1. Piercing, tattoo and infection. Do we live up to our knowledge? Alfred Halstensen Professor, Consultant Head, Institute of Medicine, University of Bergen & Haukeland University Hospital

2. Institutt for indremedisin Campus Haukeland

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4. Who is Alfred? An old man ? ”conservativ” Has seen a lot of people – a lot of ill people – a lot of dead people Has a lot of education (9+3+6+6+4++ years) Has a lot of experience Focus on internal medicine & infectious diseases Focus on science and education Focus on people But which teenage will listen to this old man ???

5. Institutt for indremedisin Focus on people / teenagers Focus on people and health and quality of life How to stimulate people to choose right ? How to protect people from self destructive actions ? But will teenagers listen to wisdom ? Do teenagers listen to an old man ? Do teenagers listen to health care workers ?

6. Institutt for indremedisin Who has impact on you ? Media – TV, magazines, internett, advertizers Commercial industry Friends - - - Role models School. Health care – but people do not like to hear about illness.....

7. Institutt for indremedisin Self destructive / risky activities.... Smoking tobacco Trafic accidents Alcohol Drugs Unhealty food (sugar,...) Sexually transmitted diseases (HIV, herpes, clamydia, gonorrhea, hepatitis, ++) Piercing and tatoo.

8. Institutt for indremedisin Smoking tobacco About 25% of all deaths in Europe is linked to smoking tobacco Specially: Cancer Heart and vascular diseases Lung diseases In addition.....

9. Institutt for indremedisin ”Piercing” and tattoo Penetrate the skin and moucus membrane ”Piercing” Tattoo Needles Knifes Accidents

10. Institutt for indremedisin Culture and rituals

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13. Why?

14. Institutt for indremedisin Why?

15. Institutt for indremedisin Is piercing and tattoo a problem?

16. Institutt for indremedisin What is the problem?

17. Institutt for indremedisin Piercing and tattoo – what is the problem? + Culture Rituals Estetic Identity Nice to look on? Self-confidence? Protest? -Allergy Infections Ugly? I regret …….. ”I love Monica”

18. Institutt for indremedisin Piercing and tattoo – what is the problem? Is piercing and tattoo self destructive activities ? Is benefits greater than losses? Is this commercial business? Who are the consumers?

19. Institutt for indremedisin Piercing and tattoo and infections Infections with common skin bacteria –Stafylococci – most common –Streptococci – most dangerous Hepatitis C (2-3000 each year in Norway) Hepatitis B HIV

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28. Piercing and tattoo and infections Very strong hygienic rules and claims in Norway and Europe Local and not dangerous bacterial infections is common during the following 1-4 weeks Stafylococci most common Proper hygiene + antibiotic ointment/creme Rare use of antibiotic tablets Transfer of hepatitis C probably still occur in Norway Outside Europe increased risk for transfer of HIV and hepatitis Do you want to have tattoo in Haiiti?

29. Institutt for indremedisin Girl, 18 years old about her piercing High school High sosioeconomical family Dreames of piercing since 10 years of age 11 years old: Piercing of her ears 18 years old: piercing of her tongue No protest No pressure from friends No infections Do not regret ………… yet

30. Institutt for indremedisin Girl, 18 years old about her piercing High school Middel sosioeconomic family ”Kult” Tough Looks good!!! Pressure from friends Pressure from TV, magazines and internett

31. Institutt for indremedisin 10 Norwegian teenagers about piercing and tattoo in school. Benefits and risks? Nothing!!

32. Institutt for indremedisin Is body decorated pupils different from others Ålesund: 6., 8. og 10. class. 1 237 pupils Body decorated teenagers compared to nondecorated: -activity id -quality of relations: id -quantity of relations: more -identifying with valus of the school: less -support from and communications with parents: less -body decoration strongly linked to risk behaviour Meland et al; 2004 http://www.tidsskriftet.no/index.php?seks_id=1039975

33. Institutt for indremedisin Ålesund – conclusions and advices Accept teenagers need for identity Notice that risk behaviour may give identity Improve selvmanagement and selfconfidence Improve communication between the generations. Meland et al; 2004 http://www.tidsskriftet.no/index.php?seks_id=1039975

34. Institutt for indremedisin 10 Norwegian teenagers about sexually transmitted diseases in high school 2 hours education (film)

35. Institutt for indremedisin Norwegian public health research about teenagers Playing, challenging, enjoying life Want to look good!

36. Institutt for indremedisin STD!! Sexual transmitted diseases Strong increase Easy to avoid Enough information but Enough knowledge ? Enough education ? Difficult to practice safe sex or no sex ?

37. Institutt for indremedisin STD!! Sexually transmitted diseases in Norway Clamydia >25000 new cases each year Genital herpes >30% infected – a chronic infection Gonorrhea Hepatitis HIV Others Why ?

38. Institutt for indremedisin What is going on? and why? Is this good for our health? our quality of life? Is there a greater benefit than loss? Do some people threaten your health to make business?

39. Institutt for indremedisin Dear friends, Good luck with your good life ! Take good care of each other! Sincerely yours alfred