Public interest in the use of tanning salons, particularly young adults, has grown over the years. United States figures have indicated that millions of Americans visit over 25,000 tanning salons each year. A British survey revealed that 25% of all 16-24 year olds use tanning beds. Informal surveys in the Greater Toronto Area indicate that manufacturersí guidelines are not enforced and not routinely posted. There are no provincial regulations governing these facilities. In 1988, the Ontario Ministry of Health issued draft guidelines for the inspection of Personal Service Facilities - Tanning Salons. Standards for the functioning and hazard warning signs for tanning lamps are contained in the Radiation Emitting Devices Act, administered by the Bureau of Radiation of Health Canada.

Ultra Violet Radiation (UVR) from tanning lamps contributes to skin cancer, premature aging of the skin and cataracts. The intensity of UVR ( especially UVA radiation ) can be significantly higher in tanning beds than in sunlight. Injury to the skin and eyes can occur without skin burn. Although all skin types can be damaged, the fairer the skin, the higher the risk. Eye damage is independent of skin type or skin colour. Damage can be immediate ( e.g. skin burn ) and long term (e.g. premature aging of the skin ). Occasionally, some medications, cosmetics and other substances can interact with UVR rays, and this can be detrimental to health.

The Environmental Health Division surveyed thirty public facilities that offered artificial tanning services in the London area during the summer of 1997.

Ministry of Health Guidelines for Personal Service Facilities ñ Tanning Salons, were used in assessing each of the local facilities. Operators and attendants were interviewed to assess levels of knowledge about the practices and operations of the equipment and the possible health risks. Assessment criteria included: shielding of tanning units, equipment maintenance, equipment disinfection, washroom facilities, timers and maximum exposure time, record-keeping, health knowledge of attendants, warning signs, etc.

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Generally, the tanning salons surveyed were maintained in sanitary and clean conditions. The main concerns that were noted involved timers and the control over the maximum time exposure, warning signs, as well as the requirement to wear protective goggles at all times when exposed to UV radiation.

Although 67% of the tanning salons clearly posted signs, there were still a large number (27%) of salons that did not have any warning signs displayed. The problem that arises is that patrons may not be informed of the precautions they should take before exposure, as well they may not be aware of the potential for a photosensitive reaction, eye injury or skin cancer.

Even though 93% of attendants said that they always remind patrons about wearing eye protection ( i.e. goggles ), there are still salons that allow patrons to make their own decisions about whether they should wear them or not

The issue of maximum time exposure to UV radiation is a very important one. None of the tanning salons (except for one), allow for a maximum time exposure to exceed 30 minutes. However, because only a small number of attendants have been trained to assess time exposure according to a personís skin type, it again becomes a serious problem.

1. The Board of Health should advocate for the establishment of provincial legislation regulating the operation of tanning salons, or in the interim, local municipal by-laws should be established to address the regulation and licensing of tanning salons.
2. Education sessions should be provided to the operators (attendants) by Middlesex-London Health Unit.
3. Tanning salons should develop a policy manual that would be in accordance with the existing guidelines. It is suggested that a manual as such, could be developed jointly by a coalition of operators and the Middlesex-London Health Unit.
4. Consumers should be made more aware of the risks of continuous exposure to harmful UV radiation.
   

This report was prepared by Jim Reffle, Director of Environmental Health, and a member of the 1996 OPHA Tanning Task Force.

Graham L. Pollett, MD, FRCPC

Medical Officer of Health

JR/jr