cost of those payments has been rising over time; the broad category of skin conditions accounts for 11% of disability claims. Any additional factor, such as tattoos that may increase the occurrence of adverse skin reactions, can substantially impact veteran benefit expenses and budgets. This may be a consideration for the military as it evaluates its policies related to tattoos among service members.
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Affiliation(s)
- James D Blando
- School of Community and Environmental Health, Old Dominion University, 4608 Hampton Blvd, Norfolk, VA, 23529, USA.
| | - Blas A Guigni
- Toxicology Directorate, Army Public Health Center, Aberdeen Proving Ground, MD, 21010, USA
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Negi S, Bala L, Shukla S, Chopra D. Tattoo inks are toxicological risks to human health: A systematic review of its ingredients, fate inside skin, toxicity due to polycyclic aromatic hydrocarbons, primary aromatic amines, metals, and overview of regulatory frameworks. Toxicol Ind Health 2022; 38:417-434. [PMID: 35592919 DOI: 10.1177/07482337221100870] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Today, tattooing has become very popular among people all over the world. Tattooists, with the help of tiny needles, place tattoo ink inside the skin surface and unintentionally introduce a large number of unknown ingredients. These ingredients include polycyclic aromatic hydrocarbons (PAHs), heavy metals, and primary aromatic amines (PAAs), which are either unintentionally introduced along with the ink or produced inside the skin by different types of processes for example cleavage, metabolism and photodecomposition. These could pose toxicological risks to human health, if present beyond permissible limits. PAH such as Benzo(a)pyrene is present in carbon black ink. PAAs could be formed inside the skin as a result of reductive cleavage of organic azo dyes. They are reported to be highly carcinogenic by environmental protection agencies. Heavy metals, namely, cadmium, lead, mercury, antimony, beryllium, and arsenic are responsible for cancer, neurodegenerative diseases, cardiovascular, gastrointestinal, lungs, kidneys, liver, endocrine, and bone diseases. Mercury, cobalt sulphate, other soluble cobalt salts, and carbon black are in Group 2B, which means they may cause cancer in humans. Cadmium and compounds of cadmium, on the other hand, are in Group 1 (carcinogenic to humans). The present article addresses the various ingredients of tattoo inks, their metabolic fate inside human skin and unintentionally added impurities that could pose toxicological risk to human health. Public awareness and regulations that are warranted to be implemented globally for improving the safety of tattooing.
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Affiliation(s)
- Sandeep Negi
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India.,Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
| | - Lakshmi Bala
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India
| | - Saumya Shukla
- School of Dental Sciences, Department of Biochemistry, 301429Babu Banarasi Das University, Lucknow, India.,Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
| | - Deepti Chopra
- Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, 538266CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India
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Cutaneous Malignancies in Tattoos, a Case Series of Six Patients. Curr Oncol 2021; 28:4721-4737. [PMID: 34898571 PMCID: PMC8628776 DOI: 10.3390/curroncol28060398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/04/2021] [Accepted: 11/09/2021] [Indexed: 02/05/2023] Open
Abstract
Background: A variety of side effects following the tattooing of the skin were reported over the years. Analytical studies showed that some tattoo inks contain harmful compounds. Methods: We presented six patient cases with cutaneous malignancies in tattooed skin and performed an extensive literature research. Results: Two patients with black ink tattoos that were diagnosed with malignant melanoma raises the number of described cases to 36 patients. One of the patients developed an immunologic reaction limited to the tattoo area after treatment with a targeted immune therapy. In the other patient, the malignancy (malignant melanoma) was fatal. Basal cell carcinoma was seen in four patients with tattoos containing varying ink colors (black, green, red). This increased the number of described patient cases to 18. Although some ink components and their cleavage products have carcinogenic properties, epidemiological evidence for a causative correlation fails. Further epidemiologic studies on tattoos and malignancies, as well as on the appearance of naevi in tattoos, are necessary. Determining the type of mutation might be helpful to separate sun-induced tumors from skin cancers due to other pathogenic mechanisms.
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Bolt HM, Hengstler JG. Tattoo toxicology, an upcoming complex scientific issue. Arch Toxicol 2020; 94:2273-2274. [PMID: 32607612 PMCID: PMC7367905 DOI: 10.1007/s00204-020-02822-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 06/18/2020] [Indexed: 02/05/2023]
Affiliation(s)
- Hermann M Bolt
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Adeystr. 67, 44139, Dortmund, Germany.
| | - Jan G Hengstler
- Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Adeystr. 67, 44139, Dortmund, Germany
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Bocca B, Senofonte O, Petrucci F. Hexavalent chromium in tattoo inks: Dermal exposure and systemic risk. Contact Dermatitis 2018; 79:218-225. [DOI: 10.1111/cod.13051] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/16/2018] [Accepted: 05/20/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Beatrice Bocca
- Department of Environment and Health; Istituto Superiore di Sanità; Rome Italy
| | - Oreste Senofonte
- Department of Environment and Health; Istituto Superiore di Sanità; Rome Italy
| | - Francesco Petrucci
- Department of Environment and Health; Istituto Superiore di Sanità; Rome Italy
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Schreiver I, Hesse B, Seim C, Castillo-Michel H, Villanova J, Laux P, Dreiack N, Penning R, Tucoulou R, Cotte M, Luch A. Synchrotron-based ν-XRF mapping and μ-FTIR microscopy enable to look into the fate and effects of tattoo pigments in human skin. Sci Rep 2017; 7:11395. [PMID: 28900193 PMCID: PMC5595966 DOI: 10.1038/s41598-017-11721-z] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 08/29/2017] [Indexed: 11/26/2022] Open
Abstract
The increasing prevalence of tattoos provoked safety concerns with respect to particle distribution and effects inside the human body. We used skin and lymphatic tissues from human corpses to address local biokinetics by means of synchrotron X-ray fluorescence (XRF) techniques at both the micro (μ) and nano (ν) scale. Additional advanced mass spectrometry-based methodology enabled to demonstrate simultaneous transport of organic pigments, heavy metals and titanium dioxide from skin to regional lymph nodes. Among these compounds, organic pigments displayed the broadest size range with smallest species preferentially reaching the lymph nodes. Using synchrotron μ-FTIR analysis we were also able to detect ultrastructural changes of the tissue adjacent to tattoo particles through altered amide I α-helix to β-sheet protein ratios and elevated lipid contents. Altogether we report strong evidence for both migration and long-term deposition of toxic elements and tattoo pigments as well as for conformational alterations of biomolecules that likely contribute to cutaneous inflammation and other adversities upon tattooing.
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Affiliation(s)
- Ines Schreiver
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
| | - Bernhard Hesse
- European Synchrotron Radiation Facility (ESRF), 38043, Grenoble, Cedex 9, France
| | - Christian Seim
- Physikalisch-Technische Bundesanstalt, Department of X-ray Spectrometry, Abbestrasse 2-12, 10587, Berlin, Germany.,Technische Universität Berlin, Institute for Optics and Atomic Physics, Hardenbergstrasse 36, 10623, Berlin, Germany
| | | | - Julie Villanova
- European Synchrotron Radiation Facility (ESRF), 38043, Grenoble, Cedex 9, France
| | - Peter Laux
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
| | - Nadine Dreiack
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany
| | - Randolf Penning
- Institute of Forensic Medicine, Ludwig-Maximilians University, Munich, Germany
| | - Remi Tucoulou
- European Synchrotron Radiation Facility (ESRF), 38043, Grenoble, Cedex 9, France
| | - Marine Cotte
- European Synchrotron Radiation Facility (ESRF), 38043, Grenoble, Cedex 9, France
| | - Andreas Luch
- German Federal Institute for Risk Assessment (BfR), Department of Chemical and Product Safety, Max-Dohrn-Strasse 8-10, 10589, Berlin, Germany.
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Wewering F, Jouy F, Caliskan S, Kalkhof S, von Bergen M, Luch A, Zellmer S. Hepatic co-cultures in vitro reveal suitable to detect Nrf2-mediated oxidative stress responses on the bladder carcinogen o-anisidine. Toxicol In Vitro 2017; 40:153-160. [PMID: 28089782 DOI: 10.1016/j.tiv.2017.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 01/07/2017] [Accepted: 01/11/2017] [Indexed: 11/15/2022]
Abstract
The azo dye o-anisidine is known as an industrial and environmental pollutant. Metabolites of o-anisidine remain in the liver for >24h. However, the toxicological impact of o-anisidine on the liver and its individual cell types, e.g., hepatocytes and immune cells, is currently poorly understood. A novel co-culture system, composed of HepG2 or Huh-7 cells, and differentiated THP-1 cells was used to study the metabolic capacity towards o-anisidine, and compared to primary murine hepatocytes which express high enzyme activities. As model compounds the carcinogenic arylamine o-anisidine and its non-carcinogenic isomer, p-anisidine, as well as caffeine were used. Global proteome analysis revealed an activation of eIF2 and Nrf2-mediated oxidative stress response pathways only in co-cultures after treatment with o-anisidine. This was confirmed via detection of reactive oxygen species. In addition, the mitochondrial membrane potential decreased already after 3h treatment of cells, which correlated with a decrease of ATP levels (R2>0.92). In the supernatant of co-cultured, but not single-cultured HepG2 and Huh-7 cells, o-anisidine caused increases of damage-associated proteins, such as HMGB1 (high mobility group box-1) protein. In summary, only co-cultures of HepG2 and THP-1 cells predict o-anisidine induced stress responsive pathways, since the system has a higher sensitivity compared to single cultured cells.
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Affiliation(s)
- Franziska Wewering
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589 Berlin, Germany.
| | - Florent Jouy
- Department of Molecular Systems Biology, UFZ, Helmholtz-Centre for Environmental Research, Permoserstrasse 15, 04318 Leipzig, Germany
| | - Sükran Caliskan
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589 Berlin, Germany
| | - Stefan Kalkhof
- Department of Molecular Systems Biology, UFZ, Helmholtz-Centre for Environmental Research, Permoserstrasse 15, 04318 Leipzig, Germany; Department of Bioanalytics, University of Applied Sciences and Arts of Coburg, 96450 Coburg, Germany
| | - Martin von Bergen
- Department of Molecular Systems Biology, UFZ, Helmholtz-Centre for Environmental Research, Permoserstrasse 15, 04318 Leipzig, Germany; Department of Biochemistry, Faculty of Biosciences, Pharmacy and Psychology, University of Leipzig, Brüderstrasse 34, 04103 Leipzig, Germany; Department of Chemistry and Bioscience, Aalborg University, DK-9220 Aalborg, Denmark
| | - Andreas Luch
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589 Berlin, Germany
| | - Sebastian Zellmer
- Department of Chemical and Product Safety, German Federal Institute for Risk Assessment (BfR), Max-Dohrn-Strasse 8-10, 10589 Berlin, Germany
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