National report - As the prevalence of body art is increasing, it behooves dermatologists to be aware of the social and medical implications of tattooing and body piercing, says Anne E. Laumann, M.D.
"While it seems self-evident from anecdotal observation that body art is much more common than it has been in the past, results from our own and other studies confirm that impression," notes Dr. Laumann, associate professor of dermatology, Northwestern University, Chicago.
A validated survey instrument including approximately 470 questions was administered by trained interviewers. The study had a 32 percent response rate resulting in 500 completed interviews representing almost equal numbers of men and women.
Its results showed that 24 percent of the population had a tattoo and 14 percent had at least one body piercing, excluding soft earlobes. There was no gender difference in tattoo prevalence, whereas females accounted for nearly three-fourths of the people with body piercings.
Age significant factor
Age was a significant predictive factor for both types of body art. With the subjects divided into three birth cohorts, the tattoo rate (15 percent) was lowest among the oldest subgroup that included people born between 1953 and 1963, intermediate (24 percent) among those born in 1964 to 1974, and highest (36 percent) in the youngest group born between 1975 and 1986. For those three groups, body piercing prevalence rates were 2 percent, 13 percent and 32 percent, respectively.
Two-thirds of the respondents had their first tattoo placed before 24 years of age and 16 percent were younger than 18 at the time of tattooing. For people with body piercing, 74 percent had their first piercing before age 24 and 30 percent were younger than 18 at the time.
Social, behavioral correlates
Body art occurred in all ethnic groups and was more common among Hispanics.
Tattoo prevalence was significantly higher among those of lower versus higher educational status (29 percent of those who did not finish college compared to 14 percent of those who did), whereas for body piercing there was no relationship to education. Drinking status and recreational drug use correlated significantly with tattoo prevalence. Ex-drinkers were most likely to have tattoos (38 percent) followed by current drinkers (25 percent) and those who never drank (14 percent).
"We presume that the ex-drinkers were also the problem drinkers," Dr. Laumann says.
There was about a twofold difference in tattoo prevalence comparing people who had ever taken versus never taken recreational drugs (38 percent vs. 18 percent), and comparing those reporting having no religious affiliation versus those who were affiliated (19 percent vs. 38 percent).
More than half of people who had been jailed at least three days (58 percent) had a tattoo compared with only 20 percent of those who had never been jailed for at least three days. Similar associations with body piercing were seen when analyzing responses regarding jail time, recreational drug use, drinking status and religious affiliation.
Only 13 percent of those with a tattoo indicated having any problems with healing during the first two weeks after the tattoo, and most of those individuals had their procedure done outside of a professional tattoo parlor, while fewer than 2 percent reported any ongoing problems.
"Self-reported complications of tattooing were surprisingly rare, although whether there is an increased risk of hepatitis C and other blood-borne infectious diseases remains unclear. Currently, the Centers for Disease Control says hepatitis C is not an issue, but tattooing clearly presents a mechanism for transmission. Other demographic features associated with tattoo prevalence are associated with hepatitis C risk as well. More data on this issue are needed," Dr. Laumann says.