I recently posted on the new law in California that bans indoor tanning for those under 14, and prohibits 14-18 year old minors from using tanning beds without their parent’s permission.  A few additional thoughts.

First, the purpose of my post isn’t to advocate the use of tanning beds.

Second, I’m not arguing that there aren’t risks to certain types of UV over-exposure, whether in a tanning bed or in the sun.  There most certainly are.  These risks, particularly for fair-skinned people, seem to include non-melanoma skin cancer (more common forms of skin cancer, though less deadly), melanoma (less common, more deadly), wrinkles (deadly to some, apparently), and other types of skin damage. 

Third, the typical experience in a typical tanning bed does not replicate the experience of being in the sun.  Tanning beds tend to go heavy on UVA, which doesn’t stimulate the production of Vitamin D, and with higher intensity levels than most people would typically experience (particularly away from the equator).  Plus, people in tanning salons are exposed to an extremely high intensity, but low quality auditory waves, also known as shitty pop music.

Fourth, the indoor tanning industry is a lot like their core clientele: pretty ditzyI’ve asked various salons for the UV spectrum and intensity emitted by their machines and bulbs, but none of them seem to know.  This is the most informed response I’ve heard: “These machines are more UVB, but you’ll get redder in them, so use these more expensive ones that are UVA.” 

Fifth, I accept that minors shouldn’t be allowed to engage in certain types of dangerous activities that adults are allowed to engage in.  Smoking cigarettes is addictive, and so on.

So I accept all that.  Those aren’t my issues.  My issue is the growing tendency to try to legislate healthy behavior.

I have both moral and pragmatic issues with this.  Morally, I’ll concede that I have a higher threshold for when the government is justified in stepping in — I think individuals should have enormous discretion over decisions in their own lives.  But I’ll put that aside for the moment to speak to pragmatic-minded people who are in favor of technocratic legislation of health decisions.  How does this process actually work in practice?

I called up the office of State Senator Ted Lieu to ask for the scientific references they are basing their decision on, and the cost-benefit analysis.  I was directed to a press release for the legislation (plus prior press releases on the topic).  At least I wasn’t put on hold, and the response was quick and courteous.

The press release includes three links to one website: indoortanningreportcard.com, a site which opposes indoor tanning and supports legislation to restrict it, as well as a link to this short overview on radiation as a carcinogen.  No link to a cost-benefit analysis.

On the Indoor Tanning Report Card site, there are a few links to various papers, but get this.  They ran their own study and this was their top finding:

“Tanning salons located in states with youth access laws were more likely to require the teen to obtain parental consent to tan. However, youth access law (presence vs. absence) did NOT relate to whether teens had actually used indoor tanning. This may be because many parents are providing their consent.”

Their top finding was that parental consent laws don’t actually work.  Apparently, California didn’t get the memo.  I found this astounding — the main conclusion of the advocacy group is that the very type of law passed by California doesn’t work.  (They advocate a total ban for minors.)

What about a cost-benefit analysis?  Still nowhere to be found.  Would it be so hard to make a single spreadsheet that has the following, with citations?

  • # of minors who visit tanning salons
  • increased risk of cancer based on visits as a minor (low, medium, high estimates)
  • prevalence of those types of cancer
  • severity of those types of cancer
  • medical benefits of tanning bed use (any vitamin D?, complexion)
  • compare with likely alternative: minors giving themselves sunburns on beaches or staying out of the sun entirely
  • consider the social cost of having to look at more people with spray tans
  • cost to enforce the legislation
  • see how this compares with other activities we would never consider banning, like swimming, bike riding, watching TV, getting a driver’s license at 16, and trick-or-treating on Halloween

If I’m going to be governed by a technocracy, then I at least expect there should be a one-page cost-benefit analysis of every single law and regulation that comes out of our government.  This probably won’t have a big impact on the big stuff, which people will just disagree on, but it will have an impact on all this little stuff that abounds.  If you can’t even do a cost-benefit analysis, then perhaps technocracy only works in theory.

When it comes to the science, I don’t have time or space to adjudicate the debate in this post.  But here are other potential risk factors that this legislation ignores or won’t address:

  • Does the use of traditional sunscreens increase the risk of skin cancer?  Traditional sunscreens only block a portion of the UV spectrum and disassociate the signal of damage (a burn) from actual damage that is still happening.
  • A society that rarely gets sun anymore, and then when we do get sun, it’s way more than our body is prepared to handle
  • General indifference to the long-term consequences of sun burns
  • Diets and medications that make our skin more sensitive to the sun
  • A base level of skin cancer inherent to certain skin types, even if people were never actually exposed to the sun or tanning beds
  • Why do many melanomas appear on parts of the body that are usually not exposed to the sun?
  • Whether regular, moderate exposure to the sun reduces the incidence of skin cancer

If the scientific community is still in disagreement about some of these issues — and what constitutes a healthy relationship with the sun — why would we ever expect our political system to arrive at good outcomes?

In and of itself, a law that bans tanning for those under 14 and requires parental permission for minor 14-18 isn’t the end of freedom in America.  But it represents an increasingly aggressive mindset that is eager to micro-manage people’s behavior, including banning fatty foods and salt.


13 Responses to “A few clarifications on tanning beds”

  1. Vitamins says:

    I really like this post. You are correct, risks are everywhere.
    Tanning beds in my opinion greatly increase the risks.

  2. uvlite says:

    I recently posted on the new law in California that bans indoor tanning for those under 14, and prohibits 14-18 year old minors from using tanning beds without their parent’s permission.  A few additional thoughts.


    Th

    e

    new California law (the one you linked..) actually bans all youth under 18. 

     

    The 14-18 parental permission option has been removed. Probably because California did get the memo. And I’m pretty sure they got the memo on this recent study that points out almost 40% of university students surveyed were introduced to tanning by their mothers. (And

    ‘the ones who went with their mothers first also started around age 14, on average, two years earlier than the others, who started around age 16

    .’)

    http://well.blogs.nytimes.com/2010/12/28/the-tans-that-bond/

     

    Here’s a cost benefit analysis for you to read up on, titled

    The Economic Burden of Skin Cancer in Canada http://www.partnershipagainstcancer.ca/wp-content/uploads/Economic-Burden-of-Skin-Cancer-in-Canada-Report-Final1.pdf

    Here you will see the long running and aggressive Australian SunSmart program used to calculate cost savings. The study predicts the direct and indirect costs avoided during the twenty eight-year modelling period are estimated to total two point twelve

    billion dollars

    , or 7.8 times the cost of prevention.

     

     

     

    I’m curious; you tell us the various salons you contacted are ditzy when it comes to the intensity of their product, and that

    ‘individuals should have enormous discretion over decisions in their own lives

    .’ Do your moral and pragmatic issues really stop you from recognizing children as individuals?  (Or are they just property, to do with as their parents wish?) My moral principles are telling me that no citizen has the right to sign another one up for a health debt. Not even a parent. Can you quit standing on principal here and think of kids who burn when their parents don’t? I was one of them,  and I got melanoma.

  3. Anonymous says:

    I work for the tanning industry and can tell you that the majority of UV beds to utilize UVB light, it depends on the bulbs you are using. But most bulbs emit 95% UVA and 5% UVB, much like the noontime sun. True, intensity is not the same and is greater than the sun, but that is a separate issue. This is why sessions in a tanning bed are thoroughly regulated by skin type, and the fairest skin type (Type 1) is not allowed to tan in most upstanding establishments. Intensity is also why you can achieve in a couple 10 minute sessions in a sunbed what would take hours in sunlight.

    Unlike professional sunbeds, dermatologists use "light therapy" all the time in burning doses, yet try to shut down tanning institutions that regularly educate and monitor their clients. There is a lot of hypocricy here and I think your thoughtful insights contrast with the vast majority of people who think they know enough to weigh in on this issue. Thanks for the post.

    • Leif Vasstrom says:

       The days of believing that it is simply a matter of how many lamps and the total wattage or UVB % are a thing of the past as it relates to True Performance.

      The issue today is to better understand the nanometer scale and the mw/cm² as the true measure of tanning efficiency, performance and customer satisfaction.The past few years there has been much discussion in the industry on the importance of lamp output, the relative amounts of UVA and UVB and who is manufacturing the best and most tanning efficient lamps.  Unfortunately, inaccuracies and partial understanding by many dealers and distributors – even manufacturers and their reps – have clouded relevant information across the tanning industry.

      After talking to many salon owners over the past few years it is clear that rather than discussing important information that determines the quality and output of a particular brand of lamp, many in the industry choose only to quote hard and fast numbers that rate a lamp’s UVB percentage, or total wattage and sometimes even just the number of lamps the unit is equipped with. Important factors such as the quality of components used in manufacturing, the manufacturing process and the subsequent “shape” of the output in mw/cm² - across the UV spectrum - often go undisclosed. Where does the particular light deliver the majority of its mw/cm² on the UV spectrum?  Where is the UVB peak?  Where is the UVA peak?  At what voltage has the lamp been tested: 208, 220 or 240 volts?  What are the real test results in mw/cm², how high are the peaks and where on the nanometer scale do they fall? 

       Small wonder politicians and even people who consider themselves enlightened are confused.

      • Anonymous says:

        Fair enough, but your comment is irrelevant to my point, which is that UVB light is what produces vitamin D. I was simply pointing out that contrary to the author’s statement that "Third, the typical experience in a typical tanning bed does not replicate the experience of being in the sun.  Tanning beds tend to go heavy on UVA, which doesn’t stimulate the production of Vitamin D, and with higher intensity levels than most people would typically experience (particularly away from the equator)." My comment simply corrects the implication that natural sunlight DOESN’T "go heavy on UVA," (it does) and the other implication that tanning beds lack the UV necessary to produce vitamin D (they don’t). These  are both fallacies. My comment was also explaining WHY the intensity of a tanning bed is higher, and why this should not be construed so easily as a weakness. The science of lamp quality and performance is not what I am addressing. It is fair to say that any distributor, manufacturer or person who stands to gain from a product is under some degree of bias, under which innocent people get bad information. It’s a sad fact of capitalism in the modern age. Thank you.

        • Leif Vasstrom says:

           Well, anonymus, I am not sure where and how you get your information, but I have been in this business for 35 years and I do know a fair amount of sun light as well as tanning beds. This is why I stated: "Where does the particular light deliver the majority of its mw/cm² on the UV spectrum?  Where is the UVB peak?

           
          Fact is that one can ‘make" the lamp and filters produce pretty much what one wants it to do these days, and fact is that the right UVB spectrum is not necessarily what the sun gives out but what a modern tanning system produces. I will stress that tanning in moderation, in a good tanning unit is good for you in that it does produce the UVB that is needed for Vitamin D production, far more so than any foods or pills.
  4. Pieter says:

    John,

    Have you ever considered using a reptile lamp for vitamin D production? See this link: http://www.vitamindwiki.com/tiki-index.php?page_id=982

    Cheers,

    Pieter

  5. ThatGuy says:

    John,

     

      Spot on analysis here. What troubles me is that all of these efforts to legislate health are very dogmatic. That is, they push grains, lean proteins, and low fat. Maybe I’m a hypocrite, because I don’t cringe when I hear about taxing soda (can we agree it has absolutely no redeeming qualities?), but when I hear about "fat taxes" and the like, I just see my grocery bill climbing as I try and stay healthy and primal. Frustrating. 

  6. Jim says:

    John,

    I think, in the future, the transparency of power of the Internet will provide a close approximation to what you are looking for. 

    For now, in practice, I think the spreadsheet you seek is actually collapsed into a single question:

    Will it get me votes and/or donations that will help me get re-elected?

    If yes, then support it.

     

     

      • Leif Vasstrom says:

         John,

        First I like your style – both intellectually and personally.

        The way you write – especially as it relates politicians and the technocracy we are now living in – is envigorating even for – maybe especially – a transplant like me who came here from Finland. I came here to live in the country of the free, with the freedom to do anyhting and be able to live one’s dream. Now it seems politicians, both local and in Washington, are doing their best to micro manage everyone’s life, when they should think differently (OK a Jobsian). These people should work on the big picture and let people take care of themselves.  The CA Tan Ban is just one example. The Tan Tax is another, one which ultimately brings less revenue to the IRS from the tanning industry.

        The type of politician that seeks to micro manage things, is the type who have no real vision for their constituency’s actual needs on a go forward basis. They simply have a need to listen to him/herself talk about some ill thought of legistlation that in the end serves no purpose,  By the way, while the USA is getting more regulated, the Nordic countries are letting loose of the reigns that were pretty strong 30 years ago, and are realizing that smart well educated people can take care of themselves and make the right choices for themselves.

        Stay at it and good luck.

  7. Erica says:

     John, I’m not sure if you’ve read The Vitamin D Solution or not, but it was very enlightening for me about all aspects of sun exposure. Dr. Holick is in support of tanning beds IF they have the correct ratio of UV lights.

    Vitamin D is a huge problem in America even for people in CA. I think better information on sun exposure is something that is desperately needed instead of people being afraid of any sun exposure without using sunscreen. I don’t think banning tanning salons for minors will be helpful in the least. As skin cancer seems to be linked to low vitamin D levels along with a multitude of other health issues.

    • John says:

      I have indeed…and have even met with Dr. Holick. His book has terrific info….didn’t have time to cite all his rejoinders in the post

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