When considering getting a tattoo, visit the shop several times beforehand, get to know the artist, and ask about "Medical Grade Sterilization" and wether the shop uses it or not. If they don't, bail. If they do, ask to see the results of their last autoclave test (well within your rights and not a problem unless they failed.) As for long term effects there has been no conclusive evidence that FDA approved inks cause cancer or any other such malady. Some unscrupulous tattoo parlors (and many overseas) use whatever they can find (including automotive paints) as inks...so if you're going to the Phillippines for your first tattoo, you might reconsider.