Toxic Chemicals Found in Tattoos: Links to Autoimmune and Inflammatory Diseases — Majority of tattoo ink intended for use as printer ink or automobile paint

From: greenmedinfo.com

Toxic Chemicals Found in Tattoos: Links to Autoimmune and Inflammatory Diseases

Posted on: Thursday, August 31st 2017
Written By: Ali Le Vere, B.S., B.S.

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Histologic Reactions Secondary to Tattoos

Although the age of moralizing tattoos as an indictment of character should be long passed, concerns linger over health implications. According to Wenzel and colleagues (2013), “Medical complications after tattooing are often seen by physicians, but are generally unknown to the public” (6, p. 138). Tattoos have been associated with “allergic, lichenoid, granulomatous, and pseudolymphomatous reactions or induction of skin diseases” (2, p. 145). Other localized skin diseases, including the autoimmune disorders lichen planus and psoriasis, as well as eczema and morphea, have also been induced by tattoos (7).

In one nationwide survey of German-speaking countries, for example, 67.5% of individuals with tattoos reported skin problems, 6% reported systemic reactions resulting from tattoos, with 1.3% reporting light sensitivity of the tattooed skin (8). The survey similarly revealed that chronic problems including burning, itching, erythema, papules, nodules, and eczema occurred in 6% of subjects (8). It is estimated that five million people in the United States have persistent skin problems secondary to tattoos, but data on toxicant-induced health problems related to tattoos has not been systematically collected (9). …

Pathological skin pigmentation, known as cutaneous dyschromia, can likewise occur due to deposition of heavy metals such as bismuth and mercury in the basement membranes of sebaceous glands and sweat ducts (10).

Tattoo Safety: A Need For More Regulatory Oversight

Researchers state, “Tattoo inks are typically composed of negligibly soluble or insoluble pigments, dispersants in which the pigments are suspended and other additives for preservation or to alter the viscosity of the ink” (11). Although some contemporary inks can contain organic pigments, colored ink conventionally contains metals (12). Because other industrial applications of tattoo inks include paint and printing, they can harbor up to 10% impurities (9). Further, studies show that the “vast majority of tested tattoo inks contained significant amounts of NPs [nanoparticles],” which are associated with a litany of ill health effects (13).

A recent study published in the Journal of Hazardous Materials revealed that chemicals present in tattoo ink induced cytotoxicity (cell death), genotoxicity (DNA mutation), and adaptive stress response pathways (11).  Adaptive stress pathways are activated to restore cellular homeostasis, or balance, following damage incurred to cell structure, indicating that tattoo ink disrupts cellular integrity (34). Chemicals in tattoo ink can contribute to deleterious health outcomes by different modes, including binding of chemicals to enzymes and biological molecules and partitioning of chemicals into cell membranes (11).

Safety Hazards of Colored Inks

Because no color additives are approved for intradermal injection, no tattoo pigments are approved for use by the Food and Drug Administration (FDA). As articulated in a study by Arisa and Alster (2012), “The majority of tattoo ink is industrial-grade color intended for use as printer ink or automobile paint” (14).

Colored pigments, on the one hand, can decompose following light exposure into dangerous aromatic amines which are subsequently disseminated throughout the body and accumulate in lymphatic system, interfacing directly with components of the immune system (6). In a recent study, the levels of genotoxicity (DNA damage) and oxidative stress (inflammatory) pathways induced by red and yellow tattoo ink were particularly troublesome, as they generated the greatest response (11). Another study by Falconi and colleagues (2009) found that red tattoo ink significantly reduced viability of fibroblast cells, which are responsible for production of the extracellular matrix that provides the structural framework for tissues (15).

When exposed to natural or ultraviolet light, azo pigments contained within red and yellow inks have been demonstrated to emit hazardous compounds, and they also have been shown to contain the probable human carcinogen 3,3-dichlorobenzidine as an intermediary in their production (11). Furthermore, o-anisidine and 4-aminobiphenyl, aromatic amines within red ink, can elicit genotoxic effects, damaging genetic material after metabolic activation (11, 16). Other investigations have elucidated a connection between red tattoo ink, skin irritation, and tumors (6). In various studies, “Coincidental lesions such as sarcoidosis, B-cell lymphoma, pseudolymphoma, melanoma, basal cell carcinoma, non-Hodgkin’s lymphoma, and squamous cell carcinoma have also been reported to occur” (14).

Safety Hazards of Black Inks

However, black inks, which predominately consist of soot products, are also problematic (9). Carbon black in black ink is derived from the incomplete combustion of hydrocarbons, which accounts for its polycyclic aromatic hydrocarbon (PAH) content (17). PAHs represent ubiquitous pollutants derived from the burning of organic materials such as wood, petrol, oil, and coal, which elicit well-defined carcinogenic (cancer-causing), mutagenic (DNA-altering), and toxic effects (18).

Researchers state, “Chemical analysis revealed the presence of polycyclic aromatic hydrocarbons in the tested black tattoo ink at concentrations twice the recommended level” (11). In particular, the PAHs pyrene and fluoranthene were found at the highest levels, and the possible human carcinogen naphthalene was also detected (11). PAHs are capable of absorbing ultraviolet radiation from the sun and producing a cytotoxic reactive oxygen species (ROS), singlet oxygen, as a byproduct, which can result in cell death (6). In another study, 10 of 11 black inks tested had levels of PAH exceeding the concentration recommended by the European Council, and 100% of black inks analyzed had levels of the carcinogen benzo(a)pyrene exceeding safe limits (17).

One toxic ingredient found in black tattoo ink, hexachloro-1,3-butadiene (HCBD), is a byproduct of manufacturing processes for chlorinated solvents, and has a history of use as a fumigant or pesticide (9). It has been shown to perpetuate skin, kidney, and liver damage in rodent studies (19). 9-fluorenone, acquired from coal tar, has likewise been found in black tattoo ink and may cause phototoxic reactions, or chemically induced skin irritation following sunlight exposure (20, 21).

Hexamethylenetetramine, a preservative used in the manufacture of coatings, resins, rubber, and cosmetics, is another agent contained within some black tattoo inks (9). It releases formaldehyde, the xenobiotic toxic substance used to embalm corpses, which is associated with systemic autoimmune disease (22). It has likwewise been shown in the literature to cause respiratory allergies and contact dermatitis (9).

Particularly alarming is the occurrence of dibenzofuran (DBF) in black tattooing agents, which is derived from “the incomplete combustion of coal biomass, refuse, diesel fuel, and residual oil, as well as tobacco smoke” 9, p. 236). When polychlorinated, or attached to chlorine atoms, it belongs to a dangerous class of persistent organic pollutants called dioxin-like chemicals (9). Dioxin-like chemicals exert gastrointestinal, hepatic, and dermal toxicity and DBF can cause respiratory irritation (9).

Components of Tattoo Ink Linked to Autoimmunity and Mitochondrial Dysfunction

Another study found that all 14 commercially available black inks analyzed contained the softener dibutyl phthalate, a sensitizing agent which “acts directly on keratinocytes and can drive Th2 responses following skin exposure via induction of thymic stromal lymphopoietin gene expression” (9, p. 231). This is to say, dibutyl phthalate can facilitate expression of a gene that tips the immune system in the direction of Th2-dominant responses, which have been implicated in some autoimmune diseases including systemic lupus erythematosus (SLE) and Sjögren’s syndrome (23).

Other chemicals found within tattoos, such as formaldehyde, may induce autoimmunity by either inducing cell death, and exposing antigenic material within the cell against which the immune system may mount an attack, or by covalently binding to tissue and creating ‘neoantigens’ which incite immune responses (24, 25, 26).

Black inks likewise have been shown to induce production of reactive oxygen species (ROS) such as singlet oxygen or peroxyl radicals, which are free-radicals that can steal electrons from neighboring molecules and damage cell constituents (17). One study by Regensberger and colleagues (2010) found that in the presence of ultraviolet light, some black inks reduced activity of the energetic powerhouses of the cell, the mitochondria, of human dermal keratinocytes, the type of cell that predominates in the outermost layer of skin (27). Impaired mitochondrial activity has health implications since mitochondrial dysfunction is implicated in mood disorders, cardiovascular disease, diabetes, neurodegenerative disorders, chronic fatigue syndrome, fibromyalgia, migraine headaches, autoimmune diseases, and cancer (28).

Risk of Infection from Tattoos

Although professional tattooist organizations have improved hygienic standards, concerns about contagious exposure through tattooing remains (29). As articulated by Serup (2017), microbial pathogens such as hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency viruses (HIV) can be introduced, and “Severity of infection varies from minor to major, ultimately with life-threatening septicemia” (29, p. 30). People who are immunocompromised are often advised to refrain from tattooing (29).

Although sanitation measures are improving and risk of contracting infectious diseases from contaminated tattoo equipment has decreased, the inks themselves may harbor infectious microbes (30). Recent studies reveal that, despite 42% of products claiming sterility on their labels, 10% of unopened and 17% of previously used stock bottles of tattoo ink were contaminated with pathogenic bacteria, and that almost a third of products had leaking physical seals (31). Those inks marketed as nontoxic, which exclude alcohol and preservatives, possess greater risk of microbial contaminants, such as the Starbrite Colors tattoo inks which were removed from the market due to the presence of Pseudomonas aeruginosa and Acremonium mold (14).

How To Ensure Tattoo Safety

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