A systematic review of 124 published studies from 30 countries found that people with tattoos were almost three times as likely to have hepatitis C as those without tattoos, according to Dr. Jane Buxton of the British Columbia Centre for Disease Control in Vancouver and colleagues.
But in some subgroups -- particularly non-injection drug users -- the odds of having the virus were almost six-fold, Buxton and colleagues wrote online in the International Journal of Infectious Diseases.
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In recent years, tattoos have become increasingly popular. An estimated 36 percent of Americans under 30 have the skin designs, the researchers wrote. In Canada, they added, around 8 percent of high school students have at least one tattoo. Among those without a tattoo, 21 percent are eager to get one.
Since tattoo instruments come in contact with blood and bodily fluids, infection is possible if instruments are used on more than one person without being sterilized or without proper hygiene, the researchers noted. Additionally, tattoo dyes are not kept in sterile containers and may also transmit infections, they wrote
To help quantify the risks, the researchers reviewed and analyzed 124 studies from 30 countries -- including Canada, Iran, Italy, Brazil and the United States. Of those, 83 studies were included in the meta-analysis.
Based on these studies, those who had tattoos were 2.74 times as likely to have hepatitis than those who had no tattoos.
However, among certain groups the risk could go much higher, they found. For example, non-injection drug users with tattoos were 5.74 times as likely to have hepatitis than their non-tattooed counterparts.
One limitation of the analysis is the observational nature of the studies included in this review, the researchers wrote.
What's needed, the researchers concluded, are infection-control guidelines for tattoo artists and clients, and enforcement through inspections, reporting of adverse events and record keeping. Also, they wrote, prevention programs should focus on young people -- those most likely to get tattoos -- and among prison inmates -- who live in environments with a higher prevalence of hepatitis C.