{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T11:36:13Z","timestamp":1786620973030,"version":"build-2736575974"},"reference-count":31,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"unspecified","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det f\u00f6r h\u00e4lsa, arbetsliv och v\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["2023-00637"],"award-info":[{"award-number":["2023-00637"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,7,15]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tattooing is common in many populations, yet population-based data on side effects remain limited. We aimed to describe the occurrence of self-reported acute- and delayed-onset side effects following tattooing and investigate individual and tattoo-related determinants in a Swedish population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Swedish Tattoo and Body Modifications Cohort includes 13\u2009049 participants, of whom 2633 reported having at least one tattoo and constituted the study sample. In 2021, participants reported predefined acute (within 1\u2009month) and delayed (after 1\u2009month) side effects following tattooing using a structured questionnaire. Information on educational attainment and yearly disposable income was obtained through linkage to national registers. Multivariable logistic regression was used to identify determinants of reporting any acute- and delayed-onset side effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 40% of participants reported at least one acute-onset side effect and 10% reported a delayed-onset side effect following tattooing. A larger tattooed body surface area (&gt;5\u2009hand palms), compared with &lt;1\u2009hand palm, was associated with higher odds of both acute- and delayed-onset side effects (OR\u202f1.81, 95%\u2009CI\u202f1.13 to 2.90\u2009and OR\u202f2.06, 95%\u2009CI\u202f1.04 to 4.10, respectively). Use of coloured inks, compared with black ink only, was also associated with increased odds of side effects. Acute-onset side effects were associated with younger age, a low-melanin, highly photoreactive skin phenotype, cosmetic tattooing and more tattoo sessions, whereas delayed-onset side effects were most strongly associated with prior acute-onset reactions (OR\u202f8.17, 95%\u2009CI\u202f5.45 to 12.20, compared with no acute-onset side effects). Healthcare-seeking for delayed-onset side effects was uncommon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Acute- and delayed-onset side effects following tattooing were common and associated with individual characteristics and tattoo-related factors. Delayed-onset side effects were strongly associated with prior acute-onset reactions, while healthcare-seeking was uncommon. These findings indicate that a substantial proportion of tattoo-related side effects never reach the healthcare system, highlighting the importance of population-based studies for assessing their occurrence and determinants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2026-005480","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T11:05:15Z","timestamp":1786619115000},"page":"e005480","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Self-reported side effects of tattooing: a cross-sectional study in the Swedish TABOO cohort"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8742-5383","authenticated-orcid":false,"given":"Emelie","family":"Rietz Liljedahl","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University Faculty of Medicine, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Rustemeyer","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology, Amsterdam University Medical Centres, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Saxne J\u00f6ud","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University Faculty of Medicine, Lund, Sweden"},{"name":"Department of Clinical Sciences Lund, Division of Orthopedics, Lund University Faculty of Medicine, Lund, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Division of Occupational and Environmental Medicine, Lund University Faculty of Medicine, Lund, Sweden"},{"name":"Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark National Institute of Public Health, Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"2026081304051083000_4.3.e005480.1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2022-069664","article-title":"Cohort profile: The Swedish Tattoo and Body Modifications Cohort (TABOO)","volume":"13","author":"Nielsen","year":"2023","journal-title":"BMJ Open"},{"key":"2026081304051083000_4.3.e005480.2","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1159\/000535536","article-title":"Tattoo-Associated Skin Reactions: A Danish Population-Based Survey in 5,914 Tattooed Individuals","volume":"240","author":"Friis","year":"2024","journal-title":"Dermatology"},{"key":"2026081304051083000_4.3.e005480.3","doi-asserted-by":"crossref","first-page":"e484","DOI":"10.1111\/jdv.15808","article-title":"The prevalence of tattooing and motivations in five major countries over the world","volume":"33","author":"Kluger","year":"2019","journal-title":"Acad Dermatol Venereol"},{"key":"2026081304051083000_4.3.e005480.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2006.09.007"},{"key":"2026081304051083000_4.3.e005480.5","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1159\/000501962","article-title":"Tattooist-Associated Tattoo Complications: \u201cOverworked Tattoo,\u201d \u201cPigment Overload\u201d and Infections Producing Early and Late Adverse Events","volume":"236","author":"Hutton Carlsen","year":"2020","journal-title":"Dermatology"},{"key":"2026081304051083000_4.3.e005480.6","doi-asserted-by":"crossref","unstructured":"Serup J , Hutton Carlsen K , Sepehri M . Tattoo complaints and complications: diagnosis and clinical spectrum. In: Serup J , Kluger N , B\u00e4umler W , eds. Current problems in dermatology. S. Karger AG, 2015: 48\u201360. Available: https:\/\/www.karger.com\/Article\/FullText\/369645","DOI":"10.1159\/000369645"},{"key":"2026081304051083000_4.3.e005480.7","doi-asserted-by":"crossref","unstructured":"Serup J . Tattoo infections, personal resistance, and contagious exposure through tattooing. In: Serup J , B\u00e4umler W , eds. Current problems in dermatology. S. Karger AG, 2017: 30\u201341. Available: https:\/\/karger.com\/books\/book\/143\/chapter\/5080284","DOI":"10.1159\/000450777"},{"key":"2026081304051083000_4.3.e005480.8","doi-asserted-by":"crossref","first-page":"668","DOI":"10.1159\/000452148","article-title":"Classification of Tattoo Complications in a Hospital Material of 493 Adverse Events","volume":"232","author":"Serup","year":"2016","journal-title":"Dermatology"},{"key":"2026081304051083000_4.3.e005480.9","doi-asserted-by":"publisher","DOI":"10.1159\/000292627"},{"key":"2026081304051083000_4.3.e005480.10","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1097\/DSS.0000000000000500","article-title":"The Demographics and Rates of Tattoo Complications, Regret, and Unsafe Tattooing Practices: A Cross-Sectional Study","volume":"41","author":"Liszewski","year":"2015","journal-title":"Dermatol Surg"},{"key":"2026081304051083000_4.3.e005480.11","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1159\/000446345","article-title":"Skin Care in the Tattoo Parlor: A Survey of Tattoo Artists in New York City","volume":"232","author":"Rosenbaum","year":"2016","journal-title":"Dermatology"},{"key":"2026081304051083000_4.3.e005480.12","unstructured":"Folkh\u00e4lsomyndigheten . 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Allergic reactions to pigments, metals, and more? Body art from the allergist\u2019s point of view. In: De Cuyper C , P\u00e9rez-Cotapos SML , eds. Dermatologic complications with body art. Cham: Springer International Publishing, 2018: 139\u201376. 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