February 28, 2013 — Oregon may be cloudy much of the year, but that doesn’t prevent the state from having alarmingly high rates of skin cancer, particularly melanoma.
House Bill 2896, which passed the House Health Committee passed unanimously on Wednesday would address one easy culprit — tanning beds — by making them off-limits to minors under 18 without a doctor’s note.
Tanning beds are particularly popular among teenage girls and young women, and Oregon has the highest melanoma death rate among women in the country, according to Dr. Brian Druker, the director of the Oregon Health & Science University’s Knight Cancer Institute.
A 2006 study said the 100 largest American cities had on average 42 tanning salons and 76 percent of American teens live within two miles of a tanning salon. The same study showed Portland had 60 tanning salons, nearly as many salons as Starbucks’ locations in the city.
Oregon’s medical heavyweights like Druker and Dr. Bud Pierce, president of the Oregon Medical Association, testified, asking Oregon legislators to join California and Vermont in stopping teenagers from using tanning salons. A vote of the full House should come next week.
“The evidence is clear. Tanning booths, like cigarettes, cause cancer and should be off limits to teenagers,” Druker said.
The Food and Drug Administration has classified ultraviolet tanning beds as a carcinogen, and tanning has been linked to skin cancers such as melanoma, squamous cell carcinoma and ocular melanoma. According the Centers for Disease Control, 13 percent of all high school students and 32 percent of 12th grade girls say they use tanning salons.
Current Oregon law requires minors to get parental permission to use tanning beds, and salons must also provide everyone with goggles and adjust their exposure settings by skin type. Washington state has no such regulations, although a bill has been introduced in Olympia that would also ban tanning beds for minors.
“We need to protect children,” Pierce said. “We need to advocate for public health.”
State Epidemiologist Dr. Katrina Hedberg said skin cancers cases are increasing overall and among young people. Melanoma is now the second most common cancer in people 15 to 29.
“To me this is similar to smoking and sometimes when we’re kids we don’t know what we’re doing,” said Rep. Jim Weidner, a conservative Republican from McMinnville. “I know kids who have abused this in my own community.”
Katie Wilkes, a young woman who tanned as much as once a day in high school and college, testified that she developed melanoma at 23 on her breast — a part of the body that could have only been exposed to ultraviolet light in a tanning bed.
“I hated the way I felt when I looked in the mirror,” said Wilkes, of her fair skin. She said that she tended to buy unlimited tanning packages marketed by the salons to save money. “I can develop a second melanoma at any time.”
The Health Committee also heard from Joseph Levy, the scientific advisor for the American Suntanning Association, who bombarded the hearing with statistics including how people who work indoors are more likely to develop skin cancer than people who work outside. He compared the danger of tanning beds to red wine, birth control pills and salted fish and accused tanning bed opponents of mixing politics and science.
“To say that sunlight is harmful and should be avoided is like saying that water causes drowning, therefore we should avoid water,” Levy said. “If you tell a teenager that the sun is just as dangerous as tobacco, you are cheapening anti-tobacco prevention.”
Levy cited a World Health Organization study that showed the absolute risk for developing melanoma was two in 1,000, while the relative risk of tanning salon users was still only three in 1,000. “In other words, the difference was one in 1,000,” Levy said.
“Or a 50 percent increase in risk, is that what you just said?” said Rep. Mitch Greenlick, D-Portland, who later grilled Levy on whether he’d he willing to say that tanning does not cause melanoma. In response, Levy wouldn’t call it safe, but said people should be smart about using tanning salons.
Bridget Thomas, a former salon owner who now has skin cancer, later testified that the state regulations are often ignored by teenagers who work at these facilities and often let their friends have free tanning.
“I was dazzled by your statistical acumen,” Greenlick told Levy. “It sort of reminded me of a book I read when I was studying statistics, if I remember correctly it was called ‘Figures Don’t Lie But Liars Figure.’ It was an explanation on how to manipulate data the way I just heard you manipulate it. I think I heard you say that since water is safe, you can’t drown, and that’s really the issue here.”
In the end, people who spoke on behalf of the tanning industry incurred more opposition by lawmakers, who decided to include an amendment that would ban salons from selling or leasing of tanning equipment except to other tanning salons.
“I just have to side with the Brian Drukers and Bud Pierces of the world and not the guy from ‘Thank You for Smoking’ who showed up here,” said Rep. Brian Clem, D-Salem, referring to Levy, explaining his yes vote Wednesday. Earlier in the week, Clem had told Levy that he was stunned that he would accuse Pierce and Druker of playing politics with health.
According to Levy, the increased taxes imposed by the Affordable Care Act are pushing tanning salons out of business and flooding the after-sale market with tanning beds, which are showing up for sale on sites like Craig’s List and eBay and used in private homes without any state supervision. Those sales will be prohibited under the amended bill.
Rep. Jim Thompson, R-Dallas, had been concerned about the use of tanning beds in private homes and questioned whether the state should change its regulations.
There’s also one exception to the legislation – teenagers can use a tanning bed with a doctor’s permission if they have a medical condition such as psoriasis. That didn’t please Dr. Timothy Flynn with the American Society for Dermatologic Surgery who opposed that exception.
“It provides the indoor tanning lobbyists with a weak argument that declares indoor tanning devices to have a medical purpose,” Flynn wrote in testimony. Similar to the way harmful X-rays can be limited to discrete parts of the body, a doctor can use smaller devices for phototherapy treatments limiting ultraviolet exposure.
“An indoor tanning device would expose the entire body to harmful UV radiation with limited control of the dosage and exposure timers,” he wrote.
