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Body piercing as a risk factor for viral hepatitis: An integrative research review*

https://doi.org/10.1067/mic.2001.114402Get rights and content

Abstract

The relationship of viral hepatitis and body piercing has been investigated in 12 research studies published between 1974 and 1997. Because there are often a large number of unknowns regarding the cause of viral hepatitis, most of the studies were conducted to identify multiple risk factors for hepatitis. Eight of the 12 studies identified percutaneous exposure, including body piercing and ear piercing, as a risk factor for viral hepatitis. Six studies found that hepatitis seropositivity was significantly associated with ear piercing. Conclusions indicate that evidence is sufficient to institute public health education along with regulation of the body-piercing industry. Recent research has found a significant increase in legislative efforts to regulate body piercing. Little research has focused directly on body piercing as a specific risk factor for viral hepatitis. Further research in this area is necessary to increase the understanding of hepatitis transmission by body piercing. (Am J Infect Control 2001;29:271-4)

Section snippets

Sampling and methods

All of the research studies in this review were completed between the years 1974 and 1997. Four of the 12 studies were conducted in Italy by the same investigator.7, 8, 9, 19 Three studies were done in the United States,5, 11, 12 2 in Taiwan,20, 21 and 1 each in Africa,6 Korea,22 and Bangkok.10

All 12 studies were nonexperimental designs that used interviews and questionnaires for data collection. Many of the interviews were performed by public health officials, physicians, or study teams.7, 8, 9

Analysis

Ear piercing was significantly associated with hepatitis in 6 of the research studies,5, 6, 9, 10, 11, 12 3 of which were conducted in the United States.5, 11, 12 Two studies found percutaneous exposure, which included body piercing, to be a risk factor for hepatitis infection.7, 8

Four of the research studies did not find body piercing to be a risk factor for hepatitis infection.20, 21, 22 Those studies had smaller sample sizes. Two studies did identify injection with nondisposable needles as a

Discussion

Despite the limited amount of research regarding body piercing as a risk factor for viral hepatitis, data are sufficient to conclude that it is a risk for the spread of this disease. The CDC has published several documents regarding the risk of hepatitis and HIV infection related to body piercing.1, 2, 3, 4 Legislative efforts to regulate the body piercing industry have recently increased.13 The National Environmental Health Association developed a Body Art Model Code and Guideline in December

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