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Among those who did use indoor tanning, 1,429 indoor tanning sessions were reported, with one in five sessions resulting in sunburn. In addition, while the study did not specifically measure eye damage incurred by participants, the data reveal that in 39 percent of the sessions, study participants did not wear goggles to shield their eyes from radiation. That frequent lack of eye protection raises concerns that participants may be at risk of injuring their eyes in addition to their skin.
Jerod L. Stapleton, PhD, behavioral scientist at CINJ and assistant professor of medicine at UMDNJ-Robert Wood Johnson Medical School, is the lead author of the study. "What our findings show is that indoor tanning -- advertised by the indoor tanning industry as a ‘controlled’ ultraviolet radiation exposure resulting in minimal risk of burn -- results in quite the opposite. Despite these claims, our results show that sunburn is a common occurrence related to tanning bed use. This is particularly worrisome given data that suggest sunburns increase future skin cancer risk," noted Dr. Stapleton.
As far as predictors, those who reported tanning-bed use at the highest levels prior to the study had a "significantly lower risk of experiencing indoor tanning-related erythema despite reporting the highest mean number of sessions during the study period." The authors say this finding suggests that perhaps those who are heavy users of tanning beds learn to adjust their tanning patterns in a manner that prevents burning despite their excessive exposure. While the authors say this approach presents somewhat less risk than one that induces burning, they also emphasize that there is no such thing as a safe tan.
Results also showed that a perceived susceptibility to burning from indoor tanning was positively associated with risk of burning. To further clarify, investigators examined the relationship between those with a sensitive skin type and their perceived susceptibility to burning and found a significant moderate correlation. For instance, they note that those more susceptible to burning because of their sensitive skin know this, but are unable to do anything to prevent such burns. The authors also note that some with sensitive skin may think it is necessary to burn first before achieving a tan. With such perceptions, the team notes that prevention efforts should seek to understand why individuals make the decisions they do, when they know they put themselves at an increased risk of burning.
"The biology of the skin-tanning response shows that any tanning or darkening of the skin is a sign of skin damage, and refraining from indoor tanning should be an overall goal for users to protect their skin’s health and appearance. However, health professionals know there are many indoor tanning users who refuse to give it up. In developing interventions for this population, clinicians may want to focus on the importance of avoiding sunburn as part of a harm-reduction approach, as previous intervention methods have not focused on that aspect before," Stapleton added.
The authors note there were limitations to the study, including a sole focus on a female college sample, although research indicates this population has a high rate of indoor tanning use. "Even though this study focused on young adults, our findings support the need to discourage tanning bed use by minors, since previous studies have shown that their skin is more prone to damage from UV exposure," said Stapleton. The authors also cite a potential for inaccuracies in reporting behavior in using the diary method, but say that because sunburn is a distinct and memorable event, it reduces the likelihood of misreporting.
With regard to future studies, the authors say information should be collected about the type of indoor tanning device used (ie: whether the device has high- or low-intensity UV light bulbs), saying that specific knowledge may determine user behavior as to how long the user chooses to tan.
Along with Stapleton, the authors include Joel Hillhouse, East Tennessee State University; Rob Turrisi, The Pennsylvania State University; June K. Robinson, Northwestern University; Katie Baker, East Tennessee State University; Sharon L. Manne, CINJ and UMDNJ-Robert Wood Johnson Medical School; and Elliot J. Coups, CINJ and UMDNJ-Robert Wood Johnson Medical School.
The study was supported by funding from the American Cancer Society: RSGPB-05-011-01-CPPB (Hillhouse).
About The Cancer Institute of New Jersey
The Cancer Institute of New Jersey (www.cinj.org) is the state's first and only National Cancer Institute-designated Comprehensive Cancer Center dedicated to improving the detection, treatment and care of patients with cancer, and serving as an education resource for cancer prevention. CINJ’s physician-scientists engage in translational research, transforming their laboratory discoveries into clinical practice, quite literally bringing research to life. To make a tax-deductible gift to support CINJ, call 732-235-8614 or visit www.cinjfoundation.org. CINJ is a Center of Excellence of the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School. Follow us on Facebook at www.facebook.com/TheCINJ.
The CINJ Network is comprised of hospitals throughout the state and provides the highest quality cancer care and rapid dissemination of important discoveries into the community. Flagship Hospital: Robert Wood Johnson University Hospital. System Partner: Meridian Health (Jersey Shore University Medical Center, Ocean Medical Center, Riverview Medical Center, Southern Ocean Medical Center, and Bayshore Community Hospital). Major Clinical Research Affiliate Hospitals: Carol G. Simon Cancer Center at Morristown Medical Center, Carol G. Simon Cancer Center at Overlook Medical Center, and Cooper University Hospital. Affiliate Hospitals: CentraState Healthcare System, JFK Medical Center, Robert Wood Johnson University Hospital Hamilton (CINJ Hamilton), Somerset Medical Center, The University Hospital/UMDNJ-New Jersey Medical School*, and University Medical Center of Princeton at Plainsboro. *Academic Affiliate