



Position statement - Solariums (archived)



This position statement is endorsed by the Australasian College of Dermatologists



Solariums emit UV radiation levels up to six times higher than the midday summer sun; their use is a serious skin cancer risk factor. Cancer Council calls for a ban on solariums in all states and territories.





Recommendations Cancer Council Australia recommends that all State and Territory Governments commit to a complete ban of solariums, as has been announced by the New South Wales, South Australian, Victorian, Western Australian, ACT and Queensland State and Territory Governments. Cancer Society of New Zealand recommends a total solarium ban in New Zealand. Cancer Council Australia, the Cancer Society of New Zealand and the Australasian College of Dermatologists do not recommend the use of solariums for cosmetic purposes or to boost vitamin D levels. Back to top

Background

The desire to acquire a tan for fashion or cosmetic purposes has led to the development of a large solarium industry in Australia and New Zealand. There was considerable growth in the industry, particularly in the decade to 2006. Audits showed increases in the number of solariums advertised in the Yellow Pages business directories of almost 400% in Australian capital cities and almost 250% in New Zealand between 1992 and 2006[1][2]. In Australia, there have been more recent decreases in the number of solariums in some states, following negative media and the introduction of legislation[3].

According to the Australian Standard, solariums may emit much higher concentrations of ultraviolet (UV) radiation than the sun – up to three times as strong as the midday summer sun[4]. However, a recent study found that 15% of tanning beds exceed this level, and some emitted up to six times more UVA than summer sun[5].

Solariums emit UVA and UVB radiation, both known causes of skin cancer. In general, solariums predominantly emit UVA, however in recent years, solariums have been manufactured to produce higher levels of UVB to mimic the solar spectrum and higher levels of UV radiation intensity to speed up the tanning process.

Overexposure to UV radiation from the sun and artificial sources is of considerable public health concern; playing an important role in the development of skin cancer, cataracts and other eye conditions, and suppression of the immune system. Cumulative UV radiation also results in premature skin ageing.

Given the health risks associated with the use of solariums, Cancer Council Australia, the Cancer Society of New Zealand and the Australasian College of Dermatologists do not recommend the use of artificial UV radiation tanning devices for cosmetic purposes. For the same reason it is not recommended that solariums be used to boost vitamin D levels.

It is recognised however, that while solariums continue to be available to the public, there is a need to reduce the risks associated with their use.

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Solarium use and skin cancer, skin ageing and eye damage

No solarium can provide a safe tan[6]. Adverse health effects associated with UV radiation including skin cancer and premature skin ageing have been well documented in international and national reports for many years[7][8][9][10]. Furthermore, the body of evidence directly linking solarium use to adverse health effects continues to grow.

The findings of a recent Australian study indicate that sunbed use is not only associated with increased risk of early-onset melanoma, but that the risk increased with greater use, an earlier age at first use and for earlier onset disease. The study estimated that one in six melanomas in Australian young people aged 18 to 29 years, would be prevented if solariums were shut down[11].

It has been estimated that each year in Australia, 281 new melanoma cases, 43 melanoma-related deaths, and 2,572 new cases of squamous cell carcinoma are attributable to solarium use, at a cost to the health system of around $3 million[12].

The Australian Consumer and Competition Commission has issued a finding that all solarium operators have a duty of care to ensure solarium patrons are aware of the risks involved with solarium use.

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Skin and eye cancers

Exposure to solariums was first listed as a known human carcinogen linked to malignant melanoma of the skin and eye in the Ninth Report on Carcinogens in 2000[13].

A systematic review of the research on the link between skin cancer and solarium use concluded that the risk of melanoma from any sunbed use was 20% which rose to 59% if exposure was before 35 years of age[14]. This risk increases with number of sunbed sessions; 1.8% increase in risk for each additional sunbed session per year[14]. Furthermore, increased melanoma risk associated with sunbed use is found in all Caucasian populations, irrespective of the individual skin type[14].

Further findings from this systematic review are summarised below[15]:

increased risk of squamous cell carcinoma of the skin associated with sunbed use;

no conclusive evidence with regard to a relationship between basal cell carcinoma and solarium use;

suggested detrimental effects from solarium use on the skin’s immune response; and

little if any protection offered by artificial tanning against solar damage to the skin from subsequent sun exposure.

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Pre-cancerous lesions

Pre-cancerous actinic keratoses and Bowen’s disease (squamous cell carcinoma in situ) have also been reported in the sunlight-protected but solarium-exposed skin of fair-skinned users after just two to three years of regular solarium use[16].

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Skin ageing

UV radiation such as from a solarium causes premature ageing of the skin. This may be evident as increased skin wrinkling, irregular pigmentation and altered skin texture (photoageing)[17][18][9][19]. Photoageing includes wrinkling and loss of skin elasticity. It is generally irreversible without cosmetic surgery.

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Eye damage

Acute effects of UV radiation on the eye include photokeratitis (inflammation of the cornea and the iris), and photoconjunctivitis (an inflammation of the conjunctiva, the membrane that lines the inside of the eyelids and white of the eye). Long-term effects of UV radiation exposure of the eye may include the development of cataracts, pterygium (white or creamy opaque growth attached to the cornea), and squamous cell cancer of the conjunctiva.

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Users at increased risk

While all solarium users are at risk of adverse health effects, certain people are at increased risk of harm. The current voluntary code of conduct, Australasian Standard AS/NZS 2635:2008 sets out (among other guidelines) a number of restrictions designed to protect those at greatest risk[4]. Many of these restrictions are now legislated in most states and territories (see Regulation below).

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Fair skinned people

Those who have fair skin which always burns and never tans in the sun (Fitzpatrick type 1 skin), are at increased risk of skin cancer[20][17]. The Standard states that people with this skin type shall not be allowed to use a solarium. The Standard additionally recommends that people with skin that burns easily and tans only minimally (Fitzpatrick type 2 skin) should not use solariums.

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Youth and adolescents

Epidemiological evidence suggests that UV radiation exposure in childhood is important in determining lifelong skin cancer risk[21][22][23]. The Standard recommends that those under the age of 18 be banned from using solariums[4].

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Other risk factors

Some cosmetics and prescription medications including anti-depressants, antibiotics, drugs for high blood pressure, some medicines for skin conditions, drugs that suppress the immune system and some anti-inflammatory drugs can photosensitise the skin, increasing its sensitivity to UV radiation. This can decrease the time it takes for the skin to burn in a solarium[24].

The Standard recommends that clients be informed of the additional risk to those ‘taking certain medications by mouth or applying medications or certain cosmetics to the skin’.

Those who have previously been treated for skin cancer or solar keratoses are also recognised as being at increased risk under the Standard which sets out that ‘sun tanning unit exposure is not recommended’ for this group.

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Regulation

At present the solarium industry in Australia is regulated on a state-by-state basis, as such legislation differs in different jurisdictions. Table 1 gives an overview of state and territory legislation and key dates.

The National Directory for Radiation Protection was developed in 2004 as a means to develop consistency in the radiation safety practices of different jurisdictions. The Directory includes nationally agreed requirements for the possession and use of solariums. It can be found on the Australian Radiation Protection and Nuclear Safety Agency website.



Table 1. State and territory legislation covering solarium use

Location State/territory legislation & key dates Provision New South Wales Announcement on 4 February, 2012 of a state-wide ban of solariums State-wide ban of solariums, effective 31 December, 2014 Amendments to Radiation Control Regulation 2003 introduced on 29 May, 2009 Increased safety provisions, see below South Australia Announcement on 25 October, 2012 of a state-wide ban of solariums State-wide ban of solariums, effective 31 December, 2014 Legislation introduced 1 March, 2009 Requires operators to be licensed Legislation introduced 14 March, 2008 Compulsory for solarium operators to comply with Standard Victoria Announcement on 13 December, 2012 of a state-wide ban of solariums State-wide ban of solariums, effective 31 December, 2014 Interim legislation introduced on 1 February, 2008 with legislation introduced on 1 February, 2009 Increased safety provisions, see below Australian Capital Territory Announcement on 13 June, 2013 of a territory-wide ban of solariums Territory-wide ban of solariums, effective 31 December, 2014 Amendments to the Radiation Protection Act 2006 took effect on 17 November, 2010 Increased safety provisions, see below Queensland Announcement on 20 October, 2013 of a state-wide ban of solariums State-wide ban of solariums, effective 31 December, 2014 Announcement in December 2012 of a ban of new solariums, to be implemented 1 January, 2013 Businesses no longer able to buy new tanning units Amendment to the Radiation Safety Regulation 2010 to commence 1 June, 2011 Increased safety provisions, see below Legislation 5 November, 2008 for ban effective 1 March, 2009 Minors (under the age of 18) banned from using solariums Tasmania Lower House motion passed on 21 November, 2012 to ban solariums State-wide ban of solariums (except for medical purposes) by 2014 Guidelines for the Operation of Solaria in Tasmania (considered regulatory and must be complied with or fines should result) commenced 26 August, 2009 Increased safety provisions, see below Northern Territory Radiation Protection Act started on 5 October, 2009 No ban announced Licensing of solariums in accordance with the National Directory for Radiation Protection Western Australia Announcement on 21 April, 2015 of a state-wide ban of solariums State-wide ban of solariums, effective 1 January, 2016 Announcement made on 4 April, 2008 for legislation to be introduced 2 September, 2008 for registration of all commercial tanning units under the section 36 of the Radiation Safety Act State-wide ban of solariums, effective 31 December, 2014 Increased safety provisions, see below

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Australian Capital Territory

On 13 June, 2013, the ACT Government announced it would ban all commercial solariums from 31 December, 2014.

The Radiation Protection (Tanning Unit) Amendment Regulation 2010 (No 1) commenced on 17 November, 2010. The Regulation puts in place a number of safety requirements including use of the Fitzpatrick skin assessment for each client, exclusion of persons with pale white skin and those under 18 years of age. The Regulation also requires registration of tanning units and licensing of operators by the ACT Radiation Council.

An overview of the responsibilities of solarium owners and operators can be found on the ACT Government Health Information website.

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New South Wales

On 4 February, 2012, the NSW Government announced it would ban commercial solariums from 31 December, 2014.

The NSW Radiation Control Amendment (Tanning Units) Regulation commenced on 29 May, 2009. Safety requirements of the current Regulation include the use of the Fitzpatrick skin assessment for each client, exclusion of persons with pale white skin and those under 18 years of age, and appropriate training of all operators.

More information is available from the Department of Environment, Water and Climate Change.

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Northern Territory

The Radiation Protection Act started on 5 October, 2009. Under the act, a licence is required to own and operate a radiation source, and users must be accredited. Tanning units must be registered under the Act. The Act is written in accordance with the framework described in the National Directory for Radiation Protection.

Find more information on the Northern Territory Government Department of Health website.

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Queensland

In October 2013, the Queensland Government announced a ban on commercial solariums, effective from 31 December 2014. This followed a December 2012 announcement to ban new commercial solariums, from 1 January 2013.

The solarium industry in Queensland has been regulated since 1 June 2011. Owning and operating a solarium in Queensland is dependent on compliance with the requirements of the Radiation Safety Act 1999 and the Radiation Safety Regulation 2010. Solarium operators are required to hold a possession license, take into account skin type and undergo training to minimise risk to consumers.

Solarium use for cosmetic purposes in commercial settings has been restricted to people aged 18 and over since March 2009, when section 47A of the Radiation Safety Act 1999 was introduced.

More detailed information about the regulatory requirements for solarium operators in Queensland is available from the QLD Health website.

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South Australia

On 25 October, 2012, the South Australian Government announced it would ban all commercial solariums from 31 December, 2014.

The solarium industry has been regulated in South Australia since March 2008. Regulations require any person who operates a solarium to be licensed under the Radiation Protection Act.

Regulations require operators of solariums to abide by the Australian Standard AS/NZS 2635:2002 Solaria for cosmetic purposes.

See the South Australia Environment Protection Authority website for more information on the requirements of solarium owners.

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Tasmania

The lower house of the Tasmanian Government passed a motion on 21 November, 2012 to ban solariums (except for medical purposes) by 2014.

Current guidelines are pursuant to section 184 of the Tasmanian Public Health Act 1997 and effective as of 26 August, 2009. The guidelines ban people aged under 18 and those with very fair skin from using tanning units for cosmetic reasons. Users must sign a consent form before beginning a course of tanning. From March 2010 operators require training in identifying skin types.

More information is available from the Tasmanian Department of Health and Human Services.

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Victoria

On 13 December, 2012, the Victorian Government announced it would ban commercial solariums from 31 December, 2014.

The solarium industry in Victoria has been regulated since 2008. Any person or business that possesses, sells or maintains a tanning unit needs to hold a management licence. In February 2009, the Victorian Government introduced further changes to the management licence for tanning units consistent with the revised Australian standard, which was released in January 2009. The licence conditions were again strengthened in late 2010 stipulating that operators must keep records of proof-of-age documentation for all customers, and making training in conducting skin checks mandatory for all those operating tanning beds. These apply to the operation of all solariums in Victoria.

Key requirements of the licence include training of staff, assessment of skin type and exclusion of those with very fair skin (skin type I) and people under the age of 18, display of health warnings and completion of a consent form by clients before solarium use.

The Victorian Government also introduced a mystery shopper monitoring program from late 2010 in conjunction with their other compliance activities to ensure the legislation is enforced. For more information on solarium regulation in Victoria see the Guide to requirements for solaria in Victoria.

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Western Australia

In 2008, registration of all tanning units for cosmetic purposes in a commercial setting became mandatory in Western Australia under the section 36 of the Radiation Safety Act.

The registered owner of a solarium must comply with the conditions of the act. Key requirements include that people under the age of 18 and those with very fair skin (skin type I) are banned from using solariums, skin assessments are undertaken and consent forms completed by all clients, and all operators are trained on the requirements of the Radiation Safety Act.

For more information about the WA Safety Regulations Act contact the Radiological Council on (08) 9346 2260.

In April 2015, the WA Government announced a ban on commercial solariums, effective from 1 January 2016.

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New Zealand

On 5 April, 2013, the New Zealand Government announced a plan to introduce an age restriction on sunbed use, prohibiting people under the age of 18 from using commercial sunbeds.

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Further information

Cancer Council Australia

The Cancer Society of New Zealand



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References

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