Possible association between tattoos and lymphoma
lunduniversity.lu.se
lunduniversity.lu.se
Ironically, while working on a drug program that involved intradermal injection, we needed to tattoo the injection site so we could find it later. The FDA was very demanding that both the procedure and more importantly to them the dye would not have any effect that might alter the body’s response to the compound under test. We had to do a whole study just to validate this.
So the FDA is concerned about this issue for guinea pigs, but is barred from investigating the effect on humans. All they can do is publish advice on their web site.
Wait they're legally prevented from investigating tattoo inks? Why?
> The Korean Ministry of Health and Welfare considers the act of tattooing similar to medical procedures and deemed they should therefore only be performed by a professional with a medical license.
BTW FDA was explicitly barred by a corrupt law* from regulating anything "natural" (a poorly defined criterion) so the same happens with all those things you see in Whole Foods: FDA can warn you of certain dangers from their web site but that's it.
They have a summary page that talks about the history of law that apply to them: https://www.fda.gov/about-fda/fda-history/milestones-us-food...
* Herbalife got their senator, Orrin Hatch, to get this law passed so they would stop getting in trouble for peddling snake oil in both their products and their MLM business model. His career was basically 100% carrying water for MLM folks and the music industry in exchange for cash.
For example, the corruption at the Atlanta airport is mind boggling. The airport is actually owned and run by the city and when the corruption becomes over bearing to the point that it had serious impacts, like the semi-recent power outage, the state legislature threatens to take over operations to keep the city in check.
So one of the senators from GA just recently slipped a line into a spending bill that would make it nearly impossible for the state to do so.
> FDA considers the inks used in intradermal tattoos, including permanent makeup, to be cosmetics. When we identify a safety problem associated with a cosmetic, including a tattoo ink, we investigate and take action, as appropriate, to prevent consumer illness or injury. The pigments used in the inks are color additives, which are subject to premarket approval under the Federal Food, Drug, and Cosmetic Act. However, because of other competing public health priorities and a previous lack of evidence of safety problems specifically associated with these pigments, FDA traditionally has not exercised regulatory authority for color additives on the pigments used in tattoo inks. The actual practice of tattooing is regulated by local jurisdictions.
- https://www.fda.gov/cosmetics/cosmetic-products/tattoos-perm...
https://en.wikipedia.org/wiki/Thalidomide_scandal#United_Sta...
>In the U.S., the FDA refused approval to market thalidomide, saying further studies were needed. This reduced the impact of thalidomide in U.S. patients. The refusal was largely due to pharmacologist Frances Oldham Kelsey who withstood pressure from the Richardson-Merrell Pharmaceuticals Co.
https://en.wikipedia.org/wiki/Thalidomide#Change_in_drug_reg...
>In the United States, the new regulations strengthened the FDA, among other ways, by requiring applicants to prove efficacy and to disclose all side effects encountered in testing. The FDA subsequently initiated the Drug Efficacy Study Implementation to reclassify drugs already on the market.
There was a swift ban on Thalidomide and the FDA went to the extreme of removing fertile women from all trials for the next 60 years, leading to 2nd order effects like Ambien car crashes.
Notice how I didn't say "FDA bad", but just asked a question, which was effectively answered.
This sort of infered bickering is not conducive to civil discussion.
Had one that was used to give someone eyebrows that got all toasty in an MR scanner.
The person we scanned had too much pain for us to continue. The tattoo was not new. I recall another similar incident too. I also have a colleague who scanned someone with recently tattooed eyebrows and the MR caused very significant pain.
The problem would seem to be under reported (see links below which make it seem fairly rare). That said, we don’t have anyone we would report it to and rely on techs talking to each other and sharing these things - which happens regularly.
New risks are discovered fairly regularly. In recent memory: smart rings, squirreled away blood sugar monitors, penile implants, penile beads, hair extensions that are attached with wire. A low level of trust is key.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3445217/
https://www.ajronline.org/doi/full/10.2214/ajr.183.2.1830541...
rohs solder. Leaded paints, enamel paints, water based paints. cars with smog pumps and catalytic converters.
I'm not sure what you're arguing for. Keep selling products that disable and kill people until the technology improves and the market selects for the superior product? Because history has demonstrated that that rarely works out as long as the option that kills and disables people is cheap enough to outweigh the immediate drawbacks. Especially when consumers think they're immune.
This kind of statement always puzzles me. Leaded solder was an absolute nightmare to use for me, after the switch to the lead-free one I was suddenly much better at soldering within minutes. It was like going from square to round wheels.
Either way, my point is that regardless of whether there are benefits, they're not worth dying for (or suffering from lead poisoning).
The people that complain are correct. For example, asbestos IS a good technical solution! But it is worse in the big picture, therefore we need another solution that might not be perfect.
Some European countries banned leaded paint in 1909 the US and Canada only banned lead in paint in the late 1970s!
Just a shower thought.
Not that I have eaten the ones bred for medical research. But a fun side point: we did drug program for which the FDA insisted that preclinical studies be done in mini pigs (similar to human skin) though our research program had been in guinea pigs. The Göttingen mini pigs, like many experimental program animals, are carefully inbred so you can get a group that are genetically quite similar. We had to do the study in Toronto because the labs in California claimed they were being outbid by certain restaurants who wanted pork short ribs.
I was (and remain) convinced that this was some kind of racist joke (among other things these kinds of animals are quite expensive), but multiple people swore it was true.
So maybe you have eaten an animal intended for scientific research.
But, as with anything, it’s about nuance. You can read through the ingredients here[0] and tell me what you’d like in your body.
The earliest tattoos, from my understanding, were done by incision and rubbing carbon into the wound. Regardless if you use old or new inks/techniques, it’s not really cut and dry to say “this is bad/good” because the size of the particulates matter. For a tattoo shop that uses high quality ink, and is diligent in its sterilization, most inks are fine. The large molecules are “trapped” by your immune system to just stay there[1], making them not dangerous.
There is a ton of research on PubMed about tattoos, most being negative. However, I suspect it’s because the authors had a predisposition to be negative from the start based on how the research is conducted and what they focus on. But I could be wrong and you should make up your own mind.
Bottom line: if you get tattoos, pay the premium and go to a good shop. The hygiene and good products are worth it, if that’s your thing.
[0]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9846827/#:~:tex....
We were able to isolate it in the HPLC and through some histopath experiments show that it didn’t have any negative local effect between (IIRC) seven and 60 days. Why those times? Protocol was to tattoo on day 0, wait a week for the site to recover, then inject our experimental material on day 7, sacrificing subject animals at D14 (one week), 21, 28, 35, 42, 49, and 56 days.
I don’t think lamp black is really a good idea, but was adequate for our purposes. We didn’t have to do any kind of long term study, just demonstrate that it would not interfere with our work in guinea pigs.
* I actually went to a specialist art store and the owner did indeed go to the back of the store and pull out one of the volumes of a multi-volume work on inks and pigments! I don’t know if it was actually named “The Encyclopedia of Ink”, though I do remember that that’s how he referred to it. He just photocopied the relevant page for me, most of which was the entry for India ink.
Breathing soot every day and caking your lungs with it over time raises your risk of cancer.
If our body was not built to handle homeopathic doses of toxins, we'd all be dead.
I believe you meant "Folie a Deux"?
Without a dose response, I'm inclined to believe that the increase in lymphoma seen in people with tattoos has more to do with confounding factors than with the ink or the act of getting a needle poked into your skin. I would think that controlling for all confounders in a study like this would be exceptionally difficult.
That said, I'm pretty sure that at least some inks do contain known carcinogens[1]
For those who don't know how to interpret medical evidence, this study is very weak.
"The mean age of death for tattooed persons was 39 years, compared with 53 years for non-tattooed persons (P = .0001). There was a significant contribution of negative messages in tattoos associated with non-natural death (P = .0088) but not with natural death."
TFA has a more direct, physical, concern - it starts from a well-known, that tattoo ink ends up in lymph nodes, and it does a statistical analysis showing there's a significant statistical result in lymphoma occurence.
I think people with negative tattoos dying younger reduces the # of people with tattoos who get lymphoma, as they have less ink-in-lymph-nodes years.
I doubt they intended to communicate something that general, and if they did, I doubt they meant to pick one that would reinforce the conclusion.
Also the slicing and dicing, “11 more than the index year” and so on, is multiple hypothesis testing on the face of it; I wonder if they adjust for that.
"Sharing traits common in motor cycle gangs increases risk of cancer - new study"
As someone pointed out on the other thread about this[1], the lack of dose response makes it very difficult to see this as a direct correlation and not reflective of other confounding factors.
https://www.jyi.org/2016-april/2017/3/12/got-ink-an-analysis...
> generally much less educated than individuals who did not have tattoos
From the article: "we found that the risk of developing lymphoma was 21 percent higher among those who were tattooed"
Let's put this number into context, because "percent of increased risk" is always something I struggle to picture"
"Overall, the chance that a man will develop NHL in his lifetime is about 1 in 42; for a woman, the risk is about 1 in 52." [1]
So the overall risk is ~2 %. That means getting a tattoo will bring your overall risk of developing NHL from 2 % to 2.5 % instead.
[1] https://www.cancer.org/cancer/types/non-hodgkin-lymphoma/abo...
Non-Hodgkin lymphoma (NHL) is a cancer that starts in lymphocytes, a type of white blood cell that helps fight infection. Lymphocytes are found in the bloodstream but also in the lymph system and throughout the body.https://chpgroup.com/evidence-in-ih/tattoo-ink-can-mimic-lym...
Plus, if you don't find an effect, there is no paper to publish.
So, the proper correction factor is not just to account for the data in this study; scientists would also need to implicitly correct for all the other (unpublished) attempts by other scientists that found no effect.
It's a tricky business for sure and not one with a reasonable solution.
Hence I would not read too much into this study ...
I don't disagree to the gist of your post. However, in biomedical and public health research, papers are published even "if you don't find an effect", for good reasons. There could be simply very many unknown factors at the initial phase of some research topics. Researchers find or notice some things, publish them with rigorous discussions, proposed hypothesis with explicitly mentioned assumptions, etc. Other researchers build upon the existing results, add more discoveries, which can be proving or disproving, partially or wholly, etc. It often takes years of multiple teams to get a good enough understanding of a topic. This implicit collaboration is a positive feedback loop to advance the research.
The issue is that the vast majority don't read the detailed discussion in the papers and thus could get a partial thesis, which in many cases lead to incorrect conclusions. Media reports don't help, because they are essentially a simplified version. Otherwise, they can simply refers to the original papers and ask the audience to read them. Also, not many reporters have solid scientific training in the fields they report and don't understand the papers well enough. I don't blame them, since it is hardly their job. Good readers must be aware that the reports can be misleading, or biased, or simply wrong.
edit: grammar
I think tattoos have gotten more mainstream in recent decades, but I'd guess that before that it correlated with other risk factors [0].
[0] I'm not making any kind of oblique reference. I have no idea what those factors might be.
When any antigen breaches the skin barrier, the local immunologic response
includes cell-mediated translocation of the antigen to the local lymph nodes
from where a systemic immune response is initiated. The translocation of tattoo
ink seems to be very effective; it has been estimated that 32% of the injected
pigment is translocated after 6 weeks, and that as much as 99% may become
translocated over time.
In clinical settings, pigmented and enlarged lymph nodes have been described in
tattooed individuals for decades. Translocation of both black and coloured
tattoo pigments to human lymph nodes has been confirmed, as have depositions of
metal particles from tattoo needle wear.
[0] https://www.sciencedirect.com/science/article/pii/S258953702...
Didn’t realize it continued after the healing process as well. That logically means that the earlier you got the tattoo the worse it is.
Tattoos indeed are known to cause cancer among other health complications.
Chemicals linked to cancer (or other conditions) are cause for concern! It's important to note & track these things. But the dose makes the poison and it's totally possible to inject a chemical that 100% causes cancer (under some circumstances) with no adverse impacts.
[1] https://www.cancer.gov/about-cancer/causes-prevention/risk/d...
Radiation is normal in nature and will give you cancer. That's the main reason why people wear sunscreen[1]. It's not like there's a "natural" amount of radiation that is 100% safe and then you cross a boundary.
I agree that avoiding tattoos is harmless. Tattoos have no "benefits" - but those aren't the statements we are critiquing.
> just like 1 cigarette is worse than 0
This is almost certainly not true. Nicotine has a number of properties that might benefit you in the moment, or under certain conditions[2]. Cigarettes are not "healthy" and they are never going to be the "best" delivery system, but there exist many situations where your health would improve if you have your very first cigarette.
Another good example is that Vitamin D, which is an essential nutrient, can cause increased cancer risk[3]. Looking at substances as "causing cancer" or "safe" will lead you to an inaccurate understanding of when you are taking risks and when you are not. You can't live without Vitamin D and also if you get too much it can help give you cancer.
[1] It's not actually clear how much sunscreen protects from cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7759112/
[2] https://pubmed.ncbi.nlm.nih.gov/8746297/
[3] https://www.cancer.gov/about-cancer/causes-prevention/risk/d...
Can't argue with a science denier unfortunately, good luck
Hmmm... I don't see how this could be harmful!
I'd be amazed if it didn't have health effects.
Otherwise I can argue that once you have all the data it is feasible to test many different combinations of variable corrections, age groupings, tattoo sizes, etc. until you find one scenario (the one you publish) with "statistical significance".
I had a quick glance at the article and the authors do not discuss any multiple testing correction method. The lack of such discussion makes me think that they were unaware of such problem and they tested multiple hypothesis until they found one "statistically significant". This is called cherry picking. https://xkcd.com/882/
I can think of two alternatives to the cherry picking hypothesis that might make me believe their conclusion will hold:
1. They had the statistical analysis plan decided from the beginning up to the smallest detail. They followed it by the book and they found the published result without exploring anything else, so there were no other hypothesis to correct for multiple testing for. This is feasible, but seeing the significance and effect size it seems this would be a very risky study design, since the effect size they see is rather small. Since it's so risky, I find it unlikely.
2. The result holds regardless of forcing minor variations to all those corrections. This means there would probably exist a simpler analysis plan, without so many corrections, that presents compatible results with the published plan. This is unlikely in my opinion, because if that were the case I would expect a simpler story in the paper, or a larger effect size.
Maybe an independent group of researchers believes in these results and decides to reproduce the study to confirm it. If this happens I hope they follow the same statistical analysis plan published in this paper, and I hope they can publish their findings in the same journal, even if they can't get a "statistical significance".
Tattoo pigment particles are quite inert.
Asbestos is quite inert, which is a good property for fire retardant materials to have. However it does have an unfortunate effect when inhaled.
Not at all what I expected. Color me impressed with the methodology.
I’m calling bullshit.
Please name a toxin that is not dependent on dosage. I claim this is then not a toxin.
Do whatever you like, it’s your life
John didn’t buy that classic car because he’s in a midlife crisis. He bought it because it’s been his dream car since he was 12, and, with the kids out of the house, he can finally get it without having a bad conscience. (It just costs $80k now instead of $8k back in 1972)
There's a huge, like 10x spike in male deaths, specifically at 50. Turns out a lot of people hit that age, think "oh fuck I'm 50", go and buy a really powerful car, and get in a bad crash.
So buy the car, but just keep the graph in mind haha.
As in: you need to be past your thirties to rent this vehicle.
It's the $3000 cars that are going for $80k.
Oddly enough, the luxury high end cars at $8k in 1972 is the equivalent of $60k in 2024. With average new car price being ~$48k today, if the average automobile price stayed the same from 1972 the average new car price would be $26k today.
Something went off the rails. Ah...tarrifs. nvm
Don't allow your life to be defined by what you imagine other people will think about it..
Also, close to 50 is probably the new mid-life point anyway if you extend out the trajectory of health science thru the second half of your life. Chill out. :)
That said, if I had the inkling (pun intended) to get a tattoo I would actually wait until this lymphoma association is verified, because if if it turns to be real, and then I get a lymphoma, I would feel very stupid. But then again, people smoke and do a lot of things that are objectively bad for their health. In short, I would not do it myself, but I would not judge you at all if you did.
That said, my friend with the most tattoos, basically every part of his body, arms, legs. Maybe his face and head don't have tattoos. When I told him I was thinking about getting one he told me "don't do it".
Midlife crisis is a pejorative term for mortality perspective. Live your best life, you only get one, and what other people think matters very little (caveat being income source and partner(s)).
For what it's worth I would never ink my body. Ever. I would sleep in the disposal hole of a porta potty first, that is how strongly I feel about it.
I have nothing against tattoos in general, many of my close friends have them. But I would never ever personally get one and can't imagine even considering it.
It sounds like you care a lot about what others think. It is never too late to stop doing that.
> I always wanted one of those Thai tattoos where they manually tap tap tap the design into your skin with a mallet.
Sounds absolute torture to me. But if you want that, hey, go for it. Never too late to decide for yourself what you want or don’t want.
Sure, that’s a meaningful percentage difference, but with the relatively small sample size and different `n` values, I don’t make much of this at the moment.
It's surprising that this type of stuff can still get published in such high journals. This just makes me think that the field of medicine is failing to grapple with its replication issues. The social sciences get more heat for bad research, but I can't imagine that this type of stuff would fly today in a remotely comparable Psychology journal.
However, to be fair to the authors, those individual numbers you point out are the quantity with lymphoma and it would be more proper to say the sample sizes were n = 1398 for the tattoo group and n = 4193 for controls. There's also nothing really wrong with having unbalanced samples here. It's either be unbalanced or throw out control data... regardless, the barely significant p-value is the biggest concern. (If you're wondering how to judge a study's robustness, the easiest and generally most effective way is to just look at the p-values).