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Author for correspondence: M. Perry, E-mail: [email protected]
Introduction
Although body piercing has historically been associated with risk-taking behaviour it has become a common form of body modification in individuals from a variety of social backgrounds [1–4]. A 2008 survey estimated that 10% of the population of England aged 16 and over have at least one body piercing, with nearly 50% of women aged 16–24 having had a piercing at a site other than earlobe [5]. Reasons for adolescents wanting body piercing include uniqueness, self-expression, fashion, curiosity and aesthetic reasons [2, 6–8].
The relationship between body piercing and the transmission of blood-borne viruses is unclear, although a theoretical risk exists. It is a requirement in the UK to wait 4 months after having a body piercing before donating blood and additional checks are undertaken for potential donors having received a body piercing in the previous 4–12 months [9]. There is evidence of an association between body piercing and the transmission of hepatitis B and C [10, 11], although quantifying this risk is difficult as those that choose to have body piercings and tattoos often have other risk factors for blood-borne viruses [1, 12, 13]. The potential for transmission of HIV through body piercing is also poorly understood, although a possible case linked to body piercing has been documented [14]. Hepatitis B outbreaks had previously been associated with tattooing before stricter legislation was introduced [15].
In November 2014, several individuals with serious pseudomonas skin infections were admitted to the Royal Gwent Hospital in Newport, South Wales. There were no other links between the cases other than all having received a piercing procedure at the same premises. Environmental Health Officers identified deficiencies in infection control and swabs from two ultrasonic water baths and a washbasin in the treatment area at the premises were found to be positive for Pseudomonas aeruginosa. Following a risk assessment where the UK Advisory Panel for Healthcare Workers Infected with Bloodborne Viruses (UKAP) [16] were consulted, it was agreed to undertake a look-back exercise to offer clients of the premises a test for hepatitis B, hepatitis C and HIV.
Here we characterise a cohort attending a body piercing and tattooing premises in South Wales and assess their health risks. We further investigated age...