Do Tanning Beds Cause Skin Cancer and Other Harmful Effects?

Elizabeth Carruth

What is UV radiation?

Before one can discuss harmful effects of tanning equipment and increased sun exposure, one must be familiar with the components of ultraviolet light and how affects the skin. Sunlight contains two types of ultraviolet (UV) light: UVA and UVB. UVA rays consist of longer wavelengths that penetrate deep into the dermal layer of skin. Limited exposure to UVA rays causes skin to tan; however, most experts agree that overexposure to UVA can lead to other long-term skin damage. UVB raysí wavelengths are much shorter, affecting the outermost layers of skin. UVB rays are known as the "burning rays" and are considered more dangerous. Tanning beds and sun lamps generally emit 93% to 99% UVA radiation increasing the benefits of a tan This is three times the UVA radiation given off by the sun (http://www.wraltv.com/features/healthteam/1998/0520-sunscreen/).
 
 

Whatís the difference between a tan and sunburn? 

It is also important to know what happens to the skin as it is tanned or burned and what the long-term, harmful effects may be. UVB rays are most responsible for a skinís burning. The rays actually pop the capillaries just beneath the surface of the skin (http://www.cybermall2000.com/stones/tanning/index.html). Long-wavelength, UVA rays have totally different results on the skin. As UVA rays penetrate into the skin, melanin granules are oxidized and tan, or, turn golden brown. However, UVB rays are required to stimulate these melanin granules to rise to the skinís surface, especially in skin that possesses small amounts of the pigment, melanin (http://www.shop.net/suncity/).
 
 

What makes tanning beds safer?

Most tanning bed industries agree that indoor tanning is much safer than receiving outdoor exposure to the sun. Light emitted from tanning equipment contains approximately 40% less UVB rays, the most harmful type of radiation, than does light from the sun. Tanning beds, therefore, have the power to control exposure time and the ratio of UVA to UVB rays for a "perfect balance" (http://www.shop.net/suncity/). Since tanning beds filter out most of the burning UVB rays, chances of getting burned decrease dramatically (http://www.darquetan.com/faq.htm). Therefore, the companies can claim that the tanning beds cannot be any more harmful than the sun.

Tanning salons also state that some UV radiation is needed for the manufacturing of vitamin D. Vitamin D certifies that a constant level of calcium remains in the blood and controls its absorption. In an advertisement for tanning equipment, one tanning bed company, The Beach House Tanning, claims that the sun is the only source of Vitamin D (http://www.beachouse.com/tanning_benefits.htm). However, vitamin D is also found in foods such as dairy products, cereal, and fish (http://shrike.depaul.edu/~vbard/vitdpg.html), and it takes far less UV radiation to obtain the necessary amount of vitamin D than it does to get a suntan (http://www.fda.gov/cdrh/tanning.html).

In addition, tanning industries claim that UVA radiation has no harmful effects on the skin. They say that only UVB radiation can harm the outermost layer of the skin. Since UVA rays penetrate deep into the skin, then they say that tanning beds cannot cause any type of premature aging, burn the skin, or thicken the skin, revealing a leathery type appearance (http://www.cybermall2000.com/stores/tanning/index.html).

In fact, The Beach House Tanning states that it isnít safe not to tan. They report that avoiding the sun highly increases the risks for many cancers including skin cancer and that most studies prove that people who are not exposed to the sun on a regular basis have a greater chance of acquiring some forms of cancer. One study that was conducted showed that malignant melanoma, the deadliest form of skin cancer, is actually more common in people who do not receive regular sun exposure and develops on areas that are not usually exposed to the sun. Also, some sun exposure abates or retards the development of breast, colon, prostate, and ovarian cancers (http://www.beachouse.com/tanning_benefits.htm). Actually, many studies have shown that heredity and repeated sunburn, which are not caused by tanning beds, are the most prominent factors for skin cancer. Since tanning is, "your bodyís natural defense against sunburn," as stated by Beach House (http://www.beachouse.com/tanning_facts.htm), and since, "tanning beds are a responsible way to get a base tan," as claimed by Raleyís Eurotan (http://beacon-www.asa.utk.edu/issues/v71/n38/tan.38n.html), then it is safe to say that tanning beds are a reliable source of UV exposure.
 
 

What are the harmful effects of tanning beds?

Nearly every single article that was researched concluded that indoor tanning is directly linked to skin cancer, specifically malignant melanoma, and other numerous health problems. Although tanning industries claim that UVA radiation is safe, medical research disproves this theory. Researchers say that because UVA rays penetrate deep into the skin, they destroy skin fibers and damage elasticity. Long-term effects of UVA rays include premature aging and wrinkles (http://pharmacy-web.com/WHP/InfoService/MedTribune/Abstract/M950728e.html). Scientists agree that UVA rays are less likely to cause burns, but that they are still linked to malignant melanoma, damage to the immune system, weakening of the skinís inner tissue, and other types of skin cancers (http://carrollton.greene.K12.il.us/websun/PrSnLmp.htm). In fact, studies show that large doses of UVA lead to an increased risk of developing skin cancer (http://beacon-www.asa.utk.edu/issuew/v71/n38/tan.38n.html). From his research, Dr. David Sidransky concluded that UVA radiation causes the same damage as UVB radiation to skin cells which leading to cancer. In cases where exposure to light was increased, it was more likely that the damage would exceed the constructive, cellular-repair mechanisms, and a tumor would be more likely to develop (http://pharmacy-web.com/WHP/InfoService/MedTribune/Abstract/M950728e.html).

A study conducted in Sweden helps to prove that tanning beds are a major factor in the development of malignant melanoma. Different people, all under the age of 30, were included in the study. The data concluded that the people who used tanning beds more than 10 times a year were seven times more likely to develop malignant melanoma than those who did not use tanning beds as often. Researchers estimated that by the year 2000, the risk of developing skin cancer for those who did not use tanning beds would be one out of every 97 persons, and that the chances for those who did use tanning beds would be one out of every 13 persons (http://winonanet.com/health/articles/1996/feb/tan.html). The study also concluded that melanoma risks are increased by 300% for those using tanning beds occasionally, and that the risks increase by 800% for those who use tanning beds more than 10 times a year (http://www.hlthmall.com/tanning.html).

Dr. Douglas Reintgen believed that as long as tanning devices were not used in excess and the customer avoided burns, then the equipment could be considered safe (http://pharmacy-web.com/WHP/InfoService/MedTribune/Abstract/M951728e.html). Service/MedTribune/Abstract/M951728e.html). However, it has been proven that tanning beds do cause sunburns, and are, therefore, dangerous (http://nytsyn.com/live/discuss/cancer/0029.html). Physicians of the Geisinger Health System report that one sunburn doubles the risk of developing skin cancer (http://www.geisner.edu/ghs/pubtips/T/TanningWithouttheSun.htm).

Tanning is also skin damage. Although skin cancer has been associated with UVB radiation and sunburns, scientists say that even tanning in moderation produces the same harmful effects, as would a burn. Tanning causes premature aging, causing the skin to appear leathery and wrinkled, and also damages the immune system (http://www.fda.gov/cdrh/tanning/html). Other sources reveal that tanning always damages the skin. Plastic surgeon Dr. Dean Johnson who treats skin cancer patients in 25% of his surgeries, declares, "There is no safe tan" (http://www.icflorida.com/healthfitness/prevention/sun.html).

A number of various authorities warn the public of the dangers of tanning devices. Dermatologists believe that tanning beds are a leading factor in skin cancer cases (http://www.ivanhoe.com/docs/backissues/tanningbedcancer.html). The Food and Drug Administration (FDA) lists tanning beds as possible health hazards (http://beacon-eee.asa.utk.edu/issues/v71/n38/tan.38n.html), and the FDA and the Centers for Disease Control (CDC) encourage people to avoid using tanning and sun lamps (http://www.fda.gov). Even the American Medical Association (ADA) and the American Academy of Dermatology (AAD) are fighting to ban the use of tanning equipment for non-medical purposes (http://www.fda.gov/cdrh/tanning.html).

Both types of UV radiation can cause damage to blood vessels, photosensitivity (allergic) reactions, or even eye damage (http://winonanet.com/health/articles/1996/feb/tan.html). According to the CDC, tanning beds create problems in the eyes such as conjunctivitis and corneal infections. Ultraviolet rays can cause serious damage to the cornea and retina (http://www.Isu-eye.Isumc.edu/tanning.html). 

What are peopleís motives for tanning?

Why do people desire a tan? In general, most people are concerned about their appearance. It can be assumed that people desire to be considered beautiful by others and to have more pleasant features. The stereotypical good-looking person is usually a thin female or muscularly built male with nice, clean hair and bronze or tan skin. In recent years there has been a tremendous amount of pressure placed upon females, especially teenagers, to become what the media considers to be a beautiful person. All this explains why more white female teens are using tanning equipment with disregard to medical warnings.
 
 

Why wonít people listen? 

Because of exposure to sun, tanning beds, and sun lamps, the number of skin cancer cases has increased dramatically. It has been predicted that this year, more than one million new skin cancer cases will be diagnosed. Also, malignant melanoma can be fatal if it is not detected early. This year in the United States, 38,000 cases and 7,300 deaths are being anticipated (http://www.fda.gov/cdrh/tanning.html). So, why are people not complying with the warnings? Why are people not changing poor skin care treatment? Perhaps the public is not fully aware of the harmful effects of UV radiation. Rex Amonett, M.D., Dermatologist, stated that most of his skin cancer patients are over 50. He also reported that lately more teenagers have become victims, and that this was probably due to the fact that now more than 2.5 million people are using tanning bed equipment daily (mostly teens) (http://www.ivanhoe.com/docs/backissues/tanningbedcancer.html). So, what is a personís motivation for tanning?

Which group is right?

Although benefits do exist from choosing to us tanning beds over bathing outdoors in the sun, tanning bed industries have failed to mention many important and harmful risk factors of tanning equipment. The long-term effects of UVA radiation far exceed the short-term, ephemeral benefits, and trust should be placed into the hands of scientists, researchers, and doctors.

What scientific research has been discovered on the effects of artificial tanning equipment? 

Studies regulated by medical researchers consistently report a number of interesting facts about the relationships between artificial tanning equipment and skin cancers. Studies prove that exposure to UV radiation is a risk factor for cutaneous malignant melanoma.1, 2 One study reviewed that approximately 80% of the radiation emitted by tanning lamps is in the UV range, proving tanning beds to be carcinogenic,3 and another study of Caucasian women with melanoma reported that women who had a history of sunburns had an increased melanoma risk, even if they also tanned.4 The reports also concluded that combined exposure to sunlight and tanning beds resulted in increased risks for developing melanoma.
 
 

Study of the UV radiation emitted by tanning beds: 

A Dermatology Department in the United Kingdom conducted a study examining DNA damage in human fibroblasts, cells that give rise to connective tissue, after they were exposed to artificial tanning lamps. During this experiment, a comet assay was performed in which cells UV-detecting cells were embedded into two different types of tanning beds to detect the amount of radiation emitted. The types of tanning equipment studied were 12 lamps of Philips TL80 W/10R (the Performance tanning bed) and five Philips TL80 W/10R lamps. The cells were placed in the tanning beds at a distance of about 35 centimeters from the lamps. In the Performance tanning bed, the UVA radiation was measured at 85-100W/m2, and the UVB radiation was found to be 16-19W/m2. For the TL80W/10R bed, the UVA and UVB radiation quantities were discovered to be 35-40W/m2 and 0.3-0.4W/m2 respectively. The radiation emitted by the sun was also measured using the same radiometers on a sunny day with the temperatures at about 25-24o C. The UVA radiation was 10-28W/m2, and the UVB radiation was measured at 4 Ė 9.5W/m2. Thus, the amount of UVA radiation, which penetrates deeper into the skin, was anywhere from about 3-8 times greater in the tanning beds than in the light from the sun. This amount depended on the type of tanning bed, but inevitably caused an increased in potential skin damage (Woollons, Clingen, Price, Arlett, & Green, 1997).

The harmful results caused by UVB radiation from tanning lamps were determined to include three types of damage to DNA. Cyclobutane pyrimidine dimers (CPDs) were induced, oxidized and hydrated pyrimidines were distorted, and breaks were found in the single-strands. The Performance sunbed was just as effective as sunlight for inducing CPDs. It was also discovered that the induction of these kinds of DNA damage occurred just before the development of skin tumors (Woollons, Clingen, Price, Arlett, & Green, 1997).

The scientists who conducted the study agreed that although the amount of evidence regarding the harmful effects of tanning lamps has been limited, it has recently been increasing. They concluded that it is highly likely that the lamps cause DNA damage that is directly related to the development of skin cancers, cutaneous effects, and damage to the immune system. They believe that the public should be warned about the dangers of using tanning beds.5
 
 

Can a tan protect a sunburn or aid in the formation of vitamin D?

Previously, UV radiation has been used to prevent vitamin D deficiency, attempting to result in a suntan rather than a burn. A study was conducted by doctors from a Department of Biochemical Medicine and Dermatology in which 38 members of a hospital staff were exposed to radiation for two sessions of 15 minutes everyday for two weeks. The time of exposure was increased to 25 minutes for each session after four days. The amount of radiation in the skin of five more volunteers was also determined to provide a control group. Ten members of the experimental group could not complete the sessions because severe adverse skin reactions or other health related problems evolved. Of the 28 subjects who completed the course, 20 developed sunburns in which 11 cases involved itching. When studying the maintaining of vitamin D, the experimental group consisted of 39 people, ages 20-46, and a control group of five volunteers, ages 28-44, was also formed. The results of the study revealed that a substantial increase in the serum levels of vitamin D occurred in the experimental group, even when only small amounts of radiation were emitted (Devgun 1981).6
 
 

Ultraviolet radiation can cause damage to eyes. 

Another study was completed, examining the effects of UV radiation from artificial sources on the cornea and studying the production of proimflammatory cytokines. Normal human corneas and stroma cells were obtained from eye banks, and keratocytes were grown culture dishes. The corneas were placed in the dishes. Some were left alone as a control, and the remaining ones were exposed to UV radiation for three hours. The corneal stroma cells were cultured and analyzed to verify that they were not contaminated. The experiment proved that there was a 30-fold increase in radiation of the stroma cells compared to the cells that were not exposed to the radiation. This proved that UV-mediated corneal inflammation can be found in people who are exposed regularly to UV radiation (Kennedy, 1997).7
 
 

Researches report why people do not adhere to warnings.

A study was conducted in the metropolitan area of Stockholm County, Sweden. Over 1500 students, 14 -19 years of age, from 46 schools, and in 3500 different classes were surveyed. The questionnaire included 26 questions concerning age, sex, skin type, tanning bed and sunscreen use, sunbathing habits, reaction to tanning bed use, and skin disease. The study was designed to examine skin types vs. sunbed and use of protection, sunburns caused by tanning beds, and tanning beds vs. skin disease. The results revealed that most of the adolescents surveyed reported that they had brown hair and type III skin, meaning that they possessed brown skin colors. The students could have quite possible felt that they were not in a high-risk category for developing skin cancer, and, therefore, did not consider tanning beds to be harmful. Forty-four of the participants reported that they had received erythema, or sunburn, from a visit to the tanning bed. Finally, the questionnaire proved that 23% of the students who use sunbeds reported having skin diseases such as eczema (an inflammation of the skin and the outbreak of lesions), psoriasis (inflammation of skin and white, scaly patches), or acne/seborrhea. However, only 16% of the students who did not use sunbeds reported having the same skin diseases. One myth of society includes that sunlight and possibly light emitted by tanning beds helps to clear acne; however, tanning bed use was reported in 63% of the students with acne. Ultimately, the surveyors concluded that the risk factors for the development of skin cancers are environmental, behavioral, and genetic (Boldeman, Beitner, Jansson, Nilsson, & Ullen).8

A study of New Zealand residents was also performed relating sun behaviors to the risks of acquiring melanoma. A group of 909 21-year olds answered questionnaires concerning how often they used sunscreen, how often they were sunburned, and what methods would be required to convince them to protect their skin. The consensus of surveys concluded that obtaining a good base tan would decrease their chances of developing melanoma. The reports revealed that the public is unaware of the harmful and potentially deadly effects of UV radiation and skin damage, particularly when dealing with tanning beds.9

Medical researchers agree that artificial tanning equipment emits predominantly UVA and some UVB radiation, UV rays cause sunburns, and sunburns increase the chances that one will develop skin cancers, including malignant melanoma. Therefore, the conclusion can be made that tanning beds can cause skin cancer. Scientists also agree that the best method of modification of potentially harmful sun behaviors is to educate people of the risks of acquiring melanoma and to eradicate the perceptions of risks.

Bibliography
 
 

Miller, S.A., Hamilton, S.L., Wester, U.G., & Cyr, W.H. (1998). An analysis of UVA emissions from

sunlamps and the potential importance for melanoma. Photochemistry and Photobiology; 68(1): 63-70. (abstract).
 
 
Swerdlow, A.J. & Weinstock, M.A. (1998). Do tanning lamps cause melanoma?. Journal of the American

Academy of Dermatology; 38(1): 89-98. (abstract).
 
 

DeMarini, D.M., Shelton, M.L., & Stankowski, L.F. (1995). Mutation spectra in Salmonella of sunlight,

white fluorescent light, and light from tanning salon beds: induction of tandem mutations and role of DNA rapair. Mutation Research. 327(1-2): 131-149. (abstract).
 
 
Cress, R.D., Holly, E.A., & Ahn, D.K. (1995). Cutaneous melanoma in women. V. Characteristics of those who tan and those who burn when exposed to summer sun. Epidemiology; 6(5): 538-543. (abstract).
 
 
Woollons, A., Clingen, P.H., Price, M.L., Arlett, C.F., Green, M.H.L. (1997). Induction of mutagenic DNA damage in human fibroblasts after exposure to artificial tanning lamps. British Journal of Dermatology 1997; 137: 687-692.
 
 
Devgun, M.S., Johnson, B.E., & Paterson, C.R. (1981). Tanning, protection against sunburn and vitamin D

formation with a UV-A Ďsun-bed.í British Journal of Dermatology 1982; 107: 275-284.
 
 

Kennedy, M., Kim, K., Harten, B., Brown, J., Planck, S., Meshul, C.,Edelhauser, H., Rosenbaum, J.T.,

Armstrong, C.A., & Ansel, J.C. (1997). Ultraviolet Irradiation Induces the Production of Multiple Cytokines by Human Corneal Cells. Investigative Ophthalmology and Visual Science. Sept, 1997, Vol. 3, No. 10.
 
 
Bolseman, C., Beitner, H., Jansson, B., Nilsson, B., &Ullen, H. (1996). Sunbed use in relation to phenotype, erythema, sunscreen use and skin diseases. A questionnaire survey among Swedish adolescents. British Journal of Dermatology 1996; 135: 712-716.
 
 
Douglass, H.M., McGee, R., & Williams, S. (1997). Sun behavior and perceptions of risk for melanoma among 21-year old New Zealanders. Australian and New Zealand Journal of Public Health 21(3): 329-334. (abstract).

 

 

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