December Analytical Posting

http://www.medscape.com/viewarticle/856197

Skin cancer has been recently on the rise, especially among young people. Just today, the FDA released new guidelines regarding the use of tanning beds. Specifically, the guidelines would prevent anyone under the age of 18 from using high-powered UV sunlamps. In addition, anyone over the age of 18 will be required to sign a waiver every 6 months that says that they understand that using these lamps has health risks that include burns and skin cancers. According to Dr. Peiris of the FDA’s Center for Devices and Radiological Health, tanning lamps give off ultraviolet radiation that’s 10-15 times stronger than the midday sun. Skin damage from UV radiation is cumulative. In other words, it adds up over the course of one’s lifetime, which implies that the concentrated doses of radiation that are delivered by tanning beds are especially dangerous to children and teens.

These guidelines come approximately 1 year after the FDA reclassified tanning beds from lower risk to moderate risk devices. These very moderate risk devices were subsequently banned from anyone that was either under 18, had open wounds or injuries, or had a family history of skin cancer. The FDA also required that anyone that was regularly using tanning beds should get regular checkups for skin cancer. Although this reclassification initiated the suspicions regarding tanning beds, it was only a month later that the surgeon general publicly singled out tanning beds as a cause of disease.

Understandably, the Indoor Tanning Association (ITA) has been very public about its belief that the decision to use tanning beds should be a personal one, even despite the risks. Of course, it is easy to see the profit incentives driven behind this statement, since teens are the industry’s biggest customers. Nevertheless, 13 states as well as the district of columbia have banned indoor tanning for minors, and 23 other states have requires tanning booth operators to adhere to time limits set by sunlamp manufacturers. While restricting access continues to be the main priority, the FDA also has made suggestions to make tanning beds safer, including improving labeling and eye safety.

Personally, I feel that the tanning bed debate speaks to a broader dilemma within healthcare – that regarding the autonomy of the patient in making individual health choices. It’s been well established that tanning beds pose significant health risks, but does this mean that it is appropriate to restrict access? A similar argument could be made regarding the relationship between smoking and lung cancer and alcohol and drunk driving. The risk is well-defined in these cases, but nothing prohibits Americans from being able to engage in these risky acts. Should tanning beds be treated differently? Given the precedents that have been set, I’m not so sure.

 

 

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