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New Brunswick doctors say ban the tan

Artificial UV tanning has been classified as a carcinogen by the World Health Organisation, and is banned for minors in many Canadian jurisdictions. Despite many guidelines, the industry continues to target young girls as prime clients for many reasons.

To respond to the clinical and social challenges inherent in underage artificial UV tanning, New Brunswick doctors are asking for a complete ban on artificial ultraviolet tanning for New Brunswickers under 19.

Background

New Brunswick was once a leader in preventing minors’ access to carcinogens. From 1992 to 2009, New Brunswick was the only province in Canada that banned children and youth from using tanning beds.[i]

When the new Public Health Act was created and the Radiation Act repealed, it omitted a section to govern the use of artificial UV tanning equipment by minors. In 2010, the Chief Medical Officer of Health announced voluntary guidelines, which include an age limit of 18, a ban on advertising any health benefits of artificial tanning and a limit of one tan every 48 hours.[ii] At the time, the industry was warned that if they failed to comply with the voluntary guidelines, they would face legislation.

Similar to national findings,[iii]a 2012evaluation conducted in New Brunswick found that 55% of tanning salon operators in New Brunswick would have allowed someone under 18 to use artificial tanning equipment.[iv] This follows on 2011 reports that 75% of tanning salons failed to display mandatory health warnings.

This year, a New Brunswick study of high school students found that 17% had recently used artificial UV tanning equipment. The findings showed that use is progressive with age, to the point where 1/3 of young girls were using tanning equipment by Grade 12.[v]

What are the clinical impacts?

Tanning comes from the impact of UVA and UVB rays on skin. Despite common myths, no tan is a safe tan. Tanning of any form has been linked to melanoma, the most deadly form of skin cancer. Its incidence is on the rise in both men and women in Canada. Last year in New Brunswick, approximately 170 people were newly diagnosed with melanoma, and 20 New Brunswickers died of this cancer.[vi]

Artificial UV tanning equipment is particularly dangerous; it has been classified as carcinogenic for humans.[vii],[viii] In fact, it has been recently reclassified to the highest cancer risk category by the International Agency for Research on Cancer – which groups the safety of artificial UV tanning with activities like smoking, paving, painting, ironworking, and chimney sweeping.

While tanning outside is also unsafe, the reason why indoor tanning equipment is so dangerous is because the UVA emissions can be five times that of the mid-day sun.[ix] For example, twenty minutes of exposure in a tanning bed may equal up to two hours spent on the beach under the hot mid-day sun with no sun protection.[x]

What is known about tanning in youth?

Tanning before the age of 30 is particularly risky[xi] because there is research which shows a link with a heightened lifelong risk of melanoma.[xii] In 2006, a systematic review showed that people who said they had ever used artificial UV tanning equipment before age 35 had a 75% increased risk of melanoma.[xiii] A 2012 update showed that risk increasing to 87%.[xiv]

Contrary to what many people think, artificial UV tanning does not provide any protection against future UV damage to the skin. [xv]  

For these reasons, the World Health Organization (WHO) released a 2005 recommendation that no person under the age of 18 should use a sunbed.[xvi]

Why do we need a ban for youth under 19?

We know that parental consent does not work. A large study conducted in the US showed that there was no significant difference in artificial UV tanning behaviour among adolescents in states with adolescent access laws, such as parental consent, versus states without such laws.

Other jurisdictions, such as Minnesota and Massachusetts, have also found that parental consent is an ineffective way to reduce the number of youth who tan. Closer to home, in the aforementioned 2012 study of New Brunswick high schoolers, a third of underage UV tanners were brought to the tanning bed by their parents.

We do not allow minors to buy cigarettes or alcohol with their parents’ permission, but adults have the ability to make their own decisions about their bodies. We note with disappointment that fifty years after we learned that smoking is incredibly harmful, you can still walk into any corner store in New Brunswick and buy a package of cigarettes. It’s important for everyone to take responsibility for their own health choices when they have reached an age that they are able to.

While we believe artificial UV tanning should only be available to those 19 and older, we discourage everyone from doing it. We note that other jurisdictions ban artificial UV tanning from entire countries, or for everyone under 30. Our warning applies for tanning even in the summertime sun.

What’s happening elsewhere?

Newfoundland and Labrador, Nova Scotia, British Columbia, and Quebec all have regulations prohibiting tanning bed use for those under 19. The Ontario Medical Association and other Provincial/Territorial Medical Associations have called for provincial bans in their respective jurisdictions.

Internationally, the Australian state of New South Wales introduced a ban that includes those in their twenties. In November 2009, Brazil banned the use of tanning beds altogether.  Belgium, Germany, Scotland, Spain, Portugal, California, and Texas all have bans in place against the use of tanning beds by people under 18.  France also bans the use of tanning beds for people under 18, and stipulates that any claims about the health benefits of tanning beds are forbidden.

 


[i] http://www.cbc.ca/news/canada/new-brunswick/story/2011/01/17/nb-tanning-rules-959.html

[ii] http://www2.gnb.ca/content/dam/gnb/Departments/h-s/pdf/en/Publications/GuidelinesforTanningSalonOwnersandOperatorsNov2010.pdf

[iii] http://www.cbc.ca/news/canada/new-brunswick/story/2012/06/05/tanning-beds-minors.html

[iv] http://www.cbc.ca/news/canada/new-brunswick/story/2012/03/06/nb-tanning-salon-legislation-cancer.html

[v] Prior, S.M., Fenwick, K.D., Bremner, J., & Lamb, M. (2012, April). "Look Good. Feel Great!": Understanding Tanning Motivations and Behaviors in Adolescents. Paper presented at a workship entitled Tanning Bed Legislation: Protecting Youth Coast to Coast. Halifax, NS.

[vi] http://www.cancer.ca/New%20Brunswick/About%20us/Media%20centre/NB-Media%20releases/Tanning%20guidelines%20fail%20to%20protect%20youth.aspx?sc_lang=EN#ixzz29gFzanMS

[vii] IARC: Ghissassi et al. Special Report: Policy. A review of human carcinogens—Part D: Radiation. Lancet Oncology. 2009; 10:751–752. 

[viii] http://ntp.niehs.nih.gov/?objectid=72016262-BDB7-CEBA-FA60E922B18C2540

[ix] Gerber et al. Ultraviolet emission spectra of sunbeds. Photochemistry and Photobiology. 2002; 76(6):664–8.

[x]http://www2.gnb.ca/content/gnb/en/departments/ocmoh/healthy_people/content/tanning_and_uv_abradiation/tanning_myths_revealed.html

[xi] http://ntp.niehs.nih.gov/?objectid=72016262-BDB7-CEBA-FA60E922B18C2540

[xii] Gruber and Armstrong. Cutaneous and Ocular Melanoma. In Schottenfeld and Fraumeni (Eds) Cancer Epidemiology and Prevention. (pp1196–1229) New York: Oxford University Press. 2006.

[xiii] Summarized in: IARC working group on artificial UV light and skin cancer. The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. International Journal of Cancer. 2007; 120(5):1116–22.

[xiv] Boniol M, Autier P, Boyle P, Gandini S. Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis. BMJ. 2012; 345:e4757.

[xv] IARC Working Group on Artificial Ultraviolet (UV) Light and Skin Cancer. The association of use of sunbeds with cutaneous malignant melanoma and other skin cancers: A systematic review. International Journal of Cancer. 2006;120(5):1116–1122. Available at http://onlinelibrary.wiley.com/doi/10.1002/ijc.22453/pdf

[xvi] http://www.who.int/mediacentre/news/notes/2005/np07/en/index.html