Quaranta et al. BMC Public Health 2011, 11:774 http://www.biomedcentral.com/1471-2458/11/774 R E S E A R C H A R T I C L E Open Access Body piercing and tattoos: a survey on young adults’ knowledge of the risks and practices in body art Alessia Quaranta, Christian Napoli*, Fabrizio Fasano, Claudio Montagna, Giuseppina Caggiano and Maria Teresa Montagna Abstract Background: The practice of tattooing and piercing has expanded in western society. In order to verify young adults’ knowledge of the risk and practices related to body art, an investigation was conducted among freshmen of the University of Bari in the region of Apulia, Italy. Methods: The study was carried out in the Academic Year 2009-2010 through an anonymous self-administered written questionnaire distributed to 1.656 freshmen enrolled in 17 Degree Courses. Results: Of the 1.598 students included in the analysis, 78.3% believe it is risky to undergo piercing/tattoo practices. AIDS was indicated as a possible infection by 60.3% of freshmen, hepatitis C by 38.2%, tetanus by 34.3% and hepatitis B by 33.7% of the sample. 28.1% of freshmen were not aware that there are also non-infectious complications. 29% of the sample had at least one piercing or tattoo (this percentage does not include earlobe piercing in women). Of those with body art, the decision to undergo body art was made autonomously in 57.9% of the participants. 56.3% of freshmen undergoing body art had taken less than a month to decide. With regard to the reasons that led the sample to undergo body art, 28.4% were unable to explain it, 23.8% answered to improve their aesthetic aspect, 18.4% to distinguish themselves from others, 12.3% for fashion; 17.1% for other reasons. 25.4% of the sample declared that they had a piercing (79.8% female vs 20.2% male; ratio M/F 1:4.0). The average age for a first piercing was 15.3 years (range 10-27; SD ± 2.9). 9.6% of the sample declared that they have a tattoo (69.9% female vs 30.1% male; ratio M/F 1:2.3). The average age for a first tattoo was 17.5 years (range 10-26, SD ± 2.4). Conclusions: Most of the freshmen knew about AIDS-related risks but not other potential risks. Body art is fairly common among young adults (especially women). The decision is often not shared with the family and is undertaken mostly without a specific reason or for the improvement of aesthetic aspect. Information about freshmen’s knowledge, attitudes and practices could help in effective planning of health promotion strategies. Background The practice of tattooing and piercing, once not very common in developed countries, has now expanded into western society. In fact, in the last twenty years, young people have shown great enthusiasm for the practice [1-4]. Unfortunately, with this higher demand, the num- ber of unprofessional tattooists and piercers has increased creating more complications due to frequent * Correspondence: c.napoli@igiene.uniba.it Department of Biomedical Science and Human Oncology - Hygiene Section - University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy procedures carried out without any knowledge of health and hygiene rules [4,5]. The scientific literature shows a wide range of health consequences both infectious (e.g. HIV, HBV and HCV, mycobacterial infections, septice- mia, abscess, endocarditis, tetanus) and non-infectious diseases (e.g. dermatitis, hemorrhage, allergies, damage to the oral cavity) [6-19]. There have been some cases with a fatal outcome [20]. A survey carried out in Great Britain has shown that 10% of the 10.503 subjects inter- viewed have piercing on another part of the body than the earlobes (nose, tongue, eyebrows, nipples and navel); © 2011 Quaranta et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.