Is the 12-month Deferral for Donors Who've Had Tattoos Still in Effect?

Is the deferral for one year following receiving a tattoo still in effect, or is this deferral out of date? I cannot recall a donor seroconverting following a deferral for being tattooed. My understanding is that awareness and hygiene at tattoo parlors is at a high level.

This question was submitted to several California Donor Center Medical Directors, all of whom are recognized blood banking experts. Here is what they had to say:

1. We defer individuals who have been tattooed for twelve months. I am not sure the deferral is out of date. I haven't seen data showing serological follow-up on those receiving tattoos to know the rate of seroconversion. I know there was previous concern that while the tattoo needles might be sterile and single use the ink pots are often re-used from one customer to the next. I have no idea about awareness and hygiene at tattoo parlors. Seems to me they would vary quite a bit. I had planned to do a field trip to tattoo parlors and body piercing shops one day, but other work seemed to always get in the way.
   
   
2. I have seen seroconversion following tattooing! You just have to live long enough to see those cases. A group of students in a nearby town performed tattoos on one another while their parents were out of town. 2 or 3 became infected with hepatitis B, one was already a carrier. One of our staff took a "tour" of the tattoo parlors in our area, and her report was hair-raising. If viruses are not on the devices they can be in the ink.
   
   
3. First, for our members, I think it best to state that the one-year deferral for a tattoo is not out of date because to do otherwise is against federal and state regulations! This is a convenient way to determine what is in date. Next question would be does the rule/reg make sense (or enough sense) to continue to support it or should the rule be changed? There may be a more important (although very pessimistic) consideration...would the effort to change the requirement be worth it?
   
   
4. I think that it is outdated - the same can be said of piercing - but I think that the FDA will have difficulty changing this restriction.
   
   
5. I feel confident that all donor center blood bankers will defer for one year anyone who has been tattooed. Even if assured that someone was tattooed with a single use needle and ink that was never touched by a needle used on someone else, the AABB Standards B2.721 states a 12 month deferral for "Application of a tattoo". In California, therefore, this is the law. The only place there is some room for discretionary judgment is in the case of permanent cosmetic application done by or under the supervision of a physician which many do not consider to fall under the tattoo deferral category. If we want to make it possible to exercise further discretion it will require changing the AABB Standards and probably some action on the part of the FDA as well.
   
   
6. We are liberal with respect to ear piercing and acupuncture, allowing for a shorter deferral if one-time needles are used. Tattoos, however, are still a one year deferral with exceedingly rare exceptions (I can't remember any, however).

ADDENDA Sept. 27, 2000

7. Our blood center is in California and therefore we strictly follow the AABB guidelines as well as FDA regulations with regards to tattoo deferral as well as piercing. The other question is whether the ruling is outdated. It probably is, but as long as there is a remote possibility that hepatitis or other infectious diseases can be transmitted to the blood supply it will never be changed. Besides, there is still the old cultural taboo that some still have associated tattoos with disease.

Editor's Note: It seems prudent to defer an individual for at least one year following their receiving a tattoo. To take their blood sooner than one year after they receive a tattoo, for allogeneic use, would be below the community standard, as defined by the regulators.

NOTE: See also the related follow-up item entitled "Does the 'rationale' for deferral after receiving a tattoo apply to ear/skin piercing, acupuncture, and electrolysis?"

Submit comments to the e-Network Forum at enetworkforum@cbbsweb.org

Ira A. Shulman, MD
CBBS e-Network Forum Senior Editor & Moderator

W. Tait Stevens, MD
CBBS e-Network Forum Editor & Moderator

Elizabeth M. St. Lezin, MD
CBBS e-Network Forum Associate Editor & Moderator