Sunbed use legislation in Europe: assessment of current status.

BACKGROUND: The use of UV-emitting tanning devices for cosmetic purposes is associated with an increased risk of melanoma and non-melanoma skin cancer. Young women are the most frequent users, therefore, there is an increasing concern about the regulation of sunbed use. OBJECTIVE: The primary objective is to assess the current legislation on sunbed use among European countries. METHODS: We developed a 30-item questionnaire to gather the most relevant information about sunbed use legislation. The questionnaire was sent to Euromelanoma coordinators and to designated coordinators out of the Euromelanoma network. RESULTS: We obtained a response rate of 64%. More than 25% of the countries did not report any specific legislation. Roughly one-third of the countries does not have a restriction for minors. Even in countries with a specific legislation, a lack or insufficient enforcement of age limit was observed in up to 100% of the inspections based on the PROSAFE report from 2012. Self-tanning devices were reported in 50%, and almost 40% of countries do not require supervision of use. Although a warning display is required in 77% of cases, a signed informed consent is not required in 80%. In the vast majority of cases, the number of licensed or closed tanning centres is unknown. CONCLUSIONS: Despite the evidence of its harmful effects, and its frequent use by young people, many of whom are at high risk of skin cancer because of fair skin, a significant number of European countries lack a specific legislation on tanning devices. In order to limit the access of young people to sunbeds, a more strictly enforced regulation is needed, as well as regulation regarding advertisement, and location of tanning centres, in addition to health promotion campaigns that target the vulnerable population of young women seeking its use for improved cosmesis.

Ultraviolet exposure from indoor tanning devices: a systematic review.

Use of indoor tanning devices increases the risk of cutaneous melanoma and nonmelanoma skin cancer. Indoor tanning devices have become important sources of ultraviolet (UV) exposure, both UVB and UVA. This systematic review assessed UV measurements performed in indoor tanning devices related to irradiance level, wavelength distribution and similarities to natural sun. The study was performed in accordance with the MOOSE and PRISMA guidelines. We searched PubMed, Embase and Web of Science from inception to May 2015, and also examined the reference lists of the retrieved studies. Eighteen studies were included. Twelve studies examined the erythema-weighted UV irradiances of indoor tanning devices, 11 studies examined UVB and 13 studies studied UVA. Compliance with irradiance limits was reported in nine studies. Erythema-weighted irradiances were highest in the most recent studies. Most studies had mean values higher than from natural sun and with large variations between devices. All studies except two had mean unweighted UVB irradiances lower than from natural summer sun (at latitudes from 37°S to 35°N), while mean unweighted UVA irradiances were, with one exception, substantially higher than from natural sun. The high values of UVA exposure from modern tanning devices are alarming in light of the increased focus on UVA irradiance as a carcinogen, and as UVA exposure confers little protection against subsequent UV exposure.

Survey of the cosmetic use of lasers and other strong optical radiation sources.

A survey was undertaken regarding the extent to which optical radiation is used in cosmetic treatments and the compliance with national regulations. Questionnaires were sent to 65 clinics, and 23 of these were later inspected. Only one of 41 class 4 lasers had been reported to the authorities according to the regulations prior to the survey. Among sources other than lasers, intense pulsed light (IPL) sources were the most frequent. Although qualified health personnel should be in charge of the treatment, it was observed that 30% of the clinics did not fulfil this requirement. Deviations with respect to personnel training, availability of written procedures, protective equipment and warning signs were frequently observed. The results give rise to concern about the safety of patients and employees.