"People who had do-it-yourself tattoos have a three times greater risk for hepatitis C than people without tattoos, and people tattooed in jail have an even higher risk. But the greatest risk comes from commercial tattoo parlors," he says. "People who get tattoos at commercial tattoo parlors have a nine times greater risk."
He bases his risk calculations on a study of over 600 people who were patients at a spine clinic in the early 1990s. The patients agreed to be evaluated for blood-borne infections, says Haley. The evaluation included detailed information about lifestyle risk factors as well as blood tests.
Haley found that 113 patients had at least one tattoo and 22% of those patients tested positive for hepatitis C. "Only 3.5% of the patients with no tattoos had hepatitis C," he says.
The news about tattoos is welcomed but not surprising, says Thelma King Thiel, who runs the Hepatitis Foundation International, an educational-advocacy group based in Cedar Grove, N.J. Thiel's group sponsors Hepatitis Awareness Month in May.
"We say that anything that invades the body by piercing the skin is a risk factor," says Thiel. She says that as soon as she saw Haley's paper "I shot a copy right off to the CDC." Thiel and Haley would like the CDC to officially designate tattooing as a risk factor for hepatitis C.
The CDC, which does list tattooing as a risk factor for hepatitis B, has stopped short of linking tattoos to hepatitis C. It states simply that more research is needed.
Brooke Seckel, MD, director of cosmetic surgery at Boston's Lahey Clinic and an assistant professor of surgery at Harvard Medical School, is an ardent opponent of tattoos. Seckel says the medical community was recently dealt a major setback when Massachusetts, which had banned tattooing, passed a law allowing tattoo parlors in the state. "Here we are supposed to be the bastion of medical science and we have just legalized this dangerous practice," says Seckel.
"Who is overseeing the process? We don't know if this equipment is properly sterilized. We don't know if the needles are disposed after a single use, says Seckel. "We don't allow nonmedical personnel to draw blood; why do we allow these people to pierce the skin?"