Practices of Unregulated Tanning Facilities in Missouri: Implications for Statewide Legislation

Division of Dermatology, Washington University School of Medicine, Campus Box 8123, 660 South Euclid Ave, St Louis, MO 63110. .
PEDIATRICS (Impact Factor: 5.47). 03/2013; 131(3):415-22. DOI: 10.1542/peds.2012-1781
Source: PubMed


The incidence of skin cancer has increased in the United States, concomitant with increased UV radiation (UVR) exposure among young adults. We examined whether tanning facilities in Missouri, a state without indoor-tanning regulations, acted in accordance with the Food and Drug Administration's recommendations and consistently imparted information to potential clients about the known risks of UVR.
We conducted a statewide telephone survey of randomly selected tanning facilities in Missouri. Each tanning facility was surveyed twice, in the morning (7 am-3 pm) and evening (3-10 pm), on different days, to determine intrasalon consistency of information provided to potential clients at different times.
On average, 65% of 243 tanning-facility operators would allow children as young as 10 or 12 years old to use indoor-tanning devices, 80% claimed that indoor tanning would prevent future sunburns, and 43% claimed that there were no risks associated with indoor tanning. Intrasalon inconsistencies involved allowable age of use, and UVR exposure type and duration. Morning tanning-facility employees were more likely to allow consumers to start with maximum exposure times and UV-A-emitting devices (P < .001), whereas evening employees were more likely to allow 10- or 12-year-old children to use indoor-tanning devices (P = .008).
Despite increasing evidence that UVR exposure in indoor-tanning devices is associated with skin cancer, ocular damage, and premature photoaging, tanning facilities in Missouri often misinformed consumers regarding these risks and lack of health benefits and inconsistently provided information about the Food and Drug Administration's guidelines for tanning devices.

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    ABSTRACT: Exposure to indoor tanning, especially at younger ages, is associated with increased risk of skin cancer. Even in states with parental consent requirements, teenagers used tanning facilities at high rates. In 2011, California became the first state to pass a complete ban on indoor tanning by those younger than 18 years. We sought to determine whether tanning facilities in California were in compliance with the new law. In a cross-sectional study, telephone calls were placed in May 2013 to a statewide random sample of tanning facilities by a study investigator indicating that she was 17 years old. Of 600 advertised indoor tanning facilities, 338 met inclusion criteria. A majority of respondents (77%, 95% confidence interval 72%-81%) told the underage caller that she could not use their ultraviolet tanning facility. Most facilities, however, denied any dangers from ultraviolet tanning (61%) and made unlawful claims of specific health benefits, including vitamin-D production (44%), skin disease treatment (22%), prevention of future sunburns (17%), and prevention or treatment of depression (8%). Tanning facilities may respond differently to a 17-year-old's request to tan in person versus by telephone. Given strong evidence linking indoor tanning to skin cancer, and the tanning industry's documented history of marketing specifically to teenagers, this study suggests that laws banning indoor tanning younger than 18 years can meaningfully impact access. Additional enforcement, however, may be required to bring about accurate disclosure of risk and prevent claims of unproven health benefits.
    No preview · Article · Oct 2013 · Journal of the American Academy of Dermatology
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