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.
Keywords: Artificial tanning, Children, Melanoma, Skin cancer, Sun, Tanning industry, Teenagers, Ultraviolet radiation, Vitamin D
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RECOMMENDATIONS
To protect children and adolescents from skin cancer and other risks posed by indoor tanning, the Canadian Paediatric Society recommends the following:
Children and youth younger than 18 years of age should be prohibited by law from using commercial indoor tanning facilities.
Governments should enact tanning industry regulations and ensure that such legislation is enforced. Regulatory actions are to be preceded and/or accompanied by public education campaigns to raise awareness concerning the dangers of exposure to artificial sources of ultraviolet radiation. These campaigns need to include messages from authoritative groups such as health care professionals and educators, and to target children, adolescents and parents. Involving young opinion leaders, as well as celebrities and sports figures, would bolster such campaigns.
The tanning industry should be required to acknowledge that their product is carcinogenic and to advise the public that artificial tanning has no health benefit. Also, they should not be allowed to promote ‘pre-vacation’ or pre-event (eg, ‘prom’) tanning.
A tax should be imposed on all commercial tanning bed operations and harmonized with levies on tobacco.
All unsupervised commercial tanning bed operations, including the use of coin-operated machines, should be banned.
Paediatricians, family physicians and other health care providers should screen for the use of artificial tanning activities by children and adolescents, and provide anticipatory guidance to families to discourage this practice. Health care professionals should advocate that individuals younger than 18 years of age be banned from commercial tanning facilities.
Acknowledgments
This position statement has been reviewed by the Canadian Paediatric Society’s Community Paediatrics Committee and by a CPS member expert in paediatric dermatology, Dr Miriam Weinstein.
Footnotes
ADOLESCENT HEALTH COMMITTEE
Members: Franziska Baltzer MD; April S Elliot MD; Johanne Harvey MD; Margo A Lane MD; Stan Lipnowski MD (Board Representative); Jorge L Pinzon MD (Chair)
Liaison: Mark Norris MD, CPS Adolescent Health Section
Principal authors: Danielle Taddeo MD; Richard Stanwick MD
The recommendations in this statement do not indicate an exclusive course of treatment or procedure to be followed. Variations, taking into account individual circumstances, may be appropriate. All Canadian Paediatric Society position statements and practice points are reviewed on a regular basis. Please consult the Position Statements section of the CPS website (www.cps.ca) for the full-text, current version.