The allure of tattoos has captured the imagination of many, but a new study raises concerns about their potential health impact.
Researchers from Sweden have found a possible link between tattoo exposure and malignant lymphoma risk, but note the findings are limited and more research on the topic is needed.
The study, published May 21 in the Lancet’s eClinicalMedicine, stated that current knowledge on the long-term health effects of tattoos is limited. To address this gap, the researchers set out to explore the potential health impacts of tattooing, noting that not many studies have looked into this before.
This is because tattoo ink often contains carcinogenic chemicals, such as primary aromatic amines, polycyclic aromatic hydrocarbons and metals. A significant and concerning number of chemicals in tattoo ink are classified as carcinogenic by the International Agency for Research on Cancer.
The study found that tattooed individuals have a 21 per cent increased risk of lymphoma relative to people who do not have tattoos.
“We already know that when the tattoo ink is injected into the skin, the body interprets this as something foreign that should not be there and the immune system is activated,” lead author Christel Nielsen, an epidemiology researcher at Lund University in Sweden, said in a media release published Monday. “A large part of the ink is transported away from the skin, to the lymph nodes where it is deposited.”
Lymphoma is a type of cancer originating from immune system cells, encompassing both Hodgkin lymphoma and non-Hodgkin lymphoma. There are also many other subtypes, each varying in severity, prognosis and treatment options, according to the Leukemia and Lymphoma Society of Canada (LLC).
The latest data from the LLC shows that in 2020 there were an estimated 11,400 new lymphoma cases in Canada.
The causes of the cancer remain largely unknown, explained Nadine Prevost, business unit director, research and community support with LLC. There may be a genetic predisposition, she said, or it could be triggered by environmental factors such as pollution.
“With blood cancers, including lymphoma, we don’t think there’s just one major risk factor. There are multiple risk factors and they are not very well defined,” she told Global News. “We don’t understand everything with lymphoma, so we do need more targeted research.”
She added that studies like the one in the Lancet are important as they contribute valuable insights to the community’s understanding of the disease. However, she advised approaching the findings with caution, emphasizing the need for further research to fully grasp the complexities of lymphoma.
“We need to be careful not to present it in a way that people are starting to go back and get their tattoo removed or anything like that,” Prevost said.
What the study found
To see if tattoos were linked to lymphoma, the researchers used Swedish data that included 11,905 people. They identified 3,000 individuals diagnosed with lymphoma between 2007 and 2017, and 9,000 people who did not develop the cancer.
After taking into account other relevant factors, such as smoking and age, the researchers found that the risk of developing lymphoma was 21 per cent higher among those who were tattooed.
The study found that the risk of lymphoma was highest in individuals who had less than two years between their first tattoo and diagnosis. The risk decreased for those who had their first tattoo three to 10 years before diagnosis. But the study said this seemed to increase again in individuals who got their first tattoo 11 or more years before diagnosis.
The researchers said they initially guessed that the size of a tattoo would affect lymphoma risk. They speculated that a full-body tattoo might carry a greater cancer risk compared with a small butterfly tattoo on the shoulder. Surprisingly, their study found that the area of the tattooed body surface did not impact lymphoma risk.
On the contrary, the researchers observed the highest lymphoma risk in individuals with tattoos smaller than one hand palm.
“We do not yet know why this was the case. One can only speculate that a tattoo, regardless of size, triggers a low-grade inflammation in the body, which in turn can trigger cancer. The picture is thus more complex than we initially thought,” Nielsen said.
What is causing the link?
The authors note that the study does not identify what aspect of tattoo ink might be driving the association between tattoos and lymphoma. However, they said, existing literature indicates that ink injected into the skin can relocate within the body and end up in the lymphatic system.
For example, a 2017 study published in the journal Nature found that nanoparticles from tattoos can travel to the lymph nodes. Among the nanoparticles were five elements that they identified as “toxic,” which were aluminum, chromium, iron, nickel and copper.
The study’s researchers emphasized the need for further research on this topic. They plan to investigate the potential link between tattoos and other forms of cancer, as well as explore whether there is a connection between tattoos and other inflammatory diseases.
“People will likely want to continue to express their identity through tattoos, and therefore it is very important that we as a society can make sure that it is safe,” Nielsen concluded. “For the individual, it is good to know that tattoos can affect your health, and that you should turn to your health care provider if you experience symptoms that you believe could be related to your tattoo.”
Prevost highlighted the importance of any research about lymphoma but expressed caution about presenting the link between tattoo ink and cancer as a definitive statement.
“I don’t want people thinking that avoiding getting tattoos people can prevent malignant lymphoma, because I really don’t think that is the case,” she said.