{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T01:28:19Z","timestamp":1792718899671,"version":"4.5.0"},"reference-count":90,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Toxicol Ind Health"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:p>Today, tattooing has become very popular among people all over the world. Tattooists, with the help of tiny needles, place tattoo ink inside the skin surface and unintentionally introduce a large number of unknown ingredients. These ingredients include polycyclic aromatic hydrocarbons (PAHs), heavy metals, and primary aromatic amines (PAAs), which are either unintentionally introduced along with the ink or produced inside the skin by different types of processes for example cleavage, metabolism and photodecomposition. These could pose toxicological risks to human health, if present beyond permissible limits. PAH such as Benzo(a)pyrene is present in carbon black ink. PAAs could be formed inside the skin as a result of reductive cleavage of organic azo dyes. They are reported to be highly carcinogenic by environmental protection agencies. Heavy metals, namely, cadmium, lead, mercury, antimony, beryllium, and arsenic are responsible for cancer, neurodegenerative diseases, cardiovascular, gastrointestinal, lungs, kidneys, liver, endocrine, and bone diseases. Mercury, cobalt sulphate, other soluble cobalt salts, and carbon black are in Group 2B, which means they may cause cancer in humans. Cadmium and compounds of cadmium, on the other hand, are in Group 1 (carcinogenic to humans). The present article addresses the various ingredients of tattoo inks, their metabolic fate inside human skin and unintentionally added impurities that could pose toxicological risk to human health. Public awareness and regulations that are warranted to be implemented globally for improving the safety of tattooing.<\/jats:p>","DOI":"10.1177\/07482337221100870","type":"journal-article","created":{"date-parts":[[2022,5,20]],"date-time":"2022-05-20T15:00:53Z","timestamp":1653058853000},"page":"417-434","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":52,"title":["Tattoo inks are toxicological risks to human health: A systematic review of their ingredients, fate inside skin, toxicity due to polycyclic aromatic hydrocarbons, primary aromatic amines, metals, and overview of regulatory frameworks"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7822-689X","authenticated-orcid":false,"given":"Sandeep","family":"Negi","sequence":"first","affiliation":[{"name":"School of Dental Sciences, Department of Biochemistry, Babu Banarasi Das University, Lucknow, India"},{"name":"Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0546-5574","authenticated-orcid":false,"given":"Lakshmi","family":"Bala","sequence":"additional","affiliation":[{"name":"School of Dental Sciences, Department of Biochemistry, Babu Banarasi Das University, Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saumya","family":"Shukla","sequence":"additional","affiliation":[{"name":"School of Dental Sciences, Department of Biochemistry, Babu Banarasi Das University, Lucknow, India"},{"name":"Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepti","family":"Chopra","sequence":"additional","affiliation":[{"name":"Photobiology Laboratory, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Lucknow, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,5,19]]},"reference":[{"key":"bibr1-07482337221100870","volume-title":"American Conference of the Governmental Industrial Hygienists, Documentation of the Threshold Limit Values (TLVs) and Biological Exposure Indices (BEIs) for Chemical Substances and Physical Agents","author":"ACGIH","year":"2012"},{"key":"bibr2-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-020-02790-7"},{"key":"bibr3-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1159\/000369222"},{"key":"bibr4-07482337221100870","unstructured":"Bocca B, Petrucci F, Alimonti A (2013) National Institute for Health, Roma, Italy.\n                      Heavy Metals in Tattoo Inks\n                      . BfR-Symposium. In: 1st International Conference on Tattoo Safety, Berlin, Germany, 6\u20137 June 2013."},{"key":"bibr5-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/cod.13051"},{"key":"bibr6-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-020-02822-2"},{"issue":"4","key":"bibr7-07482337221100870","first-page":"357","volume":"3","author":"Carson S","year":"1984","journal-title":"Journal of Toxicology: Cutaneous and Ocular Toxicology"},{"key":"bibr8-07482337221100870","first-page":"677","volume":"55","author":"Centers for Disease Control and Prevention (CDC)","year":"2006","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"bibr9-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780190238667.003.0040"},{"key":"bibr10-07482337221100870","unstructured":"CICN Groups and sub-Groups Colour Index. Available at: http:\/\/Colour-index.com\/cicn-groups-sub-groups."},{"key":"bibr11-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1124\/dmd.104.003285"},{"key":"bibr12-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-1097.2004.tb00068.x"},{"key":"bibr13-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/j.clindermatol.2007.10.009"},{"key":"bibr14-07482337221100870","first-page":"29","volume-title":"Dermatologic Complications with Body Art","author":"De Cuyper C","year":"2009"},{"key":"bibr15-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-77098-7_2"},{"key":"bibr16-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2007.01301.x"},{"key":"bibr17-07482337221100870","volume-title":"Polycyclic Aromatic Hydrocarbons (PAHs) \u2014 EPA Fact Sheet","author":"Environmental Protection Agency, U.S. (US-EPA)","year":"2008"},{"key":"bibr18-07482337221100870","volume-title":"Development of a Relative Potency Factor (RPF) Approach for Polycyclic Aromatic Hydrocarbon (PAH) Mixtures (External Review Draft, Suspended)","author":"Environmental Protection Agency,U.S. (US-EPA-IRIS)","year":"2010"},{"key":"bibr19-07482337221100870","volume-title":"(Te Mana Rauhi Taiao) Guidelines for Tattoo and Permanent Makeup Substances","author":"Environment Protection Agency, New Zeland (NZ-EPA)","year":"2012"},{"key":"bibr20-07482337221100870","unstructured":"European Chemical Agency (ECHA, Annexure XV, (2017) Proposal for restriction, substances in tattoo inks and permanent make up. Version 1.2."},{"key":"bibr21-07482337221100870","volume-title":"Committee for Risk Assessment (RAC) Committee for Socio-Economic Analysis (SEAC) - Opinion on an Annex XV Dossier Proposing Restrictions on Substances Used in Tattoo Inks and Permanent Make-Up","author":"European Chemicals Agency (ECHA)","year":"2019"},{"key":"bibr22-07482337221100870","unstructured":"European Commission, Scientific Committee on Food EC-SCF (2002) Polycyclic Aromatic Hydrocarbons\u2013Occurrence in foods, dietary exposure and health effects. SCF\/CS\/CNTM\/PAH\/29 ADD1 Final 4 December 2002 SCF \u2044 CS \u2044 CNTM \u2044 PAH \u2044 29 ADD1 2002. Available at: http:\/\/europa.eu.int\/comm\/food\/fs\/sc\/scf\/index_en.html."},{"key":"bibr23-07482337221100870","volume-title":"EC no.1333\/2008 of the European Parliament and of the Council of 16 Dec 2008 on Food Additives","author":"European Commission regulation","year":"2008"},{"key":"bibr24-07482337221100870","volume-title":"EU) 2020\/2081 of 14 December 2020 Amending Annex XVII to Regulation (EC) No 1907\/2006 of the European Parliament and of the Council Concerning the Registration","author":"European Commission regulation","year":"2020"},{"key":"bibr26-07482337221100870","volume-title":"Resolution ResAP (2003) 2 on Tattoos and Permanent Makeup","author":"European Council","year":"2003"},{"key":"bibr27-07482337221100870","volume-title":"Resolution ResAP (2008) 1 on Requirements and Criteria for the Safety of Tattoos and Permanent Make-Up","author":"European Council","year":"2008"},{"key":"bibr28-07482337221100870","volume-title":"Harmonised Classification CLH: Guidance on the Application of the CLP Criteria. Guidance to Regulation (EC) No1272\/2008 on Classification, Labelling and Packaging (CLP) of Substances and Mixtures","author":"European Council","year":"2012"},{"key":"bibr29-07482337221100870","volume-title":"The European Parliament and of the Council of 5 April 2017","author":"European Union Regulation","year":"2017"},{"key":"bibr30-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/j.canep.2019.101655"},{"key":"bibr31-07482337221100870","volume-title":"Tattoo and Permanent = Make-Up:fact Sheet","author":"Food and Drug Administration, U.S (FDA)","year":"2015"},{"key":"bibr32-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2009.08.034"},{"key":"bibr33-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1080\/10590501.2012.653887"},{"key":"bibr34-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-020-02655-z"},{"key":"bibr35-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/j.taap.2005.04.003"},{"key":"bibr36-07482337221100870","volume-title":"Inks for Tattoos and PMU (Permanent Make-Up): Organic Pigments, Preservatives and Impurities Such as Primary Aromatic Amines and Nitrosamines","author":"Hauri U","year":"2011"},{"key":"bibr37-07482337221100870","volume-title":"Inks for Tattoos and Permanent Make-Up\u2013Pigments, Preservatives, Aromatic Amines, Polyaromatic Hydrocarbons and Nitrosamines","author":"Hauri U","year":"2014"},{"key":"bibr38-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/j.jid.2018.05.031"},{"key":"bibr39-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-020-02825-z"},{"key":"bibr40-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10561.x"},{"key":"bibr41-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.04359.x"},{"key":"bibr42-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/srt.12213"},{"key":"bibr43-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.12093"},{"key":"bibr44-07482337221100870","volume-title":"A Review of Human Carcinogens. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans","volume":"100","author":"IARC","year":"2012"},{"issue":"2","key":"bibr45-07482337221100870","first-page":"647","volume":"94","author":"Ines S","year":"2020","journal-title":"Archiv f\u00fcr Toxikologie"},{"key":"bibr46-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1002\/lsm.20618"},{"key":"bibr47-07482337221100870","doi-asserted-by":"publisher","DOI":"10.2788\/542617"},{"key":"bibr48-07482337221100870","doi-asserted-by":"publisher","DOI":"10.2788\/177900"},{"key":"bibr49-07482337221100870","doi-asserted-by":"publisher","DOI":"10.2788\/011817"},{"key":"bibr50-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/cod.13908"},{"key":"bibr51-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1205114"},{"issue":"7","key":"bibr52-07482337221100870","first-page":"27","volume":"6","author":"Kirby W","year":"2013","journal-title":"The Journal of Clinical and Aesthetic Dermatology"},{"key":"bibr53-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1159\/000292627"},{"key":"bibr54-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15808"},{"key":"bibr55-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(15)60215\u2013x"},{"key":"bibr56-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2011.01947.x"},{"key":"bibr57-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092787"},{"key":"bibr58-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2017-104944"},{"issue":"2","key":"bibr59-07482337221100870","first-page":"37","volume":"12","author":"Maarouf M","year":"2019","journal-title":"The Journal of Clinical and Aesthetic Dermatology"},{"key":"bibr60-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/s12011-018-1406-y"},{"key":"bibr61-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2018.09.178"},{"key":"bibr62-07482337221100870","volume-title":"Survey of Selected Samples of Tattoo Inks for the Presence of Heavy Metals. Wellington 6145, New Zealand, 2013","author":"Ministry of Health, New Zealand","year":"2013"},{"key":"bibr63-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1038\/sj.embor.7401084"},{"key":"bibr64-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1751-1097.2011.00955.x"},{"key":"bibr65-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/0273-2300(92)90009-X"},{"key":"bibr66-07482337221100870","unstructured":"Papameletiou D, Schwela D, Zeni A (2003) Recommendations for Regulatory Action in the EU on the Safety of Tattoos, Body Piercing and of Related Practices in the EU, Ispra (VA) , Italy, European Commission, Joint Research Centre (JRC) , Institute for Health and Consumer Protection (IHCP) , Physical and Chemical Exposure (PCE) Unit, 2003."},{"key":"bibr67-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1002\/adhm.202101238"},{"key":"bibr68-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1159\/000369647"},{"key":"bibr69-07482337221100870","unstructured":"Piccinini P, Pakalin S, Contor L, et al. (2016) Safety of tattoos and permanent make-up. Final report. EUR27947."},{"key":"bibr70-07482337221100870","volume-title":"Opinion on an Annex XV Dossier Proposing Restrictions on Substances Used in Tattoo Inks and Permanent Make-Up","author":"RAC","year":"2018"},{"key":"bibr71-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0625.2010.01068.x"},{"key":"bibr72-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1177\/1941738111411698"},{"key":"bibr73-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/j.aca.2019.06.052"},{"key":"bibr74-07482337221100870","doi-asserted-by":"publisher","DOI":"10.3390\/ma14123147"},{"key":"bibr75-07482337221100870","unstructured":"SCCNFP (2000) Opinion of the scientific committee on cosmetic products and non-food products (SCCNFP) intended for consumers concerning the safety of tattoos adopted during the 11th Plenary Meeting of 17 February, 2000."},{"key":"bibr76-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-016-1740-9"},{"key":"bibr77-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1186\/s12989-019-0317-1"},{"key":"bibr78-07482337221100870","first-page":"118","volume":"48","author":"Serup J","year":"2015","journal-title":"Current Problems in Dermatology"},{"key":"bibr79-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/cod.13423"},{"key":"bibr80-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/978-981-10-5493-8_9"},{"key":"bibr81-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(09)70134-2"},{"key":"bibr82-07482337221100870","doi-asserted-by":"publisher","DOI":"10.4236\/jep.2017.811077"},{"key":"bibr83-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1562\/2004-05-17-RA-170.1"},{"key":"bibr84-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1007\/s00216-008-1978-z"},{"key":"bibr85-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1002\/tox.20241"},{"key":"bibr86-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1111\/cod.13913"},{"key":"bibr87-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1016\/j.mrgentox.2003.10.004"},{"issue":"1","key":"bibr88-07482337221100870","first-page":"122","volume":"2","author":"Yashim ZI","year":"2017","journal-title":"Fuw Trends in Science & Technology Journal"},{"key":"bibr89-07482337221100870","doi-asserted-by":"publisher","DOI":"10.1081\/GNC-120016203"},{"key":"bibr90-07482337221100870","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph2006030045"},{"issue":"6","key":"bibr91-07482337221100870","doi-asserted-by":"crossref","first-page":"497","DOI":"10.2340\/0001555577497","volume":"77","author":"Zemtsov A","year":"1997","journal-title":"Acta Dermato-Venereologica"}],"container-title":["Toxicology and Industrial Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/07482337221100870","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/07482337221100870","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/07482337221100870","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:43:34Z","timestamp":1777668214000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/07482337221100870"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,19]]},"references-count":90,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2022,7]]}},"alternative-id":["10.1177\/07482337221100870"],"URL":"https:\/\/doi.org\/10.1177\/07482337221100870","relation":{},"ISSN":["0748-2337","1477-0393"],"issn-type":[{"value":"0748-2337","type":"print"},{"value":"1477-0393","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,5,19]]}}}