Consequences of banning commercial solaria in 2016 in Australia.

OBJECTIVE: To quantify the consequences of a total ban on indoor tanning for short-term regulatory enforcement, for consumers, and the longer-term health economic effects. METHODS: Instances of illegal solarium prosecutions and tanning bed confiscations in the state of Victoria (population 7 million) were obtained from government surveillance records. Consumer interest for indoor tanning and spray/fake tanning were assessed using Google Trends' Search Volume Index (range 0 to maximum 100). Long-term health economic effects were estimated using a Markov cohort model. RESULTS: The Victorian Government completed 13 prosecutions and confiscated 39 illegal tanning units. Consumer interest for indoor tanning reduced to less than one quarter of pre-regulation seasonal peaks (Search Volume Index 12/48) while spray tanning interest remained high (70-88). For young Australians over their remaining lives, banning commercial indoor tanning is expected to avert 31,009 melanomas (-3.7%), avert 468,249 keratinocyte cancers (-3.6%) and save over AU$64 (US$47) million in healthcare costs and produce over AU$516 (US$375) million in productivity gains. CONCLUSIONS: Three years after the nationwide ban, regulation enforcement activities have decreased, and consumers have adopted substitute tanning methods.

Interventions to Increase Blood Donation among Ethnic/Racial Minorities: A Systematic Review.

Ethnic/racial minorities are under-represented in blood donor populations in most developed countries. This is of particular concern where minorities differ from a country's majority population in terms of blood or tissue typing, especially where type matching is required for effective management of rare disorders such as sickle-cell disease that require multiple transfusions. This systematic review assessed the effectiveness of interventions to increase blood donation among ethnic/racial minority populations in developed countries. We searched MEDLINE, EMBASE, CINAHL, and ProQuest on 20 March 2017 with no date restrictions and supplemented this with searches on Google Scholar, blood collection agency websites, reference lists of included studies, and a forward search of citations of included studies. We included intervention studies designed to increase recruitment and/or retention of adult, ethnic/racial minority blood donors in developed countries. The review identified eight studies reported in nine publications. Six were conducted in the USA with African Americans. Four studies reported on multifaceted, community-based interventions; three reported on one-off information and educational video interventions, presented face-to-face, or delivered via post or e-mail. The level of evidence for efficacy was low, and the majority of studies were assessed as having some risk of bias related to one or more methodological issues. All eight studies reported positive outcomes in blood donation and/or intention to donate. Seven trials found that the intervention increased presentation for donation, and three found an increase in the percentage of new donors from the ethnic minority targeted. The review findings demonstrate that it is possible to design and implement effective interventions to motivate individuals from ethnic/racial minority groups to donate blood. One-off interventions may be as effective as multifaceted, community-based interventions. There was insufficient evidence to recommend particular interventions, and future research should empirically assess alternative interventions using robust study designs.

Implications of lessons learned from tobacco control for tanning bed reform.

Tanning beds used according to the manufacturer's instructions expose the user to health risks, including melanoma and other skin cancers. Applying the MPOWER model (monitor, protect, offer alternatives, warn, enforce, and raise taxes), which has been used in tobacco control, to tanning bed reform could reduce the number of people at risk of diseases associated with tanning bed use. Among the tactics available to government are restricting the use of tanning beds by people under age 18 and those with fair skin, increasing the price of tanning bed services through taxation, licensing tanning bed operators, and banning unsupervised tanning bed operations.

Fifty years of changes in UV Index and implications for skin cancer in Australia.

Surface ultraviolet (UV) radiation plays an important role in human health. Increased exposure to UV radiation increases the risk of skin cancer. In Australia, public campaigns to prevent skin cancer include the promotion of daily UV forecasts. If all other atmospheric factors are equal, stratospheric ozone decreases result in UV increases. Given that Australia still has the highest skin cancer rates in the world, it is important to monitor Australia's stratospheric ozone and UV radiation levels over time because of the effects cumulative exposure can have on humans. In this paper, two long-term ozone datasets derived from surface and satellite measurements, a radiation code and atmospheric meteorological fields are used to calculate clear-sky UV radiation over a 50-year period (1959-2009) for Australia. The deviations from 1970-1980 levels show that clear-sky UV is on the rise. After the 1990s, an overall annual increase from 2 to 6% above the 1970-1980 levels was observed at all latitudes. Examining the summer and winter deviations from 1970-1980 showed that the winter signal dominated the annual changes, with winter increases almost twice those in summer. With ozone levels not expected to recover to pre-depletion levels until the middle of this century, UV levels are expected to continue to rise. Combined with Australians favoring an outdoor life-style, when temperatures are warmer, under high levels of UV, the associated risk of skin cancer will increase.

Compliance with age and skin type restrictions following the introduction of indoor tanning legislation in Melbourne, Australia.

BACKGROUND/PURPOSE: The study aimed to establish compliance of indoor tanning businesses with 2009 legislation, particularly with requirements to provide information on skin cancer and exclude people under 18 or with fair skin. METHODS: Compliance was tested through surveys and in-person visits to 30 businesses in Melbourne, Australia. Research assistants presented as potential customers with different profiles: young adults eligible to use a sunbed, young adults with fair skin, under age customers who prompted with their age and under age customers who concealed their age and claimed to be 18 if asked. RESULTS: Communicating the risks of skin cancer during the visit improved from 70% in 2003, prior to the introduction of legislation, to 97% in 2009. While there were improvements in restricting access to sunbeds among high-risk groups, compliance of indoor tanning businesses with age and skin type restrictions remained less than optimal. Almost half (47%) allowed access to fair-skinned research assistants, compared with 90% in 2003. Only one of the 30 operators allowed access to a teenager who prompted with her age; in 2003, 52% of under age teenagers were granted access without parental consent. However, when teenagers concealed their age or claimed to be 18, 80% of operators granted them access. CONCLUSIONS: The findings suggest that regulation of the indoor tanning industry is a better approach to this health issue than voluntary standards and/or education. Nonetheless, inadequate compliance with requirements to exclude high-risk groups lends weight to calls for stricter monitoring and enforcement, or an absolute ban.

Changes in solarium numbers in Australia following negative media and legislation.

OBJECTIVE: To monitor changes in the number of indoor tanning facilities in Australia's capital cities following widespread negative publicity and the introduction of legislation in some states. METHODS: An audit of listings under Solarium/Tanning Centres in the most recent hard copy Yellow Pages for Australia's capital cities was conducted, and results were compared with those from a previous audit from 2006. RESULTS: There was a 32% drop in solarium listings for Australia's capital cities between 2006 and 2008/09. In most cases, larger decreases were observed in states where legislation was introduced. CONCLUSIONS: Despite underestimating solarium numbers, regular audits of business listings can be a useful way of monitoring trends, particularly when more accurate figures are not available. Solarium numbers can decrease following a combination of negative publicity and legislation. IMPLICATIONS: To achieve and maintain predicted reductions in skin cancer incidence, mortality and costs to the health system, solarium legislation should be a priority for those states where it has not yet been introduced, accompanied by compliance monitoring and enforcement to ensure it is effective.