Health Risk Assessment: Heavy Metals (Antimony, Arsenic, Barium, Cadmium, Chromium, Lead, Mercury, and Nickel) in Tattoo Ink (Intra-Dermal Contact)

Overview

Gautam prepared an ESR health-risk assessment for Manatu Hauora/Te Whatu Ora on heavy metals in tattoo inks used for professional permanent tattoos. The report is not a new laboratory survey, but it selects maximum concentrations from the 2012 New Zealand Ministry of Health tattoo-ink survey for exposure assessment and summarizes international occurrence studies, NZ/EU/US regulatory context, and EU recall patterns. It is A-tier regulatory/exposure context for tattoo inks; occurrence values should be traced to the source surveys named in the report.

Key numbers

• Report identity: ESR Risk Assessment, Food and Social Systems Group client report FW23035, August 2023, reviewed by Dr Rob Lake and prepared for Manatu Hauora/Te Whatu Ora.
• Scope: professional permanent tattoo inks only. The report excludes temporary tattoos such as henna, self-tattooing risks, traditional tattoo ink from organic material, and alternative inks such as fluorescent tattoo ink.
• Heavy metals scoped for the generic risk assessment: Ba, lead (Pb), nickel (Ni), Cr(VI), total mercury (Hg), cadmium (Cd), Sb, and total arsenic (As). The report notes that Cu and Zn were not considered in the assessment because both are essential minerals.
• New Zealand incident surveillance: the National Poisons Centre identified 11 human exposure records potentially linked to tattoo ink from 2008 to 2022; 7 involved ages 0-5 ingesting small amounts of tattoo ink, 8 patients were asymptomatic, and 2 adult self-tattooing cases were advised to seek medical attention.
• EU Safety Gate tattoo-ink alerts/recalls since 2010: approximately 313 alerts or recalls; 88 due to high metal contaminants, 194 due to organic contaminants, 23 due to both metal and organic contaminants, and 8 due to microbiological contamination. The report states there were no reports of New Zealand tattoo-ink recalls due to heavy-metal contamination.
• EU recall examples in Table 2 included lead up to 25% by weight (250,000 mg/kg), cobalt up to 16 mg/kg, nickel up to 60 mg/kg, arsenic up to 8.1 mg/kg, antimony up to 1.3 mg/kg, and multi-metal recall examples involving arsenic, cobalt, lead, nickel, and antimony. Product names are omitted here under the brand firewall.
• Danish EPA survey summarized by the report: 61 tattoo inks from 10 colour series were analysed by ICP-MS; Ni, Cu, and Pb were detected in all samples, with highest concentrations of Ni 18 mg/kg, Cu 140 mg/kg, and Pb 10 mg/kg; total chromium (Cr) was detected in 57 samples with a highest concentration of 31 mg/kg; Hg was detected in two samples at 0.11 mg/kg and 0.038 mg/kg; Cd was detected in 45 samples with a highest concentration of 0.27 mg/kg.
• New Zealand MoH 2012 survey summarized by the report: tattoo ink samples (n = 169) were analysed for metals with NZ EPA recommended limits. All samples complied with Co, Se, and Cr(VI) guideline levels of 0.5, 2, and 0.5 mg/kg, respectively. Highest levels of total Hg, total As, Cd, Pb, Ni, Ba, and Sb were 0.6, 60, 0.8, 45, 23, 17000, and 147 mg/kg, respectively.
• Table 11 selected tattoo-ink concentrations for ESR’s exposure assessment (mg/kg): Ba 17000; Cr(VI) N.D*; Ni 23; Pb 45; Cd 0.8; total Hg 0.6; total As 60; Sb 147. The footnote says no limit of detection was reported for the non-detected Cr(VI).
• Exposure assumptions in Table 12: ink use 15 mg/cm2; tattooed area 488 cm2; dermal absorption 100%; body weight 70 kg; duration 50 years or 18,250 days.
• Table 13 systemic exposure doses: Ba exposure 0.10 µg/kg bw/d; Cr N.D; Ni 0.000132 µg/kg bw/d; Pb 0.000258 µg/kg bw/d; Cd 4.58E-06 µg/kg bw/d; total Hg 2.86E-06 µg/kg bw/d; total As 0.000344 µg/kg bw/d; Sb 0.000802 µg/kg bw/d.
• Table 15 margins of safety: Ba >10000; Ni >10000; Pb 1465; Cd >10000; total Hg >10000; total As 2300; Sb 4300; Cr was not calculated because Cr(VI) was not detected in the selected NZ MoH concentration table.
• Conclusion: the report states that the MoS was much greater than 100 for Ba, Ni, Pb, Cd, Hg, As, and Sb, and concludes that, based on currently available data and the selected maximum concentrations, those metals in tattoo inks were not a cause for health concerns in the modeled scenario.

Methods (brief)

This is a regulatory health-risk assessment rather than a primary analytical study. ESR reviewed tattoo-ink composition, heavy-metal occurrence studies, NZ/US/EU regulatory frameworks, product recalls, hazard identification, dose-response points of departure, and exposure assumptions for intradermal tattoo ink exposure.

For the quantitative exposure assessment, the report used maximum concentrations from the 2012 New Zealand Ministry of Health survey of 169 tattoo ink samples. It assumed a tattoo at approximately age 20, a 50-year exposure duration over a 70-year lifetime, 15 mg/cm2 tattoo-ink use, 488 cm2 tattooed skin area, 70 kg body weight, and 100% eventual absorption/migration of heavy metals from the dermis. The report calculated systemic exposure doses and compared them with toxicological points of departure using a margin-of-safety approach.

Speciation: Cr is specifically treated as Cr(VI) in the selected risk-assessment concentration table. Arsenic and mercury are reported as As and Hg without inorganic-arsenic or methylmercury speciation, so this page records them as total arsenic (tAs) and total mercury (tHg).

Related evidence

• Tattoo inks (permanent and temporary)
• Barium
• Lead
• Nickel
• Chromium, Hexavalent
• Mercury, Total
• Cadmium
• Antimony
• Arsenic, Total

Update history

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