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Bonilla C, Mejia-Lancheros C. The Skin We Live in: Pigmentation Traits and Tanning Behaviour in British Young Adults, an Observational and Genetically-Informed Study. Genes (Basel) 2022; 13:896. [PMID: 35627282 PMCID: PMC9140533 DOI: 10.3390/genes13050896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023] Open
Abstract
Skin cancer incidence has been increasing worldwide, representing a particularly high burden for populations of European ancestry. Outdoor and indoor tanning using ultraviolet (UV) radiation devices are major risk factors for skin cancer. While tanning behaviours can be modified by targeted interventions to reduce skin cancer rates, there is insufficient evidence on the motivations for tanning preferences and their relationship with pigmentation phenotypes. The present observational and genetically-informed study investigates motives for tanning and the role that pigmentation phenotypes play on outdoor and indoor tanning behaviour in British young adults. This study included 3722 participants from the Avon Longitudinal Study of Parents and Children in South West England, with data on pigmentation features, tanning ability and preferences, and SNP genotypes. Liking to tan and outdoor tanning were strongly influenced by pigmentary traits and tanning ability. However, the association of these phenotypes with UV indoor tanning was weaker. Our results provide evidence to support the implementation of skin cancer preventative interventions that consider individual biological characteristics and motives for undergoing outdoor and indoor tanning.
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Affiliation(s)
- Carolina Bonilla
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo CEP 01246-903, Brazil
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK
| | - Cilia Mejia-Lancheros
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, Toronto, ON M5B 1W8, Canada;
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Lyons S, Lorigan P, Green AC, Ferguson A, Epton T. Reasons for indoor tanning use and the acceptability of alternatives: A qualitative study. Soc Sci Med 2021; 286:114331. [PMID: 34438184 DOI: 10.1016/j.socscimed.2021.114331] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 07/26/2021] [Accepted: 08/19/2021] [Indexed: 01/08/2023]
Abstract
RATIONALE Using indoor tanning devices is associated with substantial health consequences, such as an increased risk of melanoma and other skin cancers. Many people including minors and some at high risk of skin cancer continue to use these devices. In the absence of effective restrictions on use, it is important that behaviour change interventions are designed to reduce indoor tanning. OBJECTIVE To explore reasons for use of indoor tanning devices and the acceptability of alternatives in adult users residing in North-West England. METHODS Participants were required to be current indoor tanners aged 18 years and above and were recruited online. Twenty-one participants took part in either a focus group or semi-structured interview. An inductive thematic analysis was conducted. RESULTS Six themes were identified: psychological benefits; improving physical health; denial of health risks; alternatives do not meet psychological needs; alternatives do not meet physical needs; and perceived side-effects. Participants used indoor tanning devices to improve their self-esteem and to prevent sun damage to their skin (by gaining a 'base tan'). Participants appeared to justify their usage by responding defensively to avoid accepting they were at risk, exaggerating the benefits of indoor tanning, and discounting alternatives to indoor tanning. Alternatives to indoor tanning were perceived as risky for health, inadequate to provide the desired aesthetic, and incapable of meeting their self-esteem needs. CONCLUSIONS Interventions to reduce indoor tanning behaviour should increase sources of self-esteem other than appearance, increase media literacy and address defensive responses to information around indoor tanning and alternatives. Further research is needed to develop these interventions and assess their feasibility.
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Affiliation(s)
- Stephanie Lyons
- Manchester Centre for Health Psychology, The University of Manchester, Oxford Road, M13 9PL, UK
| | - Paul Lorigan
- Division of Cancer Sciences, The University of Manchester, UK; Christie NHS Foundation Trust, Manchester, UK
| | - Adele C Green
- Cancer Research UK Manchester Institute, The University of Manchester, UK; QIMR Berghofer Medical Research Institute, Australia
| | - Ashley Ferguson
- Cancer Research UK Manchester Institute, The University of Manchester, UK
| | - Tracy Epton
- Manchester Centre for Health Psychology, The University of Manchester, Oxford Road, M13 9PL, UK.
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3
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Költő A, Rodriguez L, McAvoy H, Nic Gabhainn S. Sunburn, Sun Safety and Indoor Tanning Among Schoolchildren in Ireland. Int J Public Health 2021; 66:1604045. [PMID: 34335148 PMCID: PMC8284860 DOI: 10.3389/ijph.2021.1604045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/20/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: We present patterns of sunburn, sun safety behaviors and indoor tanning bed use in a nationally representative sample of schoolchildren aged 10–17. These behaviors were explored across gender, age, and social class groups. Methods: Within the Health Behaviour in School-aged Children (HBSC) Ireland study, 10,271 young people (aged 13.54 ± 1.92, percentage girls 53.3%) reported frequency of sun safety behaviors, sunburn, and frequency and circumstances of indoor tanning bed use. Results: Children frequently experienced sunburn (90% lifetime, 74% last year), and 3% reported never using any sun protection. Applying sunscreen and wearing sunglasses were the most commonly used sun safety measures; other ways of sun protection were less popular. Indoor tanning bed use was reported by around 5%, and a large proportion of users were not advised of any indoor tanning safety measures. Sun safety behaviors varied by age and gender, with some socio-economic differences in tanning bed use. An association was found between frequency of family holidays abroad and sunburn. Conclusion: Targeted interventions are needed to increase sun safety behaviors and eliminate tanning bed use among children in Ireland.
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Affiliation(s)
- András Költő
- Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland
| | | | | | - Saoirse Nic Gabhainn
- Health Promotion Research Centre, National University of Ireland Galway, Galway, Ireland
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Sunbed Use among 11- to 17-Year-Olds and Estimated Number of Commercial Sunbeds in England with Implications for a 'Buy-Back' Scheme. CHILDREN-BASEL 2021; 8:children8050393. [PMID: 34068910 PMCID: PMC8156792 DOI: 10.3390/children8050393] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022]
Abstract
Prior to 2011 legislation prohibiting children from using commercial sunbeds, the prevalence of sunbed use in 15- to 17-year-olds in some areas in England was as high as 50%. Despite significant decreases since 2011, children today still practice indoor tanning. We estimated current sunbed use in 11- to 17-year-olds in England, the number of available commercial sunbed units, and the associated cost of a ‘buy-back’ scheme to remove commercial sunbeds under a potential future policy to ban sunbeds. We undertook a calibration approach based on published prevalence rates in English adults and other sources. Internet searches were undertaken to estimate the number of sunbed providers in Greater Manchester, then we extrapolated this to England. Estimated mean prevalence of sunbed use was 0.6% for 11- to 14-year-olds and 2.5% for 15- to 17-year-olds, equating to 62,130 children using sunbeds in England. A predicted 2958 premises and 17,865 sunbeds exist nationally and a ‘buy-back’ scheme would cost approximately GBP 21.7 million. Public health concerns remain greatest for 11- to 17-year-olds who are particularly vulnerable to developing skin cancers after high ultraviolet exposure.
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5
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Menzies S, Daly S, O’Connor R, Kelly A, Fitzgerald M, Bourke J, McKenna DB. A re-evaluation of teenage sunbed use following the introduction of banning legislation for under 18-year-olds. J Public Health (Oxf) 2020; 42:588-593. [DOI: 10.1093/pubmed/fdz015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 12/26/2018] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is little information on the effectiveness of introducing age restriction legislation alone to reduce the rate of sunbed usage by teenagers. Prior to the Public Health (Sunbed) Act of 2014 prohibiting the use of sunbeds in under 18-year-olds in Ireland we reported the rate of sunbed use at 7.5%.
Objectives
The aim of the study was to compare the rate of sunbed usage among Irish teenagers before and after the introduction of banning legislation to determine if it had the desired effect of reducing its rate of use.
Methods
In a cross-sectional survey, students from the same schools as in our previous study completed an anonymous, written questionnaire pertaining to sunbed usage.
Results
In total, 783 questionnaires, from 13 schools across Ireland, were completed. The rate of sunbed use in the current study was 7.2%, compared to 7.5% in the pre-ban study, (P = 0.76). A higher rate of sunbed use was observed in Dublin schools and female public students.
Conclusion
Our study suggests that legislation alone is ineffective at reducing sunbed usage in a teenage population. A multifaceted approach is required that includes enforcement of the legislation together with targeted public education and awareness campaigns using all aspects of the media.
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Affiliation(s)
- S Menzies
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - S Daly
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - R O’Connor
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - A Kelly
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - M Fitzgerald
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
| | - J Bourke
- Department of Dermatology, Cork University Hospital, Cork, Ireland
| | - D B McKenna
- Department of Dermatology, Sligo University Hospital, Sligo, Ireland
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6
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Skiljevic D, Sreckovic L. Ultraviolet radiation exposure among Belgrade high school students: analysis of knowledge, attitudes and behaviour. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:63-75. [PMID: 30811695 DOI: 10.1111/jdv.15312] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND The incidence of melanoma has been increasing worldwide. Extended UV exposure during childhood or adolescence significantly increases the probability of skin cancer in adulthood. OBJECTIVE The objective of this study was to analyse knowledge, attitudes and behaviour regarding exposure to natural and artificial UV radiation among Belgrade high school students. METHODS The study was conducted using a questionnaire among 549 students of 3rd and 4th grade (17 and 18 years of age) in four Belgrade high schools. The questionnaire had 32 questions: questions about gender, date and month of birth and parents' education, nine questions regarding sunbed use, nine questions regarding behaviour in the sun during summer months, four questions regarding personal and family history and skin phototype and seven questions regarding attitude and general knowledge about effects of UV radiation. Assessment of frequency rate and relative numbers was used as methods of descriptive statistics. RESULTS As many as 39% of participants had used a sunbed at least once, 38% plan on using it in the future. One quarter spends more than 3 hours in the sun on the beach during summer without any protection, and only one-third of participants had not experienced sunburn during last summer. Only one-half of students know what melanoma is, while 37% stated that they do not know. CONCLUSION General awareness of risk factors regarding sun exposure as well as general knowledge about melanoma is not on a high level among Belgrade high school students. Therefore, besides legislative measures, it is extremely important to conduct adequate education programmes in high schools.
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Affiliation(s)
- D Skiljevic
- Clinic of Dermatovenereology, Clinical Centre of Serbia, Belgrade, Serbia.,Department of Dermatovenereology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - L Sreckovic
- Clinic of Dermatovenereology, Clinical Centre of Serbia, Belgrade, Serbia
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Suppa M, Gandini S, Njimi H, Bulliard JL, Correia O, Duarte AF, Peris K, Stratigos AJ, Nagore E, Longo MI, Bylaite-Bucinskiene M, Karls R, Helppikangas H, Del Marmol V. Prevalence and determinants of sunbed use in thirty European countries: data from the Euromelanoma skin cancer prevention campaign. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:13-27. [PMID: 30811698 DOI: 10.1111/jdv.15311] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although considered as a first-group carcinogen, indoor tanning is a common practice in Europe. Euromelanoma is a pan-European skin cancer prevention campaign. OBJECTIVES To compare several European countries in terms of the prevalence and determinants of sunbed use. METHODS Participants in the Euromelanoma campaigns filled in questionnaires containing demographics and risk factors, including type/duration of sunbed use. Multivariate analyses adjusted for age, gender, education, skin type and year of survey were employed to assess factors independently associated with sunbed use in each country. RESULTS In total, 227 888 individuals (67.4% females, median age 44, 63.4% highly educated, 71.9% skin types III-VI) from 30 countries participated. Overall, the prevalence of sunbed ever use was 10.6% (≤19-year-olds: 5.9%; 20 to 35-year-olds: 17.0%; >35-year-olds: 8.3%). Females displayed a higher prevalence than males in all countries. Balkan countries displayed the highest female/male ratios (≥4). Sunbed use was significantly more prevalent among skin type III-VI (14/30 countries) and highly educated participants (11/30 countries). Significant correlations were found between sunbed use prevalence and countries' latitude (P < 0.001) and sunshine (P = 0.002); Italy and Spain represented exceptions towards excessive exposure. Very different prevalence rates were found for Spain (19.3%) and Portugal (2.0%). Scandinavian countries ranked highest in sunbed use among ≤19-year-olds, Baltic countries among 20 to 35-year-olds. CONCLUSIONS Sunbed use prevalence was higher in northern, sun-deprived countries, with the exception of Italy and Spain. The main determinants of sunbed use were age (young adults) and gender (females), whereas education and skin type had a less relevant effect. Geographic particularities were found in four regions: Iberian (prevalence ten times higher in Spain than Portugal), Balkan (prevalence disproportionately higher among women), Baltic (highest prevalence among young adults) and Scandinavian (highest prevalence among adolescents). These data have public health relevance for future interventions aimed at reducing sunbed use in Europe.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - H Njimi
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - J L Bulliard
- Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital, Lausanne, Switzerland
| | - O Correia
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal.,Portuguese Skin Cancer Association, Lisbon, Portugal.,Center for Health Technology and Services Research (CINTESIS), Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - A F Duarte
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal.,Portuguese Skin Cancer Association, Lisbon, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Porto, Portugal
| | - K Peris
- Institute of Dermatology, Catholic University, Rome, Italy
| | - A J Stratigos
- First Department of Dermatology, National and Kapodistrian University of Athens School of Medicine, Andreas Sygros Hospital, Athens, Greece
| | - E Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Universidad Católica de València San Vicente Ferrer, Valencia, Spain
| | - M I Longo
- Department of Dermatology, University of Florida College of Medicine, Gainesville, FL, USA
| | - M Bylaite-Bucinskiene
- Clinic of Infectious, Chest Diseases, Dermatovenereology and Allergology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - R Karls
- Department of Infectiology and Dermatology, Riga Stradins University, Riga, Latvia
| | - H Helppikangas
- Dermatology Department, Clinical Center, University of Sarajevo, Sarajevo, Bosnia & Herzegovina
| | | | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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8
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Suppa M, Gandini S, Bulliard JL, Daxhelet M, Zamagni M, Forsea AM, Longo MI, Del Marmol V. Who, why, where: an overview of determinants of sunbed use in Europe. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:6-12. [PMID: 30811690 DOI: 10.1111/jdv.15318] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 09/20/2018] [Indexed: 12/28/2022]
Abstract
Although exposure to indoor tanning has been established as a clear risk factor for skin cancer, sunbeds are still commonly used in Europe. Understanding the determinants of sunbed use in Europe is key to plan educational interventions, behavioural strategies and legislative measures, which should be tailored to subgroups with different risk profiles. Evidences show that the typical sunbed users in Europe are young-adult women, with intermediate skin type, a current employment and a medium/high socio-economic status. Typical users display sun-seeking behaviours and other risky behaviours such as smoking. Indoor tanning seems more common in northern than southern Europe. However, sunbed use remains common in fair-skinned individuals and among adolescents/pre-adolescents. Commonly reported reasons for sunbed use in Europe include aesthetic motives (i.e. looking attractive), the pursue of a prevacation tan, the influence of peers/parents engaging in the same habit, and the treatment of health conditions. The most commonly reported places to get an artificial tan in Europe are tanning studios and beauty salons. However, sunbeds are also available in sport venues, such as swimming pools and gyms, hotels and private houses. All these factors should be taken into account when planning educational, behavioural and legislative interventions to reduce the popularity of artificial tanning in Europe.
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Affiliation(s)
- M Suppa
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - J L Bulliard
- Cancer Epidemiology Unit, University Institute of Social and Preventive Medicine, Lausanne, Switzerland
| | - M Daxhelet
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - M Zamagni
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - A M Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - M I Longo
- Department of Dermatology, Hospital Central de la Defensa Gómez Ulla, Madrid, Spain
| | - V Del Marmol
- Department of Dermatology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
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9
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Køster B, Meyer MKH, Andersson TML, Engholm G, Dalum P. Skin cancer projections and cost savings 2014-2045 of improvements to the Danish sunbed legislation of 2014. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2019; 35:78-86. [PMID: 30198585 PMCID: PMC7379953 DOI: 10.1111/phpp.12424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/13/2018] [Accepted: 09/02/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sunbed use increases the risk of skin cancer. The Danish sunbed legislation (2014) did not include an age limit. AIM To model skin cancer incidences and saved costs from potential effects of structural interventions on prevalence of sunbed use. MATERIALS AND METHODS Survey data from 2015 were collected for 3999 Danes, representative for the Danish population in regards to age, gender and region. Skin cancer incidences were modelled in the Prevent program, using population projections, historic cancer incidence, sunbed use exposure and relative risk of sunbed use on melanoma. RESULTS If structural interventions like an age limit of 18 years for sunbed use or complete ban had been included in the Danish sunbed legislation in 2014, it would have reduced the annual number of skin cancer cases with 455 or 4177, respectively, while for the entire period, 2014-2045 the total reductions would be 3730 or 81 887 fewer cases, respectively. The cost savings from an age limit or ban, respectively, are 9 and 129 millions € during 2014-2045. CONCLUSION Legislative restrictive measures which could reduce the sunbed use exists. Danish politicians have the opportunity, supported by the population, to reduce the skin cancer incidence and thereby to reduce the future costs of skin cancer.
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Affiliation(s)
- Brian Køster
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
| | - Maria K H Meyer
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
| | - Therese M-L Andersson
- Department of Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Gerda Engholm
- Department of Documentation and Quality, Danish Cancer Society, Copenhagen, Denmark
| | - Peter Dalum
- Department of Prevention and Information, Danish Cancer Society, Copenhagen, Denmark
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Longo M, Bulliard J, Correia O, Maier H, Magnússon S, Konno P, Goad N, Duarte A, Oláh J, Nilsen L, Peris K, Karls R, Forsea A, del Marmol V. Sunbed use legislation in Europe: assessment of current status. J Eur Acad Dermatol Venereol 2019; 33 Suppl 2:89-96. [DOI: 10.1111/jdv.15317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 09/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- M.I. Longo
- Department of Dermatology; University of Florida College of Medicine; Gainesville FL USA
| | - J.L. Bulliard
- Institute of Social and Preventive Medicine (IUMSP); Lausanne University Hospital; Lausanne Switzerland
| | - O. Correia
- Centro Dermatologia Epidermis; Instituto CUF; Porto Portugal
| | - H. Maier
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | | | - P. Konno
- Department of Dermatology; East Tallinn Central Hospital; Tallinn Estonia
| | - N. Goad
- British Association of Dermatologists; London UK
| | - A.F. Duarte
- Centro Dermatologia Epidermis; Instituto CUF; Porto Portugal
| | - J. Oláh
- Department of Dermatology and Allergology; University of Szeged; Szeged Hungary
| | - L.T.N. Nilsen
- Norwegian Radiation Protection Authority; Østerås Norway
| | - K. Peris
- Department of Dermatology; Catholic University of the Sacred Heart; Milano Italy
| | - R. Karls
- Department of Infectology and Dermatology; Riga Stradins University; Riga Latvia
| | - A.M. Forsea
- Department of Dermatology; Elias University Hospital; Carol Davila University of Medicine and Pharmacy; Bucharest Romania
| | - V. del Marmol
- Department of Dermatology; Hôpital Erasme; Université Libre de Bruxelles; Brussels Belgium
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11
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Škiljević D, Srećković L. Sunbed Use Among Belgrade High School Students. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2017. [DOI: 10.1515/sjdv-2017-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: The incidence of melanoma has been increasing worldwide. Ultraviolet (UV) radiation from the sun and sunbeds are the major risk factors for the development of melanoma and non-melanoma skin cancers. Excessive UV exposure during childhood and adolescence increases the probablity of skin cancer in adulthood. The objective of this study was to analyze the exposure to artificial UV radiation using sunbeds among Belgrade high school students.
Material and Methods: The study was conducted using a questionnaire among 549 3rd and 4th grade students in 4 Belgrade high schools. The questionnaire included 10 questions on the sunbed use, attitudes, and general knowledge about effects of UV radiation from sunbeds. Statistical analysis assessed the frequency rate and relative frequency as methods of descriptive statistics.
Results: A total of 39% of participants had used a sunbed at least once, and 38% plan on using it in the future. When asked at what age they first used a sunbed, 45.66% of high school students stated that it was at the age of 13 or 14. Most adolescents have used a sunbed less than 5 times (38%), whereas 8% of them used it over 30 times.
Conclusion: The awareness of the risks associated with UV exposure in sunbeds is not at a satisfying level among Belgrade high school students. Educational and legislative measures are necessary to protect this highly sensitive population and prevent malignant consequences.
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Affiliation(s)
- Dušan Škiljević
- Clinic of Dermatovenereology , Clinical Center of Serbia , Belgrade , Serbia
- Department of Dermatovenereology, School of Medicine , University of Belgrade , Belgrade , Serbia
| | - Lucija Srećković
- Clinic of Dermatovenereology , Clinical Center of Serbia , Belgrade , Serbia
- Department of Dermatovenereology, School of Medicine , University of Belgrade , Belgrade , Serbia
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12
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Whiteman DC, Green AC, Olsen CM. The Growing Burden of Invasive Melanoma: Projections of Incidence Rates and Numbers of New Cases in Six Susceptible Populations through 2031. J Invest Dermatol 2016; 136:1161-1171. [PMID: 26902923 DOI: 10.1016/j.jid.2016.01.035] [Citation(s) in RCA: 375] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/13/2016] [Accepted: 01/28/2016] [Indexed: 10/22/2022]
Abstract
New melanoma therapies are being developed rapidly, complementing prevention and detection strategies for disease control. Estimating the future burden of melanoma is necessary for deciding how best to deploy limited resources to achieve effective melanoma control. Using three decades of cancer registry data (1982-2011) from six populations with moderate to high melanoma incidence (US whites and the populations of the United Kingdom, Sweden, Norway, Australia, New Zealand), we applied age-period-cohort models to describe current trends and project future incidence rates and numbers of melanomas out to 2031. Between 1982 and 2011, melanoma rates in US whites, and the populations of the United Kingdom, Sweden, and Norway increased at more than 3% annually and are projected to continue rising until at least 2022. Melanoma incidence in Australia has been declining since 2005 (-0.7% per year), and melanoma incidence in New Zealand is increasing but is projected to decline soon. The numbers of new melanoma cases will rise in all six populations because of aging populations and high age-specific rates in the elderly. In US whites, annual new cases will rise from around 70,000 in 2007-2011 to 116,000 in 2026-2031, with 79% of the increase attributable to rising age-specific rates and 21% to population growth and aging. The continued increases in case numbers in all six populations through 2031 will increase the challenges of melanoma control.
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Affiliation(s)
- David C Whiteman
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; The University of Queensland, School of Public Health, Herston Road, Herston, QLD 4006, Australia.
| | - Adele C Green
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; The University of Queensland, School of Public Health, Herston Road, Herston, QLD 4006, Australia; Cancer Research UK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, UK
| | - Catherine M Olsen
- QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006, Australia; The University of Queensland, School of Public Health, Herston Road, Herston, QLD 4006, Australia
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Wøhlk IMR, Philipsen PA, Wulf HC. Factors associated with cessation of sunbed use among Danish women. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2016; 32:191-8. [DOI: 10.1111/phpp.12243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/07/2016] [Indexed: 11/30/2022]
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Nilsen LTN, Hannevik M, Veierød MB. Ultraviolet exposure from indoor tanning devices: a systematic review. Br J Dermatol 2016; 174:730-40. [PMID: 26749382 DOI: 10.1111/bjd.14388] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2015] [Indexed: 11/28/2022]
Abstract
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.
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Affiliation(s)
- L T N Nilsen
- Norwegian Radiation Protection Authority, NO-1332, Østerås, Norway
| | - M Hannevik
- Norwegian Radiation Protection Authority, NO-1332, Østerås, Norway
| | - M B Veierød
- Oslo Center for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, 0317, Oslo, Norway
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15
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Petri A, Karabetsos E. Effective ultraviolet irradiance measurements from artificial tanning devices in Greece. RADIATION PROTECTION DOSIMETRY 2015; 167:490-501. [PMID: 25468991 DOI: 10.1093/rpd/ncu346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 11/01/2014] [Indexed: 06/04/2023]
Abstract
Artificial tanning remains very popular worldwide, despite the International Agency for Research on Cancer classification of ultraviolet (UV) radiation from sunbeds as 'carcinogenic to humans'. Greek Atomic Energy Commission has initiated a surveillance action of the artificial tanning devices in Greece in order to record the effective irradiance levels from the sunbeds and to inform and synchronise the domestic artificial tanning business sector with the requirements of the European Standard EN 60335-2-27:2010. In this direction, in situ measurements of UV emissions from sunbeds in solaria businesses all over Greece were performed from October 2013 until July 2014, with a radiometer and a portable single-monochromator spectrophotometer. Analysis of the measurements' results revealed that effective irradiance in ∼60 % of the measured sunbeds exceeded the 0.3 W m(-2) limit value set by EN 60335-2-27:2010 and only 20 % of the devices could be categorised as UV type 3.
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Affiliation(s)
- Aspasia Petri
- Non-Ionizing Radiation Office, Greek Atomic Energy Commission, Patriarxou Grigoriou and Neapoleos, PO Box 60092, Agia Paraskevi, Athens 15310, Greece
| | - Efthymios Karabetsos
- Non-Ionizing Radiation Office, Greek Atomic Energy Commission, Patriarxou Grigoriou and Neapoleos, PO Box 60092, Agia Paraskevi, Athens 15310, Greece
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16
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Wallingford SC, Iannacone MR, Youlden DR, Baade PD, Ives A, Verne J, Aitken JF, Green AC. Comparison of melanoma incidence and trends among youth under 25 years in Australia and England, 1990-2010. Int J Cancer 2015; 137:2227-33. [DOI: 10.1002/ijc.29598] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/19/2015] [Accepted: 04/21/2015] [Indexed: 11/05/2022]
Affiliation(s)
- Sarah C. Wallingford
- Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre; Stopford Building, Oxford Road Manchester M13 9PT United Kingdom
| | - Michelle R. Iannacone
- Cancer and Population Studies Group; QIMR Berghofer Medical Research Institute; 300 Herston Road Herston Queensland 4029 Australia
| | - Danny R. Youlden
- Cancer Council Queensland; 553 Gregory Terrace, Fortitude Valley Spring Hill Queensland 4006 Australia
| | - Peter D. Baade
- Cancer Council Queensland; 553 Gregory Terrace, Fortitude Valley Spring Hill Queensland 4006 Australia
| | - Alexander Ives
- South West Knowledge and Intelligence Team; Public Health England; Bristol Bs1 6EH United Kingdom
| | - Julia Verne
- South West Knowledge and Intelligence Team; Public Health England; Bristol Bs1 6EH United Kingdom
| | - Joanne F. Aitken
- Cancer Council Queensland; 553 Gregory Terrace, Fortitude Valley Spring Hill Queensland 4006 Australia
| | - Adèle C. Green
- Institute of Inflammation and Repair, University of Manchester, Manchester Academic Health Science Centre; Stopford Building, Oxford Road Manchester M13 9PT United Kingdom
- Cancer and Population Studies Group; QIMR Berghofer Medical Research Institute; 300 Herston Road Herston Queensland 4029 Australia
- Cancer Research UK Manchester Institute, University of Manchester; Wilmslow Road Manchester M20 4BX United Kingdom
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17
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Gould M, Farrar MD, Kift R, Berry JL, Mughal MZ, Bundy C, Vail A, Webb AR, Rhodes LE. Sunlight exposure and photoprotection behaviour of white Caucasian adolescents in the UK. J Eur Acad Dermatol Venereol 2014; 29:732-7. [PMID: 25185510 DOI: 10.1111/jdv.12669] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 02/07/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Sun exposure has positive and negative effects on health, yet little is known about the sun exposure behaviour of UK adolescents, including those more prone or less prone to sunburn. OBJECTIVE To examine sun exposure behaviour of UK white Caucasian adolescents including time spent outdoors, holiday behaviour, use of sunscreen and clothing, with assessment for differences between sun-reactive skin type groups. METHODS White Caucasian adolescents (12-15 years) attending schools in Greater Manchester completed a two-page questionnaire to assess sun exposure and photoprotective behaviour. RESULTS A total of 133 adolescents (median age 13.4 years; 39% skin type I/II, 61% skin type III/IV) completed the questionnaire. In summer, adolescents spent significantly longer outdoors at weekends (median 4 h/day, range 0.25-10) than on weekdays (2, 0.25-6; P < 0.0001). When at home in the UK during summer, 44% reported never wearing sunscreen compared to just 1% when on a sunny holiday. Sunscreen use was also greater (frequency/coverage) when on a sunny holiday than at home in the UK summer (P < 0.0001). Adolescents of skin types I/II (easy burning) spent significantly less time outdoors than skin types III/IV (easy tanning) on summer weekends (P < 0.001), summer weekdays (P < 0.05) and on a sunny holiday (P = 0.001). Furthermore, skin types I/II reported greater sunscreen use during summer in the UK and on sunny holiday (both P < 0.01), and wore clothing covering a greater skin area on a sunny holiday (P < 0.01) than skin types III/IV. There was no difference in sun exposure behaviour/protection between males and females. CONCLUSION The greater sun-protective measures reported by adolescents of sun-reactive skin type group I/II than III/IV suggest those who burn more easily are aware of the greater need to protect their skin. However, use of sunscreen during the UK summer is low and may need more effective promotion in adolescents.
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Affiliation(s)
- M Gould
- Centre for Dermatology, Institute of Inflammation and Repair, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, Salford Royal NHS Foundation Hospital, Manchester, UK
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18
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Wehner MR, Chren MM, Nameth D, Choudhry A, Gaskins M, Nead KT, Boscardin WJ, Linos E. International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol 2014; 150:390-400. [PMID: 24477278 DOI: 10.1001/jamadermatol.2013.6896] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Indoor tanning is a known carcinogen, but the scope of exposure to this hazard is not known. OBJECTIVE To summarize the international prevalence of exposure to indoor tanning. DATA SOURCES Studies were identified through systematic searches of PubMed (1966 to present), Scopus (1823 to present), and Web of Science (1898 to present) databases, last performed on March 16, 2013. We also hand searched reference lists to identify records missed by database searches and publicly available data not yet published in the scientific literature. STUDY SELECTION Records reporting a prevalence of indoor tanning were eligible for inclusion. We excluded case-control studies, reports with insufficient study information, and reports of groups recruited using factors related to indoor tanning. Two independent investigators performed searches and study selection. Our search yielded 1976 unique records. After exclusions, 161 records were assessed for eligibility in full text, and 88 were included. DATA EXTRACTION AND SYNTHESIS Two independent investigators extracted data on characteristics of study participants, inclusion/exclusion criteria, data collection format, outcomes, and statistical methods. Random-effects meta-analyses were used to summarize the prevalence of indoor tanning in different age categories. We calculated the population proportional attributable risk of indoor tanning in the United States, Europe, and Australia for nonmelanoma skin cancer (NMSC) and melanoma. MAIN OUTCOMES AND MEASURES Ever and past-year exposure to indoor tanning. RESULTS The summary prevalence of ever exposure was 35.7% (95% CI, 27.5%-44.0%) for adults, 55.0% (33.0%-77.1%) for university students, and 19.3% (14.7%-24.0%) for adolescents. The summary prevalence of past-year exposure was 14.0% (95% CI, 11.5%-16.5%) for adults, 43.1% (21.7%-64.5%) for university students, and 18.3% (12.6%-24.0%) for adolescents. These results included data from 406 696 participants. The population proportional attributable risk were 3.0% to 21.8% for NMSC and 2.6% to 9.4% for melanoma, corresponding to more than 450 000 NMSC cases and more than 10 000 melanoma cases each year attributable to indoor tanning in the United States, Europe, and Australia. CONCLUSIONS AND RELEVANCE Exposure to indoor tanning is common in Western countries, especially among young persons. Given the large number of skin cancer cases attributable to indoor tanning, these findings highlight a major public health issue.
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Affiliation(s)
- Mackenzie R Wehner
- Department of Dermatology, University of California, San Francisco2Stanford University School of Medicine, Stanford, California3Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Mary-Margaret Chren
- Department of Dermatology, University of California, San Francisco4Department of Dermatology, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | | | - Aditi Choudhry
- Department of Internal Medicine, John Muir Medical Center, Walnut Creek, California
| | - Matthew Gaskins
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Kevin T Nead
- Stanford University School of Medicine, Stanford, California
| | - W John Boscardin
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Eleni Linos
- Department of Dermatology, University of California, San Francisco
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19
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Kyle RG, MacMillan I, Forbat L, Neal RD, O'Carroll RE, Haw S, Hubbard G. Scottish adolescents' sun-related behaviours, tanning attitudes and associations with skin cancer awareness: a cross-sectional study. BMJ Open 2014; 4:e005137. [PMID: 24793258 PMCID: PMC4025409 DOI: 10.1136/bmjopen-2014-005137] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To describe Scottish adolescents' sun-related behaviours and tanning attitudes and assess associations with skin cancer awareness. DESIGN Cross-sectional study. SETTING 20 state secondary schools in one Scottish local authority (Glasgow City). PARTICIPANTS 2173 adolescents (females: 50.7%, n=1102) with a mean age of 12.4 (SD=0.55). OUTCOME MEASURES Sun-related behaviour (suntan, sunbathing, sunburn, sunscreen use, sunbed use), tanning attitudes, skin cancer-related symptom and risk factor awareness. RESULTS Adolescents reported poor sun-related practice: 51% of adolescents reported sunburn the previous summer of whom 38% indicated sunburn on more than one occasion. Skin cancer awareness was low: 45% recognised 'change in the appearance of a mole' as a cancer symptom, and 39% agreed that 'getting sunburnt more than once as a child' increased cancer risk. 42% and 26% of adolescents, respectively, reported that friends and family held protanning attitudes. Compared with males, females were statistically significantly more likely to: report sunbathing (p<0.001), use of lotions or oil to aid tanning (p=0.009) and sunburn (p<0.001); know that changes in the appearance of a mole was a skin cancer symptom (p=0.036) and sunburn more than once as a child was a skin cancer risk factor (p=0.005); perceive their friends to hold protanning attitudes (p<0.001) and indicate that a tan made them feel better about themselves (p<0.001), more attractive to others (p=0.011) and healthier (p<0.001). CONCLUSIONS Scottish adolescents had poor sun protection practice and low skin cancer awareness. Girls adopted riskier sun-related behaviour despite greater awareness of skin cancer-related risk. Urgent action is required to promote positive sun-related behaviour and increase skin cancer awareness among Scottish adolescents. However, further research is needed to inform the development of effective sun-safe interventions.
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Affiliation(s)
- Richard G Kyle
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
| | | | - Liz Forbat
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
| | - Richard D Neal
- North Wales Centre for Primary Care Research, Bangor University, Bangor, UK
| | - Ronan E O'Carroll
- Division of Psychology, School of Natural Sciences, University of Stirling, Stirling, UK
| | - Sally Haw
- School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
| | - Gill Hubbard
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Stirling, UK
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20
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O'Sullivan NA, Tait CP. Tanning bed and nail lamp use and the risk of cutaneous malignancy: A review of the literature. Australas J Dermatol 2014; 55:99-106. [DOI: 10.1111/ajd.12145] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 12/25/2013] [Indexed: 02/06/2023]
Affiliation(s)
| | - Clare P Tait
- Dermatology Department; Royal Perth Hospital; Perth Western Australia Australia
- Dermatology Specialist Group; Perth Western Australia Australia
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21
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Wehner MR, Chren MM, Nameth D, Choudhry A, Gaskins M, Nead KT, Boscardin WJ, Linos E. International prevalence of indoor tanning: a systematic review and meta-analysis. JAMA Dermatol 2014. [PMID: 24477278 DOI: 10.1001/jamadermatol.2013.6896.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Indoor tanning is a known carcinogen, but the scope of exposure to this hazard is not known. OBJECTIVE To summarize the international prevalence of exposure to indoor tanning. DATA SOURCES Studies were identified through systematic searches of PubMed (1966 to present), Scopus (1823 to present), and Web of Science (1898 to present) databases, last performed on March 16, 2013. We also hand searched reference lists to identify records missed by database searches and publicly available data not yet published in the scientific literature. STUDY SELECTION Records reporting a prevalence of indoor tanning were eligible for inclusion. We excluded case-control studies, reports with insufficient study information, and reports of groups recruited using factors related to indoor tanning. Two independent investigators performed searches and study selection. Our search yielded 1976 unique records. After exclusions, 161 records were assessed for eligibility in full text, and 88 were included. DATA EXTRACTION AND SYNTHESIS Two independent investigators extracted data on characteristics of study participants, inclusion/exclusion criteria, data collection format, outcomes, and statistical methods. Random-effects meta-analyses were used to summarize the prevalence of indoor tanning in different age categories. We calculated the population proportional attributable risk of indoor tanning in the United States, Europe, and Australia for nonmelanoma skin cancer (NMSC) and melanoma. MAIN OUTCOMES AND MEASURES Ever and past-year exposure to indoor tanning. RESULTS The summary prevalence of ever exposure was 35.7% (95% CI, 27.5%-44.0%) for adults, 55.0% (33.0%-77.1%) for university students, and 19.3% (14.7%-24.0%) for adolescents. The summary prevalence of past-year exposure was 14.0% (95% CI, 11.5%-16.5%) for adults, 43.1% (21.7%-64.5%) for university students, and 18.3% (12.6%-24.0%) for adolescents. These results included data from 406 696 participants. The population proportional attributable risk were 3.0% to 21.8% for NMSC and 2.6% to 9.4% for melanoma, corresponding to more than 450 000 NMSC cases and more than 10 000 melanoma cases each year attributable to indoor tanning in the United States, Europe, and Australia. CONCLUSIONS AND RELEVANCE Exposure to indoor tanning is common in Western countries, especially among young persons. Given the large number of skin cancer cases attributable to indoor tanning, these findings highlight a major public health issue.
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Affiliation(s)
- Mackenzie R Wehner
- Department of Dermatology, University of California, San Francisco2Stanford University School of Medicine, Stanford, California3Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Mary-Margaret Chren
- Department of Dermatology, University of California, San Francisco4Department of Dermatology, San Francisco Veterans Affairs Medical Center, San Francisco, California
| | | | - Aditi Choudhry
- Department of Internal Medicine, John Muir Medical Center, Walnut Creek, California
| | - Matthew Gaskins
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Kevin T Nead
- Stanford University School of Medicine, Stanford, California
| | - W John Boscardin
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Eleni Linos
- Department of Dermatology, University of California, San Francisco
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22
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Wallingford S, Alston R, Birch J, Green A. Regional melanoma incidence in England, 1996-2006: reversal of north-south latitude trends among the young female population. Br J Dermatol 2013; 169:880-8. [DOI: 10.1111/bjd.12460] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2013] [Indexed: 11/30/2022]
Affiliation(s)
- S.C. Wallingford
- Manchester Academic Health Science Centre; Institute of Inflammation and Repair; University of Manchester; Oxford Road Manchester M13 9PT U.K
- Cancer Research U.K. Paediatric and Familial Cancer Research Group; Institute of Cancer Sciences; Manchester Academic Health Science Centre; University of Manchester; Oxford Road Manchester M13 9PT U.K
| | - R.D. Alston
- Cancer Research U.K. Paediatric and Familial Cancer Research Group; Institute of Cancer Sciences; Manchester Academic Health Science Centre; University of Manchester; Oxford Road Manchester M13 9PT U.K
| | - J.M. Birch
- Cancer Research U.K. Paediatric and Familial Cancer Research Group; Institute of Cancer Sciences; Manchester Academic Health Science Centre; University of Manchester; Oxford Road Manchester M13 9PT U.K
| | - A.C. Green
- Manchester Academic Health Science Centre; Institute of Inflammation and Repair; University of Manchester; Oxford Road Manchester M13 9PT U.K
- Cancer and Population Studies Group; Queensland Institute of Medical Research; Brisbane Qld 4029 Australia
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23
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Kyle RG, Nicoll A, Forbat L, Hubbard G. Adolescents' awareness of cancer risk factors and associations with health-related behaviours. HEALTH EDUCATION RESEARCH 2013; 28:816-27. [PMID: 23648385 DOI: 10.1093/her/cyt055] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Increasing adolescents' awareness of the contribution of modifiable lifestyle factors to cancer risk may influence life-long patterns of healthy behaviour. However, little is known about adolescents' awareness of cancer risk factors and the effectiveness of awareness-raising interventions. This study assessed adolescents' cancer awareness and the effectiveness of an existing cancer-specific school-based intervention delivered by Teenage Cancer Trust. The Cancer Awareness Measure was completed by 478 adolescents (male: 250, 52.3%) aged 11-17 years (mean: 13.8, standard deviation: 1.24) in four UK schools; 422 adolescents provided paired data 2 weeks before and 2 weeks after the intervention delivered in 3 schools, and twice 4 weeks apart in the fourth (control) school. Adolescents recognized on average 4.4 (of 11) cancer risk factors. With the exception of smoking, adolescents' awareness of cancer risk factors was low. Awareness significantly increased after the intervention (4.6-5.7, P < 0.001). There was no significant change in the control school. Intervention effect was greater among females. This educational intervention is an effective way to raise adolescents' awareness of cancer risk factors. However, further cross-sectional and experimental studies are required to definitively assess adolescents' awareness of cancer risk factors and the effectiveness of this educational intervention.
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Affiliation(s)
- Richard G Kyle
- Cancer Care Research Centre, School of Nursing, Midwifery and Health, University of Stirling, Stirling FK9 4LA, UK
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24
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Banerjee SC, Hay JL, Greene K. Cognitive rationalizations for tanning-bed use: a preliminary exploration. Am J Health Behav 2013; 37:577-86. [PMID: 23985280 DOI: 10.5993/ajhb.37.5.1] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine construct and predictive utility of an adapted cognitive rationalization scale for tanning-bed use. METHODS Current/former tanning-bedusing undergraduate students (N = 216; 87.6% females; 78.4% white) at a large northeastern university participated in a survey. A cognitive rationalization for tanning-bed use scale was adapted. Standardized self-report measures of past tanning-bed use, advantages of tanning, perceived vulnerability to photoaging, tanning-bed use dependence, and tanning-bed use intention were also administered. RESULTS The cognitive rationalization scale exhibited strong construct and predictive validity. Current tanners and tanning-bed-use-dependent participants endorsed rationalizations more strongly than did former tanners and not-tanning-bed-use-dependent participants respectively. CONCLUSIONS Findings indicate that cognitive rationalizations help explain discrepancy between inconsistent cognitions.
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Affiliation(s)
- Smita C Banerjee
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
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25
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Affiliation(s)
- B. Diffey
- Dermatological Sciences; Institute of Cellular Medicine; University of Newcastle upon Tyne; Newcastle upon Tyne U.K
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26
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Lee SI, Macherianakis A, Roberts LM. Sunbed use, attitudes, and knowledge after the under-18s ban: a school-based survey of adolescents aged 15 to 17 years in Sandwell, United Kingdom. J Prim Care Community Health 2013; 4:265-74. [PMID: 23799669 DOI: 10.1177/2150131913482142] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Sunbed use in childhood increases risk of melanoma. The under-18s sunbed ban was introduced in England, April 2011. Impact on use has not been investigated since. This cross-sectional study estimates the prevalence of under-18s' use in Sandwell after the commercial ban and identifies factors associated with use/intention. METHODS Adolescents aged 15 to 17 years in schools were surveyed using self-completed anonymous questionnaires. Data collected include demographics, sunbed use, tanning attitudes, knowledge of risks and ban awareness. All Sandwell schools were approached; adolescents available on the survey days were included. RESULTS Five out of 22 schools participated, 407 adolescents responded (95.1%). Twenty participants (5.3%; 95% confidence interval [CI] = 3.4-8.0) had used sunbeds, of who 16 reported use in commercial settings. After exclusion of one school cohort with atypical use (possibly associated with beauty vocational course and European migrants), the prevalence of use was 1.7% (95% CI = 0.7-3.9, n = 5). Less than half of all were aware of the ban (48.2%; 95% CI = 43.2-53.3). Users/potential users were less aware of associated risks. Being female, having family/friends who use sunbeds increased use/intention 2- to 4-fold. CONCLUSION Strategies targeting parents, stricter enforcement, and greater publicity of the ban are needed. Further research exploring the possible association between certain vocational courses, migrants, and sunbed use is required.
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27
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Preventing skin cancer through reduction of indoor tanning: current evidence. Am J Prev Med 2013; 44:682-9. [PMID: 23683987 PMCID: PMC4535424 DOI: 10.1016/j.amepre.2013.02.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 02/28/2013] [Accepted: 02/28/2013] [Indexed: 12/31/2022]
Abstract
Exposure to ultraviolet radiation from indoor tanning devices (tanning beds, booths, and sun lamps) or from the sun contributes to the risk of skin cancer, including melanoma, which is the type of skin cancer responsible for most deaths. Indoor tanning is common among certain groups, especially among older adolescents and young adults, adolescent girls and young women, and non-Hispanic whites. Increased understanding of the health risks associated with indoor tanning has led to many efforts to reduce use. Most environmental and systems efforts in the U.S. (e.g., age limits or requiring parental consent/accompaniment) have occurred at the state level. At the national level, the U.S. Food and Drug Administration and the Federal Trade Commission regulate indoor tanning devices and advertising, respectively. The current paper provides a brief review of (1) the evidence on indoor tanning as a risk factor for skin cancer; (2) factors that may influence use of indoor tanning devices at the population level; and (3) various environmental and systems options available for consideration when developing strategies to reduce indoor tanning. This information provides the context and background for the companion paper in this issue of the American Journal of Preventive Medicine, which summarizes highlights from an informal expert meeting convened by the CDC in August 2012 to identify opportunities to prevent skin cancer by reducing use of indoor tanning devices.
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28
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Lake JR, Thomson CS, Twelves CJ, Davies EA. A qualitative investigation of the motivations, experiences and views of female sunbed users under the age of 18 in England. J Public Health (Oxf) 2013; 36:56-64. [DOI: 10.1093/pubmed/fds107] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Tierney P, Ferguson J, Ibbotson S, Dawe R, Eadie E, Moseley H. Nine out of 10 sunbeds in England emit ultraviolet radiation levels that exceed current safety limits. Br J Dermatol 2013; 168:602-8. [PMID: 23330641 DOI: 10.1111/bjd.12181] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Exposure to ultraviolet (UV) radiation from sunlight is recognized as the principal cause of skin cancer. Moreover, sunbeds have been classified as carcinogenic by the International Agency for Research on Cancer. Despite this, there is a shortage of objective data on UV exposure levels in sunbeds in England. OBJECTIVES We set out to measure UV emission levels in sunbeds at sites around England, and to compare these levels with both current standards and natural sunlight. METHODS Between October 2010 and February 2011, UV spectra were measured on site from a total of 402 artificial tanning units in England. Measurement instrumentation was calibrated, traceable to the National Physical Laboratory. Compliance with the relevant British and European standard was determined, and a skin-cancer weighting factor was used to compare the carcinogenic potential of sunbeds with that of sunlight. RESULTS For compliance with the European standard, erythemal-effective irradiance should not exceed 0·3 W m(-2). The values that we measured ranged between 0·10 and 1·32 W m(-2) with a mean of 0·56 ± 0·21 W m(-2) . Only 10% of sunbeds surveyed were within the recommended limit. Application of the skin-cancer weighting factor produced values that varied from 0·17 to 2·52 W m(-2) with a mean of 0·99 ± 0·41 W m(-2). The comparable value for Mediterranean noon day sun was 0·43 W m . CONCLUSIONS Nine out of 10 sunbeds surveyed throughout England emitted levels of UV radiation that exceed the maximum levels contained within the European standard. Moreover, the skin cancer risk for comparable times of exposure was up to six times higher than that for Mediterranean sunlight. This situation is unacceptable and stricter control measures must be put in place.
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Affiliation(s)
- P Tierney
- The Photobiology Unit, Ninewells Hospital and Medical School, University of Dundee, Dundee DD1 9SY, UK
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Wendt J, Schanab O, Binder M, Pehamberger H, Okamoto I. Site-dependent actinic skin damage as risk factor for melanoma in a central European population. Pigment Cell Melanoma Res 2012; 25:234-42. [PMID: 22145962 DOI: 10.1111/j.1755-148x.2011.00946.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Sun exposure is causal for melanoma but is subject to bias of recall so that it is difficult to dissect the role of particular patterns of sun exposure. In this hospital-based case-control study (n = 1991), we aimed to analyze pigmentation traits and signs of actinic damage at different anatomic locations as markers of melanoma risk in central European patients. Although all signs of actinic damage (freckling, wrinkling and solar lentigos) were significantly associated with melanoma risk in multivariate logistic regression models adjusting for age and sex, the strongest associations were observed for the dorsal parts of the body: adjusted odds ratios [OR] were 4.22 for wrinkling on the neck, 3.43 for solar lentigos and 3.37 for freckling on the back (all P < 0.001), respectively. These associations were independent of age, sex and pigmentation traits. Our results indicate that signs of actinic damage are predictors of melanoma risk, particularly on the back.
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Affiliation(s)
- Judith Wendt
- Division of General Dermatology, Department of Dermatology, Medical University of Vienna, Vienna, Austria
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Taddeo D, Stanwick R. Banning children and youth younger than 18 years of age from commercial tanning facilities. Paediatr Child Health 2012; 17:89-90. [PMID: 23372400 PMCID: PMC3299353 DOI: 10.1093/pch/17.2.89] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2024] Open
Abstract
Cutaneous malignant melanoma has increased more than three-fold in the past 35 years. Because damage is cumulative, exposure to ultraviolet radiation early in life elevates a risk that is increased further as individuals use artificial sources of ultraviolet radiation. The full impact and scope of damage caused by year-round indoor tanning may take years to appreciate given the long latency period for most skin cancers. Teenagers are frequent visitors to tanning parlours, with girls being more frequent and sustained users. The tanning industry disputes the World Health Organization's and the International Agency for Research on Cancer's classification of their product as a Class 1 physical carcinogen. Tanning parlours have sought to establish and maintain a client-base among teenagers. Consequently, the Canadian Paediatric Society is joining other prominent health organizations in support of a ban on the use of commercial tanning facilities by Canadian children and youth younger than 18 years of age.
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Affiliation(s)
- Jean-François Doré
- Centre de Recherche en Cancérologie de Lyon, UMR Inserm U1052 - CNRS U5286, Centre Léon Bérard, 28, rue Laënnec, 69373, Lyon Cedex 08, France.
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van Rongen E. Rapporteur's report on Session 3: Biology and mechanisms. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2011; 107:408-411. [PMID: 21964523 DOI: 10.1016/j.pbiomolbio.2011.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 09/15/2011] [Indexed: 05/31/2023]
Affiliation(s)
- Eric van Rongen
- Health Council of the Netherlands, The Hague, The Netherlands.
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Beaglehole R, Bonita R, Magnusson R. Global cancer prevention: An important pathway to global health and development. Public Health 2011; 125:821-831. [DOI: 10.1016/j.puhe.2011.09.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2011] [Revised: 09/20/2011] [Accepted: 09/28/2011] [Indexed: 11/30/2022]
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Greinert R, Boniol M. Skin cancer--primary and secondary prevention (information campaigns and screening)--with a focus on children & sunbeds. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2011; 107:473-6. [PMID: 21906618 DOI: 10.1016/j.pbiomolbio.2011.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Accepted: 08/25/2011] [Indexed: 10/17/2022]
Abstract
Solar and artificial (sunbed) UV-exposure is the main risk factor for the development of epithelial skin cancer (basal cell carcinoma, BCC, and squamous cell carcinoma, SCC) as well for malignant melanoma (MM). UV exposure in childhood and adolescence is especially important. Therefore, adequate methods of primary prevention have continuously to be used and to be developed further to target these age-groups in order to reduce the risks of intensive UV-exposure. Primary prevention can effectively be combined with secondary prevention (early detection, screening) to reduce the burden of skin cancer and to decrease incidence, morbidity and mortality.
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Affiliation(s)
- Rüdiger Greinert
- Department Molecular Cellbiology, Dermatology Center Buxtehude, Elbekliniken Stade/Buxtehude, Klinikum Buxtehude, Buxtehude, Germany.
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Krarup A, Køster B, Thorgaard C, Philip A, Clemmensen I. Sunbed use by children aged 8-18 years in Denmark in 2008: a cross-sectional study. Br J Dermatol 2011; 165:214-6. [DOI: 10.1111/j.1365-2133.2011.10352.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nilsen LTN, Aalerud TN, Hannevik M, Veierød MB. UVB and UVA irradiances from indoor tanning devices. Photochem Photobiol Sci 2011; 10:1129-36. [DOI: 10.1039/c1pp05029j] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mogensen M, Jemec GB. The potential carcinogenic risk of tanning beds: clinical guidelines and patient safety advice. Cancer Manag Res 2010; 2:277-82. [PMID: 21188119 PMCID: PMC3004589 DOI: 10.2147/cmr.s7403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2010] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In 2009, the WHO listed ultraviolet (UV) radiation as a group 1 carcinogen. In spite of this, each year, millions of people tan indoor in Western countries. The aim of this review is to summarize evidence of tanning bed carcinogenesis and to present guidelines for use of tanning beds and patient safety advice. METHODS A narrative review of the literature was conducted based on both PubMed and Medline searches and on literature review of the retrieved papers. RESULTS Use of indoor tanning beds represents a significant and avoidable risk factor for the development of both melanoma and nonmelanoma skin cancers. Frequent tanners are more often adolescent females. Tanning beds have additional potential adverse effects such as burns, solar skin damage, infection, and possibly also addictive behavior. DISCUSSION The effort in preventing UV light-induced carcinogenesis should currently be aimed at developing new strategies for public health information. Tanning beds are one preventable source of UV radiation. In the majority of people solar UV radiation continues to be the major factor and therefore anti-tanning campaigns must always include sunbathers.
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Affiliation(s)
- Mette Mogensen
- Department of Dermatology, Gentofte Hospital, Hellerup, Denmark
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Boyle R, O’Hagan A, Donnelly D, Donnelly C, Gordon S, McElwee G, Gavin A. Trends in reported sun bed use, sunburn, and sun care knowledge and attitudes in a U.K. region: results of a survey of the Northern Ireland population. Br J Dermatol 2010; 163:1269-75. [DOI: 10.1111/j.1365-2133.2010.09977.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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