Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors
Karen Selick

GET UPDATES FROM Karen Selick
 

Let the Teens Tan

Posted: 02/24/2013 7:10 am

Should tanning salons be legally permitted to provide services to children and teenagers? Many people think they shouldn't -- but I say those people need to think twice.

Oakville, Ont., for instance, recently enacted a municipal by-law prohibiting the commercial tanning of anyone under age 18. Nova Scotia and British Columbia have both enacted province-wide bans, and Quebec followed suit effective February 1, 2013.

The result? According to this report by the CBC, Quebec teenagers have been skipping across the border to visit tanning salons in Ontario. No doubt teens in Oakville have found it feasible (even if somewhat inconvenient) to catch their artificial rays in neighbouring Mississauga or Burlington.

However, Ontario may soon put an end to teen tanning tourism with province-wide legislation of its own. Former premier Dalton McGuinty announced last September that his government would support a private member's bill -- the "Skin Cancer Prevention Act" -- tabled by NDP member France Gelinas. Although that bill died when the legislature was prorogued, I expect it to be reintroduced. According to Gelinas' website, 83 percent of Ontarians polled on this subject in June 2011 favoured such legislation.

Protecting teens from skin cancer seems like a no-brainer, especially when you hear the statistic that tanning opponents repeatedly toss around: namely, that using indoor tanning equipment before the age of 35 increases the risk of developing melanoma by 75%. Scary, right?

But statistics based on percentage increases should set off warning bells in every reader's head. Such numbers can be very misleading unless they also disclose the starting level from which the percentage increase was calculated. For example, suppose that only one person in Canada were to be murdered in 2014. If two people were murdered in 2015, that would constitute a shocking 100 percent increase in the murder rate -- but it would still be only two people, an extraordinarily low murder rate for a country of 34 million people.

I searched long and hard for any hint from tanning opponents about the starting point from which their scary 75 percent increase was computed. How many young people actually get melanoma? Nobody seemed to disclose this information -- neither France Gelinas, nor Cancer Care Ontario, nor the Center for Disease Control, nor the Canadian Cancer Society.

Finally, I consulted Statistics Canada's Causes of Death database (Table 102-0522). It turns out that in the decade from 2000 to 2009 (the latest year for which statistics were available), a total of 5 Canadians aged 19 or under died from malignant melanoma of the skin. That's only half a person per year.

Contrast this with the number of Canadians 19 and under who died of various other causes (StatsCan Table 102-0540) during that same decade: 195 deaths from falls, 627 from drowning, and a whopping 6,972 from what StatsCan calls "transport accidents".

The truth is that the actual risk (not the percentage increase in risk) of young people getting melanoma is tiny -- almost negligible -- compared with the risks of everyday activities that we don't think twice about allowing kids to engage in. We could prevent far more teen deaths and injuries by outlawing teenaged skating, swimming, bicycling and driving than by outlawing teenaged tanning.

Ah, but I can hear the statists cry already: "If it will save even a single teenaged life, it's worth it to ban tanning."

Actually -- no, it isn't.

Those who would ban teen tanning focus so intently on skin cancer that they seem completely oblivious to the health benefits that sun exposure (real or simulated) can confer. The ultraviolet rays of the sun allow our skin to form vitamin D, a hormone crucial for good health. Vitamin D deficiency is widespread in Canada today. As reporter Martin Mittelstaedt wrote in the Globe and Mail, "two-thirds of [Canada's] population has vitamin D levels below the amounts research is associating with reduced risk of chronic diseases...." Among the diseases that vitamin D guards against are "breast cancer, colorectal cancer, heart disease and multiple sclerosis."

A paper by Norwegian researchers entitled "Vitamin D, sun, sunbeds and health" published in April, 2012 in the journal Public Health Nutrition concluded: "The overall health benefit of an improved vitamin D status may be more important than the possibly increased CMM [cutaneous malignant melanoma] risk resulting from carefully increasing UV [ultraviolet] exposure." (The PubMed abstract is here.)

And now a maverick dermatologist, Richard Weller, has produced this TED talk. His research suggests that the sun's rays are not important just for their UVB (vitamin D-producing) component. The UVA rays -- those that tan us -- appear to help us avoid high blood pressure and cardiovascular disease by triggering the release of nitric oxide stored in the skin. This may account for the fact that Australians, with their high levels of sun exposure, have roughly 1/3 lower death rates from heart attacks and strokes than Scots with their low levels of sun exposure.

Dr. Weller says, "I'm a dermatologist. My day job is saying to people: 'You've got skin cancer. It's caused by sunlight. Don't go in the sun.' I actually think a far more important message is that there are benefits, as well as risks, to sunlight...Deaths from heart disease are a hundred times higher than deaths from skin cancer."

Science makes continual discoveries and advances that make our previous "knowledge" look like folly. All too often, we have allowed governments to make health decisions for us that have turned out to be dead wrong. Government agencies have approved drugs that later turned out to be killers. They have forbidden the publication of health information (for instance, that fish oils can prevent heart disease) that might have saved countless lives.

The rush to ban teen tanning looks like another example of legislation that will one day leave governments red-faced and back-pedalling. It could trigger a delayed increase in breast cancer or heart disease that would ultimately dwarf the number of melanomas prevented, but would leave epidemiologists scratching their heads wondering why.

Many tanning salons already insist on getting parental consent before tanning minors. It's a prudent practice that -- speaking as a lawyer -- I would encourage salons to adopt. However, the decision over whether to risk melanoma rather than heart disease should be left to the customer, not to the state.

Loading Slideshow...
  • Wear Sunscreen -- All The Time

    "Wear sunscreen constantly," says Christine Janus, executive director of the <a href="http://www.skinpatientalliance.ca/" target="_hplink">Canadian Skin Patient Alliance (CSPA)</a>, an organization that provides support for those with skin conditions. Janus recommends wearing about three quarters of a shot glass full or as much as you need to cover exposed skin. She also says we should reapply the lotion every four to six hours if you're going in the water or working out.

  • Don't Take Risks -- With Your Skin

    "If your skin looks or feels different, rough like sandpaper for example, get it checked -- don't wait," Janus says. Treatments for skin cancers exist, but the the more you expose your skin, the higher your risks are, she says.

  • Limit Exposure

    "Limit your time outdoors and during peak hours when the sun is up," Janus says.

  • Wear A Hat

    Make sure when you're outside you wear a hat. "Men should be wearing hat as well. The top spots for skin cancer for men is on their head and back," Janus says.

  • Try UV Clothing Or Umbrellas

    Ultraviolet clothing is also another level of protection, Janus says. There are now companies that manufacture specialized items that have a built-in UV layer. She also recommends an umbrella.

 

Follow Karen Selick on Twitter: www.twitter.com/@kselick

FOLLOW CANADA POLITICS
 
 
  • Comments
  • 56
  • Pending Comments
  • 0
  • View FAQ
Comments are closed for this entry
View All
Favorites
Recency  | 
Popularity
Page: 1 2 3  Next ›  Last »  (3 total)
12:50 AM on 04/13/2013
"Finally, I consulted Statistics Canada's Causes of Death database... It turns out that in the decade from 2000 to 2009 (the latest year for which statistics were available), a total of 5 Canadians aged 19 or under died from malignant melanoma of the skin. That's only half a person per year." Wow, Karen, you can do math, and consult a website. Slow clap. Karen Selick is either willfully misleading the public, or is so ignorant about skin cancer because she seems to think that melanoma happens immediately after sun exposure. She clearly does not understand a principle called lag time, so I suggest that both she and steven1984 look it up. It is the same reason why you can smoke cigarettes and not get lung cancer for many years, which I presume even Karen would not be so bold as to deny. Karen, no one is trying to protect teenagers from dying from melanoma as teenagers. We are trying to protect teenage users from becoming adult users (similar to cigarette users, a strategy that has proven successful). We are also trying to prevent teenagers from receiving unnecessary UV exposure at a vulnerable time in their lives, to prevent them from developing melanoma later in life. I know, this is such an evil concept... But I challenge you to actually provide evidence that your advocacy will result in more good than harm, based on scientific evidence. I also suggest you consult someone with medical knowledge first.
02:48 PM on 03/06/2013
“The Economic Burden of Skin Cancer in Canada: Current and Projected.” cont..

Melanoma was predicted to rise by 91% - from an estimated 4,755 cases in 2004, to 9,070 cases in 2031. The study reported “an average of 745 annual melanoma-related deaths from 2000 to 2004 (as compared to 204 annual deaths due to NMSC). This once again represents a substantial burden in terms of medical costs and years of life lost”

“Using data from some Canadian cancer registries and taking into consideration both initial and subsequent NMSC diagnoses experienced by individuals, there were an estimated 76,000 cases in Canada in 2004. As a comparison, the Canadian Cancer Society reported that all other cases of cancer in the country in 2004 totalled to 148,000. Even though the mortality rate of NMSC is low, the sheer volume of cases drives a large burden of treatment costs and lost productivity”

When the effect of an Australian ‘SunSmart’ Type Skin Cancer Prevention Program was used to calculate cost savings, CPAC predicted the direct and indirect Canadian costs “Over the 28-year period of the model (2004 to 2031), total costs avoided were estimated at $2.12 billion compared to the estimated cost of a prevention program of $270 million.”

The disease prevention estimates are staggering: 18,047 melanomas.2,428 melanoma deaths.19,843 BCC’s.641 SCC’s. 85 Non Melanoma Skin Cancer deaths.

bit.ly/Wva31l
02:44 PM on 03/06/2013
A 2010 meta-analysis of 21 NMSC studies titled “Nonmelanoma Skin Cancer and the Risk of Second Primary Cancers: a Systematic Review.” concluded “strong, consistent evidence indicates that a personal history of NMSC is associated with increased risk of developing other malignancies.”

“Although NMSC is frequently curable, its high prevalence and expense of treatment place NMSC as a major public health problem and among the costliest cancers in the United States”

“Individuals with a personal history of NMSC may also be at an increased risk for second primary cancers other than just NMSC and melanoma. Despite accumulating evidence that appears to support this association, some have hypothesized that individuals with prior NMSC may in fact have a decreased risk of other cancers. The hypothesis of an inverse association is based on the supposition that the extensive exposure to sunlight among those who develop NMSC serves as a proxy for elevated levels of vitamin D due to the cutaneous synthesis that occurs upon exposure to sunlight. In turn, vitamin D is hypothesized to have anti-cancer properties”

“Clarifying this issue has important scientific, clinical, and public health implications. To help reconcile these divergent views of the relationship between a personal history of NMSC and risk of subsequent malignancies, we carried out a systematic review of the evidence on this topic.”

“For unknown reasons, NMSC may be a risk factor for other cancers.”

http://bit.ly/Wva31l
02:40 PM on 03/06/2013
What should set off warning bells in every reader’s head is not that so few children die, but that the author has forgotten to also consider those who don’t. In her zest to present a business case for predisposing children to skin cancer, she has forgotten about the scared and scarred survivors, or to acknowledge that sun/tanning bed damage is cumulative … nobody expects the teens to get skin cancer as teens …. “Skin cancer can take as little as a few years and as long as 30 years to appear.” http://www.caringforkids.cps.ca/handouts/tanning

(Straw man argument comes to mind)

The author, Karen Selick is a board member of the Canadian Taxayers Foundation, an organization dedicated to “lower taxes, less waste and accountable government.” Canadian doctors are telling politicians how to conserve health care dollars and reduce waste. The CTF should support a move to save tax dollars..

In 2010, The National Skin Cancer Prevention Committee, a former subcommittee of the Primary Prevention Action Group of the federally funded Canadian Partnership Against Cancer, published an economic study titled “The Economic Burden of Skin Cancer in Canada: Current and Projected.”

This first of a kind economic study, intended to “better inform the efforts of primary prevention”, estimated the total economic burden of skin cancer in Canada would rise from $532 million annually in 2004, to $922 million by 2031.

http://bit.ly/XQI6hG
03:06 PM on 02/27/2013
Thanks you Kate Smith for pointing out the obvious..

@ Karen Selickawyer - "Many tanning salons already insist on getting parental consent before tanning minors. It's a prudent practice that -- speaking as a lawyer -- I would encourage salons to adopt."

Speaking as a lawyer, Karen Selickawyer, you should be aware that Canadian children also have legal rights. In fact, based on an interpretation of the Infant's Health Act, the BC Supreme Court has permitted a minor to successfully sue for injuries in spite of prior parental consent.

http://www.courts.gov.bc.ca/jdb-txt/SC/09/13/2009BCSC1385.htm

The Canadian Constitution Foundation "defends the constitutional freedoms of Canadians through education and litigation and that they "will NOT consider"
"any situation in which both parties are private individuals or businesses
-for example landlord-tenant disputes, disagreements between consumers and
businesses, and employer-employee conflicts
Family law, divorce, maintenance or custody issues.
http://www.canadianconstitutionfoundation.ca/case.php"

Why are they commenting on a public safety issue regarding school aged consumers?
HUFFPOST SUPER USER
Dolly Lama
I think too much
02:17 PM on 02/27/2013
I protected my daughter from the suns rays when she was a child, she had to wear a hat and a white blouse that covered her arms during the hottest months, she is 22 now and has flawless white skin, she gets complemented on it a lot. After 22 years of me running around unprotected, sunburned many times during the summer my skin was covered in what I thought were freckles but now I now they are not harmless freckles they are skin damage! I keep out of the sun now as these harmless freckles have turned into cancerous lesions!
07:00 PM on 02/26/2013
doesn't strike you as odd that the huge advertisement at the bottom of this article is for chemical sunscreen and "how to protect your skin from the sun...wear sunscreen everyday" If there is ANYBODY in Canada, who wears sunscreen during the winter, they are dumber than dumb...no wonder Canadians are one of the most Vitamin D deficient populations on the planet. I bet their breast cancer rates are above average also.
Karen Selick...I applaud you for taking a subject whose opponents are akin to religious zealots and giving a clear, fact filled argument. I look forward to your future articles.
07:20 PM on 02/27/2013
balance Steve, balance.

(Got any evidence high strength artificial light is any safer than 'chemical sunscreen' ....)

http://www.miamiherald.com/2013/02/27/3257093/skeptics-shine-sunlight-on-tanning.html
04:38 PM on 02/24/2013
and really the vitamin D argument isn't very helpful either, it can be argued that the added vitamin D to most milk products is sufficient for most people.
04:35 PM on 02/24/2013
The author tries to discredit the statistic that people who use a tanning bed before 35 have a 75% higher rate of melanoma, with a statistic concerning the percentage of people under the age of 19 who develop melanoma. The author is trying to make a comparison that doesn't work. People who use a tanning bed before 35 don't just have a higher risk of developing melanoma when they're young, they have a higher risk of developing it over their lifetime.
04:25 PM on 02/24/2013
It is a plain and simple fact that the number of teenagers who die from lung cancer, heart attacks or other cancers caused by smoking is zero. On the other hand the number of people who die as a resilt of smoking is high. They just aren't teenagers.
photo
HUFFPOST SUPER USER
Whistlejackett
Hey stop doing that
03:35 PM on 02/24/2013
Teenagers should have everything a 40 year old can have. We allow them to have financed debt, phones, sex etc. what's a tan, so they get cancer, they can learn how to manage fear to.
photo
HUFFPOST SUPER USER
amitchell3251
Blues, guitars, motorcycles & Reformed Theology
03:13 PM on 02/24/2013
I was an olympic level tanner from an early age. I'm now in my late 50's and my skin is a mess. Annual visits to the dermatologist usually lead to the excising of some suspicious mole/growth and then I get to wait for the biopsy. So far, no cancer. It's likely just a matter of time. My kids have seen this and avoided doing themselves any damage. I hope most parents encourage their kids, especially teens, to be careful with the sun.

Something the author seems to forget is that sun damage is cumulative. Like smoking cigarettes - the more you smoke and the longer you smoke, the more damage you do.
02:00 PM on 02/24/2013
Lets review where this 75% number came from, and I encourage everyone to do their do diligent before believing everything you hear in the media. a study of 22 studies was done, only 6 showing an increase risk the rest showing no risk or a decrease risk, so only those 6 where used, that is called cherry picking your results. Of the 6 studies used, it was found that when skin type ONE (red heads fair skin, people who cannot tan) where removed from the studies, their was no increase and often a decrease in your risk. Dr William B Grant took the time to debunk this cherry picked study, yet even so, the 75% increase number is still thrown around. Your ACTUAL RISK IS .02% OF that study also interesting to note, tanning units only represent 6% of that 75% risk, home units and mostly units in medical offices hold a much higher risk. 6% of .02% is.0009% increase risk. Even a 75% risk (.035%) is still far below 1% risk and that increased risk is removed when skin type 1 is removed from the data
03:46 PM on 02/28/2013
yes, let's review

AAD "The ITA argued that a meta-analysis, such as the IARC study, is a flawed methodology. But Henry W. Lim, MD, chairman and C.S. Livingood chair of the department of dermatology at Henry Ford Hospital in Detroit, who attended and testified at the hearing, noted that several other studies have since been published — in Cancer Epidemiology, Biomarkers & Prevention, the International Journal of Cancer, and the American Journal of Epidemiology — and all conclude that exposure to indoor tanning increases one’s risk of developing skin cancers. All of these studies have looked exclusively at the use of indoor tanning beds, so the ITA can’t argue that dermatology-supervised phototherapy is included, Dr. Lim added.

http://www.aad.org/dermatology-world/monthly-archives/2012/april/dermatologists-undaunted-by-indoor-tanning-industry-s-claims

Leading cancer epidemiologist, Dr DeAnn Lazovich Ph.D., M.P.H (lead author of one of the studies referred to by the AAD) took the time to refute Dr William B Grant's theory

“In their letter, Grant and colleagues conclude that “those with preexisting high-risk factors… should be careful in using indoor tanning…”. Our data clearly indicate that both persons with and persons without these factors should expect that use of indoor tanning, especially frequent use, will increase their risk of developing malignant melanoma.”

http://cebp.aacrjournals.org/content/19/10/2685.2.full
01:42 PM on 02/24/2013
Studies show that vitamin d produced naturally via UV exposure both indoors and outdoors plays a roll in lowering your risk of melanoma. We can drown in water but would die without drinking it. Moderation is the key. . How badly are we harming our children by taking away their ability to produce vitamin d all because of 5 deaths in 9 years, which we don't even know if those 5 deaths had anything to do with tanning or UV exposure! They could very well be related to a lack of vitamin d! Some companies make HUGE $$ by scaring people out of the sun and into their product, and most people don't even know that the main ingredient found in sunscreens called Oxybenzone is in the class one list of known carcinogens also known as cancer causing. Makes sense to me, lets rub a cancer causing agent on our skin to protect ourselves from sun exposure. We slather our kids in this, and then blame their skin cancer on sun or tanning unit, even if they only went to tanning bed once! Common sense is needed here. I don't appreciate the government making it a crime to keep my kids healthy. They are so focused on tanning, but there is no prescription needed for young girls to get birth control, another known carcinogen (cancer causing). 5 deaths in 9 years is hardly note worthy, and again, we don't even know if these 5 people ever used a tanning unit!
03:52 PM on 02/28/2013
let's review this too..."They are so focused on tanning, but there is no prescription needed for young girls to get birth control, another known carcinogen (cancer causing). "

You are mistaken.. prescriptions are needed for birth control.
07:11 PM on 03/19/2013
Tami...I love your tenacity, but you are not gonna make any sense to anyone with a username of "paleskinner" Ignorance is bliss and knowledge is power. I sometimes wonder why those of us who enjoy the sun and sun beds never really seem to make a fuss over those who don't, while they bash us over the head with statistics and call us names.
Like Mark Twain said "there are three types of lies:little lies, big lies and statistics"
I also wonder if the lack of sunlight just makes them cranky and irritable.
Good Luck
12:45 AM on 04/13/2013
I couldn't agree more with paleskinner. steven 1984 (by the way steven1984 - your nonspecific username shows that you clearly are too ashamed to come out with your real name, which is quite hypocritical of someone who is attacking another's username), you are exactly what's wrong with the anti-tanning movement. You seem to attack paleskinner without a shred of evidence to prove any of your assertions. Paleskinner has been brave enough to fight the tanning industry, which is why JCTA has falsely targeted this individual on their website. All of the information that was presented by paleskinner is founded on scientific evidence seems to be shrugged off by individuals such as yourself and Karen Selick. Karen Selick is not a scientist, and neither are you.
01:18 PM on 02/24/2013
It's quite interesting that when presented with a solid, factual argument from a clearly intelligent person, the anti-tanning folks just continue to deny. They don't even try to counter the argument, they just go back to the old "They say it's bad, so it's bad." The benefits don't outweigh the risks, one says...well the study she cites does (literally). It causes wrinkles, others say. So, that's reason to pass legislation against it? Tanning beds aren't the same as the sun, they say....well, while more intense, scientifically it is. It's like tobacco, they say....well, tobacco causes hundreds of thousands of deaths per year and hundreds die of melanoma per year (mostly older men who have never stepped foot in a tanning salon). Melanoma is no doubt a very sad and unfortunate thing -- but when you're talking about legislation, emotion should not play a role. Only science and fact -- and as the author points out, the facts don't justify it.