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Suppa M, Gandini S, Njimi H, Bulliard JL, Correia O, Duarte AF, Peris K, Stratigos AJ, Nagore E, Longo MI, Bylaite-Bucinskiene M, Karls R, Helppikangas H, Del Marmol V. Prevalence and determinants of sunbed use in thirty European countries: data from the Euromelanoma skin cancer prevention campaign. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:13-27. [PMID: 30811698 DOI: 10.1111/jdv.15311] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although considered as a first-group carcinogen, indoor tanning is a common practice in Europe. Euromelanoma is a pan-European skin cancer prevention campaign. OBJECTIVES To compare several European countries in terms of the prevalence and determinants of sunbed use. METHODS Participants in the Euromelanoma campaigns filled in questionnaires containing demographics and risk factors, including type/duration of sunbed use. Multivariate analyses adjusted for age, gender, education, skin type and year of survey were employed to assess factors independently associated with sunbed use in each country. RESULTS In total, 227 888 individuals (67.4% females, median age 44, 63.4% highly educated, 71.9% skin types III-VI) from 30 countries participated. Overall, the prevalence of sunbed ever use was 10.6% (≤19-year-olds: 5.9%; 20 to 35-year-olds: 17.0%; >35-year-olds: 8.3%). Females displayed a higher prevalence than males in all countries. Balkan countries displayed the highest female/male ratios (≥4). Sunbed use was significantly more prevalent among skin type III-VI (14/30 countries) and highly educated participants (11/30 countries). Significant correlations were found between sunbed use prevalence and countries' latitude (P < 0.001) and sunshine (P = 0.002); Italy and Spain represented exceptions towards excessive exposure. Very different prevalence rates were found for Spain (19.3%) and Portugal (2.0%). Scandinavian countries ranked highest in sunbed use among ≤19-year-olds, Baltic countries among 20 to 35-year-olds. CONCLUSIONS Sunbed use prevalence was higher in northern, sun-deprived countries, with the exception of Italy and Spain. The main determinants of sunbed use were age (young adults) and gender (females), whereas education and skin type had a less relevant effect. Geographic particularities were found in four regions: Iberian (prevalence ten times higher in Spain than Portugal), Balkan (prevalence disproportionately higher among women), Baltic (highest prevalence among young adults) and Scandinavian (highest prevalence among adolescents). These data have public health relevance for future interventions aimed at reducing sunbed use in Europe.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - H Njimi
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - J L Bulliard
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - O Correia
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal.,Portuguese Skin Cancer Association, Lisbon, Portugal.,Center for Health Technology and Services Research (CINTESIS), Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A F Duarte
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal.,Portuguese Skin Cancer Association, Lisbon, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - K Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - A J Stratigos
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Universidad Católica de València San Vicente Ferrer, Valencia, Spain
| | - M I Longo
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA
| | - M Bylaite-Bucinskiene
- Clinic of Infectious, Chest Diseases, Dermatovenereology and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - R Karls
- Department of Infectiology and Dermatology, Riga Stradins University, Riga, Latvia
| | - H Helppikangas
- Dermatology Department, Clinical Center, University of Sarajevo, Sarajevo, Bosnia & Herzegovina
| | | | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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2
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Gandini S, Doré JF, Autier P, Greinert R, Boniol M. Epidemiological evidence of carcinogenicity of sunbed use and of efficacy of preventive measures. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:57-62. [PMID: 30811691 DOI: 10.1111/jdv.15320] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 11/29/2022]
Abstract
The International Agency for Research on Cancer classified, in July 2009, exposure to artificial tanning devices (sunbeds) as carcinogenic to humans. This classification was based on evidence from epidemiological and experimental animal studies. The present chapter will review these epidemiological evidences. The summary risk estimates from 27 epidemiological studies obtained through a meta-analysis showed an increased risk of melanoma: summary relative risk (SRR) = 1.20 [95% confidence interval (CI) 1.08-1.34]. The risk was higher when exposure took place at younger age (SRR = 1.59; 95% CI 1.36-1.85). The risk was independent of skin sensitivity or population and a dose response was evident. A meta-analysis of 12 studies was conducted for non-melanoma skin cancers and showed a significantly increased risk for basal cell carcinoma (SRR = 1.29; 95% CI 1.08-1.53) and for squamous cell carcinoma (SRR = 1.67; 95% CI 1.29-2.17). As for melanoma, the risk for other skin cancers increased for first exposures at young age. Epidemiological studies have gradually strengthened the evidence for a causal relationship between indoor tanning and skin cancer and they fit with prior knowledge on relationship between UV exposure and skin cancer. Additionally, several case-control studies provided consistent evidence of a positive association between use of sunbed and ocular melanoma, also with greater risk for first exposures at younger age. Preventive measures based on information on risk or by requiring parental authorization for young users proved to be inefficient in several studies. The significant impact of strong actions or total ban, such as performed in Iceland, or a total ban of sunbed use, as in Brazil or Australian states, needs to be further assessed.
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Affiliation(s)
- S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - J-F Doré
- Centre de Recherche en Cancérologie de Lyon, Inserm U1052, Lyon, France
| | - P Autier
- International Prevention Research Institute, Lyon, France
| | - R Greinert
- Department of Molecular Cell biology, Dermatology Center Buxtehude, Elbekliniken Stade/Buxtehude, Klinikum Buxtehude, Buxtehude, Germany
| | - M Boniol
- International Prevention Research Institute, Lyon, France
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3
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Suppa M, Gandini S, Bulliard JL, Daxhelet M, Zamagni M, Forsea AM, Longo MI, Del Marmol V. Who, why, where: an overview of determinants of sunbed use in Europe. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:6-12. [PMID: 30811690 DOI: 10.1111/jdv.15318] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/20/2018] [Indexed: 12/28/2022]
Abstract
Although exposure to indoor tanning has been established as a clear risk factor for skin cancer, sunbeds are still commonly used in Europe. Understanding the determinants of sunbed use in Europe is key to plan educational interventions, behavioural strategies and legislative measures, which should be tailored to subgroups with different risk profiles. Evidences show that the typical sunbed users in Europe are young-adult women, with intermediate skin type, a current employment and a medium/high socio-economic status. Typical users display sun-seeking behaviours and other risky behaviours such as smoking. Indoor tanning seems more common in northern than southern Europe. However, sunbed use remains common in fair-skinned individuals and among adolescents/pre-adolescents. Commonly reported reasons for sunbed use in Europe include aesthetic motives (i.e. looking attractive), the pursue of a prevacation tan, the influence of peers/parents engaging in the same habit, and the treatment of health conditions. The most commonly reported places to get an artificial tan in Europe are tanning studios and beauty salons. However, sunbeds are also available in sport venues, such as swimming pools and gyms, hotels and private houses. All these factors should be taken into account when planning educational, behavioural and legislative interventions to reduce the popularity of artificial tanning in Europe.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - J L Bulliard
- Cancer Epidemiology Unit, University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - M Daxhelet
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - M Zamagni
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - A M Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - M I Longo
- Department of Dermatology, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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4
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Taylor J, Lamont A, Murray M. Talking about sunbed tanning in online discussion forums: Assertions and arguments. Psychol Health 2017; 33:518-536. [PMID: 28911238 DOI: 10.1080/08870446.2017.1375496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE There is increasing evidence of both health and appearance risks associated with sunbed use. At the same time, the sunbed industry promotes the benefits of using sunbeds, and the image of a tanned skin as attractive and healthy arguably remains embedded within contemporary western culture. These tensions are played out in everyday conversations, and this paper reports a study which explored how sunbed users manage them within online discussion forums. DESIGN A total of 556 posts from 13 sunbed-related threads, taken from six different UK-based online forums, were analysed thematically followed by techniques from discourse analysis. MAIN OUTCOME MEASURES Informed by social representations theory and discursive-rhetorical psychology, the way social representations of sunbed use are constructed, debated and disputed in online discussion forums were explored. RESULTS Sunbed users drew upon numerous representations to distance and protect themselves from negativity they were confronted with in the forums, utilising a range of rhetorical, discursive strategies to help them. CONCLUSION Theoretical contributions and potential practical implications of the findings are discussed. Findings indicate, for example, that those working on campaigns and interventions in this area need to consider the wider negativity and argumentative orientation of sunbed users' responses.
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Affiliation(s)
- Jennifer Taylor
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
| | - Alexandra Lamont
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
| | - Michael Murray
- a School of Psychology , Dorothy Hodgkin Building, Keele University , Staffordshire , UK
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5
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Meyer MKH, Køster B, Juul L, Tolstrup JS, Bendtsen P, Dalum P, Christensen ASP. Sunbed use among 64,000 Danish students and the associations with demographic factors, health-related behaviours, and appearance-related factors. Prev Med 2017; 100:17-24. [PMID: 28336336 DOI: 10.1016/j.ypmed.2017.03.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Revised: 02/24/2017] [Accepted: 03/12/2017] [Indexed: 11/19/2022]
Abstract
Sunbed use is associated with an increased risk for skin cancer and is particularly dangerous for younger persons. The objective of this study was to assess how demographic factors, health-related behaviours and appearance-related factors are associated with sunbed use. Cross-sectional data from the Danish National Youth Study collected by the National Institute of Public Health during 2014 was used. A total of 64,382 students aged 15-25years were included in the present study. Multilevel logistic regression analyses were used to determine associations. Sunbed use during the past 12months was reported by 22% of students, with a higher proportion among females (29%) than males (12%). Factors associated with sunbed use were older age, studying at a vocational college or a higher preparatory examination school compared to upper secondary school, and lower parental education. Furthermore, being a smoker, been binge-drinking, longer duration of exercise and been dieting were also associated with sunbed use. For females, poor dietary habits were also associated with sunbed use. Feeling overweight was associated with lower odds for sunbed use for males, but with higher odds for females. Lower body satisfaction was associated with higher odds of sunbed use, except for overweight males. Students who were underweight had lower odds for sunbed use, than normal weight students. Conclusively, we found evidence of associations between demographic factors, health-related behaviours and appearance-related factors and sunbed use. Understanding these relations could help to identify high-risk groups and guide preventive strategies for sunbed use and skin cancer prevention.
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Affiliation(s)
| | - Brian Køster
- Danish SunSmart Campaign, Danish Cancer Society, Copenhagen, Denmark
| | - Lise Juul
- Department of Public Health, Section of Health Promotion and Health Services, Aarhus University, Aarhus, Denmark
| | | | | | - Peter Dalum
- Danish SunSmart Campaign, Danish Cancer Society, Copenhagen, Denmark
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6
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Abstract
This study investigated cognitive predictors of tanning salon use, based on Jaccard’s Theory of Alternative Behavior. A total of 164 undergraduates completed questionnaires that assessed tanning salon use, attitudes toward tanning salon use and attitudes toward behavioral alternatives for enhancing appearance, relaxing and socializing. Results indicated that attitudes toward alternatives for enhancing appearance were not significantly related to tanning salon use. However, favorable attitudes toward engaging in a hobby to relax and going to the gym to socialize were inversely related to frequency of tanning salon use. Findings suggest that interventions for reducing skin cancer risk should focus not only on decreasing favorable attitudes toward tanning, but also on increasing favorable attitudes toward healthier alternatives to tanning salon use.
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Affiliation(s)
- Sharon Danoff-Burg
- Department of Psychology, University at Albany, State University of New York, Albany, NY 12222, USA.
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7
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Abstract
The North American public maintains an attitude that equates the acquisition of a suntan with health. However, prolonged exposure to ultraviolet radiation from the sun can lead to sunburn, premature skin aging, immunosuppression, and skin cancer. Misconceptions about the risks of tanning beds and the effectiveness of sunscreens are common. The public must be better informed about the importance of and the need for effective sun protection by means of clothing and hats, the proper use of sunscreen, and the avoidance of prolonged sun exposure during the time of maximal solar insolation.
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Affiliation(s)
- Jason K. Rivers
- From the Department of Dermatology, Faculty of Medicine, University of British Columbia, and Skin Care Centre, Vancouver General Hospital, Vancouver, BC; Division of Dermatology, McGill University, Royal Victoria Hospital, Montréal, PQ; and Division of Dermatology, University of Montréal, Sainte-Justine Hospital, Montréal, PQ
| | - Beatrice Wang
- From the Department of Dermatology, Faculty of Medicine, University of British Columbia, and Skin Care Centre, Vancouver General Hospital, Vancouver, BC; Division of Dermatology, McGill University, Royal Victoria Hospital, Montréal, PQ; and Division of Dermatology, University of Montréal, Sainte-Justine Hospital, Montréal, PQ
| | - Danielle Marcoux
- From the Department of Dermatology, Faculty of Medicine, University of British Columbia, and Skin Care Centre, Vancouver General Hospital, Vancouver, BC; Division of Dermatology, McGill University, Royal Victoria Hospital, Montréal, PQ; and Division of Dermatology, University of Montréal, Sainte-Justine Hospital, Montréal, PQ
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8
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Wøhlk IMR, Philipsen PA, Wulf HC. Factors associated with cessation of sunbed use among Danish women. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2016; 32:191-8. [DOI: 10.1111/phpp.12243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 11/30/2022]
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9
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Prävalenz, Risikogruppen und Motive der Solariennutzung in Deutschland. DER HAUTARZT 2016; 67:226-33. [DOI: 10.1007/s00105-015-3753-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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10
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Heckman CJ, Munshi T, Darlow S, Kloss JD, Manne SL, Perlis C, Oslin D. The association of tanning behavior with psycho-tropic medication use among young adult women. PSYCHOL HEALTH MED 2015; 21:60-6. [PMID: 26068581 DOI: 10.1080/13548506.2015.1051060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite its known association with skin cancer, tanning remains popular among young adult women. Indoor tanning behavior has been found to be associated with affective and addictive disorders. To better understand potential psychological and biological mechanisms of tanning behavior, we investigated associations between tanning and medication (psychotropic and other) use among young women. Two hundred and fifty-three women age 18-29 years old were recruited from two northeastern university campus communities. Women self-reported tanning frequency and chronic medication use. In both univariate and multivariate analyses, indoor tanning ≥12 times last year was significantly associated with use of psychotropic medication and anti-depressants in particular. Sunbathing was not associated with medication use. Potential reasons for associations between tanning and psychotropic medication use are discussed. Indoor tanners should be warned that some psychotropic medications are photosensitizing, thus increasing risk for burns and other skin damage from indoor tanning.
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Affiliation(s)
- Carolyn J Heckman
- a Cancer Prevention and Control Program , Fox Chase Cancer Center , Philadelphia , PA , USA
| | - Teja Munshi
- a Cancer Prevention and Control Program , Fox Chase Cancer Center , Philadelphia , PA , USA
| | - Susan Darlow
- a Cancer Prevention and Control Program , Fox Chase Cancer Center , Philadelphia , PA , USA
| | - Jacqueline D Kloss
- b Department of Psychology , Drexel University , 3141 Chestnut St, Philadelphia , PA 19104 , USA
| | - Sharon L Manne
- c Cancer Prevention and Control Program , Rutgers Cancer Institute of New Jersey , New Brunswick , NJ , USA
| | - Clifford Perlis
- d Department of Dermatology , Fox Chase Cancer Center , Philadelphia , PA , USA
| | - David Oslin
- e Department of Psychiatry , University of Pennsylvania School of Medicine , Philadelphia , PA , USA
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11
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Wehner MR, Chren MM, Nameth D, Choudhry A, Gaskins M, Nead KT, Boscardin WJ, Linos E. International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol 2014; 150:390-400. [PMID: 24477278 DOI: 10.1001/jamadermatol.2013.6896] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Indoor tanning is a known carcinogen, but the scope of exposure to this hazard is not known. OBJECTIVE To summarize the international prevalence of exposure to indoor tanning. DATA SOURCES Studies were identified through systematic searches of PubMed (1966 to present), Scopus (1823 to present), and Web of Science (1898 to present) databases, last performed on March 16, 2013. We also hand searched reference lists to identify records missed by database searches and publicly available data not yet published in the scientific literature. STUDY SELECTION Records reporting a prevalence of indoor tanning were eligible for inclusion. We excluded case-control studies, reports with insufficient study information, and reports of groups recruited using factors related to indoor tanning. Two independent investigators performed searches and study selection. Our search yielded 1976 unique records. After exclusions, 161 records were assessed for eligibility in full text, and 88 were included. DATA EXTRACTION AND SYNTHESIS Two independent investigators extracted data on characteristics of study participants, inclusion/exclusion criteria, data collection format, outcomes, and statistical methods. Random-effects meta-analyses were used to summarize the prevalence of indoor tanning in different age categories. We calculated the population proportional attributable risk of indoor tanning in the United States, Europe, and Australia for nonmelanoma skin cancer (NMSC) and melanoma. MAIN OUTCOMES AND MEASURES Ever and past-year exposure to indoor tanning. RESULTS The summary prevalence of ever exposure was 35.7% (95% CI, 27.5%-44.0%) for adults, 55.0% (33.0%-77.1%) for university students, and 19.3% (14.7%-24.0%) for adolescents. The summary prevalence of past-year exposure was 14.0% (95% CI, 11.5%-16.5%) for adults, 43.1% (21.7%-64.5%) for university students, and 18.3% (12.6%-24.0%) for adolescents. These results included data from 406 696 participants. The population proportional attributable risk were 3.0% to 21.8% for NMSC and 2.6% to 9.4% for melanoma, corresponding to more than 450 000 NMSC cases and more than 10 000 melanoma cases each year attributable to indoor tanning in the United States, Europe, and Australia. CONCLUSIONS AND RELEVANCE Exposure to indoor tanning is common in Western countries, especially among young persons. Given the large number of skin cancer cases attributable to indoor tanning, these findings highlight a major public health issue.
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Affiliation(s)
- Mackenzie R Wehner
- Department of Dermatology, University of California, San Francisco2Stanford University School of Medicine, Stanford, California3Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Mary-Margaret Chren
- Department of Dermatology, University of California, San Francisco4Department of Dermatology, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | | | - Aditi Choudhry
- Department of Internal Medicine, John Muir Medical Center, Walnut Creek, California
| | - Matthew Gaskins
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Kevin T Nead
- Stanford University School of Medicine, Stanford, California
| | - W John Boscardin
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Eleni Linos
- Department of Dermatology, University of California, San Francisco
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12
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Wehner MR, Chren MM, Nameth D, Choudhry A, Gaskins M, Nead KT, Boscardin WJ, Linos E. International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol 2014. [PMID: 24477278 DOI: 10.1001/jamadermatol.2013.6896.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Indoor tanning is a known carcinogen, but the scope of exposure to this hazard is not known. OBJECTIVE To summarize the international prevalence of exposure to indoor tanning. DATA SOURCES Studies were identified through systematic searches of PubMed (1966 to present), Scopus (1823 to present), and Web of Science (1898 to present) databases, last performed on March 16, 2013. We also hand searched reference lists to identify records missed by database searches and publicly available data not yet published in the scientific literature. STUDY SELECTION Records reporting a prevalence of indoor tanning were eligible for inclusion. We excluded case-control studies, reports with insufficient study information, and reports of groups recruited using factors related to indoor tanning. Two independent investigators performed searches and study selection. Our search yielded 1976 unique records. After exclusions, 161 records were assessed for eligibility in full text, and 88 were included. DATA EXTRACTION AND SYNTHESIS Two independent investigators extracted data on characteristics of study participants, inclusion/exclusion criteria, data collection format, outcomes, and statistical methods. Random-effects meta-analyses were used to summarize the prevalence of indoor tanning in different age categories. We calculated the population proportional attributable risk of indoor tanning in the United States, Europe, and Australia for nonmelanoma skin cancer (NMSC) and melanoma. MAIN OUTCOMES AND MEASURES Ever and past-year exposure to indoor tanning. RESULTS The summary prevalence of ever exposure was 35.7% (95% CI, 27.5%-44.0%) for adults, 55.0% (33.0%-77.1%) for university students, and 19.3% (14.7%-24.0%) for adolescents. The summary prevalence of past-year exposure was 14.0% (95% CI, 11.5%-16.5%) for adults, 43.1% (21.7%-64.5%) for university students, and 18.3% (12.6%-24.0%) for adolescents. These results included data from 406 696 participants. The population proportional attributable risk were 3.0% to 21.8% for NMSC and 2.6% to 9.4% for melanoma, corresponding to more than 450 000 NMSC cases and more than 10 000 melanoma cases each year attributable to indoor tanning in the United States, Europe, and Australia. CONCLUSIONS AND RELEVANCE Exposure to indoor tanning is common in Western countries, especially among young persons. Given the large number of skin cancer cases attributable to indoor tanning, these findings highlight a major public health issue.
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Affiliation(s)
- Mackenzie R Wehner
- Department of Dermatology, University of California, San Francisco2Stanford University School of Medicine, Stanford, California3Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Mary-Margaret Chren
- Department of Dermatology, University of California, San Francisco4Department of Dermatology, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | | | - Aditi Choudhry
- Department of Internal Medicine, John Muir Medical Center, Walnut Creek, California
| | - Matthew Gaskins
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Kevin T Nead
- Stanford University School of Medicine, Stanford, California
| | - W John Boscardin
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Eleni Linos
- Department of Dermatology, University of California, San Francisco
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13
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Al-Naggar RA. Practice of Skin Cancer Prevention among Road Traffic Police Officers in Malaysia. Asian Pac J Cancer Prev 2013; 14:4577-81. [DOI: 10.7314/apjcp.2013.14.8.4577] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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14
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Heckman CJ, Darlow S, Kloss JD, Cohen-Filipic J, Manne SL, Munshi T, Yaroch AL, Perlis C. Measurement of tanning dependence. J Eur Acad Dermatol Venereol 2013; 28:1179-85. [PMID: 23980870 DOI: 10.1111/jdv.12243] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 07/19/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Indoor tanning has been found to be addictive. However, the most commonly used tanning dependence measures have not been well validated. OBJECTIVE The study's purpose was to explore the psychometric characteristics of and compare the modified Cut-down, Annoyed, Guilty, Eye-opener Scale (mCAGE), modified Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition - Text Revised (mDSM-IV-TR) and Tanning Pathology Scale (TAPS) measures of tanning dependence and provide recommendations for research and practice. METHODS This study was a cross-sectional online survey with 18- to 25-year-old female university students. The main outcome variable was tanning dependence measured by the mCAGE, mDSM-IV-TR and TAPS. RESULTS Internal consistency of the TAPS subscales was good but was poor for the mCAGE and mDSM-IV-TR, except when their items were combined. Agreement between the mCAGE and mDSM-IV-TR was fair. Factor analysis of the TAPS confirmed the current four-factor structure. All of the tanning dependence scales were significantly correlated with one another. Likewise, most of the tanning dependence scales were significantly correlated with other measures of tanning attitudes and behaviours. However, the tolerance to tanning TAPS subscale was not significantly correlated with any measure of tanning attitudes or behaviours and had the lowest subscale internal reliability and eigenvalues. CONCLUSION Based on the data and existing literature, we make recommendations for the continued use of tanning dependence measures. Intervention may be needed for the approximately 5% of college women who tend to be classified as tanning dependent across measures. Monitoring of individuals reporting tanning dependence symptoms is warranted.
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Affiliation(s)
- C J Heckman
- Cancer Prevention and Control Program, Fox Chase Cancer Center
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Bock C, Diehl K, Litaker D, Breitbart E, Greinert R, Schneider S. Sunbed use in Germany: trends, user histories and factors associated with cessation and readiness to change. Br J Dermatol 2013; 169:441-9. [DOI: 10.1111/bjd.12390] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2013] [Indexed: 11/27/2022]
Affiliation(s)
- C. Bock
- Mannheim Institute of Public Health; Social and Preventive Medicine; Medical Faculty Mannheim; Heidelberg University; Ludolf-Krehl-Str. 7-11 Mannheim D-68167 Germany
| | - K. Diehl
- Mannheim Institute of Public Health; Social and Preventive Medicine; Medical Faculty Mannheim; Heidelberg University; Ludolf-Krehl-Str. 7-11 Mannheim D-68167 Germany
| | - D. Litaker
- Mannheim Institute of Public Health; Social and Preventive Medicine; Medical Faculty Mannheim; Heidelberg University; Ludolf-Krehl-Str. 7-11 Mannheim D-68167 Germany
- Departments of Medicine, Epidemiology and Biostatistics; Case Comprehensive Cancer Center; Case Western Reserve University; Cleveland OH U.S.A
| | - E.W. Breitbart
- Dermatology Centre; Elbeklinikum Buxtehude; Buxtehude Germany
- Association of Dermatological Prevention; Hamburg Germany
- European Society of Skin Cancer Prevention; c/o Elbekliniken; Buxtehude Germany
| | - R. Greinert
- Dermatology Centre; Elbeklinikum Buxtehude; Buxtehude Germany
- Association of Dermatological Prevention; Hamburg Germany
- European Society of Skin Cancer Prevention; c/o Elbekliniken; Buxtehude Germany
| | - S. Schneider
- Mannheim Institute of Public Health; Social and Preventive Medicine; Medical Faculty Mannheim; Heidelberg University; Ludolf-Krehl-Str. 7-11 Mannheim D-68167 Germany
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Heckman CJ, Cohen-Filipic J, Darlow S, Kloss JD, Manne SL, Munshi T. Psychiatric and addictive symptoms of young adult female indoor tanners. Am J Health Promot 2013; 28:168-74. [PMID: 23621780 DOI: 10.4278/ajhp.120912-quan-442] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
PURPOSE Indoor tanning (IT) increases risk for melanoma and is particularly common among young adult women. IT has also been linked with some psychiatric symptoms, and frequent tanning may indicate tanning dependence (addiction) associated with endorphin release during ultraviolet radiation exposure. The objective of the current study was to investigate associations between IT, tanning dependence, and psychiatric and substance use symptoms in young adult women. DESIGN Cross-sectional survey and psychiatric interview. SETTING Online, except for the Mini International Neuropsychiatric Interview (MINI), which was completed over the telephone. SUBJECTS Participants were 306 female university students aged 18 to 25 years. MEASURES MINI, Seasonal Scale Index, tanning dependence scales, reporting ever having used a tanning bed or booth with tanning lamps (single item), reporting smoking a cigarette in the last 30 days (single item). ANALYSIS Descriptive statistics, χ(2) analysis, multivariate logistic regression. RESULTS Forty-six percent of the sample reported a history of IT, and 25% were classified as tanning dependent. Multivariate logistic regression analyses showed that IT was significantly associated with symptoms of alcohol use disorders, generalized anxiety, and not having social anxiety. Tanning dependence was associated with symptoms of alcohol use disorders. CONCLUSION Tanning is of concern not only for its association with skin cancer but for its association with psychiatric and substance use symptoms. Young women with certain psychological problems may seek relief from their symptoms by IT. These findings suggest that indoor tanners may benefit from health behavior and other psychosocial interventions.
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Ng AT, Chang ALS, Cockburn M, Peng DH. A simple intervention to reinforce awareness of tanning bed use and skin cancer in non-medical skin care professionals in Southern California. Int J Dermatol 2013; 51:1307-12. [PMID: 23067078 DOI: 10.1111/j.1365-4632.2011.05425.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND (i) To assess the baseline knowledge of non-medical skin care professionals (estheticians, cosmetologists, massage therapists) on tanning bed use and its association with melanoma; and (ii) to provide preliminary evidence of the potential impact of a fast and simple educational intervention on tanning beds and melanoma on the awareness of non-medical skin care professionals towards skin cancer prevention. METHODS A pre-intervention survey was administered to non-medical skin care professional at salons or spas in Southern California to assess baseline knowledge on tanning and skin cancer. This was followed immediately by a 10-minute oral presentation on tanning bed use and its association with melanoma. One month later, a post-intervention survey was distributed to individuals who attended the initial oral presentation. RESULTS Significant changes pre- and post-intervention were found in non-medical skin care professionals' answer responses to the following: (i) increased speaking to clients about cancer risk with tanning bed use 42-66% (OR 2.44; 95% CI 1.39, 4.30)]; (ii) decreased personal tanning bed use (23-15% [OR 0.61; 95% CI 0.37, 1.00]); and (iii) decreased belief that tanning beds are an excellent cosmetic tool (29-20% [OR 0.60; 95% CI 0.38, 0.96]). CONCLUSION This study provides preliminary evidence that non-medical skin care professionals could be an important source of primary prevention information for reducing the burden of melanoma.
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Affiliation(s)
- Angie T Ng
- Keck School of Medicine, University of Southern California, CA, USA
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Petty KN, Knee CR, Joseph AK. Sunscreen use among recreational cyclists: How intentions predict reported behavior. J Health Psychol 2012; 18:439-47. [DOI: 10.1177/1359105312444644] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A nationwide survey measured 927 recreational cyclists’ cognitions and perceptions about skin cancer risks, along with sun protection practices and predictors of sunscreen use while cycling. Multiple regressions evaluated associations between perceived costs, rewards, photoaging, self-efficacy and sunscreen use, and potential moderators of the associations between intentions and sunscreen use were examined. Results suggest that when cyclists see the advantages of using sunscreen, are worried about photoaging, and feel efficacious, they have stronger intentions to apply sunscreen before riding. Intentions to use sunscreen while cycling predict reported use of sunscreen, particularly when cyclists perceive sunscreen application as easy and viable.
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Affiliation(s)
- Jean-François Doré
- Centre de Recherche en Cancérologie de Lyon, UMR Inserm U1052 - CNRS U5286, Centre Léon Bérard, 28, rue Laënnec, 69373, Lyon Cedex 08, France.
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20
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Schneider S, Krämer H. Response to the letter to the editor by Coups and Phillips. J Eur Acad Dermatol Venereol 2011. [DOI: 10.1111/j.1468-3083.2011.03997.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Mogensen M, Jemec GB. The potential carcinogenic risk of tanning beds: clinical guidelines and patient safety advice. Cancer Manag Res 2010; 2:277-82. [PMID: 21188119 PMCID: PMC3004589 DOI: 10.2147/cmr.s7403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In 2009, the WHO listed ultraviolet (UV) radiation as a group 1 carcinogen. In spite of this, each year, millions of people tan indoor in Western countries. The aim of this review is to summarize evidence of tanning bed carcinogenesis and to present guidelines for use of tanning beds and patient safety advice. METHODS A narrative review of the literature was conducted based on both PubMed and Medline searches and on literature review of the retrieved papers. RESULTS Use of indoor tanning beds represents a significant and avoidable risk factor for the development of both melanoma and nonmelanoma skin cancers. Frequent tanners are more often adolescent females. Tanning beds have additional potential adverse effects such as burns, solar skin damage, infection, and possibly also addictive behavior. DISCUSSION The effort in preventing UV light-induced carcinogenesis should currently be aimed at developing new strategies for public health information. Tanning beds are one preventable source of UV radiation. In the majority of people solar UV radiation continues to be the major factor and therefore anti-tanning campaigns must always include sunbathers.
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Affiliation(s)
- Mette Mogensen
- Department of Dermatology, Gentofte Hospital, Hellerup, Denmark
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22
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Schneider S, Krämer H. Who uses sunbeds? A systematic literature review of risk groups in developed countries. J Eur Acad Dermatol Venereol 2009; 24:639-48. [PMID: 20015180 DOI: 10.1111/j.1468-3083.2009.03509.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Skin cancer is caused by ultraviolet radiation (UVR). Indoor tanning is a totally avoidable risk behaviour. This review addresses the specific characteristics of sunbed users and the differences in motivation and risk perception compared with non-users. This review is based solely on empirical original articles. Based on literature searches with widely used reference databases ('PubMed', 'OVID', 'Social Citation Index', 'ERIC--Educational Resources Information Center', 'Web of Science' and the 'International Bibliography of the Social Sciences'), we included studies from developed nations with a publication date between 1 January 2000 and 12 August 2008. All studies were selected, classified and coded simultaneously by both authors on a blinded basis. All searches were performed on 13 and 14 August 2008. In accordance with the QUOROM and the MOOSE Statements, we identified 16 original studies. The typical sunbed user is female, between 17 and 30 years old, and tends to live a comparatively unhealthy lifestyle: Users smoke cigarettes and drink alcohol more frequently and eat less healthy food than non-users. Users are characterized by a lack of knowledge about health risks of UVR, and prompted by the frequent use of sunbeds by friends or family members and the experience of positive emotions and relaxation by indoor tanning. This review is the first systematic review on risk groups among sunbed users that has been published in a scientific journal. There is still a lack of information among users, particularly among young people regarding the safety of solariums.
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Affiliation(s)
- S Schneider
- Mannheim Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Heidelberg, Germany.
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23
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Diehl K, Litaker DG, Greinert R, Zimmermann S, Breitbart EW, Schneider S. The prevalence of current sunbed use and user characteristics: the SUN-Study 2008. Int J Public Health 2009; 55:513-6. [DOI: 10.1007/s00038-009-0100-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 09/28/2009] [Accepted: 11/19/2009] [Indexed: 10/20/2022] Open
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Hurd Clarke L, Korotchenko A. Older women and suntanning: the negotiation of health and appearance risks. SOCIOLOGY OF HEALTH & ILLNESS 2009; 31:748-761. [PMID: 19515108 DOI: 10.1111/j.1467-9566.2009.01175.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This paper examines older women's experiences and perceptions of sunbathing, sun avoidance, and suntanned appearances. Using data from in-depth interviews with 36 women aged 71 to 94, we elucidate the motivations behind the women's sunbathing practices. Specifically, we explore how the women responded to the health and appearance risks associated with exposure to and avoidance of ultraviolet radiation as well as extant feminine beauty norms. The majority of women put their experiences of sunbathing in an emergent historical context. Although most of the women suggested that suntanned appearances were indicative of health and beauty, sunbathers tended to downplay their health risks by distancing themselves from those they considered to be most at risk, namely tanning bed users and individuals who acquired overly dark suntans. Sunbathers also emphasised the benefits of sun exposure for adequate vitamin D absorption. In contrast, the women who did not suntan tended to have experienced negative health and appearance consequences from their past sunbathing practices. Thus, these women emphasised the importance of future health over immediate appearance dividends. We discuss our findings in relation to the extant research on suntanning and the literature pertaining to health, risk, and beauty work.
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Affiliation(s)
- Laura Hurd Clarke
- School of Human Kinetics, The University of British Columbia, British Columbia, Canada.
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25
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Elliott A. Issues in medical exposures. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2009; 29:A107-A121. [PMID: 19454810 DOI: 10.1088/0952-4746/29/2a/s07] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Medical exposures account, on average, for some 14% of the background ionising radiation exposure in the UK and form the great majority of the non-natural component. In the United States of America, medical exposures comprised over 50% of the total in 2006. This is due primarily to an increase in x-ray computed tomography (CT) and positron emission tomography (PET) procedures. This paper highlights the potential problems in the use of CT scanning to investigate the asymptomatic individual, where the traditional risk/benefit considerations are less clear-cut than in conventional clinical situations. It draws on a recent COMARE report which examined the use of CT for whole body, heart, lung and colon studies. The number of PET facilities is increasing rapidly in the UK and, in addition to considerations of radiation dose to subjects, careful planning is necessary to limit doses to staff. In non-ionising radiation, a topic of keen interest at present is the use of increasingly powerful sunbeds, particularly by those aged under 18. Legislation and regulation vary widely across Europe and the Scottish Parliament has recently introduced the first UK regulation. It is suggested that further research is required into the effects of current UV systems and the reasons why tanning is thought so desirable by Caucasians. Lastly, a number of issues requiring radiobiological and epidemiological input are considered and actions to satisfy these identified.
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Affiliation(s)
- Alex Elliott
- Department of Clinical Physics, University of Glasgow, Glasgow G12 8QQ, UK
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26
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Keeney S, McKenna H, Fleming P, McIlfatrick S. Attitudes, knowledge and behaviours with regard to skin cancer: A literature review. Eur J Oncol Nurs 2009; 13:29-35. [DOI: 10.1016/j.ejon.2008.11.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2008] [Revised: 11/17/2008] [Accepted: 11/20/2008] [Indexed: 11/27/2022]
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Ezzedine K, Malvy D, Mauger E, Nageotte O, Galan P, Hercberg S, Guinot C. Artificial and natural ultraviolet radiation exposure: beliefs and behaviour of 7200 French adults. J Eur Acad Dermatol Venereol 2008; 22:186-94. [PMID: 18211412 DOI: 10.1111/j.1468-3083.2007.02367.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Despite the increasing use of indoor tanning facilities, little is known regarding the behaviour of adults with respect to artificial and natural ultraviolet (UV) radiation exposure and the relationship between the two forms of exposure. OBJECTIVES To describe the beliefs and behaviour of French middle-aged volunteers regarding artificial and natural UV exposure. METHODS Cross-sectional study of a French national cohort using a self-completed questionnaire. RESULTS Participants were identified as 'indoor UV tanners' (n= 1076) and as 'non-users' (n= 6124). Predictor factors associated with indoor tanning were gender, age, smoking, phototype, region of residence, sun exposure during hobbies, voluntary sun exposure in particular during the hottest hours of the day, nudism practice, facial sunscreen habits, sunglass use, importance for lying in the sun and the claim 'ever heard of melanoma'. LIMITATIONS The quality of information may be limited by the data collection method. CONCLUSION Whereas indoor tanning should be discouraged, it seems that indoor tanners are also regular sunbathers unconcerned about the risk of photoageing and skin cancer occurrence. Moreover, indoor tanners seem to have more behavioural risk factors for cancer, such as smoking.
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Affiliation(s)
- K Ezzedine
- Unité 557, Unité mixte de recherche INSERM/INRA/CNAM, Paris, France
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28
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Oliver H, Ferguson J, Moseley H. Quantitative risk assessment of sunbeds: impact of new high power lamps. Br J Dermatol 2007; 157:350-6. [PMID: 17650177 DOI: 10.1111/j.1365-2133.2007.07985.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND A survey of all sunbeds in a local authority area was carried out in 1998. Since then, there have been technological developments leading to new 'fast-tan' sunlamps which have become increasingly popular, along with unmanned sun parlours. In addition, new British and European sunbed standards have been set. OBJECTIVES To discover the commercial uptake of new high power sunlamps and to determine the impact on carcinogenic risk from sunbeds. METHODS Onsite spectral measurements, traceable to national standards, were conducted at all commercial sunbed premises within two local authorities and a quantitative risk assessment applied to the findings using a skin cancer model. Sunbed users were asked to complete a questionnaire regarding their reasons for using a sunbed and the risk associated with its use. RESULTS We found a 30% increase in the number of privately operated sunbeds since our 1998 survey. The median cancer-weighted exposure of all 133 sunbeds was comparable to that of Mediterranean sunlight. This was a significant increase compared to 1998. Moreover, 83% of sunbeds produced ultraviolet (UV) B radiation levels that exceeded the European standard. Fifteen per cent of respondents thought that there were no risks from use of sunbeds. CONCLUSIONS Sunbeds in current use carry a cancer risk comparable to Mediterranean sunlight. This is due to the use of new high power lamps. New British and European standards are being largely ignored with more than four out of five sunbeds exceeding the limit specified in the standard. There is a strong case for regulation of sunbed operators coupled to improved public education.
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Affiliation(s)
- H Oliver
- The Photobiology Unit, University of Dundee, Ninewells Hospital & Medical School, Dundee DD1 9SY, UK
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Lawler SP, Kvaskoff M, DiSipio T, Whiteman D, Eakin E, Aitken J, Fritschi L. Solaria use in Queensland, Australia. Aust N Z J Public Health 2007; 30:479-82. [PMID: 17073233 DOI: 10.1111/j.1467-842x.2006.tb00468.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To describe the demographics of solarium users and the correlates of solarium use in Queensland. METHODS A cross-sectional survey of 9419 Queensland residents was conducted via an anonymous computer-assisted telephone interview. RESULTS Overall, 8.8% of the respondents had ever used a solarium and less than 1% had used a solarium in the previous year. Results indicated that users were more likely to be female and younger than non-users, and less than half of the users signed a consent form, suggesting that they had not been made aware of the associated risks by operators. CONCLUSIONS The Queensland Cancer Risk Study was one of the first population-based studies to address solarium use in this State and highlights that the use of solariums in Queensland is low in comparison to other countries. IMPLICATIONS There is no regulation of compliance with guidelines. It may become necessary to make compliance with the guidelines mandatory to effectively communicate the associated risks.
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Affiliation(s)
- Sheleigh P Lawler
- Cancer Prevention Research Centre and Viertel Centre for Research in Cancer Control, Queensland Cancer Fund.
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30
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Boyd AS. UV light exposure counseling and reality. J Am Acad Dermatol 2006; 55:503-5. [PMID: 16908358 DOI: 10.1016/j.jaad.2006.05.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Revised: 04/05/2006] [Accepted: 05/08/2006] [Indexed: 10/24/2022]
Affiliation(s)
- Alan S Boyd
- Department of Medicine (Dermatology), Vanderbilt University, Nashville, Tennessee, USA.
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Gallagher RP, Spinelli JJ, Lee TK. Tanning beds, sunlamps, and risk of cutaneous malignant melanoma. Cancer Epidemiol Biomarkers Prev 2005; 14:562-6. [PMID: 15767329 DOI: 10.1158/1055-9965.epi-04-0564] [Citation(s) in RCA: 180] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND A number of studies have been conducted evaluating the risk of cutaneous malignant melanoma after exposure to sunlamps and/or sunbeds. The proportion of subjects in the individual studies who have reported exposure has, in general, been modest, and the resulting risk estimates for melanoma have been unstable with wide 95% confidence intervals (95% CI). The inconclusive results seen in individual studies have resulted in confusion as to the carcinogenicity of these devices. METHODS We conducted a systematic review and meta-analysis of these studies. A review of the literature from Jan 1, 1984 to April 2004 using MEDLINE identified 12 case-control studies and 1 cohort study which quantitatively evaluated the use of sunlamps and/or sunbeds and subsequent melanoma. After applying exclusion/inclusion criteria, 9 case-control and 1 cohort study provided data for the analysis. Summary odds ratios (OR) and 95% CIs for sunlamp/sunbed use and subsequent melanoma were calculated using a random-effect model. RESULTS Ten studies provided data for assessment of melanoma risk among subjects who reported "ever" being exposed compared with those "never" exposed. A positive association was found between exposure and risk (summary OR, 1.25; 95% CI, 1.05-1.49). Significant heterogeneity between studies was present. Evaluation of the metrics "first exposure as a young adult" (5 studies) and "longest duration or highest frequency of exposure" (6 studies) also yielded significantly elevated risk estimates (summary OR, 1.69; 95% CI, 1.32-2.18, and 1.61; 95% CI, 1.21-2.12, respectively, with no heterogeneity in either analysis). CONCLUSIONS Results indicate a significantly increased risk of cutaneous melanoma subsequent to sunbed/sunlamp exposure.
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Affiliation(s)
- Richard P Gallagher
- Cancer Control Research Program, British Columbia Cancer Agency, Vancouver, BC, Canada.
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Abstract
The use of UVB and/or UVA emitting devices for cosmetic tanning is widespread in Western populations including young people and is especially prevalent in females. Several epidemiological studies, although not all, have shown a significant relationship between the use of tanning devices and malignant melanoma after, in some cases, adjustment for confounding factors such as solar ultraviolet radiation (UVR) exposure. A relationship between solar exposure, especially intermittent exposure, and malignant melanoma is well established so it is not surprising that a similar connection has been reported for the use of tanning devices. Several epidemiological studies show that childhood exposure to sunlight is a risk factor for malignant melanoma and this may also be the case for the use of tanning devices, especially if sunburns are obtained. Some studies have evaluated the relationship between the use of tanning devices and non-melanoma skin cancer and at least one has suggested an association. The use of tanning devices by a substantial minority of young people is a worrying trend in terms of a likely increased incidence of malignant melanoma, and possibly non-melanoma cancers in the future. Although two recent reviews by epidemiologists conclude that a clear link between tanning devices and malignant melanoma is yet to be proven, there is a strong case for effective legislation to prohibit the use of tanning devices by people under 18 yr of age.
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Affiliation(s)
- Antony R Young
- St John's Institute of Dermatology, Guy's, King's and St Thomas' School of Medicine, King's College London, London, UK.
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