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PubMed2005

Indoor tanning by adolescents: prevalence, practices and policies.

Despite known acute and chronic health effects from the use of indoor tanning, including the potential for all forms of skin cancer, the practice is popular in the United States (US) and Europe. A review of the scientific literature that examines adolescents and indoor tanning use was undertaken, summarising what is known about prevalence and practices among adolescents, characteristics associated with adolescent use, and policies that regulate adolescent access to indoor tanning facilities. The prevalence of indoor tanning is consistently found to be higher among girls than boys and to increase with age in both Europe and the US. An examination of other demographic characteristics, skin cancer risk factors, knowledge, attitudes and social factors points to higher prevalence of the behaviour among adolescents with positive attitudes towards tans and whose friends or parents also tan indoors. Adolescent access to indoor tanning is rarely regulated in the US or Europe, and where regulations exist, business compliance is low. In addition, businesses actively market their product to adolescents as they organise to limit further regulations prohibiting adolescent access. Pricing, licensure, advertising restrictions and media campaigns, in combination with adolescent-targeted interventions, are possible strategies that could be tested for their effectiveness to reduce adolescent indoor tanning use. Harm reduction policies, such as eye protection, that reduce risk for adolescents who choose to tan indoors, are also important.

Adolescent↗
PubMed2005

Solaria compliance in an unregulated environment: the Australian experience.

This study aimed to explore compliance with international recommendations on solaria use in a unregulated setting. Simulated customers visited 176 solaria operating in Australia and two face-to-face visits and one telephone contact were made for each establishment. From the survey, establishments compliant with the recommendations ranged from: 1.1% refusing access to the customer with skin type I; 9.7% recommending to the customer with skin type I against solaria use and up to 87.5% assessing skin type and recommending eye protection. Few (15.9%) were compliant with more than 10 of the 13 recommendations. Establishment type and number of sunbeds were significantly associated with compliance. This study has shown that a much higher level of compliance with recommendations, particularly those excluding higher-risk groups, is required to reduce the harm associated with use of solaria. While new legislation may be useful, other harm minimisation strategies including mandatory staff training and taxation should be considered.

Adult↗
PubMed2006

Sun exposure and sunburn among Swedish toddlers.

Skin cancer is an emerging public health problem in Sweden. Even though the most important preventable risk factor for the development of skin cancer--sun exposure--is known, the incidence of skin cancer is still increasing. Studies have showed an association between increased risk of skin cancer and sunburn early in life. The aim of the present paper was to examine the frequency of sun exposure, sunburn and use of sun protective measures among an urban sample of Swedish toddlers. In March 2003, the parents of 4000 randomly selected children born between September 2001 and August 2002 were contacted by mail, and asked to fill out an enclosed questionnaire. The questionnaire concerned their own and their one-year-old child's sun exposure and sunburn history, and a few questions about knowledge, attitudes and protective activities were also included. One fifth of the children had been severely sunburnt at least once. Thirty-six percent of all children had been abroad on vacation to a sunny resort. More knowledge among parents increased the likelihood that the child was properly protected when in the sun, and parents own time in the sun was positively related to child's time in the sun. Being of the opinion that children look healthier when tanned was also positively associated with child sunburn. Thirty-five percent of all parents spent two hours or more in the sun during peak hours (11a.m. - 3p.m.) on a typical work-free day in the summer, and almost 10% of all parents had their children exposed to the sun for two hours or more during peak hours. We conclude that children in Sweden seem to get exposed to extensive sun exposure very early in life. Information and increased knowledge among parents to young children seems to be a potential way of increasing sun protection behaviour and decrease sun exposure among very young children.

Child, Preschool↗
PubMed2005

Actinic damage among patients with psoriasis treated by climatotherapy at the Dead Sea.

BACKGROUND: Dead Sea climatotherapy is highly effective in the treatment of psoriasis. However, its potential side effects, especially the risk of skin cancer, are unclear. OBJECTIVE: We sought to determine the prevalence of solar damage and skin cancer among patients with psoriasis who underwent Dead Sea climatotherapy compared with control patients. METHODS: This multicenter controlled cross-sectional study was carried out at the Dead Sea Solarium Clinic and outpatient clinics of the participating centers. A total of 1198 participants (460 patients with psoriasis and 738 control patients) aged 20 to 70 years were included. A standard questionnaire including demographic parameters and sun exposure habits was administered to all participants. Patients were questioned about previous psoriatic treatments and climatotherapy at the Dead Sea. All participants underwent a structured physical examination of the skin. We compared the prevalence of solar damage for patients with psoriasis and control patients and assessed the extent of photodamage among patients with psoriasis according to exposure time at the Dead Sea in univariate and multivariate analyses. RESULTS: Elastosis ( P < .001), solar lentigines (P = .03), poikiloderma (P < .001), and facial wrinkles (P < .001) were significantly more common among patients with psoriasis compared with control patients and showed a dose response with increased Dead Sea exposure time. Self-reported previous skin cancers were more common in control patients compared with patients with psoriasis (8.2% vs 3.5%, P = .002), however, the prevalence of nonmelanoma skin cancer on examination did not differ between the two groups. No cases of malignant melanoma were detected in either group. CONCLUSIONS: Dead Sea climatotherapy is not associated with an increased risk of malignant melanoma or nonmelanoma skin cancer for patients with psoriasis in Israel. However, UV exposure at the Dead Sea may play a role in the development of solar damage.

Adult↗
PubMed2004

Tiny cripples and the sunshine of life: 15 years of children's nursing at Vancouver Island's Queen Alexandra Solarium 1927-1942.

The establishment of children's hospitals became one of the most important legacies of the child-saving movement in the early 20th century. As children's hospitals became more focused on acute and curable illnesses, facilities were developed to provide care and support for "crippled" or "incurable" children. The Queen Alexandra Solarium provided long-term care for crippled children in Western Canada and was developed to augment the acute care services of the British Columbia Children's Hospital. The staff of the solarium provided "healing by nature's method"-rest, fresh air and sunshine, nutritious food, and gentle nursing care-in the calming beachside location of Saanich Inlet on Vancouver Island. Examination of available hospital documentation from the years 1927 through 1942 shows that nurses played a key, yet silent role, in the extended care of chronically ill children.

British Columbia↗
PubMed2004

Attitudes, subjective norms and perception of behavioural control as predictors of sun-related behaviour in Swedish adults.

BACKGROUND: Exposure to ultraviolet (UV) radiation is the major preventable cause of skin cancer. The aim of this study was to investigate the explanatory value of attitudes, subjective norms and perceived behavioural control on behaviours related to UV exposure. METHOD: A random population-based sample (n = 1752, 18-37 years of age) in the Stockholm County, Sweden, answered a questionnaire with items on sun related behaviours and beliefs. The items concerned issues influenced by the Theory of Planned Behaviour, that is, attitudes, subjective norms and perceived behavioural control. Logistic regression analysis was used to examine the associations between behaviours and beliefs. RESULTS: Positive attitudes towards being tanned and being in the sun were both strongly associated with time spent in the sun, intentional tanning, sunbed use, going on vacation to a sunny resort, intention to decrease sunbathing and use of protection against the sun. Perceiving sunbathing as risky was associated with using different ways to protect and intending to reduce sun exposure. Having people around oneself who frequently sunbathe was related to intentional tanning and vacations to sunny resorts. Finally, perceived behavioural control was associated with use of sunscreen and use of other ways to protect from the sun among women. CONCLUSION: The study identified factors on which primary preventive interventions towards decreasing sun exposure should be focused.

Adolescent↗
PubMed2003

The evolution of current medical and popular attitudes toward ultraviolet light exposure: part 3.

In the 1930s, attitudes toward ultraviolet (UV) light exposure began to change significantly within the medical profession. UV radiation had been promoted as healthful since the century's start, and particularly after the discovery of its role in vitamin-D metabolism. Increasingly, however, attention would focus on the risks of UV light exposure from sunlamps and sunbathing. During this time, the American Medical Association established guidelines for the approval of UV lamps and the appropriate therapeutic uses of phototherapy. The landmark experiments of Findlay and other researchers, in which malignant skin tumors were induced in rodents after exposure to UV lamps or sunlight, would lead to widespread recognition of the carcinogenicity of UV radiation. The role of sunlight in the etiology of skin cancer was increasingly mentioned in articles in popular magazines in the 1940s and 1950s. There was rapid growth of the sunscreen industry as well, although product efficacy remained highly variable. In the 1950s, interest developed in the use of 8-methoxypsoralen ("the suntan pill") and dihyroxyacetone ("suntan in a bottle"). In spite of the known risks of UV exposure and attempts by physicians and other health professionals to educate the public and modify behavior, suntanning has remained tenaciously popular. Today, excessive UV light exposure is recognized as the major cause of the approximately 1.3 million cases of skin cancer in the United States each year.

Attitude↗
PubMed1989

Possible ultraviolet A-induced lentigines: a side effect of chronic tanning salon usage.

A patient who developed lentigines after prolonged ultraviolet A (UVA) exposure in a tanning booth is described. The patient had no exposure to psoralens or furocoumarins. Histologic examination of a representative lentigo revealed melanocytic hyperplasia and cytologic atypia. Increased nevocytic activity with histologic dysplasia was present in several junctional nevi excised during the period of UVA exposure. Several studies have revealed significant effects of UVA on melanocytes. Patients should be cautioned to avoid tanning bed use in view of these potentially deleterious effects.

Adult↗
PubMed1999

A population-based survey on the use of artificial tanning devices in the Province of Québec, Canada.

BACKGROUND: The suntanning industry has grown up over the last decade in North America, mainly because tanned skin is socially desirable and artificial tanning is perceived as a "safe tan." However, exposure to UV radiation is known to cause adverse health effects. OBJECTIVE: The purpose of this study was to estimate the prevalence of use of tanning equipment in the Province of Québec and to characterize people who reported using these devices. METHODS: In 1996, a telephone survey was carried out among adults from the two most densely populated regions (Montréal, Québec) of the Province of Québec. The final sample included 1003 white persons 18 to 60 years old. Interviewers used a standardized questionnaire to document the characteristics of the participant, skin phototype, and exposure habits to artificial UV radiation sources. RESULTS: During the last 5 years before the survey, 20.2% of the respondents reported they had used, at least once, a tanning device in a commercial tanning salon. The rate of use during the last 12 months before the study was 11.1%. A significantly higher proportion of female, young people (18 to 34 years old) and single persons was found among tanning bed users. Twenty-six percent of users experienced one or more acute adverse health effects from the artificial UV irradiation. Most of these were cases of skin burns. A high proportion (77.5%) of those who used tanning equipment during the last year before the study said they would return to tanning salons. The intention of returning to a tanning salon was not influenced by the occurrence of the acute adverse health effects. The most prevalent reason given for using tanning equipment was "to improve their appearance by a tan." Most people (60.4%) who used a tanning bed during the last 5 years before the study believe that tanning salons are not dangerous. CONCLUSION: This survey indicates that tanning bed use is very prevalent in the Province of Québec, mainly among young women. The high rate of acute adverse health effects related to artificial tanning, particularly skin burns, is of concern. Finally, our results underline the importance of changing attitudes and beliefs in the population regarding artificial tanning.

Adolescent↗
PubMed2003

Prostate cancer risk and exposure to ultraviolet radiation: further support for the protective effect of sunlight.

Recent studies have suggested that exposure to ultraviolet (UV) radiation may be protective to some internal cancers including that in the prostate. We describe a confirmatory study in 212 prostatic adenocarcinoma and 135 benign prostatic hypertrophy patients designed to determine whether previous findings showing a protective effect for UV exposure could be reproduced. We used a validated questionnaire to obtain data on aspects of lifetime exposure to UV. The data confirmed that higher levels of cumulative exposure, adult sunbathing, childhood sunburning and regular holidays in hot climates were each independently and significantly associated with a reduced risk of this cancer.

Adenocarcinoma↗
PubMed2003

Associations between prostate cancer susceptibility and parameters of exposure to ultraviolet radiation.

Low sunlight exposure confers increased prostate cancer risk. In a study conducted in northern England, we investigated how combinations of exposure measures affect this risk. Recursive partitioning was used to identify combinations of exposure parameters that distinguished 453 prostate cancers from 312 benign hypertrophy patients. Sunbathing score most significantly defined cancer patients; 78.7% men with low scores (</=3.0) and 40.2% men with high scores (>8.0) had cancer. These subgroups were stratified by childhood sunburning, holidays in a hot climate and skin type such that subgroups with a 13.0-fold increased risk of cancer were identified.

Adenocarcinoma↗