Professional tattooists have a high prevalence of musculoskeletal complaints regarding back pain, says a national survey of 448 tattoo workers across France.

The study, which was conducted by University of Helsinki’s (UH) Nicolas Kluger and published in the Jan. 2017 issue of International Journal of Occupational Medicine and Environmental Health, says these complaints are likely “due to repetitive movements, poor posture in the workstation and the use of a vibrating tattoo machine.”

Among the research’s survey respondents, 65% reported back pain, 41.5% said they have finger pain and 28.8% said they experience muscular pain. According to the study, the majority of these symptoms began during their career.

“Professional tattooists may be seen as a high-risk group due to their occupational exposure,” the study says. According to the study, tattooists are in constant contact with potentially harmful chemicals and body fluids, mostly blood, during their daily work, most of which is spent bent over customers in “awkward positions” while often under strong lights. The worker uses a tattoo machine gun, which is a vibrating hand tool with a rotating speed ranging from 3,000 to 35,000 RPM, throughout the tattoo session, which according to the study may last for several hours.

During the same month the UH study was published, researchers from Ohio State University (OSU) published a study in Applied Ergonomics concluding that tattoo artists are at risk for developing work-related musculoskeletal discomfort.

Both studies claim tattoo artists are an understudied worker population with regard to occupational health.

“Tattooists should be considered to represent a specific profession with its own risks,” Kluger states. “Musculoskeletal disorders due to postural overload are nothing new to tattooists, but they appear to be an overlooked health issue and should be considered as ‘occupational’ diseases among tattooists,” he says.

OSU’s research says the awkward posture held by tattoo artists while working contribute to high levels of static and muscle activity. The research found Rapid Upper Limb Assessment (known as RULA) scores of 5, 6 (medium risk) or 7 (very high risk) in 71% of its subjects.

In addition to the prevalence of musculoskeletal discomfort among the tattoo workers, “eye discomfort was remarkable,” the OSU study says.

In UH’s study, 84% of the respondents reported they have tingling sensations in their fingers, which is a symptom of carpal tunnel syndrome. Finger and back pain was more prevalent among women (51%) than men (32%), the study says. However, the study’s disproportionate ratio of female (21.9%) to male (78.1%) respondents as well as the observational study’s lack of a control group should be noted if inferences are to be made from these data.

“Although aging may be a possible confounding factor, back and finger pain complaints after having started to be a tattooist were the most prevalent in the age group of 25–35‑year‑old tattooists [which comprised 31.9% of the total subject pool],” the study says, adding that this trend has no statistical significance without further research.

NIOSH added a Safety and Health Topic page on body art in 2007. While the web page does not offer information about best practices for ergonomics, it does provide strategies for preventing work-related exposures to bloodborne pathogens in body art workplaces.