UV Driven Tanning Salons: Danger on Main Street.

Appearing in the early 1980s, at a time when UVA was considered as relatively safe, the tanning industry has substantially developed in occidental countries, especially in Northern European countries. In Europe, the erythemally-weighted irradiance of a modern sunbed should not exceed 0.3 W/m2, equivalent to an UV index of 12, i.e. to a tropical midday sun, but increased in recent years, the UV spectrum emitted by sunbeds had evolved towards higher UVA irradiance and solariums UV had become even less similar to natural sun.

Anatomical UV Exposure in French Outdoor Workers.

BACKGROUND: Solar ultraviolet has been recognized as the main causative factor for skin cancer and is currently classified as a carcinogenic agent by International Agency for Research on Cancer. METHOD: Results from a previous phone survey conducted in 2012 in France were used to assess exposure conditions to sun among outdoor workers. Satellite data were used in combination with an exposure model to assess anatomical exposure. RESULT: The yearly median exposure of the outdoor worker population is 77  kJ/m2 to 116  kJ/m2. Road workers, building workers, and gardeners are the more exposed. About 70% of the yearly dose estimate is due to the cumulative summer and spring exposures. CONCLUSIONS: This study highlights the role of individual factors in anatomical exposure and ranks the most exposed body parts and outdoor occupations. Prevention messages should put emphasis on spring exposure, which is an important contributor to the yearly dose.

Occupational UV exposure in French outdoor workers.

OBJECTIVES: Occupational ultraviolet (UV) exposure was evaluated in a population-based sample in France. METHODS: A random survey was conducted in 2012 in individuals aged 25 to 69 years. The median daily standard erythemal UV dose (SED) was estimated from exposure time and place and matched to satellite UV records. RESULTS: A total of 889 individuals were exposed to solar UV with highest doses observed among gardeners (1.19 SED), construction workers (1.13 SED), agricultural workers (0.95 SED), and culture/art/social science workers (0.92 SED). Information and communication technology, industry, and transport workers were highly exposed (>0.70 SED). Significant factors associated with high occupational UV exposure were sex (P < 0.0001), phototype (P = 0.0003), and taking lunch outdoors (P < 0.0001). CONCLUSIONS: This study identified not only expected occupations with high UV exposure but also unexpected occupations with high exposures. This could serve as a basis for future prevention.

Tanning salons and skin cancer.

Indoor tanning has substantially grown in USA and Europe, more especially in the sun-deprived Northern countries, but also in more sunny countries such as Queensland, Australia. Several studies have specifically addressed the prevalence of sunbed use by children and adolescents in Northern Europe and in the USA, and showed that up to 40-50% of teenagers 15-18 years old had ever used indoor tanning, the highest figures being observed among girls in Scandinavia and Minnesota. Indoor tanning among adults is mostly prevalent in age classes younger than 45. Epidemiological studies have shown that exposure to sunbeds increases the risk of both melanoma and non-melanoma skin cancers: a meta-analysis of 19 studies published before 2006 showed that ever-use of sunbeds was positively associated with melanoma (summary relative risk, 1.15; 95% CI, 1.00-1.31), and first exposure before 35 years of age significantly increased melanoma risk (7 studies, RR = 1.75; 95% CI, 1.35-2.26). Further epidemiological data documented the links between artificial UV tanning and melanoma: two large case-control studies in Minnesota and Australia yielded higher melanoma risks for ever use of sunbeds: 1.74 (95%CI, 1.42-2.14) and 1.41 (95%CI, 1.01-1.96) respectively, risk increasing with greater use and earlier age at first use. The most compelling evidence derives from a large cohort of Norwegian and Swedish women which showed that melanoma risk increased with accumulating exposure (RR for solarium use ≥1 time per month in two or three decades, 10-39 years, 2.37 (95%CI, 1.37-4.08)). In addition, the analysis of a melanoma epidemic observed in Iceland between 1995 and 2002, on the trunk of women younger than 50, pointed out the possible role of the explosion of exposure to sunbeds in this country after 1985. Exposure to artificial ultraviolet is a risk factor for melanoma. Risk appears modest in the general population, but concentrates in the population that started sunbed use before the age of 35; the risk attributable to sunbed use in melanoma patients younger than 30 may be as high as 43 to 76%. Of particular concern is the use of sunbeds by adolescents. Use of sunbeds should be strongly discouraged, and banned under the age of 18.

A multicentre epidemiological study on sunbed use and cutaneous melanoma in Europe.

A large European case-control study investigated the association between sunbed use and cutaneous melanoma in an adult population aged between 18 and 49 years. Between 1999 and 2001 sun and sunbed exposure was recorded in 597 newly diagnosed melanoma cases and 622 controls in Belgium, France, The Netherlands, Sweden and the UK. Fifty three percent of cases and 57% of controls ever used sunbeds. The overall adjusted odds ratio (OR) associated with ever sunbed use was 0.90 (95% CI: 0.71-1.14). There was a South-to-North gradient with high prevalence of sunbed exposure in Northern Europe and lower prevalence in the South (prevalence of use in France 20%, OR: 1.19 (0.68-2.07) compared to Sweden, prevalence 83%, relative risk 0.62 (0.26-1.46)). Dose and lag-time between first exposure to sunbeds and time of study were not associated with melanoma risk, neither were sunbathing and sunburns (adjusted OR for mean number of weeks spent in sunny climates >14 years: 1.12 (0.88-1.43); adjusted OR for any sunburn >14 years: 1.16 (0.9-1.45)). Host factors such as numbers of naevi and skin type were the strongest risk indicators for melanoma. Public health campaigns have improved knowledge regarding risk of UV-radiation for skin cancers and this may have led to recall and selection biases in both cases and controls in this study. Sunbed exposure has become increasingly prevalent over the last 20 years, especially in Northern Europe but the full impact of this exposure on skin cancers may not become apparent for many years.