Article Text

Cohort profile
Cohort profile: The Swedish Tattoo and Body Modifications Cohort (TABOO)
  1. Christel Nielsen1,2,
  2. Kristofer Andréasson3,
  3. H Olsson4,
  4. Malin Engfeldt1,5,
  5. Anna Jöud1,6
  1. 1Occupational and Environmental Medicine, Laboratory Medicine, Lund University, Lund, Sweden
  2. 2Clinical Pharmacology, Pharmacy and Environmental Medicine, Public Health, University of Southern Denmark, Odense, Denmark
  3. 3Rheumatology, Clinical Sciences, Lund University, Lund, Sweden
  4. 4Cancer Epidemiology, Clinical Sciences, Lund University, Lund, Sweden
  5. 5Occupational and Environmental Medicine, Region Skåne, Lund, Sweden
  6. 6Skåne University Hospital, Research and Education, Region Skåne, Lund, Sweden
  1. Correspondence to Dr Christel Nielsen; christel.nielsen{at}med.lu.se

Abstract

Purpose The Swedish Tattoo and Body Modifications Cohort (TABOO) cohort was established to provide an infrastructure for epidemiological studies researching the role of tattoos and other body modifications as risk factors for adverse health outcomes. It is the first population-based cohort with detailed exposure assessment of decorative, cosmetic, and medical tattoos, piercing, scarification, henna tattoos, cosmetic laser treatments, hair dyeing, and sun habits. The level of detail in the exposure assessment of tattoos allows for investigation of crude dose–response relationships.

Participants The TABOO cohort includes 13 049 individuals that participated in a questionnaire survey conducted in 2021 (response rate 49%). Outcome data are retrieved from the National Patient Register, the National Prescribed Drug Register and the National Cause of Death Register. Participation in the registers is regulated by Swedish law, which eliminates the risk of loss to follow-up and associated selection bias.

Findings to date The tattoo prevalence in TABOO is 21%. The cohort is currently used to clarify the incidence of acute and long-lasting health complaints after tattooing based on self-reported data. Using register-based outcome data, we are investigating the role of tattoos as a risk factor for immune-mediated disease, including hypersensitisation, foreign body reactions and autoimmune conditions.

Future plans The register linkage will be renewed every third year to update the outcome data, and we have ethical approval to reapproach the responders with additional questionnaires.

  • EPIDEMIOLOGY
  • PUBLIC HEALTH
  • STATISTICS & RESEARCH METHODS

Data availability statement

Data may be obtained from a third party and are not publicly available. The data underlying this article cannot be shared publicly due to the privacy of the participants. Register data are obtained from third parties and are not publicly available. However, data from the TABOO cohort can be made available for research collaboration upon reasonable request, and after approval from the Swedish Ethical Review Authority.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Data availability statement

Data may be obtained from a third party and are not publicly available. The data underlying this article cannot be shared publicly due to the privacy of the participants. Register data are obtained from third parties and are not publicly available. However, data from the TABOO cohort can be made available for research collaboration upon reasonable request, and after approval from the Swedish Ethical Review Authority.

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Footnotes

  • Deceased June 30, 2021

  • Contributors CN and AJ designed the study. CN, AJ, HO and ME constructed the questionnaire. CN directed the study’s implementation. CN, AJ and KA defined the ICD and ATC codes that were retrieved from registers, and CN and AJ selected the sociodemographic variables. CN conducted the literature review and drafted the manuscript. All authors read and approved the final manuscript. CN is guarantor for the paper.

  • Funding This work was supported by the Swedish Research Council for Health, Working Life, and Welfare (2018-00864 to CN); the Crafoord Foundation (20180659 to CN) and the Magnus Bergvall Foundation (201802669 to CN).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.