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Possible association between tattoos and lymphoma (lu.se)
217 points by belter 6 months ago | hide | past | favorite | 201 comments



I’m not surprised — tattoo inks are not regulated and the colors are often formed with toxic compounds (e.g. copper). Then the needle avoids the protective barrier provided by the skin.

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.


Tattoo inks are regulated in the EU, my tattoo artist wasn't happy about the regulations when they were first announced a few years ago.


Some of the regulated ones still cause issues.

Had one that was used to give someone eyebrows that got all toasty in an MR scanner.


More importantly, just because tattoo ink is regulated doesn't mean discount tattoo parlors don't use cheap imports or old surplus that don't meet regulations. There are tattoo parlors that will tattoo intoxicated people (which you shouldn't do for a number of reasons ranging from consent to health risks and excessive bleeding) because they're their main source of income, there are likely many that use ink that isn't entirely above board.


Tell me more about the toasty brow please.


As far as I can tell, the ink contains iron oxide which conducts and heats when the RF is applied.

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...

http://www.imrser.org/pdf/shellock.tattoo.jmri.pdf


sounds like lots of regulations. Stuff gets worse to get better.

rohs solder. Leaded paints, enamel paints, water based paints. cars with smog pumps and catalytic converters.


ROHS solder, aka lead-free solder, is more difficult to work with so "worse", sure, but on the flip side you don't inhale lead fumes which accumulate in your body (i.e. will never leave your body) and have the delayed effect of causing lead poisoning which can do anything from making you stupider to literally killing you. I'd say the good outweighs the bad here and maybe leaded solder shouldn't be sold to amateurs who don't work in labs under vents.

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.


> lead-free solder, is more difficult to work with

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.


I haven't had the (dis)pleasure of working with leaded solder myself so I'm going by anecdotes but lead-free solder seems to have a higher melting point so presumably it's easier to damage components through overheating when working with lead-free solder than leaded solder.

Either way, my point is that regardless of whether there are benefits, they're not worth dying for (or suffering from lead poisoning).


I was arguing for making things better (at the expense of some good solutions)

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.


> Leaded paints

Some European countries banned leaded paint in 1909 the US and Canada only banned lead in paint in the late 1970s!


You can add plastic food wrap to that list. The original was amazing at sticking to the plate.


Polyvinylidene chloride wrap somehow isn't widely regulated yet in the US, the formula for popular plastic wrap was voluntarily changed. AFAIK you can still get the "good" stuff at restaurant supply stores and certain retailers, but it's carcinogens do leach into food.


What about enamel and water based paints?


enamel paint on cars was traditionally the best paint, and lead or oil based paints the best for houses/etc. But now we use water-based paints because they are safer for lead content or chemical fumes when drying.


> barred from investigating the effect on humans

Wait they're legally prevented from investigating tattoo inks? Why?


Congress only authorizes executive branch agencies to have responsibility for certain things, and tattoos are not within scope, not being a medical treatment of any sort.

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.


Does it take only one senator to pass any law?


Yes pretty much, unless there is another senator that's actively opposing it. But lots of tiny laws with big implications get stuck on to spending bills and get passed with no opposition.

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.


No, but one senator can generally block most laws by just declaring that they would filibuster if they had to. And blocking can very easily become “block unless this is added.” We’re only a couple steps removed from the Polish-Lithuanian Sejm at this point.


One senator cannot filibuster a law. The other senators can just vote to end debate. And it requires at least 40 senators to vote to continue debate.


I don't think this is true. According to the FDA's site they could regulate tattoo inks but have chosen not to.

> 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...


Tattoo ink is not a food or a drug and is not intended to treat or diagnose any disease or medical condition.


Whereas in South Korea only licensed medical professionals are allowed to open tattoo parlors:

> 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.

https://en.wikipedia.org/wiki/Tattooing_in_South_Korea


The FDA is not empowered to regulate medical procedures. Those are regulated by state laws and agencies. So even if tattooing was considered a medical procedure the FDA would not be able to regulate them.


They’re empowered to regulate the instruments and compounds used within medical procedures though.


Even if they don't serve a medical purpose?


https://theworld.org/stories/2019/10/24/south-koreas-imperil... good read. I live in Korea and have had a lot of my tats done here, people seem to not care much about the tattoo shops, at least the artists I'm friends with said they have no fear of prosecution.


I mean, I’m glad that’s not the case


Given the awful nature of doctors handwriting?


It seems quite contrary to the current tattoo vibe if you had to get it by a doctor.


Government agencies are not restricted to only regulating the words in their names, and the FDA was named 118 years ago. It was given the authority to regulate cosmetics in 1938: https://en.m.wikipedia.org/wiki/Federal_Food,_Drug,_and_Cosm...


Isn't the FDA the same agency that authorized the use of Thalidomide for pregnant women, and then much later deauthorized it due to birth defects?


No, not really. Actually it was completely different.

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.


Nice case of mood affiliation - "FDA bad therefore remember inverse of reality"

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.


Nice selective interpretation.

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.


Forgive me - could you please clarify the relevance of thalidomide to the discussion at hand?


The best X-Files episode, "Never Again" from Season 4, is about toxic chemicals in tattoos.


I suppose that's technically true, although the toxicity is implied to be more interpersonal than chemical. :p


>The best X-Files episode

I believe you meant "Folie a Deux"?


"Bad blood", obviously


Can you reveal what was safe to use as a tattoo ink?


We ended up using India ink, which (according to the encyclopedia of ink* ) is mainly soot.

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.


But soot is carcinogenic, no? And with soot consisting of nanoparticles small enough to cross the blood-brain barrier, I can imagine a chance of soot-based tattoo substances diffusing into the brain.


As long as that takes more than 60 days it won’t interfere with their study. Absolute non-toxicity wasn’t the goal here.


He did not need to show it was safe, only that it did not interfere with the study


As with everything it's a function of dose. A few molecules of soot entering the brain will trigger some cleanup and the glia cells will suck it up.

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.


Technically? Nothing.

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....

[1]: https://pubmed.ncbi.nlm.nih.gov/29511065/


Please don‘t tattoo your guinea pig.


Why not? We tattoo all sorts of food animals, which is what they were originally bred for (and I can confirm from experience that they are yummy — they are street food in the Andes).

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.


How things have changed. 30 years ago we said "please get your pets tattooed" because ear tattoos were how veterinarians reunited lost animals with their humans. Now we use RFID tags and tattooing is frowned upon.


The often tattoo strays as part of those neuter and release programs.


Isn’t it kinda funny that tattooing a guinea pig is frowned upon but testing on animals is okay…

Just a shower thought.


"We found no evidence of increasing risk with a larger area of total tattooed body surface."

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]

[1]https://tattoo.iarc.who.int/background/


This is a Swedish study, so what might be possible is using the population registry to contact siblings of the cancer patients to ask about traits like tattooing and then their health data would already be in Swedish system and linkable. This would control for a lot of the relevant confounders.


Though not those related to people's choice to get tattoos.


Tattoos are so common these days that I'm not sure you can say much about a person just because they have tattoos.


Any given person, for sure. In aggregate though I bet you'd find correlations.


Not sure you could in Sweden. Stats[1] show 21% tattoo prevalance in Sweden compared to 12% in the EU in general.

[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163470/


they are statistically cooler


Which is a strong confounding factor ...

"Sharing traits common in motor cycle gangs increases risk of cancer - new study"


No, it would control for a lot of those factors. Things like impulsivity, sexuality, sensation-seeking etc. All very heritable or family-level. If you ever find any correlations reported for tattoos between family members, it's gonna look like everything else: steeply increasing with relatedness.


Even a correlation with the amount of ink could be a lifestyle confound. I'm pretty sure that the population that has a small tattoo differs from the one with large parts covered. Indeed, it is hard to find a cause.


Yes. Also, the survey response rate was the biggest difference between groups (54% vs 47%), which could easily explain the observed differences. The confidence intervals cross 1.0 for nearly all reported IRR values.

For those who don't know how to interpret medical evidence, this study is very weak.


Those response rates are fairly awful with two groups that are markedly different. Seems very likely that they’d self-select on the face of it especially if they knew what the research question was.


Tattoos basically shift your immune system into overdrive https://www.youtube.com/watch?v=nGggU-Cxhv0


Indeed. It's not the ink content that led to Am J Clin Pathol. 2014;142(1):99-103. saying:

"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."


I'm not sure "people with negative msgs in tattoos died 14 years earlier" sheds light for me on the TFA.

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.


It shows the existence of some very strong confounding mechanisms.


There's certainly plenty of those! :)

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.


Yeah totally agree. That the size of the tattoo or the number of them not increasing risk makes no sense. Somewhat like claiming whether you smoke a cigarette or 20 a day, the risk is the same. If the latter was true it would more likely indicate that there is some other commonality in that group increasing the risk.

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.


> A hypothesis that Christel Nielsen's research group had before the study was that the size of the tattoo would affect the lymphoma risk. They thought that a full body tattoo might be associated with a greater risk of cancer compared to a small butterfly on the shoulder, for example. Unexpectedly, the area of tattooed body surface turned out not to matter.

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.

[1] https://news.ycombinator.com/item?id=40492364


Why so? Zero-order effects are not unheard of in biology. Example: the elimination rate of ethyl alcohol is dose-independent because any practically noticeable concentration of ethyl alcohol will saturate available alcohol dehydrogenases.


I doubt if they’ve completely eliminated social factors. Apparently people with tattoos “have higher levels of need for uniqueness, sensation seeking, and thrill and adventure seeking, but they have lower levels of self-esteem, attend religious services less, and are generally much less educated than individuals who did not have tattoos.”

https://www.jyi.org/2016-april/2017/3/12/got-ink-an-analysis...


The last one bothers me the most:

    > generally much less educated than individuals who did not have tattoos
To me, this seems obviously about social/economic class. If you work a good paying job, then you are much less likely to have tattoos, primarily because your co-workers do not have them. Before every HN commenters jumps on me, think about all the office worker normies out there, working normie office jobs, the pressure to conform is much higher than bro-grammers who are allowed to go work in jeans and hoodie. From my experience, the (middle/senior) manager types (including lawyers) are the least likely to have tattoos.


Brogrammers also tend not to have tattoos


Genetic predispositions, obesity and a lot of other factors also play a role in the risk of developing lymphoma.

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...


That's 0.5 percentage points. Would be nice to get that metric, too, alongside percentages sometimes. Here the initial likelihood is relatively high, when the likelihood is low, percentage increases can be very misleading. Particularly if the uncertainty around the increase is high.


It's still important if there is a connection


The study doesn’t say there is a connection though. Just that there may be some correlation


> NHL

  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.


I would be surprised if injecting foreign material that stays almost permanently and is released slowly to the rest of the system does not influence the system in some way. Is it cancer, I don't know close enough to say, but I would be surprise if it does nothing.



The problem with these studies is that it is exceedingly difficult to correctly account for all the additional differences between people who do get tattoos and those who don't.

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 ...


> The problem with these studies is that it is exceedingly difficult to correctly account for all the additional differences between people who do get tattoos and those who don't.

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 remember hearing somewhere that cells keep absorbing the ink, die, then release the ink in a cycle as an explanation to why the tattoos blur over time. If the ink immersed cells are forced to die and regrow at a faster rate than surrounding cells, there is a higher risk of mutations?


Kurzgesagt did a video on how tattoo ink is locked in place by the immune system

https://youtu.be/nGggU-Cxhv0?si=0DZipl87lE3oDMYR


I'm beginning to think the new slogan ought to be, "There's a Kurzgesagt for that..." (vice, xkcd).


I'm curious what confounding factors might be at play.

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.


The hypothesis is that macrophages transport ink to the lymph nodes during the healing period


The study itself [0] makes a stronger claim:

  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.
That is - it's not just during the healing period, and that it's been confirmed rather than a hypothesis.

[0] https://www.sciencedirect.com/science/article/pii/S258953702...


Yes, sorry. I meant the hypothesis is that that’s what’s causing the cancer.

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.


Is there any proof that after healing there is nothing going on


See sibling reply


This was also my reaction almost immediately. Tattoos can have extensive correlation with social and lifestyle factors that could easily mean the difference between correlation and causation here.


It would be nice if the study checked whether the higher amount of individuals in the cancer group got their tattoos AFTER they got diagnosed. This may be the case if people are more open to take risky actions following such diagnoses. It would explain why the size of the tattoo didn’t correlate with change of getting cancer. Such conclusion will ultimately disprove the causation.


chance*


https://news.ycombinator.com/item?id=39542192

Tattoos indeed are known to cause cancer among other health complications.


Your linked evidence doesn't support what you say. There are plenty of examples of concerning ingredients turning up in tattoo inks (a recent study found many inks have unlisted and potentially harmful chemicals[1]). This is obviously not good, but it falls far short of "causing" anything in particular. It's similar to all the warnings in CA about "chemicals known to cause cancer" - unless you would also say something like "putting gas in your car is known to cause cancer." Tattoos are not known to cause cancer and the articles you link don't claim they are.

[1] https://news.ycombinator.com/item?id=39542567


Injecting yourself with something that has proven cancer causing chemicals cannot be harmless if course


It certainly can - I think artificial sweeteners are great examples. There are experimental studies that show that artificial sweeteners can cause cancer in animal studies, but as of yet there's no clear evidence of that showing up for any definable population in the real world[1].

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...


You are talking about non cancer causing chemicals to humans. The definition of a cancer causing chemicals is it will cause cancer. If it's a small dose it will not be easily detectable that doesn't mean it doesn't cause harm.


Everything is about dosage. Even a small enough amount of uranium isn't harmfull and is quite normal. It's at the point where trying to avoid it will cause more of an issue.


Trying to avoid tattoos doesn't cause any issues. Radiation is normal in nature. Injecting lead into your epidermis isn't. Any amount will do harm just like 1 cigarette is worse than 0.


> Radiation is normal in nature.

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...


> there exist many situations where your health would improve if you have your very first cigarette.

Can't argue with a science denier unfortunately, good luck


I wonder if laser tattoo removal adds to or decreases the potential risk. On one hand it gets rid of the ink but on the other hand it does so by releasing it into the system for a short period.


Injecting foreign particles into your body, which stay there forever, continuously irritating it?

Hmmm... I don't see how this could be harmful!


I’d be interested to know degree of tattooing. Some people get a small butterfly or whatever and other people get full sleeves. Did they take this into account or was in binary tattooed or not?


The size didn’t seem to make a difference


Semi-permanent "makeup" is popular too, which is tattoo'd-on makeup effects.

I'd be amazed if it didn't have health effects.


Hmm. Cats are subject to a cancer at injection sites (Feline Injection Site Sarcoma) but thats not a lymphoma so I guess not related.


Interesting how there's not too many studies out there, despite the increasing popularity of tattoos.


Since dosage seems to not have been addressed, my sleeve work shall continue unabated.


I’m working on filling out my arm and then on to some other ideas next. Suppose we’ll see.


Are people with tattoos more likely to smoke, drink and take drugs?


Whaaaa? Putting things into your skin is bad? Impossible??!


I would believe those results if they had published the methods (including everything they were correcting for, etc) BEFORE starting the data collection.

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".


Hair dyes would have similar absorption mechanism right?


No, I believe cancer from hair dyes was caused by touching dye during application. Poisons are volatile, dye is only toxic, while it is drying.

Tattoo pigment particles are quite inert.


> 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.


How do you know they are inert? The ingredients are mostly unstudied and unregulated.


If they weren't (mostly) inert, I guess they would do a poor job at staying in place, which is the whole point of tattoos.


Hair is dead, skin is not. Your body doesn't care about what you do to your hair, you can cut it, dye it, anything as long as it doesn't touch the root. Tattoos are about injecting a foreign substance in live tissue, which triggers an immune response, and that's what the article is about. There is a reason tattoos hurt and haircuts don't.


Well sure, but the scalp underneath the hair that's gotta have some skin properties - sure it's thicker than the rest of the skin and has some protective properties against some forms of environmental damage but the dye does go in there and years of use should cause _some_ thing - not sure there's any research around what exactly.


In dyeing your hair, do you inject the dye beneath the epidermis?


Skin absorbs stuff without having to inject it below.


So would scalp micro pigmentation also be dangerous?


If it’s done with a blade like eyebrows are then the ink likely doesn’t penetrate as deep as a tattoo.


I thought it was common sense. Also, *not* having tattoos is way cooler nowadays.


“We have identified people diagnosed with lymphoma via population registers. These individuals were then matched with a control group of the same sex and age, but without lymphoma. The study participants answered a questionnaire about lifestyle factors to determine whether they were tattooed or not”

Not at all what I expected. Color me impressed with the methodology.


Unexpectedly, the area of tattooed body surface turned out not to matter.

I’m calling bullshit.


Alcohol can cause cancer to your butt although you (probably) drink it with your mouth. It turns out human body is pretty good at moving compounds everywhere. That’s even how oral medication works.


Which is still correlated with the amount of alcohol consumed, no?

Please name a toxin that is not dependent on dosage. I claim this is then not a toxin.


If the correlation is proven true then that’s obviously terrible, but I’m in my mid 40s now, tattoo-less, and one of my biggest regrets is not getting a couple tattoos when I was younger. I feel like doing it now looks like a midlife crisis type thing. I always wanted one of those Thai tattoos where they manually tap tap tap the design into your skin with a mallet.


This is the first time I've ever heard of someone regretting not getting a tattoo.


Some people even regret not having anything to regret


Who cares if others think it's a midlife crisis, do what makes you happy. I'm nearing 40 and still get a couple tattoos a year. I love the feeling of a new tattoo, it boosts my confidence and gives me a sense of accomplishment for sitting through the fairly painful process.


Yeah.. Do it.. i just turned 40th this year and got my first tattoo last year..

Don't allow your life to be defined by what you imagine other people will think about it..


Exactly. Part of the fun of tattoos is everyone thinking you look stupid and being able to practice the stoicism of not caring what other people think and focusing on the intrinsic joy of doing what you want.


I can do that without getting a tattoo though.


Midlife is when everyone starts doing cool stuff because theyve built up the income to service it

Do whatever you like, it’s your life


Yup.

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)


Unrelated, but one of the most interesting graphs I've ever seen was road deaths, by gender and age, when I was studying for my drivers license.

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.


I looked up a premium car rental site once and saw that some vehicles there had an age restriction of... 40.

As in: you need to be past your thirties to rent this vehicle.


Yeah same with motorbikes. Someone had a 125 when they were 16, hit 50 and decide to get a 1200cc superbike, then come off.


Three other problem is they haven’t ridden for 34 years, but feel like they are just as skilled as they ever were.


$8k is a crazy amount of 1972 money for a car.

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


Midlife is when everyone starts doing cool stuff because that's when the prefrontal cortex that inhibited you starts really breaking down.


Fun by any other name would still be fun


In a way, a midlife purchase is more smart financially than an early life purchase.


I'm almost out of my 40s and I definitely support you in doing whatever you like and not overthinking the midlife crisis thing.

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.


If there is a link, I'd guess you're probably a lot safer getting tattooed at 50 than at 20 given you've (statistically) got much less time for any adverse effects to start showing up...


I don't know if I'd conclude it. What about the possibility of that the tattoo association is only at higher ages, because of some effect where younger people have a better immune system to ward off any immediate dangers of the tattoo ink and then it becomes inert. But getting it at 50, your body is less able to dispel the problematic compounds in the ink. Basically saying the ink's problems could just be front-loaded the first couple years. Without understanding those details (risk associated with when the tattoo was received and short-term vs. long term risk), I'd be wary about deciding 50 is safer than 20.


The linked study looks extremely weak, not really something that should influence decision making yet


> I feel like doing it now looks like a midlife crisis type thing.

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.


Do it. I’m early 40s, have several tattoos, and am about to get one wrist to shoulder. It’s never too late to do what you want in this regard.

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)).


I got my first at 42, I've only ever gotten positive comments. Except from my buddy who is a tattoo artist, he was upset he didn't get to give me my first one.


Why would you concern yourself with someone's perception of your motive for getting a tat?


Have you seen the blurry mess a tattoo turns into 30 years later? You made a reasonable choice.


Have you seen the mess the human body turns into over the same time span?


You should do what you want.

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".


A heavily tattooed acquaintance told me the same thing when I was younger, and now that I've got several of my own I understand what he meant by it. He could tell my "thinking about getting one" was superficial, which is not a great starting point for getting inked. If you really want a tattoo you're going to get it regardless of any advice, so by telling me not to get one, he was trying to save me from what was (back then) potentially a bad decision.


Did you friend share a reason? For me, I love tattoos, but surely I would be tired of it in less than five years. Tough luck -- that shit is permanent. Plus, tats looks pretty awful on old people. I don't want to be that person.


I'm 40, I got a sleeve done this year. I've never been more thrilled to get one. Get tattoos. It's your body, if the art is meaningful to you, why hold back?


It's never too late. It took me almost 18years of going back and forth until I did it.


I started getting them at 37, and haven’t looked back. You’re more likely to get ones you like now you’re a bit older. I got a triceratops on my forearm last year because it’s my favourite dinosaur, and also why not?


I don't know why your comment appears to have been downvoted, I say go for it! "mid life crisis" is just a pessimistic way of saying "trying something new as an adult". If it makes you happy, and you're willing to accept some risk (which is a good thing!) then go get a tattoo.

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. :)


I’ve seen one being done on an ex-partner, the process is really interesting. Just take the mid-life crisis as an excuse to do it now, you will only get older and with more regrets


The quantum (those dots and lines) part of my tattoo is stick and poke: https://s.h4x.club/jkupYOrX


On the bright side, you presumably have more developed taste and a bigger budget than your average tattoo client which means you could go get something really good.


Do it. Traditional thai tattoos look amazing and are much sharper. Who cares what others thing :)


I had a similar issue, so I ended up getting a small abstract tattoo. Highly recommended.


I've been jokingly predicting to myself for quite a while now that a tattoo fashion is imminent of studios offering deliberately blurred designs so that the result looks as if it was done before the design became cool.


Go for it!


Surprised at the number of people saying "just do it"!

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.


Why is that? Out of curiosity


I don't know exactly. Something about my feeling of "self" I think.


[flagged]


Back when they were pushing public literacy, reading books was disparaged as a morbid activity. (Sitting unmoving for a long time, staring...)

But now everybody does it.


>reading books was disparaged as a morbid activity. (Sitting unmoving for a long time, staring...)

And for people that overdid it, it was. The modern sedentary lifestyle starting from that era's combo (office / clerical jobs + stationary entertainment with books and magazines, and later tv and radio).

>But now everybody does it.

Read books? Nah:

If we count only fully-read books, the average American adult reads just over 5 books per year. (...) A less-than-ideal 46 percent finished zero books last year and 5 percent read just one.


Sitting, staring, hours spent consuming symbolic narrative etc, describes some other popular activities that we might mention too, yknow.


less-than-ideal? You want more than half of people to read no books?


That doesn’t sound surprising in light of people setting obtuse goals like reading N books per week/month/year.


Vanity is a sin, and sin corrupts the body.


In this case I think it's probably the toxic chemicals that is corrupting our bodies.


Yeah, toxic chemicals injected due to sin; it's sin the the root cause!


“There is only one lawgiver and judge, he who is able to save and to destroy. But who are you to judge your neighbor?”


Actually, there's a vast difference between exposing sin and judging. Was John the Baptist judging Herod?


So why isn’t the sky wizard giving people who wear makeup cancer?


Many of the cosmetic products have known carcinogens in them and, I guess, many unknown ones as well.


The truely funny posts always get down voted.


Another reason to get tattooed


I don't mind - you body does!


Thanks mom


Sleep tight!


> In the group with lymphoma, 21 percent were tattooed (289 individuals), while 18 percent were tattooed in the control group without a lymphoma diagnosis (735 individuals).

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.


I suggest you read 'Study Size' under 'Methods'. Detecting an odds ratio of 1.3 with 80% power, and rounding way up to 3000 cases. To me that's not a small sample size, but definitely not the highest OR to aim for. Different cases vs. controls is not a problem for this study design. You pointing that out as a negative makes me think you might not know as much about epi study designs as your comment lets on


I looked up this journal, eClinicalMedicine, and it would be considered a pretty high-end medical one (impact factor = 15). However, this finding indeed seems like rubbish. The p-value for their central claim is p = .03. When bold claims come with these types of p-values, they generally don't replicate. I didn't look into what questionnaire the authors used, but they may have very well tried a bunch of correlations and this is what stuck.

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).


Those look like sufficient sample sizes to me. How many samples would it take to convince you?


Base rate fallacy.




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