Does a legislation restricting access to indoor tanning have any effect?
This week several tanning-related media headlines reported on a new study presented in an article in the online edition of the JAMA Network, Archives of Dermatology.
The study was conducted by a team of medical staff from Colorado School of Public Health in Aurora.
The objective of the study was: “To compile current legislation of indoor tanning throughout the world and compare them with existing legislation found in 2003.”
The conclusion: “Since 2003, access to indoor tanning has become increasingly restricted around the world.”
Most likely the real purpose with the study was to show a trend which politicians would become more eager to follow. And, sadly enough, it will probably work.
The real value of a study would of course have been looking at the result from the restrictions.
The question that a responsible politician should ask is: “Does a ban for teenagers to visit indoor tanning salons reduce the incidence of skin-cancer?”
In order to answer that question, we can look at the skin-cancer statistics from the first country that introduced legislation restricting teenagers’ access to tanning beds, France.
France introduced an 18-year limitation for indoor tanning already in May 1997. In practice, indoor tanners are more or less extinct in France. The few tanning salons that still exist are constantly harassed by the health authorities and have to cope with a myriad of regulations in addition to the 18 year ban. What could be a better country to study the effects of legislation restricting access to indoor tanning? For sure, the melanoma incidences must have gone down drastically?
Unfortunately they have not. Here is the statistic over melanoma incidences from The French National Cancer Institute (L’Institut National du Cancer) and evidently it seems like neither a tanning bed restriction nor an almost exponential growth in the sales of sun-protection cosmetics have had any effect on the melanoma incidences.
In general, the melanoma marketing starts to become a victim of its own success. The mechanism that was invented to fill the dermatologist clinics with a steady stream of people worried that they might have melanoma, is hard to control.
The challenge for the melanoma marketers is that they soon have to show that all the genius measures they introduced in order to increase their sales and profit, will have a real positive result (for the public, not only for their cash-flow). So far, more than 30 years after the birth of melanoma marketing, the incidence of skin-cancer is still increasing and even the mortality-figures from melanoma, which were more or less constant up until the start of the anti-sunshine campaign, are going up.
Obviously something is very wrong with the methods used to beat the “melanoma epidemic”. And any legislation restricting access to indoor tanning is most certainly counterproductive to its intended purpose.
Maybe it is time to have another look at the findings in IARC (from February 1992, when sunshine was included in Group 1 carcinogens). This was how IARC wrote at that time:
IARC MONOGRAPHS VOLUME 55
SUMMARY OF DATA REPORTED AND EVALUATION
Malignant melanoma of the skin
The body site distribution of melanoma shows lower rates per unit area on sites usually unexposed to the sun than on usually or regularly exposed sites.
The associations with total exposure to the sun over a lifetime or in recent years, as assessed by questionnaire, are inconsistent.
Chronic exposure, as assessed through occupational exposure, appeared to reduce melanoma risk in three of the large studies, particularly in men; this observation is consistent with the descriptive epidemiology of the condition, which shows lower risks in groups that work outdoors.
Asessment of intermittent exposure is complex; nonetheless, most studies show positive associations with measure of intermittent exposure, such as particular sun-intensive activities, outdoor recreation or vacations.
Most studies show positive associations with a history of sunburn; however, this association cannot be easily interpreted, because while it might accurately reflect sunburn it could just as well reflect either the tendency to sunburn, if exposed, or intermittent exposure more generally.
This means in other words that the only thing that is proven to reduce the risk of melanoma is “chronic exposure”. And for many of us, depending on where we live, indoor tanning is the only way to get regular and moderate exposure to UV-light all year round.
Instead of restrictions, people (of any age) should be encouraged to visit tanning salons and should be educated in how to use indoor tanning in a responsible way. This would also take care of the widespread and increasing vitamin D deficiency.
It is a shame (mainly from the side of politicians and media) that a few persons abuse of tanning beds shall be used as an argument for restrictions. Following that principle, access to fast-food restaurants should also be age-limited. Because obesity among teenagers is a much, much, worse health problem than the risk of a couple of youngsters having too much tan.